Efficacy of adding ketamine to levobupivacaine in paravertebral block on acute and chronic pain in thoracotomy: a randomized controlled double-blinded trial.

Background: The inappropriate management of pain after thoracotomy results in serious complications. Several adjuvants have been added to the thoracic paravertebral block (TPVB) to enhance its effects. This work aimed to evaluate the effect of adding ketamine to TPVB on thoracotomy-related acute and chronic pain. Methods: This randomized controlled double-blinded trial included 60 patients scheduled for open thoracotomy. Patients were equally randomized into 2 groups: group K: received TPVB + 1 mL ketamine (50 mg). Group C (n = 30): received TPVB (19 mL of 0.5% levobupivacaine + 1 mL normal saline) as a control arm. Results: Group K exhibited a significant delay in requesting analgesia, required less morphine in the first 24 and 48 hours, and reported lower numerical rating scale at rest and at deep breathing at various time points compared with the control group. However, both groups were comparable in post-thoracotomy pain syndrome and the incidence of complications at 2 months and 3 months. Conclusions: Adding ketamine to TPVB resulted in better analgesia as demonstrated by significantly delayed time to first rescue analgesia, lower total amount of consumed opioid, and pain score without considerable effect on chronic pain and complications in patients undergoing thoracotomy.

Assessing the Effectiveness of Audio-Visual vs. Visual Neurofeedback for Attention Enhancement: A Pilot Study with Neurological, Behavioural, and Neuropsychological Measures.

Electroencephalogram (EEG) based Neurofeedback training has gained traction as a practical method for enhancing executive functions, particularly attention, among healthy individuals. The neurofeedback protocols based on EEG channel locations, frequency bands, or EEG features has been tested. However, the improvement in attention was not measured by comparing different feedback stimulus types. We believe that multisensory nature feedback even with few training sessions may induce strong effect. Therefore, this study compares the effect of audio-visual and visual feedback stimuli for attention enhancement utilizing neurophysiological, behavioural and neuropsychological measures. Total 21 subjects were recruited, undergoing six alternate days of neurofeedback training sessions to upregulate EEG beta power of frontocentral (FC5). Dwell time, fractional occupancy and transition probability were also estimated from the EEG beta power. Audiovisual group (G1) as compared to visual group (G2) demonstrate a significant increase of global EEG beta activity alongside improved dwell time (t = 2.76, p = 0.003), fractional occupancy (t = 1.73, p = 0.042) and transition probability (t = 2.46, p = 0.008) over the course of six neurofeedback training sessions. Similarly, the group (G1) shows higher scores (t = 2.13, p = 0.032) and faster reaction times (t = 2.22, p = 0.028) in Stroop task, along with increased score in Mindfulness Attention Awareness Scale (MAAS-15) questionnaire (t = 2.306, p = 0.012). Audiovisual neurofeedback may enhance training effectiveness, potentially achieving the same outcomes in fewer sessions compared to visual-only feedback. However, sufficient training days are essential for effect consolidation. This highlights the feasibility of completing neurofeedback training, a significant challenge in practice.

Predicting the effectiveness of binaural beats on working memory.

Working memory is vital for short-term information processing. Binaural beats can enhance working memory by improving attention and memory consolidation through neural synchronization. However, individual differences in cognitive and neuronal functioning affect effectiveness of binaural beats, necessitating personalized approaches. This study aimed to develop a machine learning model to predict binaural beats's effectiveness on working memory using electroencephalography. Sixty healthy participants underwent a 5-min electroencephalography recording, an initial working memory evaluation, 15 min of binaural beats stimulation, and a subsequent working memory evaluation using digit span tests of increasing difficulty. Recall accuracy and response times were measured. Differential scores from pre-evaluation and post-evaluation labeled participants as active or inactive to binaural beats stimulation. electroencephalography data, recorded using 14 electrodes, provided brain activity estimates across theta, alpha, beta, and gamma frequency bands, resulting in 56 features (14 channels × 4 bands) for the machine learning model. Several classifiers were tested to identify the most effective model. The weighted K-nearest neighbors model achieved the highest accuracy (90.0%) and area under the receiver operating characteristic curve (92.24%). Frontal and parietal electroencephalography channels in theta and alpha bands were crucial for classification. This study's findings offer significant clinical insights, enabling informed interventions and preventing resource inefficiency.

Highly sensitive detection of kojic acid in food samples using fluorescent carbon dots derived from pomegranate peel.

Kojic acid (KA) has gained significant attention due to its widespread use in the food and cosmetics industries. However, concerns about its potential carcinogenic effects have heightened the need for sensitive detection methods. This study introduces a fluorescence-based optical sensor for the quantification of KA in food samples, utilizing fluorescent carbon dots (CDs) synthesized from pomegranate peel via a hydrothermal method. The Stern-Volmer plot demonstrated a linear response for KA in the range of 120 to 1200 µM, with a Pearson correlation coefficient (r) of 0.9999 and. The sensor exhibited a detection limit of 30 ± 0.04 µM and a limit of quantification (LOQ) of 90 ± 0.14 µM. Application of the developed method to soy sauce and vinegar samples yielded accurate KA determinations, with recoveries of 103.11 ± 0.96% and 104.45 ± 2.15%, respectively. These findings highlight the potential of the proposed sensor for practical applications in food quality and safety assessment, offering valuable insights into the presence of KA in food products.

Deciphering Pre-existing and Induced 3D Genome Architecture Changes involved in Constricted Melanoma Migration.

Metastatic cancer cells traverse constricted spaces that exert forces on their nucleus and the genomic contents within. Cancerous tumors are highly heterogeneous and not all cells within them can achieve such a feat. Here, we investigated what initial genome architecture characteristics favor the constricted migratory ability of cancer cells and which arise only after passage through multiple constrictions. We identified a cell surface protein (ITGB4) whose expression correlates with increased initial constricted migration ability in human melanoma A375 cells. Sorting out this subpopulation allowed us to identify cellular and nuclear features that pre-exist and favor migration, as well as alterations that only appear after cells have passed through constrictions. We identified specific genomic regions that experienced altered genome spatial compartment profiles only after constricted migration. Our study reveals 3D genome structure contributions to both selection and induction mechanisms of cell fate change during cancer metastasis.

Pulmonary manifestations associated with positive anti neutrophil cytoplasmic antibodies: The tip of the iceberg.

Background: Even though anti-neutrophil cytoplasmic antibodies (ANCA) are frequently linked to ANCA associated vasculitis (AAV), it's important to understand that other illnesses, including lung diseases, can also manifest as ANCA positivity. Finding the incriminated pathology might be difficult. Aim: To report four ANCA-associated cases with a diagnosis problem. Methods: Four patients were recruited from the allergo-pneumology department of the Fattouma Bourguiba University Hospital of Monastir, Tunisia, over two years (2020-2022). Indirect immunofluorescence technique on neutrophil cells (Euroimmun, Germany) was used for ANCA screening with a positivity limit of 1/20. ANCA typing was carried out by a line-blot technique (Euroimmun, Germany). Results: This case series reports four cases (age range: 41-67 years, sex ratio: 0.3) that presented with pulmonary manifestations associated with ANCA positivity. Two patients had perinuclear ANCA with anti-myeloperoxidase on typing, and two cases had cytoplasmic ANCA with one case of anti-leukocyte proteinase 3 on typing. Final diagnoses were pulmonary tuberculosis (case 1), systemic lupus erythematosus (case 2), bronchiolitis obliterans organizing pneumonia (case 3), and pulmonary aspergillosis with AAV (case 4). Conclusion: A panel of diagnoses may be evoked in front of positive ANCA, making the diagnosis difficult to determine and requiring multidisciplinary interactions, with imaging and histological investigations having a crucial role in guiding the final decision.

Influences of Bacillus pumilus SA388 as an environmentally friendly antibiotic alternative on growth performance, blood biochemistry, immunology, cecal microbiota, and meat quality in broiler chickens.

The widespread use of antibiotics causes the development of antibiotic-resistant bacterial strains, which have a severe impact on poultry productivity and human health. As a result, research is continuing to develop safe natural antibiotic alternatives. In the current study, Bacillus pumilus SA388 was isolated from the chicken feces and confirmed to be a probiotic. The selected strain was tested for its antimutagenic and antioxidant capabilities before being employed as a probiotic food supplement and antibiotic alternative. The effect of B. pumilus SA388 impact on broiler chickens' growth performance, gut microbiome, blood biochemical markers, immunological response, and meat quality was also studied. B. pumilus SA388 showed significant bactericidal activity against Streptococcus pyogenes, Listeria monocytogenes, Staphylococcus aureus, Escherichia coli, Salmonella typhi, and Klebsiella pneumonia. A total of 200 chickens were used in the present study, divided equally among four experimental groups (ten birds per group with 5 replicates): group 1 (control, G1) received a basal diet without B. pumilus SA388, group 2 (G2) received a basal diet supplemented with 0.4 mg/kg of B. pumilus SA388, group 3 (G3) received a basal diet supplemented with 0.8 mg/kg of B. pumilus SA388, and group 4 (G4) received a basal diet supplemented with 1.6 mg/kg of B. pumilus SA388. Over 35 d, the B. pumilus SA388-supplemented groups outperformed the G1 in terms of body weight gain, performance index, and feed conversion ratio, with a preference for the G4 treatment. The levels of alanine aminotransferase (ALT), aspartate transaminase (AST), low-density lipoprotein (LDL), and total cholesterol decreased significantly (P < 0.05) with increasing B. pumilus SA388 dosages compared to the control G1 group. Dietary supplementation of B. pumilus SA388 at 1.6 mg/kg (G4) significantly (P < 0.05) resulted in improved lipid profile, immunological response, thyroid function, and gut microbiota compared to the control group (G1). Compared to the broilers in the control treatment (G1), the addition of B. pumilus SA388 to broilers in G4 significantly (P < 0.05) enhanced juiciness, tenderness, aroma, and taste. Adding B. pumilus SA388 to chicken feed at different doses significantly (P < 0.05) decreased average feed intake while increasing economic and relative efficiency measures. In conclusion, B. pumilus SA388 has been proven to be an effective antibiotic and nutritional supplement.

Prevalence and risk of hospitalization for depression in patients with heart failure.

BACKGROUND: Patients with heart failure could have a high prevalence of depression which may increase the risk of hospitalization. So this study is to estimate the prevalence of depression among patients attending heart failure clinics, and determine whether depression increases the risk of hospitalization in patients with heart failure. METHODS: In this analytical cross-sectional study, we interviewed patients with heart failure and identified those with depression; the Patient Health Questionnaire-9 was used to estimate the prevalence of depression and assess clinical outcomes, including the risk of hospitalization. RESULTS: A total of 200 patients with a mean age of 64,44±13,865 years were analyzed. The prevalence of depression among them was 36.5%. and it affected by factors like employment, education, and medical status, as Patients on diuretics were found to be greater at 41.1% than non-users at 19% (p=0,008). The majority of the patients with both heart failure and depression were hospitalized twice or more during the last year 54.8% (p=0,001). CONCLUSION: The prevalence of depression among patients with heart failure is high, which increases the risk of hospitalization.

Robotic arthroplasty software training improves understanding of total knee arthroplasty alignment and balancing principles: a randomized controlled trial.

Understanding alignment and gap balancing in Total Knee Arthroplasty (TKA) can be challenging for trainee and experienced orthopedic surgeons. Traditional learning methods may not effectively translate to real-life scenarios. The advent of advanced technologies like robotic surgery and navigation systems has revolutionized intraoperative understanding of gap balancing techniques. This trial aims to investigate the effectiveness of robotic TKA planning software in educating trainees about alignment and ligament balancing. We hypothesize that a single session with the software will significantly enhance trainees' understanding of these techniques. This UK-based single-center, two-arm, group parallel randomized controlled trial was conducted during a national robotic arthroplasty symposium. It aims to evaluate the effect of robotic knee arthroplasty software training on understanding TKA alignment and gap balancing principles using Multiple Choice Questions (MCQs). The MCQ test was crafted based on established guidelines from a different institution with expert consensus in the field. Our study revealed that baseline knowledge of gap balancing and alignment principles was generally low among all participants. However, the intervention group, which received comprehensive robotic software training, demonstrated a significant improvement in their MCQ scores compared to the control group, which did not undergo the training. In conclusion, our study demonstrates that robotic arthroplasty software training significantly improves the understanding of TKA alignment and balancing principles among orthopedic trainees. Level of Evidence II.

User Perspectives and Psychophysiological Manifestations of Fatigue with Trunk Orthosis for Dystrophinopathy Patients.

The chair-mounted passive trunk orthosis (CMPTO) is designed to enhance wheelchair safety for individuals with dystrophinopathy during their daily activities. Given the disease's progressive nature, it is crucial to ensure that assistive devices are carefully evaluated to prevent overexertion. This study aims to assess the CMPTO's user experience and its impact on fatigue-related psychophysiological measurements. We conducted electromyography (EMG) evaluations of four trunk muscles and assessed perceived exertion using the Borg CR-10 scale in 40 healthy subjects while they performed seated maximal reaching tasks with the CMPTO. Additionally, fifteen dystrophinopathy patients evaluated the CMPTO for usability with the System Usability Scale. Paired t-tests were employed to compare the median frequency (MDF) of EMG signals, the Wilcoxon signed-rank test for evaluating exertion, and the Mann-Whitney U test to compare the usability reported by patients to those of healthy subjects. The 4-way ANOVA revealed that MDF patterns were significantly influenced by task orientation for each muscle. The CMPTO did not cause a significant reduction in the MDF. Tasks requiring greater trunk rotation were perceived as more exhaustive. Patients reported acceptable usability with the CMPTO, with scores higher than those of healthy subjects. The CMPTO's usability was comprehensively evaluated in both healthy subjects and patients with dystrophinopathy. Our findings indicate that the CMPTO can be safely used by individuals with dystrophinopathy as an assistive device to improve seated comfort and functional abilities.

Pharmacists's knowledge, attitude, and practices towards pharmaceutical and patient-centred care in asthma management: A national study.

Background: Asthma, a chronic respiratory disease, is effectively managed with medications, yet many patients struggle due to irregular treatment and poor adherence. Pharmacists play a crucial role in improving asthma care through pharmaceutical care (PC) services. This study aims to assess pharmacists' knowledge, attitudes, and behaviors regarding asthma PC in Türkiye. Methods: This cross-sectional study in Türkiye evaluated community (CP) and hospital pharmacists' (HP) knowledge level, attitudes, and behaviors regarding asthma care. A validated Asthma Pharmaceutical Care Knowledge (APCL) and Asthma Attitudes and Behaviors (AAB) questionnaires were used to assess their knowledge levels and attitudes toward asthma pharmaceutical care. Results: Out of 400 pharmacists participated the questionnaire, the majority were CP (297, 74.25 %). Both CP and HP demonstrated adequate knowledge scores, 79.39 ± 12.32 and 80.66 ± 12.25, respectively. APCL mean scores of CP and HP were 4.22 ± 0.523 and 4.29 ± 0.383. No statistically significant difference in asthma knowledge levels was observed between CP and HP. Both groups reported positive attitudes and behaviors toward asthma care, with CP scoring 4.71 ± 0.446 and HP scoring 4.74 ± 0.330 on the AAB questionnaire. Conclusions: This study revealed that both CP and HP have sufficient knowledge about asthma and they have positive attitudes towards providing asthma PC. Pharmacists have crucial role in asthma care with leveraging their expertise, patient interactions, and ability to referral capabilities.

The influence of dietary supplementation with fermented agro-industrial residue of faba bean on Japanese quail performance, immunity, gut microbiota, blood chemistry, and antioxidant status.

Antibiotic overuse in poultry feeds has disastrous implications; consequently, long-term alternatives must be developed. As a result, the current study aims to assess the impact of Aspergillus niger filtrate (ANF) high in organic acids grown on agro-industrial residue of faba bean (AIRFB) on quail diet, as well as their influence on bird productivity, digestion, carcass yield, blood chemistry, and intestinal microbiota. A total of 240 Japanese quails (aged 7 d) were used in this study, divided equally among 5 experimental groups with 48 quails each. Group 1 (G1) received a basal diet without any ANF, group 2 (G2) received a basal diet supplemented with 0.5 mL ANF/kg diet, group 3 (G3) received a basal diet supplemented with 1.0 mL ANF/kg diet, group 4 (G4) received a basal diet supplemented with 1.5 mL ANF/kg diet, and group 5 (G5) received a basal diet supplemented with 2 mL ANF/kg diet. The performance parameters were monitored at 1 to 3, 3 to 5, and 1 to 5 wk. Adding ANF increased body weight at 3 and 5 wk, as well as body weight gain at 1 to 3, 3 to 5, and 1 to 5 wk, compared to the control diet. The ANF fed quails had the highest feed conversion ratio compared to the control group. The addition of ANF to the quail diet had no effect on the weight of the carcass, gizzard, heart, liver, giblets, or dressing; however, it did lower triglycerides, low-density lipoprotein, and very low-density lipoprotein while increasing high-density lipoprotein levels. The quail groups that received ANF had enhanced immunological indices such as IgG, IgM, IgA, and lysozymes. It also increased the levels of superoxide dismutase and total antioxidant contents, as well as catalase, and digestive enzymes such as protease, amylase, and lipase. However, it lowered the blood MDA levels compared to control. It has been demonstrated that the total gut microbiota, Escherichia coli, total coliforms, and the population of Salmonella are all reduced in ANF-fed quails. Histological examination of ANF quails' liver and intestinal sections revealed normal hepatic parenchyma, typical leaf-like intestinal villi, and comparatively short and frequently free lumina. In conclusion, Japanese quail showed improvements in performance, digestive enzymes, antioxidant indices, immunity, and capacity to reduce intestinal pathogenic bacteria after consuming diet supplemented with ANF.

Coccygeal tumours unveiled: a retrospective cohort analysis from a tertiary referral centre.

BACKGROUND: Isolated tumours affecting the coccyx are infrequent, with only a handful of documented cases in the literature. Herein, we highlight the most extensive consecutive case series involving various isolated coccyx tumours with varied clinical presentations and imaging features. METHODS: A retrospective search of our tertiary Orthopaedic oncology institute's oncology and Radiology database [Radiology Information System, Picture Archiving and Communication System, and Computerised Radiology Information System] for the keyword "Coccyx" and "Tumour" was performed over 15 years (between December 2007 and August 2022). Data collected was correlated with local histopathology and laboratory records. Patient demographics, clinical characteristics, and complementary imaging findings were recorded for analysis. RESULTS: One hundred and three lesions originating in the coccyx with a mean age of 62 years (range 25-90 years) were identified. There was a male preponderance with 59 male and 44 female patients (1.3:1.0). The most typical tumour noted was chordoma. Other lesions included a dermoid cyst, a myxopapillary ependymoma, a notochordal remnant, an osteochondroma, an Ewing sarcoma, and a teratoma. CONCLUSION: Our analysis suggests that most of the tumours involving coccyx are chordomas with a few rarely encountered benign and malignant tumours. Radiological imaging plays a vital role in characterising isolated tumours affecting the coccyx and guiding appropriate patient management. ADVANCES IN KNOWLEDGE: This is the largest reported series of coccygeal tumours. Chordoma is the commonest coccygeal tumour. Patients with unexplained coccydynia should undergo detailed investigations, preferably with cross-sectional imaging.

Polyphenols: Chemistry, bioavailability, bioactivity, nutritional aspects and human health benefits: A review.

Polyphenols, including phenolics, alkaloids, and terpenes, are secondary metabolites that are commonly found in fruits, vegetables, and beverages, such as tea, coffee, wine, chocolate, and beer. These compounds have gained considerable attention and market demand because of their potential health benefits. However, their application is limited due to their low absorption rates and reduced tissue distribution efficiency. Engineering polyphenol-protein complexes or conjugates can enhance the antioxidant properties, bioavailability, and stability of polyphenols and improve digestive enzyme hydrolysis, target-specific delivery, and overall biological functions. Complex polyphenols, such as melanin, tannins, and ellagitannins, can promote gut microbiota balance, bolster antioxidant defense, and improve overall human health. Despite these benefits, the safety of polyphenol complexes must be thoroughly evaluated before their use as functional food additives or supplements. This review provides a detailed overview of the types of macromolecular polyphenols, their chemical composition, and their role in food enrichment. The mechanisms by which complex polyphenols act as antioxidative, anti-inflammatory, and anticancer agents have also been discussed.

Ecological impacts and management strategies of pesticide pollution on aquatic life and human beings.

Pesticide contamination has become a global concern. Pesticides can sorb onto suspended particles and deposit into the sedimentary layers of aquatic environments, resulting in ecosystem degradation, pollution, and diseases. Pesticides impact the behavior of aquatic environments by contaminating organic matter in water, which serves as the primary food source for aquatic food webs. Pesticide residues can increase ammonium, nitrite, nitrate, and sulfate in aquatic systems; thus, threatening ecological environment and human health. Several physical, chemical, and biological methodologies have been implemented to effectively remove pesticide traces from aquatic environments. The present review highlights the potential consequences of pesticide exposure on fish and humans, focusing on the (epi)genetic alterations affecting growth, behavior, and immune system. Mitigation strategies (e.g., bioremediation) to prevent/minimize the detrimental impacts of pesticides are also discussed. This review aims to shed light on the awareness in reducing the risk of water pollution for safe and sustainable pesticide management.

Garlic bioactive substances and their therapeutic applications for improving human health: a comprehensive review.

Garlic (Allium sativum L.) is a widely abundant spice, known for its aroma and pungent flavor. It contains several bioactive compounds and offers a wide range of health benefits to humans, including those pertaining to nutrition, physiology, and medicine. Therefore, garlic is considered as one of the most effective disease-preventive diets. Many in vitro and in vivo studies have reported the sulfur-containing compounds, allicin and ajoene, for their effective anticancer, anti-diabetic, anti-inflammatory, antioxidant, antimicrobial, immune-boosting, and cardioprotective properties. As a rich natural source of bioactive compounds, including polysaccharides, saponins, tannins, linalool, geraniol, phellandrene, ß-phellandrene, ajoene, alliin, S-allyl-mercapto cysteine, and ß-phellandrene, garlic has many therapeutic applications and may play a role in drug development against various human diseases. In the current review, garlic and its major bioactive components along with their biological function and mechanisms of action for their role in disease prevention and therapy are discussed.

Efficacy of audiovisual neurofeedback training for attention enhancement: a multimodal approach.

Attention is a cognitive process that involves focusing mental resources on specific stimuli and plays a fundamental role in perception, learning, memory, and decision-making. Neurofeedback (NF) is a useful technique for improving attention, providing real-time feedback on brain activity in the form of visual or auditory cues, and allowing users to learn to self-regulate their cognitive processes. This study compares the effectiveness of different cues in NF training for attention enhancement through a multimodal approach. We conducted neurological (Quantitative Electroencephalography), neuropsychological (Mindfulness Attention Awareness Scale-15), and behavioral (Stroop test) assessments before and after NF training on 36 healthy participants, divided into audiovisual (G1) and visual (G2) groups. Twelve NF training sessions were conducted on alternate days, each consisting of five subsessions, with pre- and post-NF baseline electroencephalographic evaluations using power spectral density. The pre-NF baseline was used for thresholding the NF session using the beta frequency band power. Two-way analysis of variance revealed a significant long-term effect of group (G1/G2) and state (before/after NF) on the behavioral and neuropsychological assessments, with G1 showing significantly higher Mindfulness Attention Awareness Scale-15 scores, higher Stroop scores, and lower Stroop reaction times for interaction effects. Moreover, unpaired t -tests to compare voxel-wise standardized low-resolution brain electromagnetic tomography images revealed higher activity of G1 in Brodmann area 40 due to NF training. Neurological assessments show that G1 had better improvement in immediate, short-, and long-term attention. The findings of this study offer a guide for the development of NF training protocols aimed at enhancing attention effectively.

Comparative Neurological and Behavioral Assessment of Central and Peripheral Stimulation Technologies for Induced Pain and Cognitive Tasks.

Pain is a multifaceted, multisystem disorder that adversely affects neuro-psychological processes. This study compares the effectiveness of central stimulation (transcranial direct current stimulation-tDCS over F3/F4) and peripheral stimulation (transcutaneous electrical nerve stimulation-TENS over the median nerve) in pain inhibition during a cognitive task in healthy volunteers and to observe potential neuro-cognitive improvements. Eighty healthy participants underwent a comprehensive experimental protocol, including cognitive assessments, the Cold Pressor Test (CPT) for pain induction, and tDCS/TENS administration. EEG recordings were conducted pre- and post-intervention across all conditions. The protocol for this study was categorized into four groups: G1 (control), G2 (TENS), G3 (anodal-tDCS), and G4 (cathodal-tDCS). Paired t-tests (p < 0.05) were conducted to compare Pre-Stage, Post-Stage, and neuromodulation conditions, with t-values providing insights into effect magnitudes. The result showed a reduction in pain intensity with TENS (p = 0.002, t-value = -5.34) and cathodal-tDCS (p = 0.023, t-value = -5.08) and increased pain tolerance with TENS (p = 0.009, t-value = 4.98) and cathodal-tDCS (p = 0.001, t-value = 5.78). Anodal-tDCS (p = 0.041, t-value = 4.86) improved cognitive performance. The EEG analysis revealed distinct neural oscillatory patterns across the groups. Specifically, G2 and G4 showed delta-power reductions, while G3 observed an increase. Moreover, G2 exhibited increased theta-power in the occipital region during CPT and Post-Stages. In the alpha-band, G2, G3, and G4 had reductions Post-Stage, while G1 and G3 increased. Additionally, beta-power increased in the frontal region for G2 and G3, contrasting with a reduction in G4. Furthermore, gamma-power globally increased during CPT1, with G1, G2, and G3 showing reductions Post-Stage, while G4 displayed a global decrease. The findings confirm the efficacy of TENS and tDCS as possible non-drug therapeutic alternatives for cognition with alleviation from pain.

Factors associated with pregnancy termination in six sub-Saharan African countries.

Pregnancy termination continues to be a leading cause of maternal morbidity and mortality among young women in Africa. The sub-Saharan Africa region has the highest rate of abortion-related deaths in the world, at 185 maternal deaths per 100,000 abortions. The aim of this study is to investigate the factors associated with pregnancy termination among women aged 15 to 29 years in six sub-Saharan African countries. We used secondary data from the most recent Demographic and Health Survey of six sub-Saharan African countries: Kenya, Tanzania, Ethiopia, Burundi, Nigeria, and Rwanda. A total weighted sample of 74,652 women aged 15-29 were analyzed. A multivariable logistic regression model was used to identify the factors associated with pregnancy termination at a p-value < 0.05. Results were presented using adjusted odds ratios (AOR) with 95% confidence interval. The study showed that 6.3% of women aged 15-29 reported pregnancy termination with a higher prevalence rate in Tanzania (8.8%) and lowest in Ethiopia (4%). Highest odds of pregnancy termination occurred among women aged 20-24 as compared to women aged 15-19 in Rwanda (AOR: 4.04, 95%CI 2.05, 7.97) followed by Nigeria (AOR: 2.62, 95% CI 1.99, 3.43), Kenya (AOR: 2.33, 95%CI 1.48, 3.66), Burundi (AOR: 1.99 95%CI 1.48, 2.85), Tanzania (AOR: 1.71 95%CI 1.29, 2.27), and Ethiopia (AOR: 1.69, 95% CI 1.19, 2.42). Women with no education had 4 times higher odds of pregnancy termination compared to women with higher education in Tanzania (AOR: 4.03 95%CI 1.00, 16.13) while women with no education and primary level education were 1.58 times (AOR: 1.58 95% CI 1.17, 2.13) and 1.78 times (AOR: 1.78 95% CI 1.34, 2.37) as likely to terminate pregnancy in Ethiopia. In Tanzania, the likelihood of a pregnancy termination was associated with a relationship to the household head; head (AOR: 3.66, 95% CI (2.32, 5.78), wife (AOR: 3.68, 95% CI 2.60, 5.12), and in-law (AOR:2.62, 1.71, 4.03). This study revealed that a significant number of women had pregnancy termination. Being in the age group of 20-24 & 25-29, having a lower level of education, being a domestic employee and professional, being single/never-in-union, being in the poorest and richer wealth quantile category, and being head, wife, daughter, and in-law to the household head were the significantly associated with pregnancy termination. Taking these socio-economic factors into consideration by stakeholders and specific sexual education targeted to women aged 15 to 29 would help tackle the problem.