Background: Numerous malignancies, both benign and malignant is hosted by the sinonasal cavity that poses a diagnostic and therapeutic challenge to otolaryngologist and pathologists. One of the extremely rare neoplasm of the sinonasal cavity is secretory carcinoma (SC), previously called, mammary analogue secretory carcinoma (MASC). Majority of MASCs are localized to the parotid and salivary glands however, it is rarely documented in the sinonasal tract. Herein, we review the reported cases and report a twenty-one-year-old female patient presented to our ear, nose & throat outpatient department of tertiary care center as a polyp in the nasal cavity initially, which was excised on first diagnoses with normal histopathology (H/P). However, a year later she has a recurrence with an invasive course, followed by surgical exploration and confirmed as “Secretory Carcinoma” (SC) on histopathology, immunohistochemistry & genetic confirmation. At two-years follow-up, the patient has no clinical and radiological signs of recurrence. Aim: this review aims to outline the demographic, clinicopathologic, and confirmatory (radiologic, histopathologic, and immunohistochemistry) findings of the published cases. Methods: PubMed, Google Scholar, and MEDLINE search done with search words such as, secretary carcinoma, sinonasal tract, mammary analogue secretary carcinoma. Results: Total eight case including our case included in this review. The male/female ratio of occurrence of the SC of the sinonasal cavity was 3:5 (34.5:62.5%). Majority of the cases (7/8) reported in middle and old age group except one as reported in a 12 years old child. Equal case distribution among smoker ad non-smoker patients. The common symptoms were nasal obstruction, nasopharyngeal secretions, presence of mass, epistaxis and hyposmia. All cases were characterized by the presence of the ETV6-NTRK3 fusion transcript and / or rearrangement of ETV6 gene. Surgical excision with chemo/radiotherapy was the management considered in majority of the cases with good outcome. Almost all eight cases (100%) has no signs of recurrence both clinical and radiologically at a mean follow-up period of one year. Conclusion: Secretary carcinoma of the sinonasal tract is a new entity. More cases / studies are required to know the demographic, clinicopathologic nature, & prognosis of this newly emerging carcinoma.

Mental health has become a critical global concern, with increasing awareness of mental illnesses and their profound impact on individuals, families, and communities. Saudi Arabia is experiencing rapid social and economic changes, with the Vision 2030 initiative aiming to enhance healthcare, including mental health services. Family physicians play a pivotal role in the healthcare landscape, acting as the first point of contact for patients seeking medical assistance. In Saudi Arabia, the integration of mental health services into primary care settings could revolutionize the approach to mental health, addressing the stigma associated with mental illnesses, minimizing the service gap, and delivering timely interventions. This review article aims to explore the current state of mental health services in Saudi Arabia and assess the role of family physicians in identifying and managing mental health conditions.

Minor crimes can still be handled using the concept of a restorative justice approach. Restorative justice has an implementation method by means of penal mediation or by diversion of criminal acts. Penal mediation is used in handling ordinary crimes, in the sense that it is carried out by adults, while the use of diversion is carried out in cases involving children and is in the Children's Court. The problem in this research is how the punishment system for minor crimes is based on Pancasila justice. The research method uses a constructivist paradigm, with a social legal research approach method, and a descriptive research type. Types and sources of data use secondary materials in the form of primary legal materials, secondary legal materials and tertiary legal materials. Data collection methods use literature and qualitative analysis methods. The results of the research are that the punishment system for minor crimes is not yet fair, legal action is still carried out procedurally. One effort that can be made is a policy approach to resolving minor crimes (Tipiring) through restorative justice; so it is necessary to reconstruct the Regulations on Light Crimes Based on Pancasila Justice, namely in the Criminal Procedure Code (KUHAP), in Article 205 Paragraph 1 and the Republic of Indonesia Prosecutor's Regulation Number 15 of 2020 concerning Termination of Prosecution.

The illicit trafficking and abuse of narcotics targeting the younger generation has reached various corners of the region and the abuse is evenly distributed across all social strata of society. Basically, narcotics are very necessary and have benefits in the fields of health and science, however the use of narcotics becomes dangerous if misuse occurs. This research aims to analyze the weaknesses in the current Regulation on Cessation of Prosecution of Narcotics Abusers, to reconstruct the Regulation on Cessation of Prosecution of Narcotics Abusers Based on Restorative Justice Values. The approach method used in this legal research is a sociological juridical approach. The data obtained in this research was then selected and arranged systematically to be further analyzed and presented using qualitative analysis methods. The results of this research are that the weaknesses in the current regulations for stopping prosecution of narcotics abusers are weaknesses in terms of legal substance, weaknesses in terms of legal structure and weaknesses in terms of legal culture.

Background: Hysterectomy, widely performed for benign gynecologic conditions, is increasingly done laparoscopically due to reduced pain, quicker recovery, and lower blood loss. Recommended by AAGL and ACOG, laparoscopic hysterectomy requires advanced skills, especially for large uteri, with innovations like uterine morcellation enhancing feasibility while improving surgical precision and patient outcomes. Aim of the study: This study aims to evaluate the perioperative outcomes of laparoscopic hysterectomy for large uteri in a tertiary care hospital. Methods: This retrospective cohort study at the Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and two private Hospitals in Dhaka, Bangladesh, from February 2019 to January 2023 analyzed 120 patients undergoing laparoscopic hysterectomy for large uteri (>300g). Patients aged 18+ with benign gynecological conditions were included, excluding those with malignancies, laparoscopic contraindications, or prior extensive abdominal surgeries. Comprehensive preoperative assessments were conducted. Surgeries followed standardized laparoscopic-assisted vaginal hysterectomy protocols, addressing ovarian preservation/removal as needed. Intraoperative metrics included operating time and blood loss, while postoperative care emphasized early recovery and complication monitoring. Data were analyzed retrospectively, with outcomes reported as mean ± SD. Result: This study analyzed 100 women undergoing laparoscopic hysterectomy, with a mean age of 46.5 years and a BMI of 23.3 kg/m². Most participants (58.3%) were parous, with a mean uterine weight of 585 grams. Uterine myoma (80%) was the leading preoperative diagnosis. The average operative time was 88.9 minutes, with 575.4 mL blood loss and a 1.5-day hospital stay. Hemoglobin drop averaged 1.7 g/dL, and 17.5% required transfusions. Major complications, including bowel, bladder, or ureter injuries, were absent. Mild postoperative complications affected a few patients, with no reoperations or wound infections, showcasing the procedure’s safety and efficacy. Conclusion: Laparoscopic hysterectomy for large uteri proves safe and effective in tertiary care, offering minimal complications, reduced morbidity, and shorter hospital stays. While challenges, like increased operative time and blood loss, exist, the absence of major injuries or reoperations confirms its feasibility, showcasing the advantages of minimally invasive techniques in skilled hands.

Background: Axial spondyloarthritis (AS) causes reduced spinal mobility, functional limitations, and a decreased quality of life. The pupose of this study was to assess patient satisfaction and identify evidence-based improvements in supervised group exercise for axial spondyloarthritis. Aim of the study: The aim of this study was to evaluate patient satisfaction and identify evidence-based improvements in supervised group exercise for axial spondyloarthritis. Methods: This prospective, comparative study was conducted outdoors at the Rheumatology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2022 to June 2022, involving 40 patients with axial spondyloarthritis randomized into supervised or home-based exercise groups. The supervised group attended physiotherapist-led sessions at the Department of Physical Medicine and Rehabilitation, BSMMU, while the home-based group followed a guided regimen with weekly check-ins. Outcomes (BASDAI, ASQoL, BASFI, and adherence) were assessed at baseline and 12 weeks. Statistical analysis used t-tests, chi-square tests, and ANCOVA (p < 0.05, SPSS v25). Results: In this study of 40 patients with axial spondyloarthritis, the supervised exercise group showed significantly greater improvements in disease activity (-27.27%, p < 0.0001), quality of life (-48.80%, p < 0.0001), and functional outcomes (-52.38%, p < 0.0001) compared to the home-based group. Exercise adherence was higher in the supervised group (85% vs. 55%, p = 0.03). Satisfaction was also greater in the supervised group, with 95% reporting satisfaction versus 65% in the home-based group (p = 0.011). Conclusion: Supervised exercise significantly improves patient satisfaction, functional outcomes, and well-being in axial spondyloarthritis, highlighting the value of structured supervision.

This paper proposes a data-driven investment framework for private equity (PE) firms investing in renewable energy projects, drawing on analytical practices and financing innovations from the small and medium-sized enterprise (SME) sector. While SMEs have started to adopt clean energy through performance modeling, predictive analytics and flexible financial instruments, PE investment strategies have remained based on subjective evaluation and traditional financial metrics. This research bridges the gap by combining SME insights with private equity investment principles to identify scalable tools and models that can improve deal screening, ROI estimation and risk management in renewable energy. The methodology used a multi-faceted approach combining literature review, qualitative stakeholder insights and conceptual modeling. The literature review looked at academic and industry publications on SME energy financing and PE investment practices to identify the gaps and opportunities. Qualitative data was collected through interviews and focus groups with PE managers, renewable energy developers and SME owners who had implemented clean energy solutions. These insights informed the development of conceptual models adapting proven SME approaches pay-as-you-go financing and advanced ROI forecasting to the institutional investment context. The methodology prioritized practical applicability while maintaining analytical rigor through triangulation of multiple data sources. Empirical data analysis revealed the key barriers, financing preferences and analytical tools that have shaped SME investment behaviour, providing valuable lessons for institutional investors. The resulting framework is a replicable and interpretable model for evaluating renewable energy opportunities in private markets. This model addresses the main challenges in current PE practices and incorporates data-driven elements that have proven to work in SMEs. The paper concludes with practical recommendations for PE firms’ data-rich decision support systems, performance-linked financial structures and operational analytics in portfolio monitoring. And it outlines future research avenues real-time data integration, geospatial risk modeling and sector-specific investment frameworks for emerging renewable technologies.

The integration of advanced analytics in retail supply chains has transformed operational efficiency, demand forecasting, and risk mitigation. This study examines the impact of predictive analytics, machine learning, and AI-driven risk intelligence on supply chain performance. Using a mixed-methods approach, including case study analysis and statistical modeling, the research highlights key improvements in inventory accuracy, logistics optimization, and fraud detection success rates. Findings indicate that retailers leveraging real-time analytics have experienced a 25-40% increase in supply chain efficiency, with major gains in demand forecasting precision and supplier risk assessments. Despite these advantages, challenges remain, including high implementation costs, data security vulnerabilities, and algorithmic biases. Smaller retailers face significant barriers in adopting AI-powered analytics due to infrastructure limitations and workforce constraints. The study emphasizes the importance of ethical AI governance, cybersecurity protocols, and regulatory compliance in ensuring responsible analytics adoption. Future research should focus on scalable AI frameworks, blockchain-enhanced supply chain security, and quantum computing applications in predictive analytics. The findings underscore the need for a multi-stakeholder approach that integrates technological innovation with ethical considerations to achieve sustainable, transparent, and resilient supply chain ecosystems. This research contributes to the ongoing discourse on data-driven retail transformation, offering strategic insights for industry leaders, policymakers, and researchers in supply chain management.

Odontogenic keratocysts (OKCs) are benign yet locally aggressive cystic lesions derived from the dental lamina or its remnants. Predominantly found in the mandible, OKCs often present as asymptomatic radiolucent lesions, occasionally causing symptoms such as swelling and pain. Radiographically, they appear as well-defined, unilocular or multilocular lesions with smooth borders. Microscopically, OKCs feature a thin, parakeratinized epithelium with a high mitotic index, contributing to their aggressive behavior. Treatment typically involves surgical enucleation or resection, with careful attention to ensuring complete removal to minimize recurrence. However, recurrence rates remain relatively high, ranging from 25% to 60%, necessitating close postoperative monitoring, particularly in cases associated with nevoid basal cell carcinoma syndrome. A multidisciplinary approach involving oral and maxillofacial surgeons, pathologists, and geneticists may be required, especially in cases of syndromic association. Early detection and management of recurrences are essential for optimal patient outcomes.

Background: Rural infrastructure, agro-processing, and decentralized energy systems in the Osmanabad district of Maharashtra utilize a significant quantum of rotating machinery (e.g., centrifugal pumps, turbines, and compressors). Regular mechanical failures and erratic equipment breakdowns in these facilities result in substantial loss of productivity and maintenance problems, which can be particularly challenging in resource-poor settings with limited technical support. Objectives: The purpose of this work is to evaluate the effectiveness of AI-based PdM models in detecting faults and preventing machine malfunctions for rotating machinery. This paper aims to design context-sensitive, affordable, and understandable AI solutions that meet rural deployment requirements, to satisfy fault detection accuracy, maintenance cost savings, and stakeholders' trust. Methods: Employing a concurrent mixed-methods approach, the study integrated 6 weeks of multi-sensor data (vibration, temperature, acoustic signals) collected from five rural machinery sites in Osmanabad, with qualitative interviews with technicians and plant managers. Machine learning algorithms (CNNs, LSTMs, Isolation Forests, hybrid TCN-Autoencoders) were trained and validated under the supervised and unsupervised paradigms. The performance measures were the classification accuracy, mean squared error, and stakeholders' usability rating. Results: The fault detection accuracies were all higher than 95% for all the models. CNNs had the best performance with 99.89% for impeller blade faults, and LSTMs had 98.5% for turbine vibration anomalies. The total maintenance costs were decreased by 31% and the downtime was reduced by up to 70%. Technicians had high trust in AI systems, particularly if they were provided with explainable outputs such as fault heatmaps and predictive dashboards. Conclusions: AI-supported PdM systems are capable of generating impactful improvements in equipment reliability and operational efficiency when co-designed with community stakeholders and adjusted for a rural setting. This study adds to mechanical engineering and equitable AI adoption in underserved areas.

Background: CO₂ emissions related to the production of concrete contribute significantly to the global footprint, resulting in approximately 8% of the total anthropogenic CO₂ output. Even as India races to build its rural infrastructure, districts like Osmanabad, with its pervasive climate vulnerability and construction-induced emissions, must grapple with a potent toxic brew of the two. Carbon-neutral concrete especially through CO₂ mineralization or the use of carbon-capturing additives presents a viable way to decarbonize construction while enhancing the material's properties. Objectives: This study aims to assess the feasibility, environmental impact, and stakeholder opinions regarding carbon-neutral concrete technology in Osmanabad. More specifically, the study explores the possibility of using CO₂ mineralization during curing and locally available carbon-capturing additives to reduce embodied carbon in rural infrastructure projects. Methods: A mixed-methods exploratory design was employed, incorporating semi-structured interviews, field observations, focus groups, and technical performance tasks. The research population consisted of 80 informants: engineers, masons, municipal officers, vendors, and teachers. Thematic analysis of qualitative data was conducted through NVivo, and comparable quantitative indicators, including compressive strength and carbonation depth, were benchmarked across pilot sites. Results: There were improvements in the strength of carbon-neutral mixes of up to 25% higher and 30 to 50% in the carbonation depth than the equivalent conventional concrete. Technical professionals had a high level of stakeholder awareness; however, this was lower among field workers. Obstacles were the healing infrastructure, additional expense, and training deficiencies. Considering the local availability versus cost, fly ash and biochar were identified as potential amendments. Conclusion: Carbon-neutral concrete could be an alternative for climate-resilient construction in Osmanabad. Its scale-up relies on policy and support, regionally specific supply chains, and capacity development. Environment: Through the combination of environmental innovation and rural development, Osmanabad is demonstrative of what low-carbon infrastructure could look like in a resource-stripped context.

Background: Electronic Health Record (EHR) systems have been implemented globally to enhance healthcare delivery. In Saudi Arabia, the adoption of EHRs has rapidly increased in recent years, yet little is known about the experiences of healthcare professionals (HCPs) with EHR implementation in this context Aim: This qualitative study aims to explore the experiences of HCPs in Saudi Arabia before and after the implementation of EHR systems, with a focus on understanding the challenges and benefits associated with this transition. Methods: Semi-structured interviews were conducted with a purposive sample of HCPs from various healthcare settings across Saudi Arabia. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis to identify patterns and themes related to HCPs' experiences with EHR implementation. Results: Analysis of the interviews revealed several key themes related to HCPs' experiences before and after EHR implementation. Before implementation, HCPs expressed concerns about workflow disruptions, technical challenges, and resistance to change. However, after implementation, many HCPs reported improvements in information accessibility, care coordination, and patient outcomes. Despite these benefits, challenges such as increased documentation burden and decreased face-to-face interaction with patients were also identified. Conclusion: The findings of this study highlight the complex and multifaceted nature of EHR implementation in Saudi Arabia. While the transition to EHRs presents both challenges and opportunities for HCPs, it is crucial to address concerns related to workflow optimization, training, and support to ensure successful implementation and maximize the benefits of EHRs in improving healthcare delivery in the Saudi context.

Background: In recent years, there has been a growing interest in exploring innovative approaches to healthcare delivery that prioritize patient-centred care and enhance clinical outcomes. Nurse-led rounds have emerged as a promising strategy to foster patient engagement, improve communication among healthcare team members, and optimize patient care delivery. Therefore, the objective of the present study was to examine the impact of Nurse-Led Rounds on patient satisfaction and patient clinical outcomes in a Middle Eastern Country. Methods: A mixed-method research design was used in this study. A Clinical trial was carried out by using a non-equivalent control group design was adopted to design to assess the impact of Nurse-led Rounds on patient satisfaction and patient clinical outcomes through quantitative data collection and semi-structured individual interviews identified the benefits of hourly rounding to enhance patient satisfaction through qualitative data collection. The study was conducted at New Najran General Hospital, Najran Saudi Arabia. The quantitative data was collected from 68 clients and qualitative data with 10 participants. Results: The results of the quantitative analysis showed that the experimental group's mean score significantly improved when nurse-led rounds were implemented, reflecting the quality of care given by nurses. Compared to the control group, which had a mean score of 4.75 (SD=1.578) on the first day of hospitalization, the experimental group had a higher mean score of 6.06 (SD=0.531). This early disparity implies that the experimental group had a higher standard of care from the beginning. The qualitative study revealed two primary themes about individual advantages and organizational benefits were found, according to the qualitative study. The deployment of Nurse-led rounds was judged by clients to offer many specific benefits related to patient satisfaction and overall clinical result levels. Theme 1: Better communication, reduced anxiety, support for drug administration and patient safety, and general increases in patient satisfaction. The second theme focuses on improving overall client healthcare outcomes, improving interprofessional collaboration and teamwork, and reducing readmission rates. Conclusion: The implementation of nurse-led rounds has demonstrated a significant positive impact on both patient satisfaction and clinical outcomes. Through the integration of nursing expertise, patient-centred care principles, and effective communication strategies, nurse-led rounds have enhanced the overall patient experience and contributed to improved clinical outcomes.

Socio-political crisis tends to push students out of their communities causing them to seek for safer sanctuaries elsewhere but a good number of them still do not want to move out despite the unscrupulous happenings. Understanding how students extenuate coping strategies in such unbecoming atmospheres becomes pivotal. The crisis in the North West Region of Cameroon has propelled non-displaced students to venture in new life styles in order to acquire education amidst crisis without being repulsive. It is against this premise that this study sets out to investigate students’ resilient strategies within the current crisis in the North West Region of Cameroon. Data for the study was amassed from secondary and primary sources. The secondary sources involved soft and hard copies of both published and unpublished documents while primary data was gleaned from field interviews and observation. With the help of snowball sampling technique, 40 interviews’ guides were administered in some sampled Divisions of the North West Region of Cameroon. Extra data was gotten through direct observations and focus groups discussions. Results revealed that, for non-displaced students to effectively negotiate and obtain secured education amidst crisis; community-based learning centers were created, religious convictions was used as a mechanism for confronting insecurity, adjustment in school institutional cultures, Shifting paradigms in disciplinary practices/majors in schools and adaptability potentials towards food insecurity in the crisis zones.

In the context of digital transformation and the impact of the current market economy, building a school culture is crucial to the quality and humanity of education. Building a school culture is currently facing many difficulties. To solve these difficulties, promoting the Vietnamese cultural value system in building school culture content has theoretical and practical significance. Based on using methods of analysis, synthesis, systematization, and generalization of relevant documents on the Vietnamese cultural value system (ethnicity, humanity, democracy, science - according to Resolution 33-NQ/TW of the 9th Meeting of the Party Central Committee of the 11th tenure on building and developing Vietnamese society and people meeting the demand for national sustainable development) and school culture; The article analyzes the role of the Vietnamese cultural value system in building school culture in our country today, including the fundamental tasks: The Vietnamese cultural value system is the foundation for culture school; orientation for building school culture; protect and strengthen school culture in the direction of humanity, tradition, and modernity; through the school culture of educating the young generation in Vietnam.