Background: Ear infections rank among the most common health presentations in children attending clinics in Iraq and their microbiology continues to evolve. Staphylococcus epidermidis has transitioned from being disregarded as an innocuous commensal organism to a creeping opportunist drug-resistant pathogen, primarily due to its prolific biofilm-forming ability enabling the establishment of chronic and recurrent otitis media that are significantly more resistant to eradication. Objectives: The aim of this study was to identify the prevalence of S. epidermidis, evaluate biofilm genes carriage (icaA/icaD) and their associated factors among children with otitis media in Al-Diwaniyah. Methods: A total of 120 afresh suffering children age between 5-10 years with clinically diagnosed otitis media were enrolled in hospitals through the period between January and May 2024 in Al Diwaniyah City. Swab from the ear were cultured on blood agar and mannitol salt agar. Identification of isolates was performed by standard methods and confirmed with API Staph. Tubes were tested by PCR for icaA and icaD, and disk diffusion was performed to determine antibiotic susceptibility according to CLSI 2024. Results: Staphylococcus epidermidis was isolated from 76 out of the 120 children (63.3%). The predominant risk factor was poor nail hygiene; children with dirty nails had a much higher culture positivity (82.1% vs. 45.5%; OR = 5.42, 95% CI: 2.38–12.35, p <0·001). Bilateral ear involvement was also positively associated (p = 0.012). Conclusion: Staphylococcus epidermidis is an important pathogen in the pediatric otitis media in Al Diwaniyah and must be more than a contaminant. The close link with the bad hygiene of nails gives a very inexpensive and educable form of prevention for the ones who care for it. In addition, our antimicrobial data show that empirical penicillin therapy would otherwise be futile. Thus, it will be recommended that either ciprofloxacin or gentamicin is preferred concerning to the empirical therapy while waiting for definitive culture products.

Addressing the inherent tension between the usability and instructional effectiveness of intelligent multimodal technologies in basic education music classrooms, this review focuses on core music learning activities in compulsory education and adopts a theoretical analysis approach. It constructs a systematic analytical framework consisting of “technological attributes, classroom scenarios, pedagogical pitfalls, and improvement pathways.” The review argues that the value of intelligent technologies in music education does not lie in intensifying technology use, but in establishing structural alignment between technological support and authentic music tasks such as listening, performing, creating, and assessment. To address five prominent pedagogical pitfalls — goal displacement, resource overload, teacher capacity mismatch, suspension of learner agency, and insufficient assessment evidence — this review proposes five corresponding improvement pathways: a competence-based approach, scenario alignment, teacher guidance, activity reconstruction, and evidence construction. The theoretical contribution of this review is to integrate core competencies in music, classroom task design, teachers’ professional judgment, and learning evidence construction into a unified analytical logic, thereby providing a conceptual reference for the digital transformation of music classrooms and for subsequent empirical research.

Global textile supply chains include multiple production stages across different regions, which creates challenges for coordination and monitoring. Limited traceability across these stages results in gaps in visibility and makes verification of material origins and production practices difficult. This study examines traceability systems in multi-tier apparel supply chains, with emphasis on digital documentation frameworks that record supplier transactions, material flows, and production activities. A qualitative analytical approach is used to review documentation practices and traceability mechanisms within international textile production networks. The analysis covers supply chain mapping, documentation structures, and system integration across production tiers. Results indicate that structured traceability records improve visibility, support compliance monitoring, and reduce fragmentation of information among supply chain participants. These systems allow organizations to track production processes with greater consistency and detect irregularities in material sourcing and supplier activities. The study also presents a traceability framework that integrates supplier databases, production records, and digital tracking technologies within a unified system. This framework supports consistent documentation and improves coordination across global apparel supply chains, contributing to transparent and accountable production practices.

This study investigates the state of Qatar in its cyberterrorism-combating endeavors. The research tool designed was a questionnaire. A convenience sample (N = 200) was used, and the majority of participants were older than 35 years old (70.0%): Males and females comprised 80.5% and 19.5%, respectively. The study findings showed that more people identified cyberterrorism as a real threat to national security. Exploring the Qatari youth view on institutional capacities, legal frameworks, and education/community programs. Along with this, the results also show that Qatari institutions are deemed reliable in addressing cyberterrorism, as 89.5% place belief and capability on these institutions. One of the main findings is that an alarming 96.0% agree that decreasing awareness on digital platforms decreases extremist behavior reporting. All respondents agreed that legislation and cooperation at the regional level were required, while fewer supported educating youngsters as an appropriate strategy against digital radicalization. To sum up, the study provides insights into areas to improve upon when it comes to education programs and policy initiatives in preventing cybersecurity threats.

The physicochemical quality of the Tshopo River water before it enters the REGIDESO SA/Kisangani treatment plant in the Democratic Republic of Congo during the year 2024 was the subject of our research. The results show that the water quality of the Tshopo River does not differ significantly between quarters or between seasons in 2024, with p-values of 0.9647 and 0.9793, although there are noticeable differences between periods of heavy and dry rainfall. This is revealed by the results of analyses of more than seven physicochemical parameters, namely pH, turbidity, color, conductivity, temperature, oxidizable matter, and total alkalinity.

Endoscopic polypectomy is the first-line treatment for colorectal polyps. However, this procedure carries an increased risk of bleeding in patients with hemostatic disorders, particularly in the presence of a large pedunculated polyp. We report the case of a 52-year-old man with hemophilia A and associated von Willebrand factor deficiency, admitted for rectal bleeding evolving over the previous year. Laboratory investigations revealed severe iron-deficiency anemia and a reduced factor VIII level. Colonoscopy showed a large pedunculated sigmoid polyp located 50 cm from the anal verge, with a 15 mm stalk and a 30 mm head. A multidisciplinary approach involving gastroenterologists and hematologists allowed endoscopic polypectomy to be performed using a hot snare after hemostatic preparation with coagulation factor concentrates and tranexamic acid, together with prophylactic placement of an end loop. No periprocedural or postprocedural bleeding complications were observed. Histopathological examination revealed a tubulovillous adenoma with low-grade dysplasia, with complete resection and negative margins. This case highlights that endoscopic polypectomy can be safely performed in a hemophilic patient, provided that careful preparation, appropriate hemostatic prophylaxis, and preventive endoscopic techniques are used.

Nepal's construction industry faces persistent challenges including payment delays, contract management inefficiencies, supply chain opacity, and systemic governance failures. Blockchain technology offers potential solutions through smart contracts, immutable record-keeping, and transparent shared ledgers. This paper systematically reviews blockchain applications in construction management and documented challenges in Nepal's construction sector from peer-reviewed studies. The review identifies four primary blockchain applications: smart contracts for payment automation, supply chain traceability, immutable document management, and shared transparent ledgers. Documented challenges in Nepal include payment delays (RII=0.80-0.92), contract management inefficiencies (78.6% expert agreement), low bidding averaging 37.52% below tender prices, NPR 20 billion in outstanding contractor payments, land acquisition taking 2-3 years, tree cutting approval taking 2 years, average project lag of 37 months with only 15% completed on time, and 17 National Pride Projects requiring 41 years to complete at current funding levels. Blockchain can strongly address payment delays, document coordination, supply chain tracking, and transparency. Blockchain technology offers targeted solutions for specific documented challenges in Nepal's construction sector.

Introduction: Mucinous anal adenocarcinoma is a rare and often misleading entity, because its presentation may mimic suppurative perineal disease [abscess/fistula]. We report a case of fistulizing mucinous anal carcinoma diagnosed by endoscopic ultrasound and fine-needle aspiration, and discuss the diagnostic and therapeutic aspects. Case presentation: A 73-year-old man with a history of surgery for an anal fistula [2000] presented with purulent anal discharge associated with mild anal incontinence, without rectal bleeding or bowel habit disorders, and with preserved general condition. Proctological examination found fistulous openings and sphincter hypotonia. Pelvic MRI showed a mass in the left ischioanal fossa fistulizing toward the anal canal. Rectal endoscopic ultrasound showed a heterogeneous pararectal mass measuring 33 × 47 mm, with a fluid component and sparing the rectal wall; histological examination of the fine-needle aspiration sample confirmed mucinous adenocarcinoma. The staging work-up found no secondary lesions. A multidisciplinary decision was made to proceed with chemoradiotherapy, followed by reassessment and surgical discussion according to the clinical course. Conclusion: In the presence of a chronic, recurrent, or complex anal fistula, particularly when associated with a mass, induration, or functional impairment, malignant degeneration should be considered and documented by tissue sampling. MRI and endoscopic ultrasound with fine-needle aspiration/biopsy guide the diagnosis. Management is often multimodal and resembles that of rectal adenocarcinomas, with discussion of neoadjuvant treatment followed by radical surgery such as abdominoperineal resection.

Background: Hypoglycemia in Type 2 Diabetes Mellitus (T2DM) is typically drug-induced. Persistent hypoglycemia after discontinuation of all glucose-lowering agents is rare and suggests alternative etiologies such as insulinoma. Case Presentation: A 56-year-old female with T2DM presented with recurrent fasting hypoglycaemia despite cessation of all oral antidiabetic medications. Initial attribution to sulfonylurea uses delayed further investigation. Persistent hypoglycemia prompted endocrine evaluation revealing endogenous hyperinsulinemia. MRI identified a pancreatic tail lesion consistent with insulinoma. Conclusion: This case highlights diagnostic anchoring bias in diabetic patients and underscores the importance of evaluating persistent hypoglycemia beyond medication-related causes.

Aim/Objective: This study aimed to examine how a buddy-supported onboarding program affected early-career nurses in medical-surgical units, focusing on their integration, perceived support, sense of belonging, confidence, competence, and turnover intention. Background: Early-career nurses often face significant obstacles when they enter clinical practice, including stress, low self-esteem, and a lack of professional support. These difficulties can increase job dissatisfaction and turnover intention, particularly in demanding settings such as medical-surgical units. Many healthcare organizations have adopted buddy-supported onboarding programs to help new nurses integrate, develop professionally, and stay in their roles. Design: The study used a qualitative phenomenological design. Method: The researcher recruited seven registered nurses with fewer than three years of clinical experience in medical-surgical units at King Abdulaziz National Guard Hospital in Al Ahsa, Saudi Arabia, using purposive sampling. Data were gathered through semi-structured, in-person interviews and analyzed thematically using Braun and Clarke’s approach. Results: The analysis produced six themes: structured onboarding supports early adjustment; buddy support acts as an emotional and practical anchor; a sense of belonging develops gradually and depends on team dynamics; psychological safety strengthens learning and confidence; inconsistent support hinders confidence development; and interpersonal and family-related factors shape turnover intention. Conclusions: Buddy-supported onboarding programs can build early-career nurses’ confidence, strengthen their professional integration, and ease their early adjustment. To support nurses’ transition and improve workforce retention, healthcare organizations should reinforce structured onboarding frameworks and ensure consistent coaching.

Forensic science is a broad field that covers a variety of scientific disciplines used to investigate crimes through the examination of physical evidence found at the crime scenes. Evidence can determine if a crime has occurred or not. Evidence is a vital object in all crime scenes, which may exist in the form of solid, liquid or gas. Sometimes, it may be visible or invisible, and most of the impression evidence found at the scenes is visible. Some of the examples of impression evidence include fingerprints, handprints, footprints, tyre prints and so on. The first officer who visits the crime scene preserves the crime scene to avoid evidence damage until the police investigator arrives. At the initial stage of investigation, forensic officers give importance to estimating stature, gender and body weight from physical evidence left by the offenders through the anthropometric technique. Researchers have shown that impression evidence can be used to determine the above three components. But whenever dealing with stature estimation from impression evidence, ethnicity should be considered because impression evidence varies from one ethnicity to another. Hence, the present study was planned to investigate the relationship between stature and handprint among Indians living in the Klang Valley region in Selangor state, Malaysia. It is the maiden study conducted in the Klang Valley, one of the regions in Selangor state, Malaysia.

Background: Traumatic brain injury (TBI) is a leading cause of mortality and disability worldwide, with intracranial haemorrhage and haematoma expansion representing critical determinants of poor outcomes. Tranexamic acid (TXA), an antifibrinolytic agent, has demonstrated mortality benefits in extracranial trauma, but its efficacy in isolated TBI remains debated, particularly regarding optimal patient selection, timing, and dosing. Objective: To systematically synthesise the available evidence on the efficacy of TXA in reducing mortality and haematoma expansion in patients with isolated traumatic brain injury treated in emergency department or prehospital settings. Methods: A comprehensive literature search of PubMed/MEDLINE, Embase, Cochrane CENTRAL, Web of Science, and Scopus was conducted for the five-year period ending in 2026. Randomised controlled trials, cohort studies, nested substudies, and post hoc analyses evaluating intravenous TXA versus placebo, no TXA, or standard care in adult patients with isolated TBI were included. Primary outcomes were all-cause or head injury-related mortality and radiographic haematoma expansion. Risk of bias was assessed using Cochrane RoB 2 (RCTs) and ROBINS-I (non-randomised studies). Due to substantial heterogeneity, a narrative synthesis was performed. Results: Thirteen studies (n = 24,227 patients) met inclusion criteria, including four RCTs, one prospective cohort, three retrospective analyses, and five secondary/post hoc analyses. In mild-to-moderate TBI (GCS 9–15), TXA significantly reduced mortality (CRASH-3 subgroup: RR 0.78, 95% CI 0.64–0.95; Bian meta-analysis: RR 0.71, 95% CI 0.60–0.85). In severe TBI (GCS 3–8), no mortality benefit was observed in RCTs (RR 0.98, 95% CI 0.91–1.05), while observational studies suggested potential harm due to confounding by indication (Bossers: OR 4.49, 95% CI 1.57–12.87). Haematoma expansion was reduced with TXA in two small RCTs (mean expansion 1.5±1.1 mL vs 4.6±1.9 mL), though the CRASH-3 imaging substudy found no prevention of established haematoma expansion but did show reduced new haemorrhage in patients with reactive pupils (aRR 0.80, 95% CI 0.66–0.98). Early administration (within 2 hours) was consistently associated with improved outcomes. Thromboembolic events were not significantly increased with TXA. A novel imaging biomarker (≥3% voxels in 10–20 Hounsfield unit range) showed promise for predicting TXA responsiveness but requires prospective validation. Conclusions: TXA reduces mortality in isolated mild-to-moderate TBI when administered early (within 2 hours), with the strongest evidence supporting its effect in patients with reactive pupils and smaller baseline bleeding volumes. TXA does not improve survival in severe TBI, and observed harm signals are likely confounded. Emergency physicians should consider early TXA administration in mild-to-moderate TBI with intracranial haemorrhage, while severe TBI patients should follow standard protocols pending further research.

Following the complete removal of fuel subsidy in 2023 by the Nigerian government, the effects are still subject of debate to both proponents and opponents of the policy. While its proponents believe it had saved huge revenue and blocked leakages in government expenditures thereby saving funds for developmental project, its opponents believe it has worsened the socioeconomic conditions of the populace through wide spread poverty and inequality in the society. The study focuses on a critical analysis of the effect of fuel subsidy removal on poverty alleviation and bridging the inequality in Nigeria. The work adopted the documentary and qualitative research design. Also, secondary sources of data were explored to generate data needed for the study and content analysis method was used to analyze the derived data. The study findings reveal that the removal of subsidy have strong effects on societal poverty and inequality in Nigeria and thus far the impact of palliative measure put in place are yet to meaningfully change the status quo. The study therefore recommends the need for the government to ensure its policy formulation and policy implementation process are well guided to address the challenges posed by the removal of fuel subsidy.

Background: Early mobilization (EM) is an evidence-based approach that promotes physical activity in critically ill patients in intensive care units, though its implementation remains challenging. Aims: To examine the perceived barriers to EM and assess differences according to clinical role, unit type, and years of experience among healthcare providers in critical care units. Methods and Materials: A cross-sectional, survey-based design was used. Using convenience sampling, 376 healthcare providers were recruited from critical care units across Saudi Arabia. Data were collected via the validated Patient Mobilization Attitudes and Beliefs Survey for Intensive Care Unit (PMABS-ICU). Descriptive statistics and one-way analysis of variance (ANOVA) were used for analysis. Results: Participants were 39.1% male and 60% female. Respiratory therapists reported the highest overall perceived barriers (M = 40.4, SD = 7.4), followed by nurses (M = 38.5, SD = 9.3), physicians (M = 36.1, SD = 8.1), and physical/occupational therapists (M = 33.7, SD = 8.1); (p = 0.001). Attitude-related barriers had the highest mean score (M = 39.6, SD = 11.7), followed by knowledge (M = 37.7, SD = 16.8) and behavior (M = 37.3, SD = 9.5). Significant associations were observed between barriers and clinical role (p = 0.001), unit type (p < 0.001), and years of experience (p = 0.001). Conclusions: Findings highlight that attitude-related barriers were the highest among healthcare providers. Therefore, targeted training programs are essential to strengthen healthcare providers' confidence and competence in implementing safe mobilization practices for critically ill patients.

Background: Artificial intelligence (AI) is increasingly being integrated into healthcare systems, including dentistry, where it has applications in diagnosis, treatment planning, digital imaging, and patient communication. Public understanding of AI technologies may influence future adoption of digital healthcare systems; however, awareness of AI applications in oral healthcare among community populations remains inadequately explored. Aim: To assess digital literacy and awareness regarding artificial intelligence technologies in oral healthcare among participants attending a community oral health screening setting. Materials and Methods: A cross-sectional questionnaire-based survey was conducted among 250 participants attending a community oral health screening setting. A structured and validated questionnaire assessed awareness of artificial intelligence, familiarity with AI applications in healthcare and dentistry, and sources of digital health information. Associations between demographic variables and AI awareness were analyzed using Chi-square tests. Statistical significance was set at p < 0.05. Results: Awareness regarding artificial intelligence technologies varied among participants. Educational status demonstrated a significant association with AI awareness (p = 0.021), with participants having higher educational attainment exhibiting greater familiarity with AI applications in healthcare. Participants with greater exposure to digital technologies showed improved awareness regarding AI-based healthcare systems. No statistically significant association was observed between age group and AI awareness (p = 0.084). Conclusion: Educational status and digital literacy appear to influence community awareness regarding artificial intelligence technologies in oral healthcare. Improving public familiarity with digital healthcare systems may support future integration of AI-assisted technologies into oral healthcare delivery and patient communication.