A scoping review of the benefits and challenges of mHealth for clinical decision-making in neuro-physiotherapy.

OBJECTIVE: Mobile health (mHealth) technologies have emerged as promising tools in the field of neuro-physiotherapy, offering innovative solutions for enhancing clinical decision-making processes. This scoping review explores the existing literature on the use of mHealth applications in neuro-physiotherapy with a specific focus on their impact on clinical decision-making. MATERIALS AND METHODS: The PubMed, Google Scholar, Cochrane Library, ScienceDirect, and Scopus databases were comprehensively searched for both qualitative and quantitative peer-reviewed articles written in the English language and published till 2023 that focus on mHealth applications in neuro-physiotherapy and clinical decision-making. RESULTS: The key findings from the 14 included studies highlighted the diverse array of mHealth applications employed in neuro-physiotherapy, ranging from wearable sensors and mobile apps to virtual reality platforms. Synthesis of the evidence from these studies demonstrated the potential of these technologies in clinical decision-making and improving patient outcomes, patients' and therapists' perspectives of these applications, their clinical clues, and the challenges with their use. CONCLUSIONS: The findings from the review underscore the need for continued exploration of these technologies to optimize their effectiveness in rehabilitation settings and ultimately improve clinical decision-making and patient care in neuro-physiotherapy.

Effect of supplemental sericea lespedeza leaf meal pellets on gastrointestinal nematode infection in grazing goats.

Feeding sun-dried sericea lespedeza [SL; Lespedeza cuneata (Dum-Cours.) G. Don.] reduces gastrointestinal nematode (GIN) infection in goats fed in confinement, but effects of this forage when fed as a supplement to goats on pasture are unclear. A study was completed in which supplemental feeds (75 and 95% SL leaf meal pellets and a commercial pellet, all fed at 0.91 kg/head/day) were offered to thirty growing male Spanish goats (9 months old, 20.6 ± 2.8 kg, 10/treatment) grazing perennial warm-season grass pastures in Fort Valley, GA, from September to November, 2010. Fecal and blood samples were taken from individual animals weekly to determine fecal egg count (FEC) and packed cell volume (PCV), respectively, and animal weights were recorded at the start and end of the trial. After 11 weeks grazing, animals were slaughtered for recovery, counting, and speciation of adult GIN from the abomasum and small intestines. There was no difference in FEC between goats fed the 75 and 95% SL leaf meal pellets, but both groups had lower (P<0.05) FEC than the goats fed the commercial pellets from days 35 to 77. The PCV values were not affected by the dietary treatments. Animal gain per day averaged 102.0, 77.2, and 53.3g for goats fed 95% SL, commercial, and 75% SL pellets, respectively (P<0.05). The 95% SL leaf meal pellet goats had 93.0 and 47.3% fewer (P<0.05) total (male+female) adult Haemonchus contortus and Teladorsagia circumcincta, respectively, than control animals, while only male H. contortus were lower (47.6%; P<0.05) in 75% SL-fed goats compared with commercial pellet-fed animals. Feeding supplemental SL leaf meal pellets improved animal performance (95% SL pellets) and reduced worm burdens (75 and 95% SL pellets) in young grazing goats and is a useful tool for natural GIN control in small ruminants.

Efficacy of copper oxide wire particles against gastrointestinal nematodes in sheep and goats.

Profitable sheep and goat production in the USA is severely limited by gastrointestinal nematode (GIN) parasitism, particularly by Haemonchus contortus. Copper oxide wire particles (COWP) have anti-parasitic properties in the diet of small ruminants, but efficacy of COWP may differ between sheep and goats. In a study with weaned kids (Kiko x Spanish cross, 6 months old) and lambs (Katahdin or Dorper x Blackface crosses, 5 months old), grazing the same pasture area in Central Georgia, 2g of COWP in a gel capsule was given to half the animals of each species, while the other half were given no COWP. Fecal and blood samples were taken weekly to determine GIN fecal egg counts (FEC) and blood packed cell volume (PCV). After COWP treatment, animals were grazed for 4 weeks and then slaughtered, with adult GIN recovered from the abomasum and small intestines for counting and identification to species. For both sheep and goats, COWP treatment reduced EPG (P<0.05), increased PCV (P<0.05), and lowered abomasal GIN numbers (P<0.05). For EPG, these differences were 82.5 and 90.5% for sheep and goats, respectively, 26 days after treatment, while adult H. contortus were 67.2 and 85.8% lower for COWP-treated sheep and goats, respectively. In this study, COWP treatment was equally effective against H. contortus infection in lambs and kids and appears to be an effective method of controlling H. contortus infection for up to 6 weeks in small ruminants following weaning.

Administration of copper oxide wire particles in a capsule or feed for gastrointestinal nematode control in goats.

Widespread anthelmintic resistance in small ruminants has necessitated alternative means of gastrointestinal nematode (GIN) control. The objective was to determine the effectiveness of copper oxide wire particles (COWP) administered as a gelatin capsule or in a feed supplement to control GIN in goats. In four separate experiments, peri-parturient does (n=36), yearling does (n=25), weaned kids (n=72), and yearling bucks (n=16) were randomly assigned to remain untreated or administered 2g COWP in a capsule (in Experiments 1, 2, and 3) or feed supplement (all experiments). Feces and blood were collected every 7 days between Days 0 and 21 (older goats) or Day 42 (kids) for fecal egg counts (FEC) and blood packed cell volume (PCV) analyses. A peri-parturient rise in FEC was evident in the untreated does, but not the COWP-treated does (COWP x date, P<0.02). In yearling does, FEC of the COWP-treated does tended to be lower than the untreated (COWP, P<0.02). FEC of COWP-treated kids were reduced compared with untreated kids (COWP x date, P<0.001). FEC of treated and untreated bucks were similar, but Haemonchus contortus was not the predominant nematode in these goats. However, total worms were reduced in COWP-fed bucks (P<0.03). In summary, it appeared that COWP in the feed was as effective as COWP in a gelatin capsule to reduce FEC in goats. COWP administration may have a limited effect where H. contortus is not the predominant nematode.

Efficacy of sericea lespedeza hay as a natural dewormer in goats: dose titration study.

Gastrointestinal nematodes (GIN) parasitism is the greatest threat to economic sheep and goat production in the southern USA, and there is widespread prevalence of GIN resistance to broad-spectrum anthelmintics in this region. A natural alternative for controlling GIN in small ruminants is feeding hay of sericea lespedeza [SL, Lespedeza cuneata (Dum.-Cours., G. Don)], a perennial warm-season legume high in condensed tannins. To determine the level of SL needed to reduce GIN infection, a confinement study was completed with 32 Spanish/Boer/Kiko cross yearling bucks offered one of four diets with 75% hay and 25% concentrate (n=8, 2 pens/treatment, 4 goats/pen). The hay portion of each diet consisted of a combination of ground SL (0%, 25%, 50%, and 75% of the diet) and bermudagrass [BG, Cynodon dactylon (L.) Pers.; 75%, 50%, 25%, and 0% of the diet]. The bucks were allowed to acquire a natural GIN infection on pasture prior to moving to the pens. After a 3-week adjustment period in the pens, the goats were stratified by fecal egg count (FEC) and packed cell volume (PCV), randomly assigned to treatments and pens, and then fed the treatment diets for six weeks. During the experimental period, fecal and blood samples were collected from individual animals weekly to determine FEC and PCV, respectively. Adult worms from abomasum and small intestines were collected for counting and identification of species at slaughter. Goats fed SL hay at 25%, 50%, and 75% of the diet had 45.3% (P=0.2048), 66.3% (P=0.0134), and 74.5% (P=0.0077) lower FEC than control animals (75% BG hay) after 21 days. The 50% and 75% SL goats had 84.6% (P=0.0625) and 91.9% (P=0.0340) lower FEC than controls by day 42. The 75% SL-fed goats tended to have higher (P=0.0624) PCV and had fewer (P=0.035) abomasal worms than control animals, while PCV and adult worm numbers of the 50% and 25% SL goats were not different from controls. The optimum level of SL hay in the diet for reducing worm numbers of small ruminants appears to be 75%, whereas 50-75% SL reduces FEC, which could lead to reduced larval infection on pasture.

The effects of feeding sericea lespedeza hay on growth rate of goats naturally infected with gastrointestinal nematodes.

Goat production is increasing in the United States due to high ethnic demand, but infection with gastrointestinal nematode (GIN) parasites is a major constraint to the industry. Increasing GIN resistance to chemical anthelmintics worldwide has led to the development of alternative control strategies, including use of forages containing condensed tannins (CT). An experiment was designed using infected and dewormed male kids (Kiko x Spanish, 6 mo old, 18.9 +/- 3.25 kg) fed diets containing 25% concentrate and either 75% sericea lespedeza [SL; Lespedeza cuneata (Dum-Cours.) G. Don], a high CT forage (87 to 181 g of CT/kg), or 75% bermudagrass [BG; Cynodon dactylon (L.) Pers.] hay (n = 10/treatment). The kids were weighed every 14 d, and fecal and blood samples were taken weekly for fecal egg counts and packed cell volume determination, respectively. Fecal cultures were processed every 14 d to determine CT effect on larval development. At slaughter, adult GIN were collected from the abomasum and small intestines for counting and speciation. Blood samples were also analyzed for plasma urea-N, and ruminal VFA and pH were determined. The infected SL-fed kids had consistently lower (P < 0.05) fecal egg counts than the infected BG goats throughout the trial and greater (P < 0.05) packed cell volume beginning by d 77. Average daily gain was greater (P < 0.001) in kids fed SL- than BG-based diets, regardless of infection status (104.3 +/- 5.0 and 75.5 +/- 4.8 g/d, respectively). Total VFA and acetate concentrations were greater (P < 0.001) in the BG- than in SL-fed goats, whereas propionate levels were unaffected by diet. Acetate:propionate ratio (P = 0.01) and plasma urea-N (P = 0.03) levels were greater in BG-fed goats, whereas rumen pH was greater (P < 0.001) in the SL-fed goats. Feeding SL hay can reduce GIN infection levels and increase performance of goats compared with BG hay.

Effect of pelleting on efficacy of sericea lespedeza hay as a natural dewormer in goats.

Resistance of gastrointestinal nematodes (GIN) to anthelmintic treatment has increased pressure to find alternative, non-chemical control methods. Feeding hay of the high condensed tannin (CT) forage sericea lespedeza [SL; Lespedeza cuneata (Dum-Cours.) G. Don.] to sheep and goats has reduced GIN fecal egg count (FEC) and worm numbers in the abomasum and small intestines. This effect has been reported with both unground (long) and ground hay. Pelleting of ground hay increases ease of storage, transport, and feeding, but heating during the pelleting process could reduce biological activity of CT. Eighteen naturally GIN-infected 5-6-month-old Kiko-Spanish cross bucks were fed pelleted and ground SL hay and ground bermudagrass [BG; Cynodon dactyon (L.) Pers.] hay diets (n=6 per treatment) in a confinement trial. The bucks were fed the ground BG hay (75% of daily intake) plus a pelleted 16% CP commercial goat chow (25% of daily intake) for 3 weeks, after which they were assigned to treatment groups based upon FEC, 12 animals were switched to ground and pelleted SL hay plus goat chow for 4 weeks, and then all animals were fed the BG ration for one additional week. Throughout the trial, feces and blood were collected from individual animals weekly to determine FEC and blood packed cell volume (PCV), respectively. All goats were slaughtered at the end of the trial, with adult worms in the abomasum and small intestines recovered, counted, and identified to species. Both forms of SL hay reduced (P<0.05) FEC in goats relative to BG hay-fed animals, with a greater reduction in goats fed the SL pellets. There was no effect on PCV until the final sampling date, when the SL pellet-fed goats' PCV increased (P<0.05) compared with the other treatments. Feeding pelleted SL reduced (P<0.05) abomasal worms, primarily Haemonchus contortus, relative to the BG hay-fed goats. Worm numbers in the goats fed ground SL hay were intermediate. Pelleting SL hay enhanced its efficacy against parasitic nematodes and may facilitate the broader use of this forage in small ruminant GIN control programs.

Sericea lespedeza hay as a natural deworming agent against gastrointestinal nematode infection in goats.

Infection with gastrointestinal nematodes (GIN), particularly Haemonchus contortus, is the biggest constraint to profitable goat production in the United States (US). Due to widespread prevalence of anthelmintic resistance in goat GIN, alternative, non-chemical control methodologies are needed to increase profitability of small ruminant industries. A study was designed to test the efficacy of a high condensed tannin (CT) legume, sericea lespedeza [SL, Lespedeza cuneata (Dum.-Cours. G. Don)] against GIN of goats fed in confinement. The goats were given a trickle infection of 500 H. contortus larvae/animal three times per week during the trial to simulate natural infection. Twenty Boer bucks (6-8 months old) were fed bermudagrass [BG, Cynodon dactylon (L.) Pers.] hay plus concentrate for 5 weeks in confinement and then 10 animals were switched to SL hay for an additional 7 weeks. Throughout the trial, feces and blood were collected weekly from individual animals to determine fecal egg count (FEC) and blood packed cell volume (PCV). Fecal cultures were made weekly from pooled samples to determine treatment effects on GIN larval development. All goats were slaughtered at the end of the trial, with adult worms in the abomasum and small intestine of each goat recovered, counted, and identified to species. Feeding SL hay to goats significantly (P<0.01) reduced FEC and increased PCV compared with BG hay. In addition, a lower percentage of ova in feces from SL-fed goats developed into infective (L3) larvae. There was a direct effect of SL hay on adult worms, with significantly (P<0.01) lower numbers of both abomasal (H. contortus, Teladorsagia circumcincta) and small intestinal (Trichostrongylus colubriformis) nematodes compared with goats fed BG hay. Feeding SL hay to goats is an effective means of controlling parasitic nematodes and may be a potential supplement/replacement for chemical anthelmintics.

Paediatric burn injuries in the Jeddah area of Saudi Arabia: a study of 197 patients.

A prospective study was conducted on paediatric thermal injury patients admitted to the Burns Unit at King Fahd Hospital, Jeddah, Saudi Arabia over a 2-year period (December 1985 to December 1987). A total of 197 patients (out of 319) were paediatric, aged up to 18 years. Infants and toddlers accounted for 59.4 per cent and adolescents for 14.2 per cent. Scalding and flame injuries accounted for 98 per cent with most injuries occurring at home (97.5 per cent) and the overall paediatric mortality rate was 4.4 per cent.

Burn injuries in the Jeddah area of Saudi Arabia: a study of 319 cases.

Three hundred and nineteen patients with different types of burns were studied at King Fahd Hospital, Jeddah, Saudi Arabia over a 2-year period (December, 1985 to December, 1987). Scalding was the most common cause (56.4 per cent) of burn injuries compared with 41.4 per cent of patients who sustained flame injury; 84.6 per cent of the thermal injuries occurred at home, with children (less than or equal to 18 years of age) being affected most frequently (61.8 per cent). The overall mortality was 9.4 per cent.