Introduction: Acute esophageal necrosis (AEN), or “black esophagus,” is a rare but serious condition that mainly occurs in elderly patients with vascular frailty and significant comorbidities. It is thought to result from acid injury combined with esophageal ischemia. It frequently presents with upper gastrointestinal bleeding. Diagnosis relies on esophagogastroduodenoscopy (EGD), which shows diffuse, circumferential black discoloration of the esophageal mucosa, predominantly distal and ending sharply at the Z-line. AEN may progress to severe complications, including esophageal stricture and perforation, and remains associated with high mortality. Case Presentation: We report the case of a 50-year-old man with alcohol-related liver cirrhosis, still actively drinking and not under medical follow-up, admitted for mild acute alcoholic pancreatitis. His course was complicated by delirium tremens in the setting of abrupt alcohol withdrawal. Clinically, he presented with blackish vomiting and melena. Laboratory tests revealed severe anemia (hemoglobin 6.3 g/dL), acute kidney injury, and severe hypokalemia requiring admission to the intensive care unit. EGD revealed grade D ulceronecrotic esophagitis according to the Los Angeles classification, without active bleeding, consistent with black esophagus syndrome. Biopsies were deferred given the acute bleeding context. Caustic ingestion was ruled out by history. The patient was managed with fluid resuscitation, parenteral nutrition, correction of fluid and electrolyte disturbances, high-dose intravenous proton pump inhibitor (PPI) therapy followed by double-dose oral PPI combined with sucralfate, and initial fasting. Follow-up EGD on day 8 showed marked improvement without esophageal stricture. The outcome was favorable, with resumption of oral feeding, continuation of PPI therapy for eight weeks, and referral to an addiction medicine clinic. Conclusion: Our case shows that early and optimal management can lead to healing of esophageal lesions. Control of comorbidities is an essential component of treatment, together with supportive resuscitative measures and combined PPI and sucralfate therapy. The outcome is often favorable, but mortality remains high owing to the frail background frequently associated with this condition.

Background: Oral health is closely linked to systemic health, yet preventive oral health education remains insufficient in many low- and middle-income settings. School-based interventions offer a scalable platform for early prevention and long-term behavioral change. Objective: To evaluate the impact of a repeated school-based oral health education and treatment program on oral disease burden and related systemic outcomes over a three-year period in Kathmandu, Nepal. Methods: A quasi-longitudinal community-based study was conducted through annual dental camps at Mahendra Public School and Shee Thangpal Secondary School between 2018 and 2021 in collaboration with Lions Clubs International. Approximately 500 participants were evaluated annually. Standardized oral examinations were performed using dental charting and Palmer notation. Interventions included oral health education, preventive care, and basic treatment services. From the second year onward, audiovisual and small-group interactive learning strategies were implemented. Oral disease prevalence and self-reported systemic complaints were recorded and compared across years. Results: A significant reduction in oral disease burden was observed. Dental caries prevalence decreased from 62% (≈310 cases) in 2018 to 130 cases in 2021, representing a 58.1% reduction. Gingivitis prevalence declined from 38% (≈190 cases) to 80 cases, also reflecting a ~58% reduction. Participants demonstrated improved oral hygiene practices and increased engagement in peer-led education. Additionally, a reduction in self-reported digestive complaints was noted among adult participants. Conclusion: Sustained school-based oral health programs integrating education, prevention, and treatment are associated with significant improvements in oral and systemic health outcomes. These findings support the scalability of community-based dental education models in resource-limited settings.

This study assessed estate management practices and their implications for sustainable urban development in Enugu Metropolis, Nigeria. The study adopted a descriptive survey design and focused on property management, maintenance, land administration, development control and sustainability practices. A structured questionnaire using a five-point Likert scale was designed for property owners, tenants, estate surveyors and valuers, developers and relevant public officials. For the model analysis, 200 responses were generated and analysed using frequencies, percentages and mean scores. The results indicate that estate management practices are moderately effective, with mean scores ranging from 3.57 to 3.88 for the major practices. Preventive maintenance was strongly recognised, with a mean score of 4.00, although timely responses to defects and infrastructure maintenance recorded lower means of 3.60 and 3.41 respectively. Respondents identified high maintenance costs, inadequate development finance, weak enforcement and institutional coordination as major constraints, with mean scores above 3.90. Sustainable estate management indicators recorded generally high mean scores between 3.97 and 4.10. The study concludes that improved professional management, maintenance financing, digital land administration, development-control enforcement and sustainability-oriented practices can strengthen urban development in Enugu Metropolis.

Saudi Vision 2030, launched in 2016, is a comprehensive national transformation strategy that seeks to decrease Saudi Arabia's dependency on hydrocarbons, diversify the economy, increase the participation of human capital, modernize governance, and strengthen Saudi Arabia's global standing. This study is an attempt to look at Vision 2030 as a multi-dimensional transformation process and not a single economic reform programme after 10 years of its application. Qualitative documentary analysis thus describes, based on qualitative evidence, official Vision 2030 documents, government documents, national statistics, international assessments and academic literature between 2016 and 2026. Economic diversification, social change, governance reform and strategic repositioning are all central themes for the analysis. Results show that there have been major achievements in some of the areas that are not oil related, women in the workforce, tourism development, digital governance, and international investment engagement. However, there are financial and institutional shortfalls around the dependence of oil, project sustainability, and productivity in the private sector. As the study points out, Vision 2030 is still a transformation model and not a transition to something else.

This study investigates the synergistic effect quarry dust, as a partial replacement for fine aggregate, and micro-silica, used as a partial replacement for cement, on the compressive and flexural strength of high-strength concrete (HSC), with a target grade of 80 MPa. Twenty mixes were produced using a combined percentage replacement of 0%, 5%, 10%, 15%, and 20%, across four water-binder ratios of 0.20, 0.24, 0.28, and 0.32. Compressive strength was measured at curing ages of 3, 7, 14, and 28 days, while flexural strength (modulus of rupture) was determined experimentally on prisms at 28 days and further compared against values predicted by the Eurocode 2 and ACI 318-11 code equations. Results showed that strength increased with percentage replacement up to an optimum of 10% PR, beyond which it declined, with the highest 28-day compressive strength of 73.40 MPa and highest flexural strength of 5.85 MPa both recorded at 10% PR and a water-binder ratio of 0.20, representing increases of 27.43% and 16.30% respectively over the control mixture. The Eurocode 2 equation consistently overestimated experimental flexural strength by approximately 10%, while ACI 318-11 underestimated it by approximately 17–18%. Result also revealed that combined 10% quarry dust and micro-silica replacement at a water-binder ratio of 0.20 produced the maximum strength performance and is recommended for high-end structural applications.

Background: Ovarian cancer is one of the most lethal gynecological cancers, with an age-standardized incidence rate of 3.0–11.4 per 100,000 women worldwide [1], and is commonly diagnosed at an advanced stage with poor survival outcomes. Accurate staging is essential for treatment planning, and CT is the recommended imaging modality for assessing the extent of ovarian malignancy and tumour resectability. The purpose of this study was to correlate pre-operative CT scan findings with surgicopathological staging in patients with ovarian cancer. Methods: This observational, cross-sectional study was conducted at the Department of Gynecological Oncology, National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh, from January to December 2021. A total of 100 women with suspected ovarian cancer underwent pre-operative CT and surgery, with CT, per-operative, and histopathological findings compared according to the 2014 FIGO staging system. Data were analysed using SPSS version 23.0; p<0.05 was considered significant. Results: Among 100 patients, mean age was 43.2 ± 11.7 years; most were aged 41–50 years (38, 38.0%), urban (66, 66.0%), and poor socioeconomic status (44, 44.0%). All had a lower abdominal lump (100, 100.0%), and anemia was present in 72 (72.0%). Most masses were unilateral (72, 72.0%) and solid (78, 78.0%). Stage IA predominated on CT (60, 60.0%), peroperative (42, 42.0%), and histopathological (41, 41.0%) staging. Papillary serous cystadenocarcinoma was most common (64, 64.0%). CT sensitivity was 100.0% for IA, IIIB, and IIIC. Conclusion: Pre-operative CT scan is a useful tool for staging ovarian cancer, although early-stage disease may be under-staged compared with surgicopathological assessment.

Background: Aneurysmal fibrous histiocytoma (AFH) is a rare variant of benign fibrous histiocytoma characterized by fibrohistiocytic spindle cells, blood-filled pseudovascular spaces, and hemosiderin deposition. Clinically, it may mimic vascular or melanocytic lesions, posing a diagnostic challenge. We describe the clinicopathological features of 18 cases of AFH and discuss its differential diagnosis. Methods: Archival records from a tertiary institution were searched for cases diagnosed between January 2009 and December 2021. Hematoxylin and eosin-stained sections and immunohistochemical preparations were independently reviewed by two soft tissue pathologists, and clinical, histopathological, and follow-up data were systematically analyzed. Results: The 18 patients had a mean age of 37.1 years (range, 14–64 years), with a slight male predominance M:F = 5:4 (10:8). Preoperative diagnoses were documented in 7 cases (38.9%), most commonly hemangioma (n=3). The back/scapular region was the most frequent site (33.3%), followed by the lower limb (22.2%). Grossly, lesions demonstrated a solid-cystic appearance with blood-filled spaces. Histologically, non-endothelialized blood-filled spaces were surrounded by bland spindle and histiocyte-like cells, most commonly arranged in a storiform pattern (55.6%). Mean hemosiderin deposition was 40.6%. Atypical/monster cells and Touton giant cells were each identified in 35.3% of cases, collagen trapping in 52.9%, and staghorn vessels in 23.5%. Resection was performed in 72.2% of cases. Among 12 patients with available follow-up (4–20 years), local recurrence occurred in 2 (16.7%). Conclusions: AFH can closely mimic vascular and melanocytic tumors. Recognition of its characteristic histopathological features, supported by targeted immunohistochemistry, is essential for accurate diagnosis and avoidance of overtreatment.

Background: Haemorrhage dominates discussion of early puerperal morbidity, but other complications arising in the first 24 hours after delivery also contribute to maternal illness. Their distribution across maternal risk factors in Bangladeshi tertiary hospitals is poorly documented. This study aimed to describe the types of non-haemorrhagic immediate puerperal complications and their distribution according to maternal risk factors. Methods: A hospital-based cross-sectional study with prospective data collection was carried out at Dhaka Medical College Hospital from July to December 2009. Three hundred women aged 15 to 45 years, selected randomly from those admitted for delivery, were observed for 24 hours after birth. Women with teenage pregnancy, grand multiparity, severe anaemia, pre-eclampsia, eclampsia, antepartum haemorrhage, prolonged or obstructed labour or prolonged rupture of membranes formed the risk group. Data were analysed descriptively. Results: Twenty-three non-haemorrhagic complications (7.66%) were recorded, 22 (7.33%) in the risk group and 1 (0.33%) in the non-risk group. Tachycardia was the most frequent complication (16 events), followed by paralytic ileus (4) and urinary retention (3). Prolonged rupture of membranes accounted for 8 events, obstructed labour for 6, prolonged labour for 4, antepartum haemorrhage for 3 and severe anaemia for 1. No complication was reported with age below 18 years, grand multiparity or pre-eclampsia/eclampsia. Lower uterine caesarean section was performed in 58.00% of the risk group and 4.60% of the non-risk group. Conclusion: Non-haemorrhagic immediate puerperal complications were concentrated among women with identified risk factors, particularly prolonged rupture of membranes, obstructed labour and prolonged labour. Close observation of such women in the first 24 hours is warranted.

This study examined entrepreneurial self-efficacy as a predictor of graduate venture performance in Akwa Ibom State, Nigeria. Driven by structural unemployment and the necessity for economic self-reliance, graduate-led enterprises have become critical nodes for economic development; however, many suffer from premature failure due to low psychological resilience and poor risk management. The study specifically investigated the predictive influence of opportunity recognition self-efficacy and resilience self-efficacy on the performance of graduate ventures in Akwa Ibom State. A descriptive survey research design was adopted. The target population comprised 1,850 graduate entrepreneurs operating micro, small, and medium enterprises (MSMEs) across Akwa Ibom State. A sample size of 329 respondents was determined using the Taro Yamane formula. Data collection was carried out using a structured instrument titled "Entrepreneurial Self-Efficacy and Graduate Venture Performance Questionnaire (ESEGVPQ)". The instrument was validated by experts in Business Education and Psychometrics, yielding an overall Cronbach Alpha reliability coefficient of 0.86. Data were analysed using mean and standard deviation to answer the research questions, while simple linear regression analysis was deployed to test the null hypotheses at a 0.05 level of significance. The findings revealed that opportunity recognition self-efficacy exerts a significant predictive influence on graduate venture performance, despite variances in lower-level task execution. Furthermore, resilience self-efficacy was shown to significantly predict venture survival and overall performance metrics. The study concluded that psychological capital, specifically task-specific self-efficacy, is a strong determinant of entrepreneurial outcomes. It was recommended among others, that tertiary education institutions embed experiential psychological training into entrepreneurship curricula, and that local business incubators provide targeted mentorship frameworks to fortify the cognitive resilience of graduate startup owners.

Background: Neonatal hypoglycaemia is a common metabolic abnormality in newborns and may be associated with neurological injury and death, particularly in high-risk neonates. This study assessed the burden and clinical correlates of low blood glucose among neonates admitted to the Special Care Baby Unit (SCBU) of the University of Benin Teaching Hospital (UBTH). Methods: This retrospective cross-sectional study reviewed SCBU records from 1 January to 31 December 2024. Of 623 records identified, 219 neonates had sufficiently complete records and documented blood glucose values for analysis. Data were analysed with SPSS version 27. Categorical variables were summarized as frequencies and percentages, and associations were assessed using chi-square tests. Hypoglycaemia was defined in the source dataset as blood glucose ≤40 mg/dL, with values <30 mg/dL classified as severe and 31–40 mg/dL as moderate. Results: Of the 219 neonates analysed, 121 (55.3%) were male. Preterm low birth weight was the commonest recorded diagnosis (52.5%), followed by neonatal sepsis (37.4%) and neonatal asphyxia (10.0%). Severe hypoglycaemia occurred in 88 (40.2%) and moderate hypoglycaemia in 80 (36.6%), giving a prevalence of 76.7% among analysed neonates. Ninety neonates (41.1%) died. Blood glucose category was significantly associated with mortality (χ²=15.91, p=0.007) and diagnosis (χ²=24.21, p=0.0071), but not with gestational-age category (χ²=30.18, p=0.067) or sex (χ²=5.0, p=0.60). Conclusion: Low blood glucose was frequent among neonates with complete glucose records admitted to this tertiary SCBU and was associated with mortality and diagnostic category. The findings support early glucose surveillance and prompt management in high-risk admitted neonates, while the retrospective, selected-record design limits generalization of the prevalence estimate.

Background: Traditional home delivery remains an important maternal-health issue in many Nigerian communities where cultural preferences, affordability, access to formal health services and trust in traditional birth attendants (TBAs) may influence place of childbirth. Objective: To assess knowledge and prevalence of traditional home delivery and identify factors associated with delivery choices among women of reproductive age in Oluku Community, Ovia North-East Local Government Area, Edo State, Nigeria. Methods: A descriptive cross-sectional survey was conducted among 110 women aged 15–49 years residing in Oluku Community. Participants were selected using simple random sampling and data were collected with a structured questionnaire. Data were analysed using SPSS version 20.0. Frequencies and percentages were used for descriptive analysis, while chi-square tests examined associations between selected sociodemographic characteristics and delivery-related variables. Results: Awareness of traditional home delivery was high (90.9%), and 85.5% identified TBAs as the common attendants at traditional home deliveries. Fifty participants (45.5%) reported delivering their last child at home, compared with 44 (40.0%) who delivered in a hospital or health centre; 16 (14.5%) reported other locations. TBAs were reported as the delivery attendant by 59.1% of respondents. Lack of access to healthcare facilities (27.3%), cultural or religious beliefs (22.7%), trust in TBAs (20.0%), fear of medical interventions (16.4%) and cost of hospital delivery (13.6%) were reported reasons for home delivery. Only 41.8% considered traditional home delivery to carry higher risks than hospital delivery, while 60.9% reported no access to a health facility within their community. Education level was significantly associated with location of last delivery (χ²=14.090, p=0.029); age and marital status were not significantly associated with location of last delivery. Conclusion: Traditional home delivery was common in Oluku Community despite high awareness of the practice. Access barriers, cost, sociocultural beliefs and trust in TBAs influenced delivery choices. Interventions should strengthen access to skilled childbirth care, reduce financial and transport barriers, improve respectful maternity care and establish effective referral linkages with community-based providers.

The study analyzes a direct relationship between solar radiation, temperature and an inverse relationship with rainfall and relative humidity and also sunshine. The study scrutinizes the reliability and validity of existing analysis that focus on the various environment factors on photovoltaic (PV) system's performance for the first time four environmental factors (temperature, relative humidity, rainfall and sunshine). Affecting the system performance are investigated simultaneously. The study area is Southern Delta University, Ozoro. Ozoro is the Headquarters of Isoko North Local Government Area of Delta State, Nigeria. During the dry season (October -March), the average temperature in Rainfall in Delta State Polytechnic Ozoro ranged between 26.48 - 27.790C and in rainy season (April - September), the average monthly temperature ranged 25.01 27.150. Temperature in Ozoro is low at night and high in the day as a result of the external heat supply by the sun.

Clients expect density, movement, proportional harmony, and results that hold up over weeks of ordinary care, yet the planning of volume and length remains largely intuitive. The same request for "more fullness" may call for entirely different solutions depending on the thickness, curvature, density, and chemical history of the client's natural hair. This article develops a structured strategy for modeling volume and length during hair extension procedures. It draws on twenty English-language sources covering hair morphology, fiber variability, biomechanics, cosmetic alteration, and extension-related disorders. It also incorporates the Hair Biomechanical Tolerance Dataset (Cowan Y, 2026), a synthetic set of 108 illustrative archetypes, not derived from clinical practice, that maps hair and scalp parameters to safe strand counts and wear cycle durations. In these illustrative data, the maximum safe number of donor attachments per scalp zone ranged from 23 strands for fine hair in the high-risk marginal hairline to 85 strands for coarse hair in the supportive crown zone, a 3.7-fold difference associated with hair profile and anatomical placement. Mean wear cycle fell from 8.1 weeks for virgin hair with high aftercare compliance to 4.3 weeks for chemically compromised hair with low compliance. On this basis, the article proposes the Comprehensive Extension Modeling Strategy, a five-stage authorial method integrating base profiling, aesthetic intention mapping, tolerance alignment, zonal distribution planning, and proportional validation. Volume and length must be co-modeled, and both must remain compatible with the structural profile of the natural base and the realistic wear cycle.

Healthcare organizations face challenges in workforce allocation because fixed staffing approaches may not adequately reflect changing demand, workflow bottlenecks, staff qualifications, workload, and operational constraints. This study develops an Explainable Process Intelligence framework for Workforce Allocation and Operational Governance in Digital Healthcare Systems to connect healthcare process analysis with transparent staff-to-task recommendations. A quantitative, simulation-based design was used with a simulated healthcare event log and workforce records. The framework integrates process discovery, conformance analysis, bottleneck identification, demand estimation, constrained workforce allocation, explainable artificial intelligence, and governance monitoring. The allocation model was compared with a historical baseline roster using identical demand periods and eligibility rules. The proposed approach increased demand coverage from 78.1% to 88.7%, reduced median waiting time from 1.70 to 1.29 hours, decreased workload coefficient of variation from 0.31 to 0.21, and reduced overtime exposure from 12.4% to 8.9%. Explanations were available for accepted and rejected recommendations, while human reviewers retained authority to modify or reject recommendations. The findings indicate that integrating process intelligence, explainable allocation, and governance can support more transparent workforce planning, workload management, and operational oversight in digital healthcare environments.

Modern enterprises increasingly depend on interconnected information systems, cloud services, software applications, third party platforms, and digital business processes. This dependence creates exposure to cyber incidents, abnormal behavior, service failures, and operational disruption. Existing cybersecurity approaches often focus on threat identification without translating technical risk into business impact or actionable response priorities. This study proposes an Explainable AI Driven Decision Intelligence framework for cyber resilient enterprise operations under uncertainty. The framework integrates cybersecurity telemetry, enterprise context, dual stream predictive modeling, service criticality, dependency analysis, Business Impact Score assessment, explainable reasoning, resource constrained prioritization, and resilience response. The predictive layer processes temporal technical signals and contextual severity attributes to estimate malicious activity and disruption probabilities. TreeSHAP and rule-based reasoning provide interpretable factors, affected services, estimated consequences, and recommended actions. The framework is designed for comparative evaluation against XGBoost, SVM, standard BiLSTM, and conventional threshold alerting using predictive, operational, explainability, resource allocation, and uncertainty measures. The study provides an integrated approach for connecting cyber threat prediction with transparent operational decisions and enterprise resilience.