Effect of Elevated Acetabular Cup on Contact and Failure Analysis in Hip Implants for Different Microseparations and Cup Inclinations Under Routine Gait Activities Using In Silico Approach.

Objectives: The acetabular cup design plays a critical role in reducing contact stress between femur head acetabular cup. Many studies used ellipsoidal and spheroidal geometry in acetabular cup design to effectively reduce contact stress. The present study focuses on elevated acetabular cup rim with round corner design to reduce contact stress with round corner geometry. Methods: The cobalt chromium femur head and cup are considered for finite element (FE) model of hip resurfacing. The gait loads of routine activities of humans like normal walking, stair ascending and descending and sitting down and getting up gait activities are applied to the developed 3D FE model. Five microseparations of 0.5, 1, 1.5, 2 and 2.5 mm are considered in the present study. The acetabular cup inclination angle considered for this study are 35°, 45°, 55°, 65° and 75°. The contact stress and von Mises stress plot for each gait activities under these microseparations are analyzed for betterment of longevity of implants. Results: Overall elevated cup rim design helped in reducing contact stress to a greater extent than conventional cup with different geometries. Also, the predicted von Mises stress for all the parameters considered in the current study are well within the yield strength of CoCr material. Therefore, elevated cup rim could be used as a better alternative to spline and, ellipsoidal and circular geometries of cup.

Analysis of laboratory data transmission between two healthcare institutions using a widely used point-to-point health information exchange platform: a case report.

Objective: The objective was to identify information loss that could affect clinical care in laboratory data transmission between 2 health care institutions via a Health Information Exchange platform. Materials and Methods: Data transmission results of 9 laboratory tests, including LOINC codes, were compared in the following: between sending and receiving electronic health record (EHR) systems, the individual Health Level Seven International (HL7) Version 2 messages across the instrument, laboratory information system, and sending EHR. Results: Loss of information for similar tests indicated the following potential patient safety issues: (1) consistently missing specimen source; (2) lack of reporting of analytical technique or instrument platform; (3) inconsistent units and reference ranges; (4) discordant LOINC code use; and (5) increased complexity with multiple HL7 versions. Discussion and Conclusions: Using an HIE with standard messaging, SHIELD (Systemic Harmonization and Interoperability Enhancement for Laboratory Data) recommendations, and enhanced EHR functionality to support necessary data elements would yield consistent test identification and result value transmission.

EnZolv delignification of cotton spinning mill waste and optimization of process parameters using response surface methodology (RSM).

BACKGROUND: EnZolv is a novel enzyme-based, eco-friendly biomass pretreatment process that has shown great potential in the field of textile engineering and biotechnology. It employs laccase from Hexagonia hirta MSF2 and 2% ethanol in the process of delignification. The process is designed to evaluate optimal conditions to remove lignin and other impurities from cotton spinning mill waste (CSMW), without compromising the quality and strength of the fibers. CSMW is a low-cost and readily available source of cellulose, making it an ideal candidate for delignification using EnZolv. By optimizing the pretreatment conditions and harnessing the potential of enzymatic delignification, this research aims to contribute to more sustainable and efficient ways of utilizing lignocellulosic biomass in various industries for the production of biochemical and bioproducts. RESULTS: The present study emphasizes the EnZolv pretreatment in the delignification of cotton spinning mill wastes irrespective of the cellulose content. EnZolv process parameters such as, moisture content, enzyme load, incubation time, incubation temperature, and shaking speed were optimized. Under pre-optimized conditions, the percent lignin reduction was 61.34%, 61.64%, 41.85%, 35.34%, and 35.83% in blowroom droppings (BD), flat strips (FS), lickerin fly (LF), microdust (MD) and comber noils (CN), respectively. Using response surface methodology (RSM), the statistically optimized EnZolv pretreatment conditions showed lignin reduction of 59.16%, 62.88%, 48.26%, 34.64%, and 45.99% in BD, FS, LF, MD, and CN, respectively. CONCLUSION: Traditional chemical-based pretreatment methods often involve harsh chemicals and high energy consumption, which can have detrimental effects on the environment. In contrast, EnZolv offers a greener approach by utilizing enzymes that are biodegradable and more environmentally friendly. The resulting fibers from EnZolv treatment exhibit improved properties that make them suitable for various applications. Some of the key properties include enhanced cellulose recovery, reduced lignin content, and improved biophysical and structural characteristics. These improvements can contribute to the fiber's performance and processability in different industries and future thrust for the production of cellulose-derived and lignin-derived bioproducts.

Circulating vaccine derived polio virus type 2 outbreak and response in Yemen, 2021-2022, a retrospective descriptive analysis.

BACKGROUND: The outbreaks of circulating Vaccine Derived Polio Viruses (cVDPVs) have emerged as a major challenge for the final stage of polio eradication. In Yemen, an explosive outbreak of cVDPV2 was reported from August 2021 to December 2022. This study aims to compare the patterns of cVDPV2 outbreak, response measures taken by health authorities, and impacts in southern and northern governorates. METHOD: A retrospective descriptive study of confirmed cases of VDPV2 was performed. The data related to cVDPV2 as well as stool specimens and environmental samples that were shipped to WHO-accredited labs were collected by staff of surveillance. Frequencies and percentages were used to characterize and compare the confirmed cases from the southern and northern governorates. The average delayed time as a difference in days between the date of sample collection and lab confirmation was calculated. RESULTS: The cVDPV2 was isolated from 227 AFP cases reported from 19/23 Yemeni governorates and from 83% (39/47) of environmental samples with an average of 7 months delayed from sample collection. However, the non-polio AFP (NPAFP) and adequate stool specimen rates in the north were 6.7 and 87% compared to 6.4 and 87% in the south, 86% (195) and 14%(32) out of the total 227 confirmed cases were detected from northern and southern governorates, respectively. The first and second cases of genetically linked isolates experienced paralysis onset on 30 August and 1st September 2021. They respectively were from Taiz and Marib governorates ruled by southern authorities that started vaccination campaigns as a response in February 2022. Thus, in contrast to 2021, the detected cases in 2022 from the total cases detected in the south were lower accounting for 22% (7 of 32) of compared to 79% (155 of 195) of the total cases the north. CONCLUSION: A new emerging cVDPV2 was confirmed in Yemen. The result of this study highlighted the impact of vaccination campaigns in containing the cVDPV2 outbreak. Maintaining a high level of immunization coverage and switching to nOPV2 instead of tOPV and mOPV2 in campaigns are recommended and environmental surveillance should be expanded in such a risky country.

A Novel Plasmonic Sensor Based on Dual-Channel D-Shaped Photonic Crystal Fiber for Enhanced Sensitivity in Simultaneous Detection of Different Analytes.

A dual-channel D-shaped photonic crystal fiber (PCF) based plasmonic sensor is proposed in this paper for the simultaneous detection of two different analytes using the surface plasmon resonance (SPR) technique. The sensor employs a 50 nm-thick layer of chemically stable gold on both cleaved surfaces of the PCF to induce the SPR effect. This configuration offers superior sensitivity and rapid response, making it highly effective for sensing applications. Numerical investigations are conducted using the finite element method (FEM). After optimizing the structural parameters, the sensor exhibits a maximum wavelength sensitivity of 10000 nm/RIU and an amplitude sensitivity of -216 RIU -1 between the two channels. Additionally, each channel of the sensor exhibits its unique maximal wavelength and amplitude sensitivities for different refractive index (RI) ranges. Both channels demonstrate a maximal wavelength sensitivity of 6000 nm/RIU. In the RI range of 1.31-1.41, Channel 1 (Ch1) and Channel 2 (Ch2) achieved their maximum amplitude sensitivities of -85.39RIU -1 and -304.52 RIU -1 , respectively, with a resolution of 5×10 -5 . This sensor structure is noteworthy for its ability to measure both amplitude and wavelength sensitivity, providing enhanced performance characteristics suitable for various sensing purposes in chemical, biomedical, and industrial fields.

UK adult ADHD services in crisis.

The UK's services for adult attention-deficit hyperactivity disorder (ADHD) are in crisis, with demand outstripping capacity and waiting times reaching unprecedented lengths. Recognition of and treatments for ADHD have expanded over the past two decades, increasing clinical demand. This issue has been exacerbated by the COVID-19 pandemic. Despite an increase in specialist services, resource allocation has not kept pace, leading to extended waiting times. Underfunding has encouraged growth in independent providers, leading to fragmentation of service provision. Treatment delays carry a human and financial cost, imposing a burden on health, social care and the criminal justice system. A rethink of service procurement and delivery is needed, with multiple solutions on the table, including increasing funding, improving system efficiency, altering the service provision model and clinical prioritisation. However, the success of these solutions hinges on fiscal capacity and workforce issues.

An outbreak of SARS-CoV-2 in a public-facing office in England.

BACKGROUND: An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with an attack rate of 55% (22/40 workers) occurred at a public-facing office in England from August to September 2021. Published evidence regarding outbreaks in office workplaces remains limited. AIMS: To describe an investigation of workplace- and worker-related risk factors following an outbreak of SARS-CoV-2 in a public-facing office. METHODS: The COVID-19 (coronavirus disease 2019) Outbreak Investigation to Understand Transmission (COVID-OUT) study undertook an investigation of the outbreak. This included surface sampling, occupational environmental assessment, molecular and serological testing of workers, and detailed questionnaires. RESULTS: Despite existing COVID-19 control measures, surface sampling conducted during a self-imposed 2-week temporary office closure identified viral contamination (10/60 samples, 17% positive), particularly in a small, shared security office (6/9, 67% positive) and on a window handle in one open-plan office. Targeted enhanced cleaning was, therefore, undertaken before the office reopened. Repeat surface sampling after this identified only one positive (2%) sample. Ventilation was deemed adequate using carbon dioxide monitoring (typically ≤1000 ppm). Twelve workers (30%) responded to the COVID-OUT questionnaire, and all had been vaccinated with two doses. One-third of respondents (4/12) reported direct physical or close contact with members of the public; of these, 75% (3/4) reported a divider/screen between themselves and members of the public. CONCLUSIONS: The results highlight the potential utility of surface sampling to identify SARS-CoV-2 control deficiencies and the importance of evolving, site-specific risk assessments with layered COVID-19 mitigation strategies.

Health Recommendation System using Deep Learning-based Collaborative Filtering.

The crucial aspect of the medical sector is healthcare in today's modern society. To analyze a massive quantity of medical information, a medical system is necessary to gain additional perspectives and facilitate prediction and diagnosis. This device should be intelligent enough to analyze a patient's state of health through social activities, individual health information, and behavior analysis. The Health Recommendation System (HRS) has become an essential mechanism for medical care. In this sense, efficient healthcare networks are critical for medical decision-making processes. The fundamental purpose is to maintain that sensitive information can be shared only at the right moment while guaranteeing the effectiveness of data, authenticity, security, and legal concerns. As some people use social media to recognize their medical problems, healthcare recommendation systems need to generate findings like diagnosis recommendations, medical insurance, medical passageway-based care strategies, and homeopathic remedies associated with a patient's health status. New studies aimed at the use of vast numbers of health information by integrating multidisciplinary data from various sources are addressed, which also decreases the burden and health care costs. This article presents a recommended intelligent HRS using the deep learning system of the Restricted Boltzmann Machine (RBM)-Coevolutionary Neural Network (CNN) that provides insights on how data mining techniques could be used to introduce an efficient and effective health recommendation systems engine and highlights the pharmaceutical industry's ability to translate from either a conventional scenario towards a more personalized. We developed our proposed system using TensorFlow and Python. We evaluate the suggested method's performance using distinct error quantities compared to alternative methods using the health care dataset. Furthermore, the suggested approach's accuracy, precision, recall, and F-measure were compared with the current methods.

Identification and structural characterization of a pathogenic ARSA missense variant in two consanguineous families from Jammu and Kashmir (India) with late infantile metachromatic leukodystrophy.

BACKGROUND: Metachromatic leukodystrophy (MLD) is a rare lysosomal storage disorder caused by a deficiency of Arylsulfatase A (ARSA) enzyme activity. Its clinical manifestations include progressive motor and cognitive decline. ARSA gene mutations are frequent in MLD. METHODS AND RESULTS: In the present study, whole exome sequencing (WES) was employed to decipher the genetic cause of motor and cognitive decline in proband's of two consanguineous families from J&K (India). Clinical investigations using radiological and biochemical analysis revealed MLD-like features. WES confirmed a pathogenic variant in the ARSA gene. Molecular simulation dynamics was applied for structural characterization of the variant. CONCLUSION: We report the identification of a pathogenic missense variant (c.1174 C > T; p.Arg390Trp) in the ARSA gene in two cases of late infantile MLD from consanguineous families in Jammu and Kashmir, India. Our study utilized genetic analysis and molecular dynamics simulations to identify and investigate the structural consequences of this mutation. The molecular dynamics simulations revealed significant alterations in the structural dynamics, residue interactions, and stability of the ARSA protein harbouring the p.Arg390Trp mutation. These findings provide valuable insights into the molecular mechanisms underlying the pathogenicity of this variant in MLD.

Blind prediction of toluene/water partition coefficients using COSMO-RS: results from the SAMPL9 challenge.

Accurately predicting partition coefficients log P is crucial for reducing costs and accelerating drug design as it provides valuable information about the bioavailability, pharmacokinetics, and toxicity of different drug candidates. However, the performance of the existing methods is ambiguous, making it unclear whether these methods can be effectively utilized in drug discovery. To assess the performance of these methods, a series of SAMPL challenges have been conducted over the past few years, aiming to enable the development and validation of predictive models. In this study, we present two independent contributions to the SAMPL9 challenge for predicting the toluene/water partition coefficients for 16 molecules. Both submissions, A and B, use the COSMO-RS approach, albeit in slightly different procedures, to compute the transfer free energies from water to toluene of the molecules presented in the challenge, and consequently, their corresponding log P values. Based on the results, COSMO-RS submission A achieves the top position with an R2 value of 0.93 while it ranks second in terms of root-mean-square error (RMSE) with a value of 1.23 log P units. COSMO-RS submission B achieves an R2 value of 0.83 and an RMSE value of 1.48 log P units. Following the challenge, we predict the log P values using a neural network model, which was pre-trained on COSMO-RS data achieving an R2 of 0.92 and RMSE of 1.04 log P units. Compared to previous SAMPL challenges, all contributions displayed large deviations in predicting the toluene/water partition coefficient. These large deviations emphasize that further research is needed to develop accurate and reliable methods for modeling solvent effects on small molecule transfer-free energies.

Factors influencing time management skills among nurses in North West Bank, Palestine.

BACKGROUND: In today's companies, time management abilities have grown as a significant predictor of nurses' success. Organizations have simplified their internal operations and flattened their organizational structures in an effort to increase productivity and cut expenses. As a result, successful time management skills are particularly crucial for nurses in recently restructured healthcare organizations. This study aimed at exploring factors influencing time management skills among Palestinian nurses. METHODS: Cross-sectional quantitative study of all nurses (715) working in private and government hospitals and primary healthcare centers in north Palestine was conducted. Time management skills were measured on a continuous scale using the Nursing Time Management Scale (NTMS), Arabic version. The scale measures various aspects of time management including goal setting, planning, scheduling, and organizing activities. The relationship between time management skills and background variables was assessed using the multivariate linear regression. RESULTS: The average total score for NTMS scale was 63.39 out of a total score of 90. This score indicates relatively good time management skills among the respondents. The multivariate linear regression results showed that females obtained slightly lower scores than males, coefficient = -2.36, p = 0.043. Nurses in primary care centers had significantly higher scores than nurses who work at hospitals, coefficient = 4.47, p = 0.004. The type of healthcare organization emerged as a significant factor predicting time management skills. Nurses in private hospitals had worse time management skills than nurses in government hospitals, coefficient = -12.27, p < 0.001. Nurse supervisors had better time management skills than staff nurses, coefficient = 4.01, p = 0.023. Nurses working in non-teaching hospitals had worse time management skills than nurses in teaching hospitals, coefficient = - 3.86, p = 0.001. Nurses who did not attend a time management course had worse time management skills than nurses who attended time management course, coefficient = - 4.05, p = p < 0.001. CONCLUSIONS: Healthcare institutions should consider organizational and individual factors to improve the time management skills of their staff. Time management training interventions are proven and effective policies that are recommended to be adopted by all healthcare centers.

Perception of Jordanian pharmacy students towards community pharmacy-virtual training experience during COVID-19 outbreak

Background: This study aims to assess the perception of pharmacy students towards this new modality of training during CoViD-19 period. Methods: Senior pharmacy students were included in this study. Accredited and certified community pharmacy preceptors were asked to simulate the community pharmacy training and record that as videos, which were evaluated and assessed by expert academics before being delivered to students. A validated online questionnaire was then distributed for self-administration electronically to evaluate their perception. Results: A convenience sample (n=109) of senior pharmacy students were recruited. The majority of the participants were females (70.6%) and the median age of students was 22.0 years (IQR= 1). Around half of the participants showed positive perceptions towards the virtual training module and the pharmacy training preceptors. A 46.8% of the students benefited from the virtual training in time management, and 43.1% in developing lifelong learning skills. The absence of eye contact during the learning was the most important barrier revealed by the students (52.3%). Half of the students agreed/strongly agreed that combining the virtual and conventional techniques for future training would improve training outcomes. Conclusion: While students had an overall positive experience, there were many hurdles that need to be addressed, such as lack of communication and technical support. This spot the light on the crucial need to continually improve and redesign our experiential education; to achieve optimum learning outcomes for students. (AU)

Genome sequencing identifies coding and non-coding variants for non-syndromic hearing loss.

Hearing loss (HL) is a common heterogeneous trait that involves variants in more than 200 genes. In this study, we utilized exome (ES) and genome sequencing (GS) to effectively identify the genetic cause of presumably non-syndromic HL in 322 families from South and West Asia and Latin America. Biallelic GJB2 variants were identified in 58 probands at the time of enrollment these probands were excluded. In addition, upon review of phenotypic findings, 38/322 probands were excluded based on syndromic findings at the time of ascertainment and no further evaluation was performed on those samples. We performed ES as a primary diagnostic tool on one or two affected individuals from 212/226 families. Via ES we detected a total of 78 variants in 30 genes and showed their co-segregation with HL in 71 affected families. Most of the variants were frameshift or missense and affected individuals were either homozygous or compound heterozygous in their respective families. We employed GS as a primary test on a subset of 14 families and a secondary tool on 22 families which were unsolved by ES. Although the cumulative detection rate of causal variants by ES and GS is 40% (89/226), GS alone has led to a molecular diagnosis in 7 of 14 families as the primary tool and 5 of 22 families as the secondary test. GS successfully identified variants present in deep intronic or complex regions not detectable by ES.

Psychometric properties of Nursing Time Management Scale (NTMS), Arabic version.

Despite the presence of numerous generic time management instruments, relatively few research articles have assessed the validity and reliability of time management skills specific for the nursing profession. This study aimed at developing and validating a time management scale for nurses.Method A self-administered questionnaire was administered to 715 nurses working in hospitals and clinics in the northern region of the West Bank, Palestine. The scale was examined through exploratory factor analysis, reliability measures, and correlations with other scales.Results The scale revealed a 3-factor structure 1) organization of nursing work 2) planning and goal setting and 3) coordination of nursing work. The scale demonstrated excellent psychometric properties.Conclusions The Nursing Time Management Scale (NTMS) is a valid and reliable measure that can be used in assessing time management skills of nurses and in evaluating interventions and training modules aiming at developing nurses' time management skills.

Thyroid autoimmunity and autoimmune thyroid disease in Malaysian girls with Turner syndrome: An understudied population.

AIMS: Knowledge on the spectrum of thyroid disorders amongst Turner syndrome (TS) patients in Southeast Asia is limited. This study aimed to evaluate the prevalence of thyroid autoimmunity, the spectrum of autoimmune thyroid disease and association with age and karyotype amongst Malaysian TS girls. METHODS: A cross-sectional study was conducted at 11 paediatric endocrine units in Malaysia. Blood samples for antithyroglobulin antibodies, antithyroid peroxidase antibodies and thyroid function test were obtained. In patients with pre-existing thyroid disease, information on clinical and biochemical thyroid status was obtained from medical records. RESULTS: Ninety-seven TS patients with a mean age of 13.4 ± 4.8 years were recruited. Thyroid autoimmunity was found in 43.8% of TS patients. Nineteen per cent of those with thyroid autoimmunity had autoimmune thyroid disease (Hashimoto thyroiditis in 7.3% and hyperthyroidism in 1% of total population). Patients with isochromosome X and patients with 45,X mosaicism or other X chromosomal abnormalities were more prone to have thyroid autoimmunity compared to those with 45,X karyotype (OR 5.09, 95% CI 1.54-16.88, P = 0.008 and OR 3.41, 95% CI 1.32-8.82, P = 0.01 respectively). The prevalence of thyroid autoimmunity increased with age (33.3% for age 0-9.9 years; 46.8% for age 10-19.9 years and 57.1% age for 20-29.9 years) with autoimmune thyroid disease detected in 14.3% during adulthood. CONCLUSION: Thyroid autoimmunity was significantly associated with the non 45,X karyotype group, particularly isochromosome X. Annual screening of thyroid function should be carried out upon diagnosis of TS until adulthood with more frequent monitoring recommended in the presence of thyroid autoimmunity.

A comprehensive overview of substance abuse amongst Syrian individuals in an addiction rehabilitation center.

Objectives: This study aims to provide a comprehensive overview of substance abuse amongst Syrian individuals in an addiction rehabilitation center. Methods: This is a descriptive cross-sectional survey-based study, from patients receiving treatment in an addiction rehabilitation center in Damascus. Syria. The study was conducted over a period of nine months. Results: A total of 82 participants were recruited, the majority of them were males (n = 78.95.1%). More than half of those investigated reported multi-level failure (n = 46, 56.1%) during their education. Most of the participants (n = 44, 53.7%) started to use drugs at a friend's home. The family was shown to play a positive role in stopping the initial drug taking trials at early stages (33/56, 58.9%). Again, friends' effect was the main reason for the return of abusing drugs (20/56, 35.7%). Sources of drugs were mainly from drug promoters for most of the participants (n = 58, 70.7%) followed by friends (n = 28, 34.1%). Participants revealed that taking drugs were mostly accompanied by additional habits such as cigarette smoking before using their drugs (n = 65, 79.3%), or drinking alcohol (57.3%). Surprisingly, participants believed that drug abuse does not lead to addiction (n = 52, 63.4%). The most common experienced feeling was depressed, desperate, or sad (n = 47, 57.3%), followed by anxiety and the desire to escape reality and resort to imaginations (n = 44, 53.7%). Conclusions: The findings of this study indicate the need of policymakers to give more attention, in developing preventive strategies, to friends, as a main cause of addiction, in addition to the family influences on individual's drug abuse, addiction behaviors, and mindsets. Understanding the influencing factors could spot the light on the key to solve the addiction problem. A realist rehabilitation programs must be well designed and implemented as the level of individuals, institutions and communities to face this problematic addiction disaster.

Evaluating the Difference in Neuropsychological Profiles of Individuals with FASD Based on the Number of Sentinel Facial Features: A Service Evaluation of the FASD UK National Clinic Database.

(1) It might be implied that those with Fetal Alcohol Spectrum Disorder (FASD) with fewer sentinel facial features have a "milder" neuropsychological presentation, or present with fewer impairments than those with more sentinel facial features. The aim of this service evaluation was to compare the neuropsychological profile of people with FASD with varying numbers of sentinel facial features. (2) A clinical sample of 150 individuals with FASD, aged between 6 and 37 years, completed various standardised assessments as part of their diagnostic profiling. These included the documented level of risk of prenatal alcohol exposure (4-Digit Diagnostic Code), sensory needs (Short Sensory Profile), cognition (Wechsler Intelligence Scale for Children-4th Edition; WISC-IV), and communication and socialisation adaptive behaviours (Vineland Adaptive Behavior Scale-2nd Edition; VABS-II). As FASD has high comorbidity rates of Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), these were also reviewed. The profiles of the 'FASD with 2 or 3 sentinel facial features' group (n = 41; 28 male, 13 female) were compared with the 'FASD with 0 or 1 sentinel facial features' group (n = 109; 50 male, 59 female) using Chi² tests, independent sample t-tests, and Mann-Whitney U analyses (where appropriate). (3) There were no significant differences between the two comparison groups across any measure included in this service evaluation. (4) Whilst sentinel facial features remain an important aspect in recognising FASD, our service evaluation indicates that there is no significant relationship between the number of sentinel facial features and the neuropsychological profile of people with FASD in terms of severity of presentation.

Fetal alcohol spectrum disorders.

Alcohol readily crosses the placenta and may disrupt fetal development. Harm from prenatal alcohol exposure (PAE) is determined by the dose, pattern, timing and duration of exposure, fetal and maternal genetics, maternal nutrition, concurrent substance use, and epigenetic responses. A safe dose of alcohol use during pregnancy has not been established. PAE can cause fetal alcohol spectrum disorders (FASD), which are characterized by neurodevelopmental impairment with or without facial dysmorphology, congenital anomalies and poor growth. FASD are a leading preventable cause of birth defects and developmental disability. The prevalence of FASD in 76 countries is >1% and is high in individuals living in out-of-home care or engaged in justice and mental health systems. The social and economic effects of FASD are profound, but the diagnosis is often missed or delayed and receives little public recognition. Future research should be informed by people living with FASD and be guided by cultural context, seek consensus on diagnostic criteria and evidence-based treatments, and describe the pathophysiology and lifelong effects of FASD. Imperatives include reducing stigma, equitable access to services, improved quality of life for people with FASD and FASD prevention in future generations.

Colonoscopy Colorectal Cancer Screening Programme in Southern Iraq: Challenges, Knowledge Gaps and Future Potential.

Data on current colorectal cancer screening practices in Iraq are limited. This study aimed to better understand the current colorectal cancer screening practice and perceived barriers. The project also aimed to use UK expertise to introduce Bowel Cancer Screening Programme (BCSP) in Basra, Iraq. The study consisted of two parts: A pre-visit online survey of clinicians to test the project's feasibility. A public survey was conducted to understand and gauge the general knowledge and perceived barriers to having colorectal cancer screening. The second phase included a short visit to Basra and the delivery of a multidisciplinary meeting for bowel screening colonoscopists. Fifty healthcare providers completed the survey. Basra has no established bowel cancer screening programme, let alone the country. Opportunistic colonoscopy surveillance is done on an ad hoc base. A total of 350 individuals completed the public survey. The survey showed that more than 50% of participants were not familiar with the concept of a BCSP and less than 25% were aware of "red flag" symptoms of bowel cancer. The short visit to Basra included a roundtable discussion and delivered a training workshop for screening colonoscopists using UK training materials in conjunction with the Iraqi Medical Association. Feedback from the course was extremely positive. Several potential barriers were identified to participate in BCSP. The study highlighted potential barriers, including a lack of public awareness and insufficient training resources to be addressed in future screening programmes. The study has identified several potential areas for future collaboration to support the development of a BCSP centre in Basra.

Synthesis, structure and luminescence properties of bifunctional KCaF3 phosphor influenced by incorporating Eu3+ ions for solid state lighting and TL dosimetry applications.

Europium doped KCaF3 phosphors (KCaF3:Eu3+) were prepared using various concentrations of Eu3+ by conventional solid-state reaction process. The X-ray diffraction (XRD) studies confirmed the formation of orthorhombic structured KCaF3:Eu3+ phosphors. Scanning Electron Microscopy (SEM) image of the synthesized phosphor exhibits agglomerated particles with irregular shapes. The composition of the synthesized sample was determined by Energy Dispersive Spectroscopy (EDS) spectrum and elemental mapping showed the homogeneous dispersion of Eu3+ ions into the synthesized KCaF3:Eu3+ phosphor. The emission peak intensity at 594 nm from photoluminescence (PL) spectra was found to increase with the increase of Eu3+ concentrations from 0.02 mol% to 0.06 mol% and decreased with the further increase of Eu3+ concentration up to 0.1 mol%. CIE1931 chromaticity diagram coordinates (x, y) of KCaF3:(0.06 mol%) Eu3+ phosphors were positioned in the reddish-orange region (x = 0.5736, y = 0.4224). Photoluminescence property confirms the suitability of KCaF3:Eu3+ phosphors for Solid state lighting application. X-ray induced luminescence (radioluminescence, RL) is recorded for KCaF3:Eu3+ phosphors showing the characteristic emission of Eu2+ and Eu3+. ESR study on KCaF3:Eu3+ phosphors confirm the presence of Eu2+ ions. Beta irradiated thermoluminescence (TL) glow curve of Eu3+ doped KCaF3 phosphors is measured and deconvoluted using Gaussian fitting. TL kinetic parameters like activation energy (Ea) and frequency factor (s) are calculated for all the deconvoluted peaks using peak shape method which shows the synthesized KCaF3:Eu3+ phosphors is suitable for dosimetry application.