Knee osteoarthritis (KOA) is a chronic degenerative joint disorder that significantly impairs mobility and quality of life. While surgical interventions such as total knee arthroplasty (TKA) are effective in severe cases, conservative treatments are critical for early and intermediate disease management. This review evaluates the efficacy, safety, and clinical applications of both conservative and surgical treatment approaches, including lifestyle modifications, physical therapy, pharmacological interventions, regenerative medicine, and surgical procedures. The integration of a multidisciplinary approach is emphasized as a key strategy for optimizing clinical outcomes and tailoring interventions to disease severity.

Recent advancements in the screening, diagnosis, and management of obstructive sleep apnea (OSA) have significantly improved patient outcomes. For screening, the use of home sleep apnea testing (HSAT) has become more prevalent, offering a convenient and cost-effective alternative to traditional in-lab polysomnography. HSAT devices have shown good specificity and sensitivity, particularly in patients with a high pre-test probability of OSA. In terms of diagnosis, advancements in wearable technology and mobile health applications have enabled continuous monitoring of sleep patterns and respiratory parameters. These tools provide valuable data that can be used to identify OSA more accurately and promptly. Additionally, machine learning algorithms are being integrated into diagnostic processes to enhance the accuracy of OSA detection by analyzing large datasets and identifying patterns indicative of the condition. Management of OSA has also seen significant progress. Continuous positive airway pressure (CPAP) therapy remains the gold standard, but new developments include auto-adjusting CPAP devices that optimize pressure settings based on real-time feedback. Mandibular advancement devices and hypoglossal nerve stimulation are emerging as effective alternatives for patients who are CPAP-intolerant. Furthermore, lifestyle interventions such as weight management, positional therapy, and exercise have been shown to complement medical treatments, leading to better overall outcomes. This review article highlights these advancements that collectively contribute to improved patient adherence, reduced symptoms, and enhanced quality of life for individuals with OSA.

Active Pharmaceutical Ingredients (APIs) serve as the cornerstone of pharmaceutical development, driving therapeutic efficacy and safety in drug formulations. This article provides a comprehensive overview of the lifecycle of APIs, starting from their discovery and development, through to manufacturing processes and regulatory oversight. The development of APIs begins with intensive research and discovery efforts, where medicinal chemists and pharmacologists identify and optimize potential compounds through computational modelling, high-throughput screening, and structure-activity relationship studies. Promising candidates undergo rigorous preclinical testing to assess pharmacological properties, safety profiles, and potential adverse effects in animal models. Upon successful preclinical outcomes, APIs progress to clinical trials, involving phases of testing in human subjects to evaluate efficacy, dosage regimens, and safety profiles under controlled conditions. Clinical trial data are meticulously analyzed to support regulatory submissions, demonstrating the API's therapeutic benefits and safety for eventual patient use. Manufacturing APIs involves complex chemical synthesis or biotechnological methods, ensuring precise control over reaction conditions, purity, and yield. The scale-up from laboratory synthesis to industrial production demands adherence to Good Manufacturing Practices (GMP), where stringent quality control measures verify consistency, potency, and stability throughout production batches. Regulatory oversight by authorities such as the Food and Drug Administration (FDA) in the United States and the European Medicines Agency (EMA) in Europe ensures that APIs meet stringent standards of safety, efficacy, and quality before market approval. Manufacturers must submit comprehensive Chemistry, Manufacturing, and Controls (CMC) data, detailing manufacturing processes, analytical methods, and stability studies to support regulatory filings.

Central line-associated bloodstream infections (CLABSIs) are important hospital-acquired infections that are related to increased mortality in cardiac intensive care units (CICUs). To determine the risk factors for CLABSIs, a case-control study was conducted in the CICU of our hospital. Emergency surgery (odds ratio: 9.6, 95% confidence interval: 1.633-56.926) was the strongest risk factor comparing the case group (n=11) to the control group (n=22). In addition, the indwelling period was significantly longer in the case group than in the control group (median 9 days versus 7 days, p=0.004). An intervention for the insertion of central lines was then started, with 1) thorough use of chlorhexidine-impregnated dressings (also known as chlorhexidine patches, CHG patches) in the insertion of central lines before emergency surgery, and 2) exchange of the central line 7 days after emergency surgery. After the intervention, the CLABSI incidence rate decreased from 6.8 to 0.8/1,000 device-days. These data suggest the usefulness of CHG patches and the importance of the early exchange of central lines in the CICU in patients following emergency surgery.

Digital forensics in cloud computing environments presents significant challenges due to the distributed nature of data storage, diverse security practices employed by service providers, and jurisdictional complexities. This study aims to develop a comprehensive framework and improved methodologies tailored for conducting digital forensic investigations in cloud settings. A pragmatic research philosophy integrating positivist and interpretivist paradigms guides an exploratory sequential mixed methods design. Qualitative methods, including case studies, expert interviews, and document analysis were used to explore key variables and themes. Findings inform hypotheses and survey instrument development for the subsequent quantitative phase involving structured surveys with digital forensics professionals, cloud providers, and law enforcement agencies, across the globe. The multi-method approach employs purposive and stratified random sampling techniques, targeting a sample of 100-150 participants, across the globe, for qualitative components and 300-500 for quantitative surveys. Qualitative data went through thematic and content analysis, while quantitative data were analysed using descriptive and inferential statistical methods facilitated by software such as SPSS and R. An integrated mixed methods analysis synthesizes and triangulates findings, enhancing validity, reliability, and comprehensiveness. Strict ethical protocols safeguard participant confidentiality and data privacy throughout the research process. This robust methodology contributed to the development of improved frameworks, guidelines, and best practices for digital forensics investigations in cloud computing, addressing legal and jurisdictional complexities in this rapidly evolving domain.

Background: COVID-19-related pneumonia was initially rare, though influenza-related pneumonia is well known as a severe complication of influenza. However, COVID-19-related pneumonia may be increasing since the omicron variant of COVID-19 appeared. Methods: The clinical differences between COVID-19-related and influenza-related pneumonia patients were retrospectively investigated in patients hospitalized from January 2022 to December 2023. Results: COVID-19-related and influenza-related pneumonias were found in 46 of 285 (15.8%) and 6 of 12 (50.0%) patients, respectively (p<0.001). Their mean ages were 75.5 (45-93) years and 53.8 (19-73) years in COVID-19-related and influenza-related pneumonia cases, respectively (p=0.002). Aspiration pneumonia was more common in COVID-19-related pneumonia (28/46=60.9%) than in influenza-related pneumonia patients, and it was treated by sulbactam/ampicillin (31/46=67.4%). The influenza-related pneumonia patients were more often infected in the work place (2/6=33.3%) and not vaccinated (4/6=66.7%), compared with COVID-19-related patients. Death occurred in 7 of 46 (15.2%) COVID-19 patients, but none of 6 influenza-infected patients died. Conclusions: These data suggest that COVID-19-related pneumonia presented as aspiration pneumonia in older patients, although influenza-related pneumonia was more common in younger and non-vaccinated patients and might be associated with immune mechanisms during the omicron variant surge era.

The digital drug traceability systems ensure the patient-centric dose, dosage form, and strength delivered to the patient as intended in the supply chain. It helps the digital healthcare platforms securely establish drug information supplied to patients for potential treatments. Therefore, it is important for the global supply chain to explore the number of high-end digital health solutions and drug traceability to create an interactive loop on drug security for patients. This article provides an overview of advanced technologies for digital drug traceability, such as blockchain, that would establish a secure pharmaceutical supply chain for the digital world.

The objective of this study was to examine the barriers to effective solid waste management in the Komenda-Edina-Eguafo-Abrem Municipality in the Central Region of Ghana. This study adopted the cross-sectional descriptive survey research design. The population for the study comprised all residents of 18 years or older as well as waste management agencies in the KEEA Municipality. A simple random sampling technique was used to select 380 residents together with 45 staff of the Zoomlion Company Ltd in the KEEA Municipality for the study. The questionnaire was the main instrument used for the data collection. Frequencies, percentages, means and standard deviations were used to analyse the questionnaire items on the research questions. This was done with the use of the Statistical Package for Service Solutions (SPSS) version 21. There were a number of barriers to effective solid waste management practices. Some of the barriers were inadequate environmental education; inadequate logistics and funds; inadequate depots, skips and dustbins; lack of adequate skilled personnel to manage services efficiently; and apathetic attitude/inertia on the part of some of the residents. Some other barriers included: irregular collection of waste by waste management companies; lack of appropriate sites for waste disposal; unwillingness of some households to pay for the collection and appropriate disposal of solids; and refuse dumps located very far from home. It is recommended that the government through the Ministry of Local Government should provide adequate logistics and funds for the procurement of dustbins in order to ensure proper solid waste management. The Assembly should ensure that Zoomlion collects waste regularly. The Assembly should encourage residents to pay for the collection of waste and sanction recalcitrant residents who do not adhere to appropriate solid waste management practices.

Assessment is a vital aspect of curriculum practice. The study adopted explanatory mixed-method approach and sequential research design. The population for the study comprised all Social Studies teachers in Junior High Schools in the Ayensuano District. Convenient sampling techniques and census method were used to select the district, and all the one hundred and twenty-seven (127) teachers who teach Social Studies in the junior high schools in the district. The main instruments used for data collection and analysis were questionnaire and interview guide. The quantitative data was analysed both descriptive and inferential statistical tools. The qualitative data was transliterated and coded based on themes. Pre-set themes were used to generate the transcript (text) data based upon the research questions and discussed. The study concluded that authentic assessment practices by Social Studies teachers included the occasional guidance they give to their students about how to interpret topics and situations into relevant tasks with a clearly defined goal, and how to relate their knowledge in practical challenges. The study also revealed that refined essays, oral presentations, interviews, case study discussions, and live performances as authentic assessment strategies or tools Social Studies teachers used in assessing their students' learning outcomes in lessons. The study indicated that large class size, traditional assessment (examination) system, insufficient logistics and infrastructure, a paucity of funds to begin various activities and programs, a lack of motivation from school administrators, time constraints and difficulty in developing some authentic assessment tasks coupled with assessing some lessons using authentic assessment method are some of the criteria that influence the effectiveness of authentic assessment execution in teaching Social Studies courses. It is recommended that educational leaders should provide the resources to motivate Social Studies teachers to use authentic assessments for students’ learning in the classroom situation. It is also recommended that, Colleges of Education, Universities and National Teaching Council should organise professional development workshops and seminars to build the capacity of trained Social Studies teachers on the effective uses of authentic assessment practices.

The purpose of this study was to examine Religious and Moral Eduction teachers’ usage of the flipped classroom model Model and its Influence on JHS Students’ Academic Performance in the Nzema-East Municipality of Ghana.The study adopted the quasi-experimental research design. The population for this study comprised all JHS Religious and Moral Education students and teachers within the Nzema-East Municipality of the Western Region. With the help of the Krejcie and Morgan’s sample determination table, a sample of 110 comprising 10 teachers and 100 students were selected for the study through multi-stage sampling. The instruments used for data collection were tests and questionnaires. The study indicated that, the flipped classroom is a very potent method of teaching RME. This is so because the study provides enough evidence that the flipped classroom significantly improves the performance of learners more than the traditional approaches to teaching. This is even more appropriate in a technological era such as ours. The study also revealed that, teachers have a positive view of the use of the flipped classroom in teaching RME. Junior High School RME teachers are ready to adopt the flipped classroom model in their teaching provided challenges students face are eliminated. It is recommended that, School Improvement Support Officers and Headteachers should ensure that teachers use the flipped classroom to bring variations in lesson delivery so as to improve the academic achievements of learners. It is also recommended that government should provide technological devices to schools and teachers and ensure that teachers employ the various technological devices at their disposal to the benefit of their students.

Biodiversity Conservation is a priority issue for the scientific community, and a main subject in the Biology and Geology curriculum at secondary school level in Spanish Educational System. In the present didactic proposal, we use the demographic monitoring of an endangered plant species to illustrate a research tool for estimates of biodiversity loos in nature, the local endemic Astragalus tremolsianus Pau. The aim of the proposal is to bring students closer to a real experience, which brings together knowledge of Biology, Algebra and Trigonometry, through Information and Communication Technologies (ICTs). Showing a census to monitor the populations of a threatened high mountain flora species into the classroom is an innovative teaching activity that combines and uses knowledge from different disciplines, as well as demonstrating a real application of the knowledge acquired. The use of mathematical tools encompasses a number of skills that require the application of mathematical principles and processes in the scientific context. The introduction of the structure of scientific texts is another positive aspect of this didactic experience.

There is an ongoing debate regarding how to feed Sub-Saharan Africa's fast rising population in the long run, as well as the implications for food security. To maintain food security, various strategies have been recommended, including a focus on the significance of diversifying and improving people's diets. Proposals have been tabled elsewhere with a primary focus on enhancing agricultural inputs and technology adoption in order to increase agricultural production and productivity, hence strengthening food security. The current opinion piece attempts to contribute to this debate by examining smallholder agriculture and its role to African food security. This discussion proposes a future paradigm shift toward a gendered climate-smart smallholder agriculture and food production and security conceptual framework based on the promotion and development of smallholder agriculture and food production and security. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For Africa, today’s predicament is to ensure food security for the anticipated rapid population expansion, while on the other hand handling an overall net adverse effect of worldwide global climate change, and increased socio-economic ills associated with gender inequality in smallholder agriculture and ensuring long-term agriculture sustainable development. The failure to address gender inequality in smallholder agriculture and food production and pontificate of global climate change effect has thrown Sub-Saharan Africa into a state of perpetual food scarcity and insecurity because of low agricultural productivity and food supply, and by force of circumstances exposing the agricultural communities and its people to extreme poverty and nutrition and food insecurity. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For this purpose, this discussion proposes a future paradigm shift towards a gendered climate-smart smallholder agriculture and food production and security conceptual framework hinged on the promotion and development of the micro-livestock and/or unconventional animal species sub-sector to strengthen food security on the continent. Overall, the discussion emphasizes the importance of taking immediate action to alleviate the negative effects of climate change and address gender inequality through promotion of micro livestock to assist in the development of long-term adaptation measures to maintain smallholder agricultural productivity.

Background: Cigarette smoking is one of the 10 greatest contributors to global death and disease. Cigarette smoking is the most common type of tobacco use. In average, to date 47.5% of men and 10.3% of women are current smokers. Tobacco continues to be the second major cause of death in the world. It consists of many chemicals, including cytotoxic, carcinogenic and free radicals, therefore it affects many organs if not all. Objective: The aim of this study is to assess the extent of adverse effect of cigarette smoking on blood pressure, liver function, and hemoglobin concentration in male population on the West Coast of Libya. Methods: This study was conducted on (200) healthy male subjects, their ages ranged from 15 to 85 years. They were divided into four groups; 50 non-smokers as control group (age between 15-35 years), 50 smokers (age between 15-35 years), 50 non-smokers as control group (age between 36-84 years) and 50 smokers (age between 36-84 years). The blood was collected in EDTA tubes to test the Complete blood count (CBC) and in plain tubes for biochemical assay (activities of liver enzymes). The Blood pressure of subjects was measured directly after sample collection. Result: The blood pressure among the group of age 36-84y was significantly higher (P < 0.05) when compared between the smokers and the nonsmokers group, while among the group of age 15-35 was not significant. The results of liver enzymes activities among the group of age 36-84y showed that ALT and ALP were significantly high (P <0.05) in the smoker group when compared with the nonsmoker group, while serum AST was not significant (P>0.05). However, among the group of age between 15-35 years, the results showed that statistically significant differences (P<0.05) were observed in ALT and AST activities for the smoker group when compared with the nonsmoker group. Regarding RBCs count and hemoglobin concentration among both of groups (age between 15-35 & 36-84 years), the results showed that a significant difference in mean RBCs count and hemoglobin concentration were noted between the smokers and the nonsmokers. Conclusion: It can be concluded that exposure to cigarette smoking leads to an increase the blood pressure. Cigarette smoking can lead to an increase in liver enzymes activities, RBCs count and Hb concentration.

The purpose of this study was to examine the Free Sanitary Pad Intervention Programme for Girls’ Education and School Retention in Tolon District in the Northern Region of Ghana. Quantitatively, a descriptive cross-sectional research design was adopted for the study. The study population consist of female menstruating school adolescent girls from these five St, Monica’s R/C, Nyankpala D/A, Nizamia E/A, Islamia E/A and Nawaria E/A junior high schools between the ages of 10 to 22 years who were beneficiaries of CAMFED intervention programmes in the Tolon district. A homogeneous purposive sampling technique was used to select the five junior high schools and the one-hundred and fifty (150) adolescent girls in their menstrual cycle stage. The main instrument for data collection was a semi-structured questionnaire. The data entry and analysis were done by using the SPSS version 20 software package. The data was edited, coded and analysed into frequencies, percentages with interpretations. The study concluded that, there were frequent distribution of free sanitary pads among the beneficiaries’ schools. The study also indicated that the education given to the respondents during the distribution of the free sanitary pads led to improved menstrual hygiene management practices. It is recommended that, schools within the Tolon district should put in place the necessary and adequate toiletry and disposal systems to ensure menstrual hygiene among students especially, girls, during that time of the month. It is also recommended that, Government should make it a priority to provide every school with some sanitary products and drugs to cater for the female student taken by surprise with her monthly flow or the pain associated with mensuration not interfering with her academic work.

Probiotics, prebiotics, and synbiotics modify various aspects of local and systemic immune function in multiple experimental models. However, their impact and mechanisms of action are not known across all products or noticed in every population studied, and impacts on in vitro, ex vivo, or other measures of immune function do not necessarily result in an impact on infection and illness in vivo. Studies have discussed that intestinal microbiota has an essential role in enhancing the immune system against viruses. The regulatory impact of the intestinal microbiota on viral infection is connected with local and systemic immune responses and plays a part in congenital and adaptive immune responses. The microbiota composition critically modulates the production of virus-specific CD4 and CD8 T cells and antibody responses following influenza virus infection. The intestinal microbiota has an important role in the stabilizing of immune homeostasis by augmenting the integrity of the barrier functions of the gut mucosa, which is a crucial aspect of systemic immunity. In conclusion, the intestinal microbiota can influence organismal immunity locally and systemically, proximally, and distally. Studying the possible mechanism by which the intestinal microbiota maintains host immunity can provide a clearer understanding of the occurrence and development of diseases.

Probiotics as an intestinal microbe regulator, not only improve the ability of the gastrointestinal microbiota to modulate immune activity, but also strengthen the body's immune system, inhibit allergic reactions and has a significant role especially in the anti-viral immunomodulation. Therefore, in patients with COVID-19, the intestinal micro-eco-regulator, represented by probiotics, may be a therapeutic choice. However, there is still a lack of evidence-based studies to support probiotic treatment of patients with COVID-19. New cohort studies and randomized controlled clinical trials to assess the effectiveness of probiotics in the management of COVID-19 are strongly and urgently needed.

This study seeks to collect, recycle and repurpose fabrics waste into decorative household items to reinforce the concept of recycling as a viable alternative to indiscriminate dumping that leads to environmental pollution. It has been observed that garment producers, fashion designers, dressmakers, seamstresses and tailors generate several quantities of fabric waste which are initially piled up to occupy space at their workshops then later disposed indiscriminately. For this studio-based study, an average of 300kg of fabric remnants which are generated by the 30 workshops of garment producers in four suburbs of Kumasi in the Ashanti region of Ghana were collected. The fabric waste was sorted into types, sizes, colours and textures, out of the 300kg collected, approximately 250kg were identified as cotton and the remaining 50kg were an assortment of polyester, nylon, rayon, wool, acetate and sateen. It also came out that the garment producers lack adequate knowledge on waste management, hence the indiscriminate disposal of the waste fabrics. The need for effective means of recycling without adverse repercussion to the environment was found critical. Based on the idea of recycle art, 280 kilograms of the fabric waste collected were converted into interior decoration pieces such as a pair of footrest, a set of arm rest, a set of chair-back, Others include a set of table mats, a set of placemats, a door mat, and a set of curtains and window blinds. It is anticipated that such craft activities will serves as pointers to craft people about the potential of waste fabrics as cheaper raw materials for diverse products and by extension help to reduce the waste management problems associated with fabric waste.

The purpose of the study was to examine solid waste disposal situation and its resultant effects in Winneba The research adopted quantitative approach for the study. The design for this research was a descriptive survey. The population for the study were residents of Winneba Township the capital of the Effutu municipality. The area is a fast growing urban community. Stratified sample sampling technique was used to select the respondents for the study. One hundred and fifty-six (156) residents were selected using strata sampling to answer questionnaires. The data entry and analysis was done by using the SPSS software package. The data was edited, coded and analysed into frequencies, percentages with interpretations. The study revealed that there was irregular or lack of routine collection of waste by WMD of EMA and ZoomLion Ghana Ltd. The study also indicated that, the landfill did not meet the requirement of a sanitary landfill as in the case of EMA and therefore could be described as an open dump. It is recommended that, adequate dustbins and skips should be provided by ZoomLion Ghana Ltd. in collaboration with the WMD and Municipal Assembly for residents in the Municipality for waste storage. It is recommended that the landfill site should be properly managed to avoid heaping of waste and burning.

The Nigerian Government both previous and present has introduced several policies and programmes to reduce or proffer remedial measures to militate against the negative impact of high inflationary levels on the Nigerian economy. All these measures have not led to a productive result as the inflation rate has continued to sour higher over the years. This paper aimed at examining the economic influence of the determinant factors that influence inflationary trends that are multi-dimensional and dynamic which continue to defy solutions. The data used for this work was sourced from the National Bureau of Statistics and Central Bank of Nigeria, from 1983 to 2020. The ordinary least square approach was used to analyze the data and the result shows that consumer’s price index, interest rate and total export has a positive effect on Nigeria inflation, but only the Consumer’s Price Index (CPI) have a statistically significant effect on the Nigeria inflation at 99% confidence interval. Result also shows that the exchange rate, foreign reserve, money supply, real GDP, real income and total imports has a negative effect though not statistically significant on the Nigeria inflation rate. The result of the granger causality test shows exchange rate and total imports to granger cause Nigeria inflation. It is recommended that Government should improve locally manufacture products to meet international demands to reduce total imports.

This study took place in the Far North region of Cameroon. The general objective was to assess the floristic diversity of the undergrowth of Agrosystems in Azadirachta indica. The data were collected in 100 m long by 20 m wide transects surveyed in plantations of different ages. In total, 5 transects were carried out, ie a total area of 1 ha per site. The sampling bands were established using the compass, decameter, GPS and wires. The experimental set-up used was a 5-repetition split plot. A total of 7689 individuals divided into 9 families, 13 genera and 16 species have been identified. Guiera senegalensis and Piliostigma thonningii are the most common in terms of relative abundance. The analysis of the Family Importance Index (VIF) shows overall that the Combretaceae, and Mimosaceae are the most important in ecological terms. While those of the species show that Guiera senegalensis, Combretum micranthum and Acacia nilotica finally for the genera, it is Acacia, Guiera and Combretum which contains the most important ecological indices. The overall density of species within the plots varies between 129 and 105 ind / ha. The basal area varies from 2.02 to 3.88 m² / ha. The Importance Value Index (IVI) is of the order of 300 in the different plots. The floristic diversity of the undergrowth of Agrosystems (average ISH> 2) shows homogeneity and an even distribution between the different plots. Plots with similarity indices of less than 50% do not meet floristic affinity while similarity indices are high in plots with floristic affinities greater than or equal to 50%. The diameter structure showed a predominance of young individuals. This information drawn from the conclusion of the present study shows that they constitute an important argumentation of the advantages so that the services of agricultural development should be interested in the conservation and valuation of such an agroforestry system for the protection of the environment against the climate change mitigation and sustainable development of local communities.