Articles

C-phycocyanin (C-PC) is a high-value pigment–protein in <i>Spirulina</i> biomass whose thermolability makes it vulnerable to degradation during post-harvest drying, yet freeze-drying—the gold-standard preservation method—remains prohibitively energy-intensive for large-scale production. This study investigated whether controlled-humidity air drying can preserve C-PC content and its antioxidant functionality in dried biomass comparably to freeze-drying. Wet <i>Spirulina</i> biomass (25 g fresh weight) was dried under nine factorial combinations of temperature (25, 40, and 60°C) and relative humidity (20, 30, and 40%) using a temperature–humidity chamber, with freeze-drying (FD) as the reference. C-PC was extracted, quantified spectrophotometrically along with allophycocyanin and chlorophyll, and its purity index (A<SUB>620</SUB>/A<SUB>280</SUB>) and antioxidant activity (DPPH radical scavenging, IC<SUB>50</SUB>, and ascorbic acid equivalent antioxidant capacity) were determined. Statistical analyses included one-way ANOVA with Tukey's post-hoc test and partial Pearson correlation. Air drying at 25°C yielded C-PC contents of 184.39 - 194.72 mg g<SUP>-1</SUP> DW (98 - 104% of the FD reference, 188.11 mg g<SUP>-1</SUP> DW) with food-grade purity indices of 0.95 - 1.00, whereas drying at 40°C and 60°C reduced C-PC to 76 - 85% and 58 - 63% of the FD value, respectively. Partial correlation analysis identified temperature as the dominant determinant of C-PC loss (Pearson <i>r</i> = -0.90 to -1.00), while relative humidity exerted a secondary, modulatory influence. The 25°C air-dried C-PC retained 86 - 87% of the antioxidant capacity of a commercial C-PC reference standard, approaching the 94% retention achieved by freeze-drying. These findings demonstrate that controlled-humidity air drying at 25°C and 20 - 30% relative humidity effectively preserves both C-PC yield and bioactivity at levels comparable to freeze-drying, offering a potential scalable and low-cost drying alternative for the <i>Spirulina</i> nutraceutical industry

The pachychoroid spectrum is a new entity grouping pathologies with common choroidal features. First described in 2013 by American ophthalmologist Bailey Freund and his team [1]. It is defined by a diffuse or focal increase in choroidal thickness with dilatation of choroidal vessels adjacent to Bruch's membrane, associated with retinal pigment epithelial dysfunction, loss of the choriocapillaris and thinning of Sattler's layer [1, 2]. At present, the pachychoroid spectrum includes well-known pathologies such as central serous chorioretinitis (CSCR) and polypoidal choroidal vasculopathy (PCV), as well as pathologies of more recent description such as epitheliopathy or type 1 neovessels secondary to pachychoroid, pachydrusen, choroidal excavation and peripapillary pachychoroid. The morphological changes of the lens which is a cataract can be unilateral or bilateral and occur symmetrically or not over variable durations. A cataract is said to be mature when the opacification occupies the entire lens, it induces a complete loss of vision. It makes the visualization of the fundus reflection impossible, which explains the impossibility of visualizing hemorrhages and other lesions of the eye with the possibility of concealing a pachychoroid spectrum during the ocular examination in patients. The aim of our study is to describe the symptomatology and therapeutic approach of SPC.

This systematic review aimed to evaluate the biomechanical properties, functional performance, and clinical outcomes of different hip prosthesis materials and designs used in total hip arthroplasty (THA). A comprehensive search strategy identified 34 peer-reviewed studies published between 2015 and 2024. The materials investigated included cobalt-chromium-molybdenum (CoCrMo), titanium alloys, PEEK, ceramics, and advanced surface coatings such as polycrystalline diamond (PCD). In addition, dual mobility systems, lattice structures, and additively manufactured and patient-specific implants were assessed. The studies utilized clinical trials, finite element analysis, and biomechanical testing to compare outcomes such as wear resistance, stress distribution, osseointegration, and range of motion. The findings demonstrated that titanium alloys and porous lattice structures reduce stress shielding, while ceramics and CoCrMo provide superior wear resistance. Dual mobility implants improved joint stability and range of motion, particularly in high-risk patients. PEEK and PCD showed promising properties but lacked robust long-term data. The integration of advanced manufacturing technologies and material innovations has led to more personalized and biomechanically efficient solutions for THA. Further longitudinal studies are needed to validate these developments. This review provides a critical synthesis of the biomechanical, functional, and clinical implications of contemporary hip prosthetic systems.

The Mambaka watershed is extends between latitudes 1 3°45'E and 14°15'E and longitudes 7°16'N and 6°45'N. The geology, various tectonic and structural events that have affected the Adamawa Plateau in Cameroon make it rich in multi-substance mining. The objective of this study is to map rare earth (REE) geochemical anomalies in the sediments of the watershed streams west of Mambaka, and to trace their origins and geochemical processes. Predictive maps from inverse distance interpolations (IDW), factor analysis (F1) or principal component analysis (PCA) and hierarchical bottom-up classification maps provided a better understanding of the central tendency, distribution and dispersion of REE in the samples and in the study area, based on standard deviation and variance values that generated two factors F1 (Ho-Tm-Er-Yb-Lu-Dy-Tb-Gd-Eu-Sm) and F2 (Pr-Nd-Ce-La-Sm) representing 92.44% of the total cumulative variance. The ratios Ce/Ce* > 0.78 and Eu/Eu* > 1 demonstrate positive anomalies in Ce and Eu, and clear differentiation. The normalized concentrations used to calculate fractionation ratios show that the values for LaN/YbN (0.58 to 1.34), LaN/SmN (0.61 to 0.88) and LaN/LuN (0.62 to 1.43) suggest higher fractionation in SS09 and lower fractionation in SS01. Similarly, the ratios La/Lu (61.71 to 143.46), La/Yb (9.00 to 20.72), La/Sm (4.02 to 5.83) and La/ Lu (61.71 to 143.46) confirm these higher ratios in SS09 and lower in SS01. The REE in the study area comes from hydrothermal processes based on high lineament densities at sampling points in igneous rocks with a mean ∑REE value of between 174-219 ppm.

<b>Background:</b> Peripartum cardiomyopathy (PPCM) is a life-threatening heart muscle disease of unknown aetiology that affects women during the peripartum period, particularly in sub-Saharan Africa. While many studies have observed normal blood pressure (BP) in PPCM patients, none have explored whether their BP is appropriate for their body size. This study investigated the correlation between body anthropometric parameters and BP in PPCM patients, comparing the findings with those of age-matched normal peripartum controls. <b>Methods: </b>A cohort of 105 women, each from PPCM and matched normal peripartum control groups, were recruited from three healthcare facilities in Sokoto. Blood pressure (BP) parameters were assessed in relation to their anthropometric measurements, and the findings were compared between the two groups. <b>Results:</b> The PPCM patients were significantly smaller in body weight (57.0 ±11.6 Kg vs 66.8 ±13.8 Kg, P <.0001), body mass index (BMI) (21.9 ±4.1 Kg/m2 vs 25.4 ±5.4 Kg/m2, P <.0001, body surface area (BSA) (1.3 ±0.7 m2 vs 1.7 ±0.2 m2, P <.0001), Lean body mass (LBM) (45.3 ±7.0 Kg vs 49.4 ±4.1 Kg, P <.0001) and Percentage body fat (BF) (23.5 ±10.9 % vs 31.2 ±6.9 %, P <.0001). Similarly, PPCM patients had significantly higher systolic BP (SBP), Pulse pressure (PP) and Mean arterial blood pressure (MABP) compared to the normal peripartum PPCM control. Further, linear regression analysis showed that there was higher slope of the relationship between anthropometric indices and SBP and PP in the PPCM cohort, compared to the normal peripartum control group. A similar trend of the slope was seen in the Pearson’s coefficient of the relationship of the anthropometries and BP parameters. <b>Conclusions:</b> This study found that women with peripartum cardiomyopathy (PPCM) exhibited disproportionately higher systolic blood pressure (SBP) and pulse pressure (PP) for each unit increase in anthropometric measurements compared to normal peripartum controls. Notably, PPCM patients had significantly lower anthropometric measures, potentially attributable to poverty and chronic undernutrition. Additionally, the effects of poor antenatal care, lack of immunization and recurrent infection should be considered. These findings suggest an abnormal relationship between anthropometry and blood pressure in PPCM patients, which may have detrimental effects on their cardiovascular health. This abnormal relationship may contribute to the development of heart failure (HF) in PPCM patients and potentially increase the risk in women susceptible to PPCM. Even-though our assumption, yet to be proven. To address this concerning trend in vulnerable populations, improvements in nutritional status, socioeconomic determinants health, adequate antenatal care (ANC), immunization, and infection prevention should be considered.

The study aimed to examine the availability of protective clothing and its usage among workers at the University of Cape Coast in the central region of Ghana. It used the Accident-Proneness Theory and the Theory of Reasoned Action to achieve the study's objectives. The study adopted the positivist research paradigm. The study used a descriptive design with mixed methods. The study population comprised all workers and supervisors whose work demands the use of protective clothing at the University of Cape Coast. The study used multistage sampling techniques (stratified, purposive, proportional and Systematic random sampling techniques) to select one hundred and ninety-six departmental workers and five (5) supervisors in the University. The main instruments for data collection were a Semi-structured questionnaire and an unstructured interview guide. Mean and standard deviation, frequency count, and percentages were used to analyse the quantitative data. The qualitative data was analysed through the development of data categories and themes. The study concluded that “not all the protective clothing for the various departments were available. The University ensured that workers used what was in stock at the department. The protective clothing supplied to the various departments was insufficient, so their continuous use of the existing ones got them defaced, bringing about shortages. The study also revealed that workers used protective clothing most often, but not all used it because safety laws were relaxed. The study recommended that the University ensure a regular and adequate supply of PPC, insist on its usage, and enforce the use of PPC by all workers whose work demands it.

<b>Introduction:</b> Meigs’ Syndrome, characterized by a benign ovarian tumor that leads to ascites and occasionally pleural effusion, is a rare condition that often presents significant diagnostic challenges, particularly in young female patients. This case report highlights an 18-year-old-female with persistent gross ascites and pleural effusion unresponsive to diuretics, paracentesis, and thoracentesis. Despite extensive diagnostics evaluations including negative results from several tumor makers, histology and pathology reports, Liver and renal function tests, abdominal CT scans, ECHO, Ecg, Chest X-rays and HBV screening PCR test, the underlying causes of the ascites and pleural effusion remained elusive. The diagnosis was only made following an exploratory laparotomy, which revealed the presence of bilateral benign ovarian tumors. Subsequent bilateral Oophorectomy and Salpingectomy resulted in the complete resolution of the ascites. This case underscores not only the importance of considering ovarian pathology in young females with unexplained ascites but also highlights the critical role of exploratory laparotomy when non-invasive diagnostics fails to provide answers. <b>Conclusion:</b> This case emphasizes the need for a high index of suspicious for Meigs’ Syndrome in young females presenting with persistent ascites and pleural effusion, even when standard diagnostic tests yield negative results. It highlights the potential necessity of surgical intervention when other diagnostic approaches fail to identify the underlying causes. Clinicians should be aware of this condition and consider it in their differential diagnosis to ensure appropriate and effective management

High-Performance Computing (HPC) is indispensable for large-scale scientific simulations, but achieving optimal performance on modern supercomputers is increasingly challenging. As HPC systems scale toward exascale, they face escalating complexity in hardware, software, and workloads. Traditional optimization methods (manual tuning and heuristic algorithms) struggle to cope with dynamic workloads and intricate system behaviors. Artificial Intelligence (AI) techniques offer a promising approach to address these challenges. This article provides an overview of AI-powered optimization in HPC, focusing on how machine learning and related AI methods enhance performance, efficiency, and scalability of scientific simulations. We survey key AI techniques applied to HPC optimization including machine learning for performance modeling, deep reinforcement learning for resource management, and AI-driven surrogate models for accelerating simulations and illustrate their impact through case studies in domains such as job scheduling and fluid dynamics. We discuss the practical applications of these techniques, highlighting reported performance gains (e.g., substantial reductions in simulation run time and improved resource utilization). We also examine the challenges in integrating AI with HPC (such as training overhead, data movement, and reliability concerns) and outline future directions for research. The convergence of AI and HPC is poised to produce “smart” simulation workflows that intelligently adapt and optimize in real time, pushing the frontiers of scientific computing.

Background</b>: The study of phenolic compounds and their potential to contribute to health is a major interest in research. This work was to determine phenolic compound contents as well as antioxidant properties of roasted maize-peanut snack product with and without spices. <b>Methods</b>: HPLC was used to determine the phenolic composition of the maize flours, peanut flour and their composite snacks with and without spices. Total phenolic content (TPC), total flavonoid content (TFC), tannin content (TC) and radical scavenging activity (measured by 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2-azino-bis (3- ethylbenzothiazoline-6-sulphonicacid) (ABTS) and hydrogen peroxide radical scavenging assays was also used. <b>Results:</b> TPC of the extract of roasted maize flour, roasted peanut flour and composite roasted maize-peanut flour ranged from 48.93 to 178.31 mg GAE/100 g, while the TFC was 3.18–25.94 mg CE/100 g and TC (0.22 – 0.73 mg CE/g). The dominant phenolic acid was protocatechuic acid ranged from 13.73 to 1643.54 µg/g. Among the flavonoids, quercetin and catechin were dominant. The extracts of the free soluble fraction exhibited 23.88 – 81.52 %, 49.59 – 85.17 % and 0.58 -5.13 µmol AAE/g of DPPH, hydrogen peroxide and ABTS radical scavenging abilities respectively. <b>Conclusion:</b> Maize–peanut product showed potential ability in contributing to alleviating radical induced oxidative stress.

Respiratory virus co-infections have been suggested to happen frequently and exacerbate patients’ conditions, but little is known about the detailed rates and the combinations of viruses during the COVID-19 pandemic period. A total of 255 symptomatic patients who underwent multiplex PCR tests were analyzed, and it was found that 6 (6/255=2.4%) patients were infected with multiple viruses. The patients ranged in age from 1 to 38 years, and one female patient was pregnant. Of the 6 patients, 4 had fever, and 5 had human rhinovirus/enterovirus and another virus. These data suggested that the rate of respiratory virus co-infection was low, and the combination of SAS-CoV-2 and other viruses was rare even during the COVID-19 pandemic.

The pulmonary characteristics of <i>Staphylococcus </i><i>aure</i><i>u</i><i>s</i> (<i>S</i><i>.</i><i> </i><i>aureus</i>) co-infection with respiratory viruses, such as SARS-CoV-2 and influenza virus, are still unclear.<b> </b><b>Case series</b>: Two patients with methicillin-susceptible <i>S</i><i>.</i><i> </i><i>aureus</i><i> </i>(MSSA) infection in the lungs co-infected with either SARS-CoV-2 or influenza virus are reported. Case 1 was a 66-year-old woman who was admitted with SARS-CoV-2 infection. Her chest X-ray and computed tomography (CT) showed multiple cavity formations with infiltration shadows, and MSSA was detected from her sputum and blood, suggesting COVID-19-related bacterial pneumonia and pulmonary embolism. No catheters had been used, but she had skin eruptions and a history of SARS-CoV-2 vaccination. Ampicillin/sulbactam (ABPC/SBT) was administered, and she finally improved. Case 2 was an 87-year-old man with a history of atopic dermatitis who was admitted with moderate pneumonia, and influenza virus co-infection was found. He showed multiple cavitary shadows, and MSSA was isolated from both his sputum and blood. He was diagnosed with influenza-related bacterial pulmonary embolism. No catheters had been used, but he had a history of influenza vaccination. He was also treated by ABPC/SBT and finally improved. <b>Conclusions:</b> These cases suggest that MSSA showed affinity to the lungs when co-infected with either SARS-CoV-2 or influenza virus, and it presented as septic emboli without catheter use. We should consider MSSA infection when patients have SARS-CoV-2 or influenza virus co-infection, and multiple cavity formation and skin disorders are seen, even though they were vaccinated and no catheters were used.

Background:</b> The World Health Organization (WHO) has declared COVID-19 a public health emergency of international concern. In this context, effective and affordable diagnostic procedures are essential for identifying and managing cases. Complete blood counts (CBC) are among the most common and readily available diagnostic tests. The current study aimed to evaluate the efficacy of CBC in diagnosing COVID-19 and identifying cases. <b>Patients and Methods:</b> A case-control study was conducted on 173 patients at Ain Shams University Hospitals over a period of three months. Patients were allocated into two groups according to COVID-19 PCR results: Group 1 included patients with COVID-19 positive PCR, and Group 2 included patients with COVID-19 negative PCR. <b>Results:</b> The study found that differential CBC had significant value in diagnosing COVID-19 disease. Many COVID-19 patients had lymphopenia and leucopenia compared to non-COVID-19 suspected patients. The low values of leukocytes, neutrophils, lymphocytes, and eosinophils with a CBC test were found to be valuable in the initial diagnosis of COVID-19. <b>Conclusion:</b> The definitive diagnosis of COVID-19 requires RT-PCR analysis, which is time-consuming and less accessible. Thus, the initial diagnosis and treatment of patients may be delayed. This study suggests that CBC, which is easily available and affordable, can be valuable in the early identification of COVID-19 cases, allowing for prompt treatment and management.

<b>Background</b>: <i>Pseudomonas aeruginosa </i>(<i>P</i><i>.</i><i> aeruginosa</i>)<i> </i>is one of the most common pathogens in hospital-acquired pneumonia (HAP) including ventilator-associated pneumonia (VAP). Recently, ceftolozane/tazobactam (CTLZ/TAZ) has been used to treat pneumonia due to<i> P</i><i>.</i><i> aeruginosa</i>. <b>Case series</b>: Two cases of <i>P</i><i>.</i><i> aerugi</i><i>n</i><i>osa</i> pneumonia treated by CTLZ/TAZ that had been initially treated by piperacillin/tazobactam (PIPC/TAZ) are presented. (Case 1): A 76-year-old man who underwent esophagectomy developed severe pneumonia caused by <i>P</i><i>.</i><i> aeruginosa </i>infection and received oxygen by high-flow nasal canula. PIPC/TAZ was started, and he improved 10 days later. PIPC/TAZ was switched to sulbactam/ampicillin, but on day 14, his respiratory condition worsened, and septic shock developed. <i>P</i><i>.</i><i> aeruginosa</i> was isolated from his blood, and CTLZ/TAZ was started because the isolated <i>P</i><i>.</i><i> aeruginosa</i> showed resistance to PIPC/TAZ. Although he recovered on Day 28, and CTLZ/TAZ was switched to levofloxacin, his condition worsened again, and<i> P</i><i>.</i><i> aeruginosa </i>resistant to CTLZ/TAZ was isolated from his blood on day 32. Finally, he died of septicemia and renal failure. (Case 2) A 51-year-old woman who underwent surgery for a brain tumor developed VAP due to<i> P</i><i>.</i><i> aeruginosa </i>and was treated by PIPC/TAZ. Her pneumonia improved, but pneumothorax developed, and she was therefore switched to CTLZ/TAZ on day 7. Her pneumonia improved smoothly without bacteremia 10 days later. <b>Conclusions:</b> These data and cases suggest that CTLZ/TAZ was effective for severe <i>P</i><i>.</i><i> aeruginosa</i> pneumonia although the isolated <i>P</i><i>.</i><i> aeruginosa</i> was resistant to PIPC/TAZ. However, the duration of CTLZ/TAZ administration may need to be considered for pneumonia cases with bacteremia due to <i>P</i><i>.</i><i> aeruginosa</i>.

Effective Inclusive education experiences can be built through structured interventions. The purpose of the study was to assess the impact of inclusive education experiences on teacher-trainees with sensory impairment in the Ghana Colleges of Educations of Ghana. The study was based on pragmatist philosophy. The study adopted convergent parallel mixed-methods approach. The population involved all 66 students with sensory (visual and hearing) impaired in the three (3) CoEs (PCE, Akropong Akwapim, WESCO, Kumasi and NJA, Wa) that practice inclusive education (IE) during the 2018/19 academic year. Purposive and census sampling techniques were used to select the three (3) colleges of education and sixty-six students for the study. The main instruments for data collection were questionnaire and focus group discussion. The quantitative data items were coded for input into the Statistical Product and Service Solutions (SPSS) version 23 software and analysed using means and standard deviations. The qualitative extracts collected into themes that were coded, analysed and interpreted. The study revealed that teacher-trainees had varied experiences on campus, while they felt welcomed into the inclusive institution; they also felt the Colleges were not well prepared to meet their needs. The physical environment was not conducive for the VI on campus. It is recommended that, College authorities should work with the MoE and agencies concerned with disability issues in the society to provide comfortable environment on College campuses for TTSI. It is also recommended that, providing a comfortable environment should include facilities and resources needed for the TTSI to learn effectively. It also involves physical arrangement of the campus environment. The TTSI, regardless of their disabilities, should be provided with an environment where their movement, their studies, their interactions with their peers and tutors are made easier to help them graduate successfully.

The complexity of manufacturing photolithography has increased significantly. The increase in the level of integration has driven smaller feature-sized integrated circuits (ICs). The evolution in stepper technologies has been geometric. This has enabled the printing of printed ICs with a 45 nm feature size. Improvement in lithographic technology is moving towards 32 nm. This feature-size roadmap poses many challenges to semiconductor manufacturing technology. Advanced photomask synthesis, high-NA steppers, and computational lithography are some examples of the solution space. Optical proximity correction (OPC) and model-based optical proximity correction (MBOPC) are subsets of this solution space. OPC has matured significantly and is the de facto solution for manufacturing photomasks up to the 65 nm node. The OPC technique has been further refined as model-based OPC and has been applied to advanced printing technology of 45 nm. The OPC solution for 45 nm technology has limitations of mask rule check (MRC) and manufacturability restrictions. These restrictions are inevitable in OPC and MBOPC solutions because of the limits in lithographic technology. The technology evolution towards 32 nm has equally challenged the non-linear treatment of wafer-level problems in OPC solutions. PBOPC has limitations in reducing the wafer optical proximity error of the granny's issue, edge placement, mask rule check, etc. PBOPC also has limitations in reducing the mask error enhancement factor. With all these challenges, it is still a formidable solution methodology to address the wafer and mask level issues. Such a formidable solution architecture can result in a limited number of PBOPC solutions. This text looks at the performance of advanced PBOPC features on exposure tuning and the effects of higher-order wafer and aerial image effects. This text also discusses the performance of continuous process correction of masks, lenses, and scanners.

The automated parking system is an extensive branch of smart transport systems. The smartness of such systems is determined by different parameters such as parking maneuver planning. Coding this control system includes vehicle parking and understanding the environment. A high-quality classification mask has been used on each sample to analyze the automated vehicle parking parameters. Mask region-based convolutional neural networks (R-CNN) was taught using a small computational workload titled faster R-CNN that operates in five frames per second. In this paper, the rapidly-exploring random tree (RRT) method was used for routing the parking space and a nonlinear model predictive control (NMPC) controller was added to develop this system. We add the line detection algorithm commands to the mask R-CNN algorithm. The results can be useful to design a secure automatic parking system as well as a powerful perception system.

Groundwater geochemistry refers to the general chemical properties of water, particularly groundwater. Precipitation, volatilization, oxidation/reduction, sorption/partition, and complexation are processes involved in the distribution and fate of organic molecules in water. Determining hydrogeochemical facies is a great help for determining relationships and similarities among the chemistry of waters in an aquifer. This study focused on the coastal aquifer of Tripoli (Lebanon) with Mio-Quaternary age. It is considered as a confined aquifer and an important hydraulic reserve for domestic water use in the region. Recently, it underwent an urban development that leads to an increase in water demand causing a decrease in the piezometric level and a high-risk of deterioration to water quality through seawater intrusion and anthropic pollution. To understand the origin of mineralization and the mechanism of water hydro-chemistry variation and to provide a vision to underground water recharge, this study aims to analyze the hydrodynamic, piezometric, and geochemical characteristics of the coastal aquifer. The fluctuation of physicochemical parameters for cool and warm seasons has been studied and monitored for 16 coastal wells during April, May, and June 2020. Results were interpreted by using a statistical analysis called Principal Components Analysis (PCA). Cartographic of groundwater levels and concentrations for nitrate, chloride, sulphate ions, the ratio sulphate/chloride were determined by using SUFFER8 software. It can be noticed that the Mio-Quaternary formation at Tripoli consists of thick sedimentary sandstones and conglomerates with argillaceous roots, which provide significantly high permeability characteristics. It is mainly recharged from precipitations through karstic formations. Chemical analysis shows that bicarbonate ions (HCO₃^-), characterized by dissolution of carbonate rocks from geological upstream formations of Tripoli, means that the aquifer is subjected to intensive recharge of fresh water and snow melting making a hydrostatic equilibrium facing marine intrusion [1]. High contents of chloride and Sodium are due to anthropic contamination or seawater intrusion. However, Magnesium ion concentration assures this intrusion. Meanwhile, nitrates, sulfates and phosphorus high concentrations are related to wastewater leakage or agricultural activities [2].

<i>Streptococcus </i><i>pneumoniae</i> is an important pathogenic bacteria causing pneumonia and invasive pneumococcal diseases, and the vaccination for pneumococcal vaccination is recommended in patients with RA and other autoimmune disorders. Compared with the immunocompetent individuals, frequency and the mortality rate were higher in the RA patients. The effect of pneumococcal vaccination may not be weakened in people using corticosteroid and biological disease-modifying anti-rheumatic drug (DMARD) currently being used, but mild to relatively inhibition of immunogenicity was suggested in patients using either methotrexate or rituximab. Administration of 13-valent pneumococcal conjugate vaccine (PCV13), rather than 23-valent Pneumococcal polysaccharide vaccine (PPSV23) may be desirable in preventing pneumonia in people with autoimmune disease and sequential administration of PCV13<b> </b>in people aged ≤64 years and PPSV23 from age ≥65 years may be useful for preventing pneumonia in people with autoimmune disease according to the insurance system. In addition, PCV15 and PCV 20 will be available soon and expected for more clinical efficiency rather than current PCV13 and PPSV23.

The study objective was to assess the perceptions of Junior High School (JHS) Social Studies teachers in the Yilo Krobo Municipality of the Eastern Region of Ghana on teachers’ Pedagogical Content Knowledge (PCK). The study adopted Shulman's theory of Pedagogical Content Knowledge (PCK) as its theoretical framework. The philosophical approach upon which the study is hinged on is the ideology of interpretivism and positivism, in other words, pragmatism. The study used a mixed methodological approach as well as a descriptive survey design. A random sampling technique was used for the study. The study participants were JHS social studies teachers in Yilo-Krobo Municipality, Ghana. Eighty (80) out of the one hundred and two (102) representing 78.43% JHS Social Studies teachers were selected from the fifty-four JHSs in the Municipality. Both Questionnaire and interview guide were used for data collection. The survey data was analyzed using descriptive statistics and the interview data was analyzed using content analysis. The study indicated that at the heart of the PCK concept is the idea that 'deep knowledge' of content is essential for effective teaching and cannot be taken for granted; that it has a significant bearing on teaching and student learning, and that it is used as a cadre to define professional teaching knowledge. PCK also provides the uniquely necessary knowledge for the transformation of the different types of knowledge required for Social Studies teaching and evolves over time due to the progressive awareness of students' needs, while a wealth of content knowledge is imperative for the development of a comprehensive pedagogical content knowledge. The paper recommends that the Ghana Education Service (GES) should conduct regular in-service training for teachers on the enhancement of their PCK, to enable them select appropriate TLMs and pedagogical approaches that foster meaningful learning for students.

<b>Introduction:</b> Concurrent infections or co-infections in patients diagnosed with Coronavirus Disease-19<b> </b>(COVID-19) are not uncommon and predict a pejorative prognosis. A co-infection accounts for 1 out of every 5 cases of COVID-19 and increases the likelihood of adverse health outcomes such as mechanical ventilations, ICU admissions, and death. Specifically, Legionella spp. co-infection presents additional challenges in COVID-19 patients because of its rarity, similar clinical presentation to SARS-CoV-2, and poorer outcomes without prompt treatment. <b>Cases</b><b> </b><b>Presentation</b><b>: </b>Case 1. A 62-year-old female presented with a 3-day history of subjective fever and worsening shortness of breath. Room air saturation (saO2) was 70% and improved to 100% on noninvasive positive- pressure ventilation (NIPPV). Lung auscultation revealed rales BL. Chest X –Ray (CXR) showed patchy airspace opacities bilaterally (BL), SARS-CoV-2 PCR and urine legionella antigen tests were positive. The diagnosis of hypoxic respiratory failure secondary to COVID-19 and Legionella pneumonia was made. Patient was admitted to intensive care unit (ICU) and managed with decadron, remdesivir, one unit of convalescent plasma for COVID-19 and Azithromycin for Legionella. Patient subsequently developed acute respiratory distress syndrome (ARDS). ARDS protocol was initiated. 13 days after, the patient was compassionately extubated. Case 2. A 41-year-old male presented with 5-day history of fever, worsening shortness of breath, cough and diarrhea. Patient admitted history of ethanol abuse. SaO2 was 88% and improved on oxygen canula. Lung auscultation revealed rhonchi BL. CXR showed extensive left lung consolidation. Urine test for legionella antigen was positive. COVID-19 PCR was negative, but SARS-CoV-2 IgG was reactive. The diagnosis of Legionnaire disease was made. Despite initial treatment with Azithromycin, patient's hypoxia continued to worsen requiring NIPPV, and subsequently mechanical ventilation in the ICU. The adjunction of empiric treatment for COVID-19 with convalescent plasma, remdesivir and steroids improved both clinicals and laboratory findings. <b>Discussion:</b> The cases illustrated the practical challenges of managing COVID-19 and legionella co- infection. <em>Legionella spp</em> and SARS-CoV-2 overlapping incubation periods and similar clinical presentations and complications. In the absence of diagnosis and treatment, legionella pneumonia has an intrinsic mortality rate of up to 80%. As some COVID-19 mitigation strategies, such as the closure of businesses, have enhanced the conditions for <em>Legionella spp</em> proliferation, the incidence of Co-infection with COVID-19 may increase. We recommend clinicians to have high-indexed suspicion of COVID-19 and Legionella co-infection in order to obtain complete work up at patient’s initial presentation.