Articles

This study developed a co-design model for integrating children’s drawings into textile design and production within Ghana’s Creative Arts and Design (CAD) curriculum. Using a qualitative research design informed by Design-Based Research, the study involved 24 teachers and 120 visual artworks produced by pre-school and primary school learners from the northern, central, and southern zones of Ghana. Through co-design sessions, learners engaged in establishing narratives, contextual reflection, ideation, and low-tech prototyping to transform their artworks into textile designs and products. The findings informed the development of a context-specific model comprising three iterative phases and six textile design stages: motif, trace, transfer, arrange, colour, and texture. The model provided opportunities for learners to develop creativity, critical thinking, problem-solving, collaboration, decision-making, and practical design skills while expressing their cultural identities and everyday experiences. The study concluded that integrating co-design into the CAD curriculum can promote child-centred, culturally responsive, and inclusive learning while positioning children as active design partners. The study recommended incorporating the model into pre-school and primary school teaching practices to strengthen creative learning and practical textile design education in Ghana.

Bronchogenic cysts are rare anomalies of the tracheobronchial tree. These are fluid-filled lesions most commonly located in the mediastinum, and less frequently demonstrate communication with the respiratory tract. Diagnosis is typically made prenatally or incidentally on chest radiography during evaluation of respiratory infections. Because of the risk of infection or malignant transformation, bronchogenic cysts require urgent surgical intervention – either excision in cases without communication to the tracheobronchial tree, or pulmonary resection when the cyst is located within the lung parenchyma. We present a clinical case of a two-year-old child who underwent surgical treatment via video assisted thoracoscopic surgery (VATS) for two incidentally diagnosed bronchogenic cysts. Minimally invasive surgical techniques offer several advantages, including substantially decreased postoperative pain, accelerated mobilization and functional recovery, and earlier resumption of normal physical activities.

Background: Enamel pearls are developmental anomalies consisting of ectopic enamel, with or without dentine and pulp tissue. They most commonly occur on maxillary second and third molars and are less frequently associated with mandibular third molars. Although they may have periodontal implications, their anatomical location can also influence surgical management. Case report: A 32-year-old female was referred with recurrent episodes of pain and inflammation associated with the mandibular third molars. Both lower third molars were partially erupted and mesioangular, with no active pericoronitis or periodontal pathology at presentation. An orthopantomogram demonstrated an intimate relationship between both mandibular third molars and the inferior dental canals. Subsequent cone beam computed tomography (CBCT) demonstrated three convergent roots associated with the mandibular right third molar and an enamel pearl arising from the mesial root and extending lingually around the middle third of the root. The inferior dental canal demonstrated pronounced narrowing and deviation around the tooth, with the enamel pearl extending into the canal and towards the lingual cortical plate. The mandibular left third molar also demonstrated an intimate relationship with the inferior dental canal. Management and outcome: The increased risk of inferior alveolar nerve injury associated with surgical removal was discussed alongside the options of observation, coronectomy and complete extraction. Following informed discussion, the patient elected to monitor the mandibular third molars. The carious maxillary third molars were subsequently removed under local anaesthesia. Conclusion: This case highlights an unusual enamel pearl associated with a mandibular third molar and its potential implications for third molar surgery. CBCT provided important three-dimensional information regarding the relationship between the enamel pearl, tooth roots and inferior dental canal, facilitating risk assessment, treatment planning and informed patient decision-making.

Route-optimization models for hazardous-materials freight now routinely combine safety risk and environmental cost within a single multi-objective function, using increasingly sophisticated methods, genetic algorithms, entropy weighting, robust bilevel formulations, to balance the two. This article identifies a problem the weighting sophistication has not addressed: every reviewed model computes the emissions or fuel-consumption term as a fixed function of route distance, speed, and cargo load, treating the vehicle's combustion efficiency as a fixed constant that does not change with fuel-system operating condition. Engine-reliability data show fuel-system failure concentrated enough within heavy-duty diesel engines to make that constant-efficiency assumption a modeling choice, not an empirical fact. The article argues that improving how risk and emissions objectives are weighted against each other addresses a different problem from improving the fidelity of what generates the emissions number in the first place, and that current research effort concentrates almost entirely on the former. Closing that gap requires an emissions term that responds to a vehicle-condition input the reviewed literature currently has no place for, a distinction with direct consequences for how much confidence a Pareto-optimal hazmat route actually deserves.

Background: Malawi has a rudimentary NHS providing government-funded haemodialysis for approximately 100 patients. Aim: To explore the feasibility of establishing a peritoneal dialysis (PD) service in Malawi. Methods: An explorative, qualitative design was used. Face-to-face interviews collected data from 16 patients and 9 healthcare professionals. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Results: Understanding of dialysis was excellent. Many of the nurses had provided PD in the past. Lack of surgical and community expertise; risk of infections when living conditions are poor and availability of affordable consumables were identified as potential barriers. Patients were self-motivated and welcomed a home-based regimen with cost-savings on travel. PD was viewed as an opportunity to expand dialysis provision, especially for those who live remotely. Conclusion: There is need and willing to expand renal services in Malawi. Accurate, transparent records of renal disease and allocation of dialysis provision are essential. This must be prioritized in plans to improve renal care. PD could provide an effective dialysis modality. Concerns regarding education, sanitation and consumables are not unsurmountable.

Background: Adjacent segment disease (ASD) is a well‑recognised long‑term complication of lumbar spinal fusion, with the L5/S1 segment being particularly vulnerable when fusion terminates at L5. Data from resource‑constrained Nigerian centres on the incidence, features, and outcomes of L5/S1 ASD are scarce. This study evaluated the specific features, outcomes, and predictors of L5/S1 ASD following lumbar spine surgery at a Nigerian tertiary centre. Methods: A retrospective cohort study of 311 patients who underwent lumbar spine surgery with fixation terminating at L5 at the National Orthopaedic Hospital Dala, Kano, from January 2019 to June 2025 was conducted. Sixty‑three patients (20.3%) developed ASD over a minimum 1‑year follow‑up. Outcomes assessed included specific ASD features, management strategy (surgical vs conservative), patient satisfaction, and predictors of ASD and satisfaction. Results: The most common ASD features were disc degeneration (82.5%), facet joint arthropathy (68.3%), spinal stenosis (55.6%), and spondylolisthesis (36.5%). Twenty‑eight patients (44.4%) underwent surgical extension to S1, with 3 (4.8%) requiring additional S2AI screw fixation. The remaining 35 patients (55.6%) were managed conservatively. Surgical patients had significantly better pain relief (VAS 2.8±1.4 vs 4.6±1.8, p<0.001) and functional outcomes (ODI 28.4±12.6 vs 42.6±15.2, p<0.001). Patient satisfaction was reported by 48 patients (76.2%), with surgical management (OR 3.2, 95% CI: 1.4–7.3) and shorter symptom duration (OR 2.6, 95% CI: 1.1–6.1) being independent predictors of satisfaction. Predictors of ASD included: fusion length ≥3 levels (OR 3.4, 95% CI: 1.6–7.2), preoperative disc degeneration at L5/S1 (OR 2.8, 95% CI: 1.3–6.1), and age >55 years (OR 2.4, 95% CI: 1.1–5.2). Conclusions: L5/S1 ASD occurs in 20.3% of patients following lumbar fusion terminating at L5. Surgical extension to S1 with or without S2AI screws provides superior outcomes compared with conservative management. Fusion length, preoperative L5/S1 degeneration, and older age are significant predictors of ASD.

This study examines the perceived effectiveness of remedial pedagogical measures implemented in Cameroonian secondary schools following the OTS ("On a Trop Supporté") teachers' movement, which has caused prolonged disruptions to instruction since 2022. Employing a mixed-methods research design involving 286 participants (234 students, 30 teachers, and 22 administrators) from two high schools in the city of Dschang, Cameroon, this study analyzes—through structured questionnaires and semi-structured interviews—how school stakeholders perceive pedagogical support measures (remedial classes, additional tutorials, educational materials, and distance learning). The results show that while these measures contributed significantly to improved academic performance (44.5% of variance explained), their effect remains limited regarding, on the one hand, student motivation and engagement, and on the other, teachers' intentions to engage in collective action—which are influenced by perceptions of organizational constraints and a sense of hierarchical threat. On this basis, the present study suggests that the success of post-crisis remedial measures depends as much on organizational and relational conditions as on their pedagogical content, calling for a more collaborative approach to managing educational crises.

Decentralized control loops are widely credited with improving system resilience, on the reasoning that removing a central point of coordination also removes a central point of vulnerability. This article separates two properties that applied literature on decentralized architecture routinely conflates: bounded fault tolerance, the capacity of a control architecture to remain stable when an individual loop or node is switched off or corrupted in isolation, and network-level resilience, the capacity to recover from correlated disturbances such as communication loss, targeted compromise, or cascading propagation across dependency chains. Reviewing control-theoretic stability results alongside consensus and infrastructure-resilience research shows that the first property follows from specific, testable structural conditions: a steady-state gain condition in one case, a minimum-neighbor redundancy count in another. These conditions come in different strengths depending on whether the disturbance is benign disconnection or active compromise, a distinction the second property depends on and that decentralization leaves for the designer to resolve. The analysis concludes that a resilience claim attached to a decentralized control loop is a claim about a specific structural parameter matched to a stated disturbance model, a parameter whose verification requires evidence beyond the topology itself.

In this paper, we focus on human stature, which reflects both genetic inheritance and environmental influences, particularly nutrition. This study introduces a variable-order fractional Caputo model that integrates genetic contributions, nutritional dynamics, and demographic modifiers. By allowing the fractional order α(t) to vary with age, the model captures hereditary memory and delayed responses to environmental changes. Because analytical solutions for such models are rarely feasible, the predictor–corrector scheme was adopted. This method, combining an explicit Adams–Bashforth predictor with an implicit Adams–Moulton corrector, was chosen for its efficiency, stability, and adaptability to variable-order problems. Numerical simulations closely reproduce the WHO Child Growth Standards with minimal error, confirming the reliability of the approach. The study demonstrates that the strength of fractional modeling lies not only in its theoretical framework but also in the numerical method that makes it practical and applicable to pediatric endocrinology, nutrition policy, and family counseling.

Lifecycle architectures for rental fleets couple pricing, vehicle assignment, maintenance scheduling and disposal timing, and the profit they add over revenue-based scoring has two sources that behave differently. Mileage steering changes the odometer reading at which a vehicle reaches disposal, and decision-focused forecast training reduces ranking regret at that point. Both sources matter only where the cost-optimal disposal mileage lies within a band around an odometer mark at which wholesale prices drop. The band half-width equals the residual-value forecast error divided by the slope of the retention margin. On realized retirements of midsize sedans at one enterprise rental operator, 28.2% of vehicles fall inside the band. Coupling adds $206 to $228 per vehicle there and $7 to $13 elsewhere, differences indistinguishable from zero. Mileage steering supplies 60.7% of the premium and survives a step-aware forecaster; the decision-focused component falls from $67.60 to $8.20 once the forecaster learns the price drops. Richer telematics raise profit by $86 to $118 per vehicle in every cell, so architecture and data are separable contributions. Operators can restrict the cost of coupling to vehicles inside the band.

Fleet management systems increasingly fold a vehicle's predicted mechanical condition into the same decision that assigns it to a delivery, a route, or a shift, treating the health signal as one more input alongside distance and time windows. This article derives the condition under which that practice improves fleet-level outcomes instead of relocating cost from one part of the fleet to another. Two bodies of prior work bear on the question without meeting: optimization research that couples maintenance forecasts with routing decisions treats forecast reliability as fixed, while cost-benefit research on prognostics quantifies how forecast error erodes value only up to the maintenance-scheduling decision. Reading the two together yields a closed-form breakeven inequality linking a diagnostic classifier's recall and false-positive rate to the ratio between a missed-failure cost and a false-exclusion cost, scaled by the fleet's base fault rate. Applied to published component-level classifier performance and to two documented vehicle telemetry regimes, the inequality holds comfortably for every heavy-duty component category under baseline operating costs, producing a positive net benefit at each, but flips sign for a constrained on-board-diagnostic regime once exclusion cost and base fault rate shift toward values realistic for a tightly scheduled light-duty fleet, generating a measured net loss per dispatched vehicle. The result identifies fleet heterogeneity in sensing infrastructure as the variable that determines whether condition-aware dispatch pays for itself.

Background: Type 2 diabetes requires sustained self-care, yet the relationship between specific self-care behaviors and quality of life may vary across populations and care contexts. Evidence focused on Filipino men remains limited. Objective: To describe dietary, exercise, medication, and glucose-monitoring adherence and examine their relationships with quality of life among Filipino men with type 2 diabetes in Manila, Philippines. Methods: This quantitative cross-sectional study analyzed questionnaire data from 31 adult Filipino men with type 2 diabetes. Seven adapted diabetes self-care items assessed diet, exercise, medication use, and home glucose monitoring. Quality of life was assessed with the World Health Organization Quality of Life-BREF. Descriptive statistics and two-tailed Pearson correlations were used. Results: Overall self-care adherence was moderate (M = 3.00). Dietary adherence (M = 3.11) and exercise adherence (M = 3.02) were moderate, whereas the combined medication and glucose-monitoring domain was low (M = 2.57). Mean quality of life was moderate (M = 3.11). Diet (r = -.002, p = .99), exercise (r = .31, p = .09), and medication/glucose-monitoring adherence (r = -.006, p = .97) were not significantly correlated with quality of life. Conclusion: The findings identify actionable gaps in structured exercise, medication-taking, and glucose monitoring but do not support a statistically significant relationship between measured self-care adherence and quality of life. Larger, analytically robust studies should examine clinical, psychological, social, and economic determinants alongside self-care.

Water management is a critical challenge for uranium processing operations in arid regions, where industrial activities depend heavily on limited groundwater resources. This study evaluates the performance of the filter cloth washing water recycling circuit at the Aïr Mining compagny (SOMAÏR) uranium processing plant in Niger and identifies the principal factors limiting continuous water reuse. The investigation combined operational water-flow monitoring, historical production records, field sampling from Pit 3, physicochemical characterization of recycled water, suspended-solids determination, and particle-size analysis. Under normal operating conditions, the recycling circuit achieved an average recycling efficiency of 57.5%, corresponding to approximately 850 m³/day of industrial water savings. The recycled water exhibited a density of 0.994 g/cm³, pH of 2.53, oxidation- reduction potential of 480 mV, and suspended-solids concentration of 2052 mg/L. Particle-size analysis showed that approximately 97.6% of the suspended particles were smaller than 200 μm, allowing a substantial fraction of solids to bypass the 250 μm vibrating-drainer screen and accumulate in Decanter 1. Progressive sediment accumulation, together with screen deterioration and mechanical limitations, reduced clarification capacity and ultimately interrupted the recycling circuit. Engineering measures including improved fine-particle separation, optimization of screen aperture, systematic screen maintenance, improved sludge removal, and continuous monitoring are therefore proposed. These measures could enhance recycling reliability, reduce freshwater consumption, and improve water- management sustainability at SOMAÏR.

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal morbidity and mortality, with a disproportionate burden in low- and middle-income settings such as Bangladesh. This study assessed knowledge and attitude regarding hypertension prevention among pregnant women at a private hospital in Dhaka and their association with socio-demographic characteristics. Methods: A descriptive cross-sectional study was conducted among 122 pregnant women attending antenatal care at Ashulia Women and Children Hospital, Dhaka, using systematic random sampling. Data were collected via face-to-face interviews using a pre-tested, bilingual, structured questionnaire (10-item knowledge and 10-item attitude scales; Cronbach's alpha 0.814 and 0.795). Scores were dichotomized as low (≤50%) or high (>50%). Chi-square tests examined associations with socio-demographic variables (p<0.05). Results: Overall, 50.8% of women had high knowledge and 60.7% had a favorable attitude toward hypertension prevention; 63.9% had a high combined perception score. Knowledge was significantly associated with age (χ²=18.177, p<0.001), highest among women aged 20-29 years. Attitude was significantly associated with number of children (χ²=9.545, p=0.023), most favorable among women with two children. Education and occupation showed no significant association with either. Gaps persisted around dietary intervention, organic foods, and bed rest, despite high perceived importance of prevention (81.1%) and social media influence (81.1%). Conclusion: Knowledge and attitude toward hypertension prevention were moderate to favorable, with age and family size as the key socio-demographic correlates. Age-specific and family-inclusive education, potentially via social media, may be more effective than broadly targeted interventions.

Background: Hospital-acquired infections (HAIs) caused by multidrug resistant (MDR) bacteria are a major public health problem especially in resource-limited settings. Local data on antimicrobial resistance (AMR) are crucial to inform empirical therapy and infection prevention. Objectives: To identify bacterial pathogens causing HAIs, determine their AMR profiles and independent risk factors for MDR infections in a tertiary hospital in Erbil City, Iraq. Materials and Methods: A cross-sectional study was done at Hawler Teaching Hospital between January and June 2026. Standard microbiological methods were used to analyse 200 clinical specimens from patients with HAIs (≥48 hr after admission). Antimicrobial susceptibility testing was performed according to CLSI 2024 guidelines. MDR was defined as nonsusceptibility to at least one agent in three or more antimicrobial classes. Multivariate logistic regression was used to assess independent risk factors. Results: Bacterial growth was obtained in 149 of 200 specimens (74.5%). The major pathogens were Escherichia coli (31.5%), Klebsiella pneumoniae (23.5%), Staphylococcus aureus (21.5%), Pseudomonas aeruginosa (14.1%) and Acinetobacter baumannii (6.1%). In total, 69.1% of the isolates were MDR, with the highest rates in K. pneumoniae (80.0%) and A. baumannii (77.8%). Independent predictors of MDR infection were previous antibiotic use (AOR=4.45), ICU admission (AOR=3.92), and hospitalization >7 days (AOR=3.10). Conclusion: This study documented a significant burden of MDR-HAIs in Erbil City and determined modifiable clinical risk factors. The findings provide evidence to support antimicrobial stewardship, infection prevention and AMR surveillance in Iraqi healthcare settings.

This study investigates the spatial and temporal dynamics of shoreline deformation along the San Bartholomeo River over 30 years (1995–2025) using an integrated geospatial approach. The research combines Interferometric Synthetic Aperture Radar (InSAR) and Digital Shoreline Analysis System (DSAS) techniques to quantify both vertical land motion and horizontal shoreline change. Results reveal a decline in land area from 32.622 km² (56.65%) in 1995 to 30.284 km² (52.59%) in 2025, alongside an increase in water body extent, indicating progressive shoreline retreat. Shoreline change rates varied significantly, with erosion reaching −8.04 m/yr and accretion up to 16.73 m/yr. Net Shoreline Movement (NSM) and Shoreline Change Envelope (SCE) analyses further highlighted zones of persistent erosion and high variability. InSAR-derived deformation patterns confirmed the presence of subsidence contributing to shoreline instability. The findings demonstrate that a combination of hydrodynamic forces, sediment imbalance, and anthropogenic activities drives shoreline deformation in the study area. This study contributes to improved shoreline monitoring by integrating vertical and horizontal deformation metrics, providing a robust framework for sustainable shoreline management in deltaic environments.

Heterotaxy syndrome comprises a group of congenital anomalies resulting from disrupted left-right axis patterning during embryonic development, leading to an abnormal arrangement of the thoracic and abdominal organs [1]. It is a rare condition, with an estimated prevalence of approximately 1 per 10,000 live births, and is frequently associated with complex congenital heart defects, making it a life-threatening disorder with significant morbidity and mortality [1]. Clinically, heterotaxy syndrome is classified into right atrial isomerism (Ivemark syndrome) and left atrial isomerism. Ivemark syndrome represents the most severe form and is primarily characterized by asplenia, complex cardiovascular anomalies, and abnormal positioning of the thoracoabdominal organs [2]. In this condition, paired organs exhibit right-sided morphology bilaterally, commonly accompanied by functionally univentricular physiology, extensive septal defects, dextrocardia, and extracardiac malformations such as intestinal malrotation and congenital absence of the spleen [2,3]. Asplenia is a hallmark feature that markedly increases susceptibility to overwhelming bacterial infections, while the associated congenital heart defects account for the high morbidity and mortality observed during the neonatal period [2]. Herein, we report the case of a male neonate with clinical and imaging findings consistent with Ivemark syndrome who experienced a rapidly progressive and fatal clinical course during the first week of life. A comprehensive review of the available literature identified only a limited number of published cases and scarce documented evidence. Therefore, this case report is supported primarily by the currently available international literature.

This study utilized a qualitative approach to completely ascertain Junior High School Social Studies teachers’ knowledge, strategies and tools used in formative assessment. This study employed a qualitative approach. The study, which was based on a qualitative paradigm, used a phenomenological research methodology to investigate the lived experience and acuity of formative assessment procedures. A selected sample of nine (9) Junior High School Social Studies teachers was chosen based on their academic credentials and professional teaching experience. A focus group discussion was employed to gather data, which was then thematically examined in light of the research questions. The results showed that the participants had a robust knowledge and were adept at using formative assessment strategies and tools in Social Studies lesson. It was recommended that pre-service and in-service teachers should be allowed to use formative assessment techniques sparingly. The National Teaching Council seminars ought to focus on how Junior High School Social Studies teachers can effectively use formative assessment techniques to enhance instruction.

This study presents a physics-based parametric optimization framework for thermoelastic energy harvesting from cyclic temperature variations using a cylindrical AISI 4340 steel rod. The model couples thermoelastic force and displacement, Euler buckling and yielding constraints, lumped-capacitance heat transfer, and mass-power multi-objective optimization. The feasible design space was evaluated as a function of rod diameter, length, temperature change, and load-transfer parameter. The results show that Euler buckling governs the practically relevant portion of the design space at moderate temperature changes, whereas yielding becomes increasingly restrictive at higher thermal loads. The Pareto-optimal solutions exhibit a clear mass-power scaling law, with the analytical prediction P_avg ∝ m^2/3 closely reproduced by the numerical fit (n = 0.66717, R² = 0.999999). Under the baseline condition λ = 0.50, the maximum-power design produces approximately 0.16624 W, while a distance-to-ideal criterion identifies a substantially lighter compromise design with m = 223.0 kg and P_avg = 0.09231 W. Refined optimization gives λ_opt = 0.473 and P_max = 0.170454 W, indicating a power penalty of only 2.47% when the simpler λ = 0.50 condition is used. Grid-refinement tests show changes below 0.006% in maximum power and below 0.5% in the compromise-design mass between the 250 × 250 and 500 × 500 grids. The results establish compact scaling and optimization rules for balancing structural stability, thermal response, mass, and average mechanical power in thermoelastic energy-harvesting elements.

Background: The rising prevalence of diabetes mellitus and its adverse effects on pregnancy outcomes have made pre-pregnancy care (PPC) a critical component of diabetes management among women of reproductive age. Diabetes poses significant risks during pregnancy, but PPC provides an opportunity to prevent complications. Despite these benefits, Nigerian women of childbearing-age living with diabetes still miss out on these advantages due to poorly defined and imperfect integration of PPC into the country’s healthcare system by Health Birth professionals (HBPs). Therefore, their understanding of PPC and the integration of PPC into routine diabetes management practices for childbearing women is essential. The study, therefore, aims to explore HBPs’ provision of PPC for women with pre-existing diabetes in Lagos, Nigeria. Methodology: A qualitative exploratory research design was conducted at two tertiary health institutions in Lagos. A total of 20 participants were purposively selected among doctors and nurse/midwives. The data collected through in-depth semi-structured interviews were transcribed verbatim and analyzed thematically. The trustworthiness of this study was established following the criteria of trustworthiness (credibility, dependability, transferability, and conformability), authenticity was added based on the research worldview. Result: Five themes and eleven subthemes emerged from the analysis. The main themes were clinical importance of PPC for women with diabetes, pregnancy-intention screening for diabetic women, PPC as standard care practice for women with diabetes, raising awareness of PPC, and the enablers of PPC provision. Conclusion: The study emphasized the clinical significance of PPC for women with diabetes; the need for pregnancy-intention screening among diabetic women; the need to make PPC a standard of care for women with diabetes; the importance of raising awareness; and the enablers of PPC. The study highlighted the significance of PPC and the factors that would facilitate its integration PPC into Nigeria's healthcare system. The provision of PPC for women of childbearing potential living with diabetes, as it is key to improving obstetric outcomes and reducing the risks associated with diabetes in pregnancy. It would also be beneficial for leaders at various levels of healthcare institutions to seek the necessary regulatory approvals from the Nigerian government to establish PPC.