Background: Dysphagia is a common functional impairment in elderly populations, often leading to severe complications such as malnutrition and aspiration pneumonia, significantly increasing healthcare burdens. Currently, effective prognostic assessment tools are lacking. The absolute lymphocyte count (ALC), a biomarker reflecting immune-nutritional status, has potential predictive value in this context, though its role in dysphagia prognosis remains unclear. Methods: This retrospective cohort study included 253 dysphagic patients who received percutaneous endoscopic gastrostomy (PEG) or total parenteral nutrition (TPN) between 2014 and 2017. Five patients with missing ALC were excluded. Cox regression models assessed the association between ALC and mortality. ALC was analyzed as both continuous variable (using restriocted cubic splines) and categorical tertiles, with additional threshold analyses to assess non-linearity. Kaplan–Meier survival curves and subgroup analyses were also performed. Results: Lower ALC was associated with poorer nutritional status, higher inflammatory markers, and greater comorbidity burden. Higher ALC was independently associated with reduced mortality (adjusted HR: 0.60; 95% CI: 0.44–0.83; p = 0.002). Patients in the highest tertile had significantly better survival than those in the lowest (HR: 0.37; 95% CI: 0.23–0.59; P < 0.001). A non-linear threshold effect was identified at ALC = 1.899×10⁹/L (p for non-linearity = 0.009). Kaplan–Meier analysis confirmed improved survival with higher ALC (p < 0.0001). Subgroup analyses showed the protective effect of higher ALC was consistent across age, sex, BMI, PEG use, and comorbidity strata, with no significant interactions. Conclusions: ALC is an independent, non-linear predictor of mortality in older dysphagic patients and may aid clinical risk stratification across diverse patient subgroups.

Background: Adolescent girls living in disaster-prone coastal regions of Bangladesh face heightened nutritional vulnerability due to limited food access, poor dietary diversity, and environmental stressors. Despite growing concerns about adolescent malnutrition, few studies have examined the combined influence of food security, dietary diversity, and age on nutritional outcomes in these settings. Objectives: This study aimed to assess the association between dietary diversity, food security, and age with the nutritional status of adolescent girls in coastal Bangladesh. Methods: A cross-sectional survey was conducted among 345 adolescent girls aged 10–19 in Chattogram and Cox’s Bazar. Data on dietary intake were collected using a 24-hour dietary recall and a food frequency questionnaire. Household food security was assessed using a validated scale. Nutritional status was determined using BMI-for-age classifications. Bivariate and multivariate analyses explored associations between dietary diversity, food security, age, and nutritional status. Results: Among participants, 10.14% were underweight, and 29.85% were either overweight or obese. While 17.39% demonstrated high dietary diversity (≥7 food groups), the majority had moderate diversity (5 or 6 food groups) (59.42%). Food-insecure households were significantly more likely to have overweight or obese adolescents (p < 0.05). Although dietary diversity was associated with BMI in bivariate analysis, it was not a significant predictor in the multivariate model. Age showed a significant relationship with both dietary diversity and nutritional status. Conclusion: The findings emphasize the importance of addressing household food security and age-related nutritional vulnerabilities in coastal areas. Interventions should prioritize age-sensitive, culturally appropriate strategies to improve dietary quality and prevent the double burden of malnutrition among adolescent girls.

A residual-set framework is introduced for analyzing additive prime conjectures, with particular emphasis on the Strong Goldbach Conjecture (SGC). For each even integer $E_n\ge 4$, the residual set $ℛ\left(E_n\right)=\{E_n-p\mid$ $p<E_n,p\in \mathbb{P}\}$ is defined, and the universal residual set ${ℛ}_{\mathbb{E}}={{{\displaystyle \cup }}^{\text{}}}_{E_n}ℛ\left(E_n\right)$ is constructed. It is shown that ${ℛ}_{\mathbb{E}}$ contains infinitely many primes. A nontrivial constructive lower bound is derived, establishing that the number of Goldbach partitions satisfies $G\left(E\right)\ge 2$ for all $E\ge 8$, and that the cumulative partition count satisfies ${\displaystyle \sum }_{E\le N}G\left(E\right)\gg \frac{N^2}{{\text{log}}^{4}N}$. An optimized deterministic algorithm is implemented to verify the SGC for even integers up to 16,000 digits. Each computed partition $E_n=p+q$ is validated using elliptic curve primality testing, and no exceptions are observed. Runtime variability observed in the empirical tests corresponds with known fluctuations in prime density and modular residue distribution. A recursive construction is formulated for generating Goldbach partitions, using residual descent and leveraging properties of the residual sets. The method extends naturally to Lemoine's Conjecture, asserting that every odd integer $n\ge 7$ can be expressed as $n=p+2q$, where $p,q\in \mathbb{P}$. A corresponding residual formulation is developed, and it is proven that at least two valid partitions exist for all $n\ge 9$. Comparative analysis with the Hardy-Littlewood and Chen estimates is provided to contextualize the cumulative growth rate. The residual-set methodology offers a deterministic, scalable, and structurally grounded approach to additive problems in prime number theory, supported by both theoretical results and large-scale computational evidence.

Objective: The knowledge, attitudes, and practices of SUA students about the use of plastics containing endocrine disruptors were investigated in this study. Methodology: A study with 150 participants was conducted to assess individuals' knowledge about endocrine disruptors, attitudes, and plastic use practices. Results: The findings indicate that the participants possessed an average degree of knowledge 50.2 ± 3.85 with the main emphasis of awareness being generic concepts rather than specific substances. Regarding the potential health impacts of endocrine-disrupting chemicals present in plastics, respondents' attitudes ranged from fair to positive, with a mean score of 3.5 ±0.09 indicating a fair attitude overall. Conclusion: It is important to practice polite behavior and increase public awareness of safe plastic disposal methods. Surprising only 38.0% of the participants mentioned that they refrain from heating their food in plastic containers to reduce their exposure to plastics. Students' practices revealed a notable dependence on plastic products despite their awareness of the concerns surrounding endocrine disruptors, as most of them reported using plastic water bottles, plastic cups, and plastic bags almost always. Additionally, only 20.7% of the respondents consistently implemented strategies to prevent exposure to endocrine-disrupting chemicals. Recommendation: The study recommended increasing the use of cleaner plastic substitutes and improving educational programs to convert information into practical actions. Policies that encourage environmentally friendly behavior and raise public awareness of safe plastic disposal techniques should be put into practice.

Background: Type 2 Diabetes Mellitus (T2DM) and Alzheimer’s Disease (AD) are increasingly linked through shared pathophysiological mechanisms, giving rise to the concept of Type 3 Diabetes Mellitus (T3DM). Brain insulin resistance, oxidative stress, and neuroinflammation are central to both conditions, contributing to cognitive decline and AD progression. Aim: This review aims to explore this emerging relationship and its implications for prevention and management. Methods: Using an integrative review, 21 studies were systematically analyzed. The review focused on identifying demographic, genetic, and lifestyle factors contributing to T2DM and AD and examined shared molecular pathways such as insulin dysregulation and amyloid-beta accumulation. Results: The findings reveal that T3DM shares key features with T2DM and AD, including insulin resistance and chronic inflammation. Lifestyle interventions, such as diet and exercise, alongside routine cognitive and metabolic screenings, are critical in mitigating progression. Conclusions: Further research into diagnostic biomarkers and targeted therapies is essential to manage T3DM and its impact on AD. The role of nursing professionals in early detection, education, and holistic management is emphasized as vital in addressing this dual disease burden. This review offers actionable insights into integrated strategies for addressing these interconnected conditions.

Pembrolizumab, an immune checkpoint inhibitor targeting the programmed cell death 1 (PD-1) protein, is widely used for renal cell carcinoma but rarely causes central nervous system adverse events such as myelitis. A 58-year-old woman with stage IV renal clear cell carcinoma developed radiating hip pain, paresthesia, hypoesthesia (T10 and below), constipation, urinary retention, and sudden right-eye blurred vision one month after her sixth cycle of pembrolizumab and lenvatinib. Neurologic examination revealed asymmetrical inferior paraparesis, upper motor neuron signs, and right eye papilledema. MRI demonstrated patchy hyperintensity on C2-C6 and T2-T5, supportive of myelitis. Intravenous methylprednisolone was initiated, leading to pain relief and motor improvement. This is the first reported case of pembrolizumab-induced myelitis in Indonesia, emphasizing the importance of early recognition and corticosteroid therapy for optimal recovery.

Background: Proper umbilical cord care prevents neonatal infections and reduces neonatal mortality. Despite global recommendations for evidence-based cord care practices, traditional beliefs, and inadequate maternal knowledge often lead to unsafe practices, particularly in low-resource settings like Bangladesh. This study aimed to assess the understanding of umbilical cord care among mothers of neonates in Sherpur District, Bangladesh, and identify factors associated with knowledge levels. Methods: A descriptive cross-sectional study was conducted from July to October 2020 at Sherpur Sadar Hospital. A total of 193 mothers of neonates were recruited using a non-randomized purposive sampling method. Data was collected through a pre-tested, semi-structured, interviewer-administered questionnaire. Knowledge levels were categorized as "Good" (>6) or "Poor" (≤6) based on responses to 10 structured questions. Statistical analyses, including chi-square tests and crude odds ratios (COR), were performed to identify socio-demographic factors associated with knowledge levels. Results: Of the 193 participants, 48.7% demonstrated "Good" knowledge, while 51.3% had "Poor" knowledge. Education level (p = 0.01), occupation (p = 0.02), family type (p < 0.001), and family size (p = 0.04) were significantly associated with knowledge levels. Mothers with higher education and those from joint families exhibited better knowledge. However, 28.5% of respondents were unaware of the typical umbilical cord-shedding timeframe, and 44% could not identify signs of infection. Unsafe practices, such as using medications (14.5%) or hot compression (7.2%) for drying the cord, were reported. Conclusion: The study reveals significant gaps in maternal knowledge regarding umbilical cord care in Sherpur District, driven by socio-demographic disparities and cultural practices. Targeted health education programs, emphasizing evidence-based cord care practices and leveraging local social structures, are urgently needed to improve neonatal health outcomes in similar resource-limited settings. Future research should evaluate the effectiveness of these interventions to inform policy and practice.

Artificial Immune Systems (AIS) are bio-inspired computational frameworks that emulate the adaptive mechanisms of the human immune system, such as self/non-self discrimination, clonal selection, and immune memory. These systems have demonstrated significant potential in addressing complex challenges across optimization, anomaly detection, and adaptive system control. This paper provides a comprehensive exploration of AIS applications in domains such as cybersecurity, resource allocation, and autonomous systems, highlighting the growing importance of hybrid AIS models. Recent advancements, including integrations with machine learning, quantum computing, and bioinformatics, are discussed as solutions to scalability, high-dimensional data processing, and efficiency challenges. Core algorithms, such as the Negative Selection Algorithm (NSA) and Clonal Selection Algorithm (CSA), are examined, along with limitations in interpretability and compatibility with emerging AI paradigms. The paper concludes by proposing future research directions, emphasizing scalable hybrid frameworks, quantum-inspired approaches, and real-time adaptive systems, underscoring AIS's transformative potential across diverse computational fields.

Background: Diabetes is a chronic global health issue that requires effective management to improve patient outcomes and quality of life. Nursing education plays a critical role in empowering diabetic patients with self-management skills. Aim This systematic review evaluates the impact of diabetes-focused nursing education on patient outcomes and quality of life. Methods: This study uses PRISMA guidelines and a systematic approach to identify and evaluate relevant literature. Results and Discussion: Among the 14 studies reviewed, eight emphasized self-management education, while four incorporated multidisciplinary approaches. Findings consistently demonstrated that structured nursing education programs significantly improved self-management behaviors, glycemic control, and patient knowledge. For instance, nurse-led self-management programs resulted in substantial enhancements in self-care skills and diabetes-related knowledge. Moreover, interventions that combined health education with psychological support were particularly effective, leading to better blood glucose control and increased adherence to treatment. Studies that examined quality of life reported reductions in anxiety, improved lifestyle habits, and better overall self-management. These findings highlight the multifaceted benefits of nursing education, suggesting that structured, supportive programs positively impact both clinical and psychological aspects of diabetes care. Conclusion: The review emphasizes the value of comprehensive nursing education that integrates both clinical guidance and psychological support for holistic diabetes management. Implications: Ongoing professional development and culturally sensitive education programs are recommended to address the diverse needs of diabetic patients. Future research should investigate the long-term effects of nursing education and explore innovative strategies to enhance diabetes management outcomes.

This paper investigates the constructability of angles multiples of 3 within the framework of Euclidean geometry. It makes a significant contribution by presenting the first geometric construction for all such angles, offering a rigorous solution to a longstanding geometric problem. The paper reaffirms the efficacy of Euclidean geometry in providing precise constructions and robust proofs for these angles, demonstrating the enduring strength of Euclidean principles from classical to modern times. The presented workflow goes beyond Euclidean geometry to examine non-Euclidean methods, particularly analytical approaches, revealing misconceptions that compromise the genetic and geometric rigor of Euclidean principles. The paper exposes incongruities when algebraic proofs related to angle constructability are applied to the Euclidean system, emphasizing the misalignment of fundamental geometric concepts. A notable result in the paper is the construction of a angle, introducing the “ angle chord” as a novel geometric property. This property challenges assumptions made by non-Euclidean methods and highlights the nuanced geometric properties crucial for rigorous constructions. The paper refutes the fallacy of relying solely on algebra for solutions to angles multiples of , emphasizing the necessity of embracing Euclidean geometry for geometric discoveries. The paper underscores the merits and resilience of Euclidean geometry, showcasing its independence and depth across historical and modern perspectives. The newly presented geometric construction not only resolves a longstanding question but also emphasizes the intrinsic strength and uniqueness of Euclidean principles in contrast to alternative methodologies.

The spiny xeromorphic shrublands on serpentine (cuabales) constitute outstanding plant formations for the conservation of Cuban biodiversity, due to their floristic richness, high number of endemic species and local endemism, as well as their economic, social, cultural value and functions environmental. In the Callejón de Los Patos of Santa Clara, there are relicts of cuabal, although they show a high level of deterioration due to human activity. This article presents the main results of an investigation, which focused on implementing actions for the development of Community Environmental Education, with emphasis on the conservation of cuabal, in Callejón de Los Patos. For the intervention process, the Community Self-Development Methodology was used, which is qualitative par excellence, and the investigative methods: document analysis, participant observation, in-depth, group and structured interviews, drawing directed, the reflective group, techniques group and triangulation of data. The main results of the research are: the diagnosis and implementation of actions, designed from the process of Community Environmental Education, which was developed at the Carlos Manuel de Céspedes National Rural School, of said settlement. During the intervention process, the development of cognitive, procedural and attitudinal knowledge for the conservation of cuabal was verified in the schoolchildren, contributing to the strengthening of the school as the most important cultural center of the community, as aspired in the Cuban National Education System.

Background: The titers of SARS-COV-2 antigens are frequently used as markers of viral activity and threshold for release from quarantine and treatment. COVID-19 patients were treated with several antiviral agents, including remdesivir (RDV) and ensitrelvir (ESV), which is a novel anti-SARS-CoV-2 agent recently suggested to have strong antiviral activity. Cases: We present the cases of two patients whose SARS-CoV-2 antigens were successfully decreased by oral administration of ESV after they could not be decreased by RDV drip infusion. Case 1 was a 74-year-old man who was admitted with SARS-CoV-2 infection and had been infected by the virus a month earlier and relapsed twice. He had been treated with rituximab for diffuse B cell lymphoma and not received vaccination for SARS-CoV-2. RDV was administered intravenously two weeks earlier and again 4 days earlier, but it failed to control the infection, and he was transferred to our hospital (day 1). Intravenous RDV was restarted on day 1, but viral antigens remained high until day 5. The RDV was then switched to oral ESV, and viral antigen titers were successfully decreased on days 8, 10, and 12. Case 2 was an 81-year-old man who was admitted with SARS-CoV-2 infection on day 0. He had heart failure and diabetes mellitus, and had not received vaccination for SARS-CoV-2. Intravenous RDV was started on day 1, but viral antigens were still high until day 8. He was then switched from RDV to oral ESV, and viral antigen titers were successfully decreased on day 11. Conclusions: These cases suggest that ESV might be more effective than RDV for reducing viral activity, and it is easy to administer orally.

Major depressive disorder (MDD) is a significant psychiatric condition, with many affected individuals not gaining remission from conventional treatments, leading to classification as treatment-resistant depression (TRD). This study aimed to investigate the potential of intravenous (IV) ketamine, particularly the S-enantiomer esketamine in nasal spray form, for treating patients with TRD and associated comorbidities. We report three cases of patients with diverse psychiatric and medical backgrounds whom all reported significant symptomatic relief from depressive episodes and suicidal ideation (SI) following esketamine administration. Additionally, esketamine seemed to proffer benefits beyond the primary depressive symptoms, positively impacting other comorbid conditions, such as agitation, self-injurious behavior (SIB), and chronic pain. The goal of this paper is to highlight that while esketamine's primary utility is in addressing TRD, its therapeutic potential may extend to a variety of associated conditions. However, it is crucial to underscore the heterogeneity of MDD, emphasizing the necessity for individualized therapeutic approaches and further research into esketamine's broader applications.

Background: The World Health Organization (WHO) has declared COVID-19 a public health emergency of international concern. In this context, effective and affordable diagnostic procedures are essential for identifying and managing cases. Complete blood counts (CBC) are among the most common and readily available diagnostic tests. The current study aimed to evaluate the efficacy of CBC in diagnosing COVID-19 and identifying cases. Patients and Methods: A case-control study was conducted on 173 patients at Ain Shams University Hospitals over a period of three months. Patients were allocated into two groups according to COVID-19 PCR results: Group 1 included patients with COVID-19 positive PCR, and Group 2 included patients with COVID-19 negative PCR. Results: The study found that differential CBC had significant value in diagnosing COVID-19 disease. Many COVID-19 patients had lymphopenia and leucopenia compared to non-COVID-19 suspected patients. The low values of leukocytes, neutrophils, lymphocytes, and eosinophils with a CBC test were found to be valuable in the initial diagnosis of COVID-19. Conclusion: The definitive diagnosis of COVID-19 requires RT-PCR analysis, which is time-consuming and less accessible. Thus, the initial diagnosis and treatment of patients may be delayed. This study suggests that CBC, which is easily available and affordable, can be valuable in the early identification of COVID-19 cases, allowing for prompt treatment and management.

Background: The increasing prevalence of Diabetes Mellitus (DM) is closely tied to complications, particularly diabetic foot ulcers, which significantly raise the risk of lower extremity amputations due to infected, non-healing ulcers. This study aimed to assess diabetic foot prevention knowledge, practices and associated factors among patients at the Edward Francis Small Teaching Hospital (EFSTH), Banjul. Methods: In this cross-sectional study, we employed a convenience sampling technique to enroll 357 diabetic patients, both inpatients and outpatients, who were under the care of EFSTH. Data on diabetic foot prevention were collected through semi-structured interviews conducted by trained interviewers. Statistical analyses were carried out using SPSS, encompassing descriptive analysis, chi-square, Fisher exact tests, and logistic regression. Statistical significance was set at p<0.05, with a 95% confidence interval. Results: The mean age of the respondents was 47.3 years (±10.5), with women comprising 55.2% of the study population and 94.4% were married. About 73% demonstrated good knowledge of diabetic foot care and prevention, while 25.8% exhibited fair knowledge. A significant association was observed in bivariate analysis with patients’ educational level (P = 0.032). Specifically, patients with Madarasa (Arabic) education had a 68% lower likelihood 【aOR: 0.320, 95% CI: (0.103, 0.992), p = 0.048】 of practicing diabetic foot care and prevention compared to those with tertiary education. Conclusion: The study revealed that participants’ knowledge of preventing diabetic foot was high. However, the practice was poor. Therefore, there is a need for more health education on the practices that would emphasize diabetes management among diabetes patients.

The government of Mexico City carried out the introduction of palm trees in the 50s to increase the visual appearance of the main avenues. As a result of introduction of these exotic species, phytosanitary problems appeared. Currently there is scarce information on how to evaluate the health of these majestic monocots, in this sense, it is necessary to implement assessment scales to determine the health condition of the most frequently found species to advance on their care and management. The present study had the following objectives: 1) To determine the current state of health of palm trees by means of a scale of visual evaluation of the crown; 2) To know the diversity and structural characteristics of palm trees and 3) To determine the influence of composite variables on the ecosystem services such as the amount of shade provided. Health of palm trees were evaluated two times (dry and rainy seasons in 2022) on 35 transects of 200 m length. An imaginary circle divided into twelfths was overlapped on palm tree “crowns”, and through it, two absolute variables, Live Crown Ratio (LCR) and Crown Quality (CQ) were evaluated. Composite variables were also calculated. The 12/12 health scale adapted in the present study was useful. Four health categories were obtained for the Live crown ratio (LCR): 7.62% of the palm trees were in critical condition, 7.80% were in intermediate condition, 80.36% were in normal condition, and 4.20% were in excellent condition. Meanwhile, for crown quality (CQ), the percentages were 13.50%, 20.00%, 56.96% and 0.43%, respectively. The total height and “crown” diameter showed a positive correlation with the volume composite variables. The shadow area projected as an important ecosystem service increased as the health of the palm trees improved. This is the first study on palm trees health assessment in Mexico City.

Background: Prolonged decline in the ability of the kidney to regulate acid–base balance, eliminate waste products, and manage water homeostasis and entered chronic phase, toxic metabolic accumulates and erythropoietin secretion by the kidney is decreasing and causes hematological changes including decrease of HCT, MCV, RBCs and platelet counts. Hemodialysis became a practical treatment for kidney failure and is the most common method used to treat advanced and permanent kidney failure. Anemia is one of the most common complications in hemodialysis patients. Objectives: The study aimed to evaluate the prevalence of anemia among hemodialysis patients and investigate the variations of hematological parameters among anemic hemodialysis patients in the Tripoli region. Materials and Methods: The present study was conducted on 250 renal failure patients, attending Tripoli Center for dialysis and 100 normal healthy subjects. The study Ethical Committee of the medical centers and the Libyan Academy of graduate studies reviewed and approved the study design and patient consent statements were taken from each patient. Information's about the patients were recorded in a questionnaire. A blood sample of 5 ml was drawn by venous puncture from each normal healthy individual and hemodialysis patient. 2.5 ml of the blood sample was collected in K-EDTA tubes for the hematological examinations and another 2.5 ml of the blood sample was collected in a plain tubes for biochemical tests (serum urea, creatinine, and uric acid concentrations). The hematological parameters (RBCs count, Hb, HCT, MCV, MCH, MCHC, WBCs count, differential count of WBCs, and Platelets count) were determined using an automated hematology analyzer Sysmex (K- 4500) machine. The data were compared using GraphPad Prism version.9. The statistical significance of differences between groups was evaluated with the independent t-test. A P-value of <0.05 was considered significant for all statistical tests. Results: The results showed that the prevalence of anemia among hemodialysis patients was 89.8%. The degrees of anemia were 17% severe, 71.66% moderate, and 11.34% mild anemia. The types of anemia were 13.36% microcytic hypochromic, 82.59% normocytic hypochromic, and 4.05% macrocytic hypochromic anemia. RBCs, WBCs & platelets counts, Hct, MCHC, and Lymphocytes % showed a significant (P<0.01) decrease, and MCV was a significant (P<0.01) increase in the anemic hemodialysis patients compared with the healthy individuals. But, a significant (P<0.05) decrease in MCH was observed in the anemic hemodialysis patients when compared with the healthy individuals. A significant correlation was observed between RBCs and their indices with most of the hematological parameters. A significant (P<0.01) negative correlation was observed between serum urea with Hb, and RBCs count and Hct. While, a significant (P<0.01) positive correlation was recorded between uric acid with platelets count. A significant (P<0.05) positive correlation was observed between gender with platelets count, while, a significant negative correlation was recorded between gender with serum urea (P<0.01), creatinine, and uric acid, and Hb (P<0.05). A significant (P<0.01) negative correlation was observed between blood groups with serum uric acid. A significant (P<0.01) positive correlation was observed between durations of hemodialysis with RBCs count and Hb, while, a significant (P<0.05) negative correlation was recorded between durations of hemodialysis with body weight, and MCHC. Conclusion: It can be concluded that a higher prevalence of moderate, normocytic hypochromic anemia among hemodialysis patients. Also, results showed a significant variation in hematological parameters among the anemic hemodialysis patients. So, hemodialysis patients advice to examine the hematological parameters and treated from anemia if detected.

The aim of this article is to examine the impacts of Coronavirus Disease -19 (Covid-19) vaccines on economic condition and sustainable development goals. In other words, we are going to study the economic condition during Covid19. We have studied the economic costs of pandemic, benefits in terms of gross domestic product (GDP), public finances and employment, investment on vaccines around the world, progress and totally the economic impacts of vaccines and the impacts of emerging markets (EM) on achieving sustainable development goals (SDGs), including no poverty, good health and well-being, zero hunger, reduced inequality etc. The importance of emerging economies in reducing the harmful effects of the Corona has also been noted. We have tried to do experimental results and forecast daily new death cases from Feb-2020 to Aug-2021 in Iran using Artificial Neural Network (ANN) and Beetle Antennae Search (BAS) algorithm as a case study with econometric models and regression analysis. The findings show that Covid19 has had devastating economic and health effects on the world, and the vaccine can be very helpful in eliminating these effects specially in long-term. We observed that there is inequality in the distribution of Corona vaccines in rich countries compared to poor which EM can decrease the gap between them. The results show that both models (i.e., Artificial intelligence (AI) and econometric models) almost have the same results but AI optimization models can robust the model and prediction. The main contribution of this article is that we have surveyed the impacts of vaccination from socio-economic viewpoint not just report some facts and truth. We have surveyed the impacts of vaccines on sustainable development goals and the role of EM in achieving SDGs. In addition to using the theoretical framework, we have also used quantitative and empirical results that have rarely been seen in other articles.

Proper and effective management of obstructive sleep apnea (OSA) in elderly patients represents an important yet under-researched therapeutic target. Therefore, the main purpose of our research was to employ age stratification to analyse sleep quality and sleep fragmentation, the daily sleepiness, OSA severity and CPAP compliance in elderly. Conforming to the inclusion criteria of minimum 70 years of age at the time of polysomnography and CPAP titration night a total number of 162 elderly patients was included, median age 73,00±4 (MED±IQR). The comparison group consisted of 448 adult subjects under the age of 70 years old, median age 54,00±14,00 (MED±IQR). Sleep fragmentation in elderly was promoted to suboptimal CPAP adherence, as the probability of CPAP use ≥ 4 hours per day was less than 20%. Overall CPAP compliance hours in the elderly group achieved 3,991±3,804 hours/day with bigger variation in between the subjects versus 5,547±3,465 hours/day for the controls, (MED±IQR, p<0,001). Despite naturally occurring sleep fragmentation worsened by OSA, less than 30% of elderly patients would score ≥ 10 points on Epworth sleepiness scale. The study emphasizes acute need for standardized age-specific diagnostic tools to address different perception of daily drowsiness and sleepiness by older people. Further, it underlines the importance of early recognition of possible comorbid OSA and insomnia and suggest paying more attention to “non-obese phenotype” in the subgroup of elderly patients with suspected OSA. Elderly patients might also need development of more flexible CPAP compliance criteria; however, those must be standardized and objective.

Smallholder farmers play a pivotal role in global food security; however, they remain exceptionally vulnerable to the impacts of climate change due to their reliance on natural resources and limited adaptive capacities. This narrative review synthesizes a wide range of global sources to explore the intersection of smallholder agriculture and climate adaptation strategies. The review examines adaptation practices, agroecological methods, and the adoption of climate-resilient crop varieties. It reveals that the implementation of these strategies is frequently hindered by systemic barriers such as financial constraints, limited technological access, and institutional inefficiencies. Recognizing that previous studies have addressed isolated aspects of adaptation or relied on secondary data, this review highlights research gaps and offers a comprehensive synthesis of relevant literature. This review uses a narrative synthesis model suitable for integrating evidence from agronomy, economics, and social science to capture the complex challenges faced by smallholder farmers. The review emphasizes the importance of policy frameworks and participatory approaches that empower smallholder communities. This review synthesizes current evidence to inform potential directions for targeted interventions and future field-based studies, while recognizing the limitations of relying on secondary data. These recommendations aim to facilitate integrated policy reforms and drive research initiatives, ultimately strengthening the resilience and adaptability of smallholder agriculture in the face of ongoing climate change.

This review article provides a comprehensive anatomical analysis of soccer footwear, delving into the intricate structure and functional roles of its constituent components, including the upper, heel counter, tongue, toe box, outsole/sole plate, studs, and insole. Manufacturing processes influencing these structural elements are also discussed. Current market offerings and patented innovations in soccer cleat technology are examined through a biomechanical lens, highlighting their intended functions and limitations. A critical synthesis of existing knowledge underscores the anatomical and biomechanical distinctions between male and female athletes' feet, arguing for the necessity of sex-specific footwear design. This review culminates in emphasizing the imperative for specifically engineered soccer footwear for female athletes to optimize performance, enhance comfort, and mitigate the elevated risk of lower extremity injuries prevalent in the female game, thereby identifying crucial directions for future research in sports biomechanics and footwear engineering.

This exploratory review article synthesizes existing literature on the evolution and increasing significance of women's soccer, particularly in the United States. While acknowledging the sport's progress and the achievements of the U.S. Women's National Team (USWNT), it critically examines two key challenges that impede further advancement: the alarmingly high incidence of knee injuries among female players and the persistent underrepresentation of Black women. The review highlights the biomechanical factors contributing to these issues, emphasizing the need for footwear designed to accommodate the specific anatomical and functional requirements of female athletes. Furthermore, it explores the systemic barriers that contribute to the lack of diversity within the sport, advocating for equitable opportunities and support for Black women. This review concludes by underscoring the necessity for innovative, interdisciplinary approaches to ensure the continued growth and well-being of all participants in women's soccer, and identifies critical areas for future research in kinesiology and related fields.

Background: Early life socioeconomic conditions and race/ethnicity are critical determinants of long-term health and behavioral outcomes. Epigenetic changes, particularly those measured by the GrimAge biomarker, may mediate the impact of these early adversities on later life outcomes. This study investigates the relationships between race/ethnicity, poverty at birth, epigenetic aging at age 15, and subsequent self-rated health, school discipline, depression, and school dropout at age 22. We explored sex differences in these paths. Methods: Data were drawn from the Fragile Families and Child Wellbeing Study (FFCWS), which included 733 youth with comprehensive follow-up data up to age 22. Structural Equation Modeling (SEM) was employed to assess the pathways from race/ethnicity and poverty at birth to epigenetic aging (GrimAge) at age 15, and subsequently to self-rated health and school discipline at age 22. The model controlled for potential confounders including sex, family structure, and parental education. Results: Race/ethnicity and poverty at birth were significantly associated with higher GrimAge scores at age 15 (p < 0.05). Higher GrimAge scores were predictive of poorer self-rated health (β = -0.08, p < 0.05) and increased instances of school discipline (β = 0.13, p < 0.01) at age 22. The indirect effects of race/ethnicity and poverty at birth on self-rated health and school discipline through GrimAge were also significant (p < 0.05), suggesting that epigenetic aging partially mediates these relationships. Sex differences were also observed. Poverty at birth predicted faster epigenetic aging at age 15 for males not females. We also observed that faster epigenetic aging at age 15 was predictive of school discipline of male not female participants at age 22. In contrast, faster epigenetic aging at age 15 was predictive of self-rated health (SRH) of female not male participants at age 22. Conclusions: This study provides evidence that with some sex differences, race/ethnicity and poverty at birth contribute to accelerated epigenetic aging (GrimAge) by age 15, which in turn predicts poorer self-rated health and increased school discipline issues by age 22. These findings emphasize the importance of early interventions targeting social determinants to mitigate long-term health and behavioral disparities. Addressing these early life conditions is crucial for improving health equity and outcomes in young adulthood.

Background: Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. Objectives: This study aimed to examine differences in smoking cessation rates among daily smokers based on race, ethnicity, and socioeconomic status (SES) using data from the Population Assessment of Tobacco and Health (PATH) study, spanning waves 1 to 6 (eight years). Methods: Longitudinal data from PATH were analyzed, focusing on baseline daily cigarette smokers followed over an eight-year period to assess cessation outcomes. SES was measured by education and poverty status. Successful smoking cessation was defined as sustained abstinence from cigarettes for 12 months or more at the final wave. Logistic regression models identified predictors of successful cessation, adjusting for potential confounders, including age, nicotine dependence, and access to cessation resources. Results: The analysis revealed significant disparities in cessation success across racial, ethnic, and SES groups. Smokers living in poverty and those with lower educational attainment were less likely to achieve cessation success than their counterparts. Race (Black) and ethnicity (Latino) were also significantly associated with lower cessation success. Conclusions: This study highlights the social determinants of smoking cessation success among U.S. adult smokers, with lower success rates observed among those in poverty and with less educational attainment. These findings emphasize the need for targeted interventions that address the unique barriers to cessation faced by low-SES groups. Public health strategies should prioritize equitable access to cessation resources and culturally tailored interventions to reduce these disparities and improve cessation outcomes among all smokers.

Intersectionality has significantly enhanced our understanding of how overlapping social identities—such as race, ethnicity, gender, sex, class, and sexual orientation—interact to shape individual experiences. However, despite its theoretical importance, much of the existing literature has relied on qualitative approaches to define and study intersectionality, limiting its application in predictive modeling, comparative analysis, and policy development. This paper introduces the concept of Quantitative Intersectionality Scoring System (QISS), a novel approach that assigns numerical scores to intersecting identities, thereby enabling a more systematic and data-driven analysis of intersectional effects. We argue that QISS can substantially enhance the utility and predictive validity of quantitative models by capturing the complexities of multiple, overlapping social determinants. By presenting concrete examples, such as the varying impacts of socioeconomic mobility on life expectancy among different intersectional groups, we demonstrate how QISS can yield more precise and reliable forecasts. Such a shift would allow policymakers and service providers to dynamically assess economic and health needs, as well as the uncertainties around them, as individuals move through different social and economic contexts. QISS-based models could be more responsive to the complexities of intersecting identities, allowing for a more quantified and nuanced evaluation of policy interventions. We conclude by discussing the challenges of implementing QISS and emphasizing the need for further research to validate these quantifications using robust quantitative methods. Ultimately, adopting QISS has the potential to improve the accuracy of predictive models and the effectiveness of policies aimed at promoting social justice and health equity.

Introduction: Meigs’ Syndrome, characterized by a benign ovarian tumor that leads to ascites and occasionally pleural effusion, is a rare condition that often presents significant diagnostic challenges, particularly in young female patients. This case report highlights an 18-year-old-female with persistent gross ascites and pleural effusion unresponsive to diuretics, paracentesis, and thoracentesis. Despite extensive diagnostics evaluations including negative results from several tumor makers, histology and pathology reports, Liver and renal function tests, abdominal CT scans, ECHO, Ecg, Chest X-rays and HBV screening PCR test, the underlying causes of the ascites and pleural effusion remained elusive. The diagnosis was only made following an exploratory laparotomy, which revealed the presence of bilateral benign ovarian tumors. Subsequent bilateral Oophorectomy and Salpingectomy resulted in the complete resolution of the ascites. This case underscores not only the importance of considering ovarian pathology in young females with unexplained ascites but also highlights the critical role of exploratory laparotomy when non-invasive diagnostics fails to provide answers. Conclusion: This case emphasizes the need for a high index of suspicious for Meigs’ Syndrome in young females presenting with persistent ascites and pleural effusion, even when standard diagnostic tests yield negative results. It highlights the potential necessity of surgical intervention when other diagnostic approaches fail to identify the underlying causes. Clinicians should be aware of this condition and consider it in their differential diagnosis to ensure appropriate and effective management

This aimed to examine the societal perception of new religious movements' televangelism in Dunkwa-On-Offin, Ghana's Central Region. The study used a sequential explanatory mixed-methods design, using the mixed methods approach to research. The population of this study comprised Women, Regular churchgoers, believers, and those listening to televangelism services by new religious movements, as well as clergy, lay leaders, and other male worshippers. Random and purposive sampling techniques were used to select 200 women and 20 men from House of Power Ministry International and GILGAL Pentecostal Prayer Ministry International as the respondents for the study. The instruments used for data collection were questionnaires and interview guides. IBM SPSS statistics software version 23 was used to analyse the quantitative data, while qualitative data was analysed thematically with an interpretative lens. The study has revealed that society perceives the televangelism movements as helpful and encouraging but could also create trouble in fundamental Christian worship principles. The study also indicates that televangelists emphasise material things rather than spiritual matters. Other concerns included that televangelism brings about the separation of family and friends because they always inform members that their friends and family are evil. It is recommended that there is the need to change or improve the credibility perception among Christians in Ghana about televangelism. Televangelists must exhibit accountability and integrity to their worshippers by providing adequate information to encourage viewers to support their ministries.

This integrative literature review aims to explore the pivotal role of dignity and respect in maternity care, focusing on their profound impact on the experiences of pregnant individuals. Emphasis is placed on cultural competence as a crucial factor in fostering understanding and respect for diverse backgrounds, promoting inclusive approaches to maternal care. The overarching goal is to underscore the significance of dignified and respectful care in enhancing maternal satisfaction, postpartum outcomes, and overall well-being. Methods: The review synthesizes existing literature (n=22) on maternity care, dignity, and respect, drawing insights from diverse sources to comprehensively analyze the multifaceted nature of this critical healthcare aspect. Cultural competence is explored as a key theme in understanding and appreciating the varied backgrounds of pregnant individuals. The analysis encompasses factors such as effective communication, healthcare provider attitudes, cultural competence, informed consent, and systemic considerations, shedding light on their collective influence on dignity and respect in maternity care. Principal Findings: The literature review reveals that providing dignified and respectful care significantly contributes to improving maternal satisfaction and postpartum outcomes. Cultural competence emerges as a crucial element, ensuring that care approaches are inclusive and tailored to diverse cultural backgrounds. Effective communication, positive healthcare provider attitudes, and considerations for systemic factors are identified as key determinants of the dignity and respect experienced by pregnant individuals. The findings underscore the interconnectedness of these factors in shaping the overall quality of maternity care. Practical Applications: Recommendations stemming from the literature review include interventions aimed at enhancing healthcare providers' communication skills, cultural competence training, and the promotion of patient-centered care models. Acknowledging the systemic factors influencing maternity care, the review calls for collaborative efforts among healthcare providers, policymakers, and researchers to create an environment that upholds pregnant individuals' autonomy and values. The practical applications emphasize the need for comprehensive and culturally sensitive approaches to ensure that all pregnant individuals receive dignified and respectful care. In summary, this integrative literature review provides a comprehensive understanding of the critical role of dignity and respect in maternity care, offering insights into effective strategies for improvement and emphasizing the importance of cultural competence and collaborative efforts in shaping the future of maternal healthcare.

This study aimed to assess the proximate composition, microbial quality, and sensory acceptability of canned Bambara beans in Ghana to determine their nutritional value and consumer perceptions. The research was conducted in Tamale in the northern region of Ghana, focusing on sensory evaluation, nutritional analysis, and consumer preferences for canned Bambara beans. The study utilized canned Bambara bean varieties sourced from local markets in Ghana. It involved sensory panels, proximate analysis, and microbial testing to evaluate the quality and safety of the canned products. Data analysis included sensory scoring, proximate composition determination, and microbial count assessments. The findings indicated positive consumer attitudes towards canned Bambara beans, emphasising their convenience, nutritional richness, and sensory appeal. Nutritional analysis revealed the nutrient content of the canned beans, highlighting their potential as a nutritious food source. Conclusions emphasised the importance of sensory attributes in consumer acceptance and women's role in producing and promoting Bambara beans. It is recommended that Increase awareness among consumers, especially women and homemakers, about the nutritional benefits and culinary versatility of canned Bambara beans. Educational campaigns highlighting canned Bambara beans' health advantages and convenience can encourage their inclusion in household diets. It is also recommended that women involved in the production and processing of Bambara beans should be supported and empowered through training, capacity building, and access to resources. Recognising the pivotal role of women in the Bambara bean value chain is essential for sustainable production practices and economic empowerment.

This study examines the influence of socio-demographic factors on work-family conflict among management staff in star-rated hotels in the Accra Metropolis. The research aims to explore how variables such as gender, age, marital status, and educational background impact the experiences of work-family conflict among hotel managers. A quantitative research design was employed, and data were collected through structured questionnaires distributed to a purposive sample of hotel managers. The findings reveal significant associations between socio-demographic characteristics and work-family conflict, highlighting the complexities of balancing work responsibilities with family obligations in the hospitality industry. The implications of the study underscore the importance of tailored interventions to support the well-being of hotel managers, while the recommendations emphasise the implementation of work-life balance programs, support for family obligations, promotion of diversity and inclusion, and continuous training and development. It is recommended that hotel organisations create a supportive work environment that enhances the job satisfaction and productivity of their management staff. This study contributes valuable insights to the existing literature on work-family conflict in the hospitality sector and provides a foundation for future research endeavours in this area.

Delirium is a major complication most commonly observed in patients with advanced cancer. However, despite its prevalence, the early diagnosis, management, and prevention of this condition have not seen significant progress. Aim of this research is to provide insights into the prevalence of delirium, the optimization of interventions for managing delirium symptoms, their effectiveness and the impact of underlying factors on the reversibility of delirium in advanced cancer patients receiving palliative care. The review involved systematic searches of relevant databases including MEDLINE, CINAHL, ProQuest Nursing and Allied Health, and PsychInfo using refined search terms. Eight publications out of 614 studies originally searched were selected and critically reviewed. Their quality was assessed using Joanna Briggs Institute's Critical Appraisal Tool for Case Series. Data abstraction and content analysis were performed to synthesize the findings. Delirium is prevalent among advanced cancer patients in palliative care, with rates ranging from 10.3% to 24.1%. Pharmacotherapy and non-pharmacological interventions showed effectiveness in reducing delirium symptoms. Delirium was found to be reversible through palliative care interventions, antipsychotic medications, and exercise therapy. Effective delirium management is crucial in improving the quality of life of cancer patients. This review emphasizes the importance of subtype-specific treatments, standardized guidelines, and long-term follow-up studies. Implementing evidence-based individualized approaches to delirium management can optimize treatment efficacy and clinical outcomes in patients as well as improve the quality of care. Tailored interventions, standardized protocols, and further research are hereby recommended.

The world of the stock market is an intricately complex financial ecosystem that demands years of dedicated study to comprehend fully. It relies on risk mitigation practices and fundamental theoretical techniques to engage in speculation regarding stock and cryptocurrency fluctuations. However, this realm is progressively becoming more inclusive, with accessibility expanding beyond traditional educational barriers. Technological advancements, coupled with the ease of entry into this domain and the information-disseminating power of social networks, contribute to a rising number of individuals participating in this financial movement. What makes this evolution disruptive is that the same tools facilitating accessibility also exert influence on the way market trends unfold. This paper delves into the escalating impact of social media within the financial sphere, emphasizing the heightened accessibility to information and market involvement facilitated by platforms like Twitter and Reddit. It sheds light on how social media plays a pivotal role in market manipulation, as evidenced by phenomena such as the r/wallstreetbets subreddit, where meme-based strategies were employed to inflate the prices of stocks like GameStop. The study explores the utilization of social media by influential figures, exemplified by Elon Musk, who leverage their platforms to sway market movements. Additionally, this paper addresses instances of misinformation, such as the confusion surrounding Virgin Galactic's shares following a SpaceX failure and the introduction of "AGUA" in the Mexican stock market, leading to widespread misunderstandings. The paper extends its examination to the effects of social media on cryptocurrencies, highlighting how comments from public figures can significantly impact the prices of Bitcoin and Dogecoin. Overall, it underscores the imperative need for adaptation to these changes in the digital financial paradigm.

The purpose of this study was to assess the structural attributes of black and white Printed Printex Textile Fabrics in Ghana. The study adopted a factorial experimental research design. The three fabrics with black prints and white as base colours were purchased from the market. These three fabrics had the same designs but two had different fabric finishes and the third one had no finish (plain, embossed and plisse). Key soap purchased from the Ghanaian market and standard soap from Ghana Standard Authority were used for the study. A purposive sampling procedure was used in choosing the fabrics and soap for the study. Specimens totalling 219 were cut randomly from along the warp and weft directions of the Printex black and white cotton fabric with finishes (plain, embossed and plisse). The use of laboratory experiments and the apparatus used to experiment. The data obtained were presented using both descriptive and inferential statistics. The descriptive statistics (frequencies, percentages, means and standard deviation) were used as summary statistics of variables of the study. The one-way analysis of variance (ANOVA) was used to test for significant differences among three variables (three washing cycles), whereas the independent samples t-test was used to test for statistically significant differences between the performance of the fabric finishes under Key soap and the standard soap. The study indicated that differences in the attributes of the finishes caused differences in the structural attributes of the fabrics. This was because some of the finishes required certain structural attributes to bond well with the fabrics. The implication is that continuous washing weakens the structural attributes of fabrics which causes them to fail or weakens their resistance to stress tests. The study, however, found that differences in the structural attributes of the fabric finishes caused differences in the effects of washing on the selected fabric finishes. It is recommended that Printex Textile Limited should place critical emphasis on the weight of the fibres used in the construction of the fabrics. This was necessary since the study found that the fabric finish with the greatest weight performed better in tensile strength than those with the lowest weight. As a result, the use of fibres with high weight is expected to improve the use and care of the fabric finishes in terms of their ability to resist stress or tension during washing.

The extensive globalization of services and rapid technological advancements driven by IT have heightened the competitiveness of organizations in introducing innovative products and services. Among the noteworthy innovations is enterprise resource planning (ERP). An integral field in computer science, known as artificial intelligence (AI), is undergoing a transformative integration into various industries. Grasping the concept of artificial intelligence and its application in diverse business applications is crucial, given its broad and intricate nature. The primary focus of this paper is to delve into the realm of artificial intelligence and its utilization within enterprise resource planning. The study not only explores artificial intelligence but also delves into related concepts such as machine learning, deep learning, and neural networks in greater detail. Drawing upon existing literature, this research examines various books and online resources discussing the intersection of artificial intelligence and ERP. The findings reveal that the impact of AI is evident as businesses attain heightened levels of analytical efficiency across different ERP domains, thanks to remarkable advancements in AI, machine learning, and deep learning. Artificial intelligence is extensively employed in numerous ERP areas, with a particular emphasis on customer support, predictive analysis, operational planning, and sales projections.