Micro, Small and Medium Enterprises or MSMEs have proven to be the spearhead of the Indonesian economy at the national, regional, and regional levels, including in the Regency/City of Tasikmalaya. The sustainability of MSMEs is a success in business ventures. This can be seen from the digital marketing strategy, financial management, and access to capital, which are the determining factors for the competitiveness of MSMEs products. This study aims to determine the effect of digital marketing, access to capital, and financial management on product competitiveness in Tasikmalaya Regency/City. It can be used as supporting and evaluation material in planning activities and policy planning, increasing MSMEs product competitiveness in Tasikmalaya Regency/City. The research method used quantitative research using a questionnaire instrument distributed to MSMEs actors in the Tasikmalaya Regency/City with 74 respondents. The data analysis technique used is multiple linear regression with the help of the SPSS program. The study results show that digital marketing, access to capital, and financial management positively affect product competitiveness in Tasikmalaya Regency/City.

Nonketotic hyperglycemia is a rare cause of hemichorea-hemiballismus. We report a case hemichorea-hemiballismus secondary to nonketotic hyperglycemia revealing an inaugural diabetes mellitus. A 55 year-old woman, admitted for subacute-onset of continuous involuntary movements in the right upper and lower limb since three days ago. The movements increased with action, decreased with relaxation, and disappeared during sleep. As the condition did not affect her trunk, other limbs, or her face and no other conditions were evident. At admission, the right upper and lower limb was moving involuntarily. The movement was wild, flailing, and repetitive with varied amplitudes and frequencies. No tremor and rigidity were elucidated and cerebellar signs were negative. Laboratory tests revealed diabetes mellitus, with a fasting blood glucose level of 4,60 g/L and a hemoglobin A1C level of 14.0%. The urine examination was negative for ketones. CT of the brain showed left pallidum hyperdensity. The brain MRI revealed hyperintense signal in the left pallidum on T1-weighted images and isointensity on T2-weighted images. Other laboratory results were within the normal range. A diagnosis of hyperglycemia-associated hemichorea-hemiballismus was made. An insulin treatment and oral antidiabetics were instored. She was subsequently discharged after 14 days of hospital stay with improved glycemic control. Three months after, her chorea-ballismus was completely resolved. A control of brain MRI six month after showed marked improvement in the putaminal changes. Vigilance for this cause of hemichorea-hemiballism is important, since the movement disorder may be the presentation of potentially dangerous underlying hyperglycemia.

Perinephric abscess is a rare life-threatening condition. It can complicate a urologic infection or occur secondary to hematogenous seeding. We report a case of a 49-year-old diabetic female who came to the outpatient department with complaints of right-sided abdominal pain for 2 days. It was associated with fever, headache, vomiting, and generalized weakness. Non-contrast computerized Tomography (NCCT) showed a subcapsular collection measuring 6.1× 5.7 × 4.4 cm noted adjacent to the lateral aspect of the right kidney. Following percutaneous nephrostomy, thick pus was drained from the abscess and sent for culture and sensitivity in the microbiology laboratory. Culture grew extended-spectrum beta-lactamase-producing (ESBL) Klebsiella pneumoniae which was sensitive to Carbapenems, Piperacillin Tazobactam, Fluoroquinolones, Netilmicin, Amikacin, and Tetracycline. The patient improved on treatment with the appropriate antibiotics. Perinephric abscesses should be considered as a differential diagnosis of fever with abdominal pain or flank pain since its non-specific nature can delay the diagnosis. Underlying diabetes mellitus (DM), urinary tract abnormalities, and immunodeficiency should be considered in a patient with a perinephric abscess. Ultrasonography (USG) and Computerized Tomography with contrast enhancement are crucial for diagnosis. The drainage of the abscess, either percutaneous or open, should be done. Klebsiella pneumoniae is a frequent cause of perinephric abscesses and mostly follows a complicated urinary tract infection. With high mortality rates, early diagnosis, and effective treatment of perirenal abscesses are required to improve the prognosis of patients.

COVID-19 pandemic caused enormous damage to the economy and financial status of many countries as well as influenced the peoples’ health and wellbeing, also its impact nurses' job satisfaction and their intention to leave their profession as the nurses form the vast majority of health care workers who have been in the frontline in the pandemic fight. This review aims to assess the factors associated with nurses intention to leave during the covid-19 pandemic. This research paper was made by analyzing the findings of previous studies related to nurses' job satisfaction and intention to leave the job during the (COVID-19) pandemic. The review used Whittemore and Knalfl to conduct the review and locate the related paper. This method considers a broad review method because it allowed the researcher to include varied research types. The findings showed three factors that had a significant impact on nurses' intention to leave, which include: a) fear of COVID 19,b) leak of social support, and c) work-related factors. Analyzing the studies on factors associated with nurses' Intention to Leave during the COVID-19 pandemic revealed various interrelated factors on nurses' intention to leave, including fear of COVID 19, leak support, and several work-related factors.

Intercellular communication is an integral part of the physiological process in a living organism. Evidence has shown that a significant amount of human protein-coding genes is endowed with the production of membrane and secreted protein types. Some of these proteins possessed post-translational influence that interferes with cellular functions. Recently the concept of cell communication gravitated to the use of membrane-bound particles called Extracellular Vesicles (EVs). EVs are released from the host cell and impact on the recipient cell through its contents (Cargo). The cargo contains various particles such as lipids, proteins, RNA, and glycolipids derived from the host cells. The current widespread research in EVs has brought its mediating role in physiological and pathological processes to limelight. Though the regulatory part of EVs has been widely embraced by researchers, the discrepancy associated with its collection and isolation as well as its analysis has remained a subject of debate in the literature. The facts emanating from the literature suggest that EVs, with its prospective application in Reproductive biology, has prompted extensive research in the last decade. Its knowledge has broadened the scope of understanding the physiology and pathology scenarios involved in reproductive processes. As a potential biomarker, it has become a valuable tool for diagnosis, prognostic, and therapeutic purposes, especially in the context of reproductive processes. However, the challenges of standardizing the isolation, purification, and analyzing EVs have remained a nightmare that need to be surmounted. Emerging evidence has demonstrated its impact in gamete development, fertilization, and embryo implantation. Thus, it could serve as a platform to understand the mechanism of conception and implantation. By extension, define a therapeutic approach for women with recurrent pregnancy loss.

We present thirteen examples of pulmonary pneumocystis (PCP) in patients without HIV infection. Eight men and five women, average age 55, with one instance of breast neoplasia, two cases of DICV, one case of "Goodpasture's syndrome," one case of idiopathic fibrosing PINS treated with extended corticotherapy for two years, and the other patient without known immunosuppression. In 11 cases, there is persistent dyspnea and severe hypoxia. Lymphopenia (9 instances), with a 920.76 element/mm3 average rate. Except in two cases where examination of the bronchoalveolar lavage fluid was required, the diagnosis was established by the isolation of Pneumocystis jiroveci in the induced sputum. The evolution was positive in every case while receiving trimethoprine-sulfametaxazole and corticosteroid therapy.

The digitalization of commerce and finance has brought us to the era of e-business and e-transactions. E-business transactions refer to the use of electronics in the carrying out of commercial activities (sales and purchases). Unfortunately, the rise of e-business transactions has been plagued by the issue of electronic fraud, which has become prevalent now more than ever. Mathematics as a field is fundamental to life and present in virtually every aspect of man’s life and is an essential tool required and used in problem-solving. The business world is not exempt from the influence of mathematics, and considering this, this study explores the relevance of mathematical knowledge and skills in e-business transactions, as well as in solving the problem of electronic fraud. Mathematics was shown to be useful in fraud prevention tools and strategies like cryptography, data management, and optimization, risk assessment, fraud prevention algorithms, etc. We suggest that all the stakeholders in every field should teach the importance and use of mathematical knowledge and skills to all learners in the entire education system and efforts toward encouraging the development of mathematical knowledge and skills for individuals across all fields, especially in science, technology, business world and in form of training among others.

This study was conducted to assess the level of Patient’s Satisfaction towards "WASFATY" E-Prescriptions Service provided by community Pharmacies in Qassim Region. Method: The study used a cross-sectional approach; it was conducted between September and November 2022. Data was collected using a random sampling technique, and an online questionnaire was distributed among the study population. A Ten-point scale, ranging from 1 (Extremely Poor) to 10 (Excellent), was used to assess patient satisfaction. Results and Conclusion: A total of 294 beneficiaries participated in the study. The level of satisfaction towards "WASFATY" E-Prescriptions Service provided by community Pharmacies in Qassim Region is (2.92) out of 5, (58.4% SD (3.235)). Aspects related to the pharmacy was divided to two points, the barriers consist of six domains, not all medicines are available (24.4%), E- prescription program-WASFATY- at the pharmacy has broken (9.6%), Receiving alternative medicines (Brand change/company name different) (11.8%), The pharmacist asked to come at another time(5.4%), Unavailability of a participating pharmacy in the WASFATY close to home (24.4%), Not applicable (24.4%), and the advantages consist of six domains, Freedom of timing in receiving medication (20.7%), No waiting time needed (16.3%), Fast access to obtain the medication (11.7%), Ease of obtaining medication (9.9%), The number of pharmacies participating in the WASFATY program(20.7%), Availability of a pharmacy participating in the e-prescription near the house(20.7%).

The current study was carried out to isolate and identify Enterococcus species from clinical samples and to analyse the antimicrobial susceptibility pattern of Enterococcus Species. All clinical samples which were received in Microbiology laboratory were included in the study. A total of 2958 samples were received. These 129 Enterococci isolates were obtained over a period of 1 year from various samples namely, urine, blood, pus. Samples were processed for microscopy and culture as per the standard guidelines. all samples were inoculated on MacConkey agar and Blood agar. Identification and antibiotic sensitivity pattern of bacterial isolates were carried out by automated system. i.e. VITEK 2 Compact. Out of 2958 samples, Total 129 samples showed growth of enterococci. Out of 129 isolates, 84 were Enterococcus spp, 18 were E.faecalis, 16 were E.faceium. Out of total 129 samples, 76 samples were of males and 53 were of females. Most common samples from which enterococci were isolated was urine accounting for 85 followed by Pus accounting for 15. Medicine department showed the highest isolates with 88. Out of 129 Enterococci 64 showed resistance to primary line of drug like Benzyl penicillin, 79 Enterococci showed resistance to Ampicillin. Out of 129 enterococci 70 showed resistance to secondary line of drug like tetracycline,59 isolates showed resistance to High level Gentamycin, 41 isolates showed resistance to Vancomycin,23 isolates showed resistance to Linezolid. The strains of Enterococci were multidrug resistant. Anitibiotic selection should be done judiciously based on the antibiotic sensitivity pattern of the organism.

Taurine chemically known as 2 aminoethanesulfonic acid; NH2CH2CH2SO3H it’s a non essential amino acid, due to absence of carboxyl group it does not participate in protein synthesis, it does not metabolized and thus not involved in gluconeogenesis, thereby not constituting a direct energy source, This wonderful molecule was discover in 1827 by two German scientist Tiedemann and Gmelin from bile of ox (Bos taurus), Ten years later, this amino acid got its name as Taurine by Demarcay, and 20 years later Jacobsen and Smith discovered that its structure contains sulfur. In a wide variety of invertebrate and vertebrate tissues the natural occurrence of taurine has been recognized, It is also present in plants algae and fungi. In this review we try to cover all possible beneficial role of taurine.

There is much empirical evidence that Ghanaian banks have adopted electronic banking. By using an automated teller machine, the internet, a phone call, or a mobile device, customers of a bank can request information and conduct majority of banking transactions without having to physically visit the bank branch. Electronic banking, entails all kinds of bank transactions carried out through an electronic medium. This study evaluates how COVID-19 has affected bank clients' adoption of electronic banking in Ghana. Using explanatory research approach and purposive sampling technique, we applied SPSS tool on data collected from four-hundred (400) respondents of a targeted customer population to meet the study's goal. Self-administered close-ended questionnaires were used to collect primary data from the respondents.

Technological growth and advancement, coupled with the advent and expansion of the Fourth Industrial Revolution, has brought about the invention of products that facilitate and enhance human life. Artificial intelligence and Machine Learning have permeated virtually all sectors of the world and have received both positive and negative feedbacks. Undoubtedly, the human race is yet to keep up with the accelerating expansion of the Fourth Industrial Revolution. Artificial Intelligence being a subset of the Fourth Industrial Revolution is packed with enormous benefits which shall be accrued to participating states, and one of these benefits is the Lethal Autonomous Weapons (LAWs) otherwise known as Autonomous Weapons Systems (AWS) or “killer robots”. Since the inception of LAWs, researchers, lawyers, IT experts, and scientists have opposed its adoption, urging the international community to impose strict laws on states utilising it. The invention of AI programmed weapons is not the subject matter of contention, rather, the ground for opposition is the “autonomy” granted to the weapons. These machines can function without human oversight and are programmed to be unpredictable. International Humanitarian Law opposes the use of weapons that pose threats to the civilian population, of which LAWs is inevitably a part of. LAWs defile ethical and legal positions. These weapons are so accurate and swift that they can destroy hundreds of humans in a couple of minutes and countries in possession of these machines could use them without recourse to the victims. This research work investigates the threats and risks posed by Lethal Autonomous Weapons to the Society. It analyses International law provisions in respect to LAWs and feasible measure to curb the use of LAWs across the globe.

Advances in fisheries system have been made in the few past years due to different technological progress in the food chain system by improving the mutual communication among different types of organisms. Overfishing, anthropogenic climate change, and pollution are already having measurable impacts on the marine environment throughout the majority of the globe, and their potential long-term repercussions are very concerning. Fishing activity contributes to marine debris; the proportional contribution of recreational fishing has not been quantified. New approaches that are being used in various ways include the precautionary approach, the ecological approach, adaptive management, and harvest control rules. Growth in coastal population has made water and land pollution worse and placed additional pressure on coastal development. Satellite remote sensing has been an essential tool in fishery research, management, and harvesting because it offers synoptic ocean measurements for evaluating environmental influences on the abundance and distribution of fish populations and allows ecological analyses at community and ecosystem scales. Synthetic super-active analogues with higher inducing potency at lower doses were developed using biotechnological techniques including protein engineering and recombinant DNA technology. There are many methods of preservation, including as drying, smoking, freezing, chilling, and brining. Fish that has been smoked or dried has more nutrients and is easier to digest. Fish is often prepared by smoking or drying; both processes eliminate moisture by heating, which reduces the development of germs and increases shelf life. Advances in genetic engineering also helpful for improving the new varieties in the fisheries system.

This review article examines the importance of postoperative management and follow-up for individuals who undergo bariatric surgery. The study covers various aspects of postoperative care, including patient selection and preparation, nutritional management, physical activity, monitoring and follow-up, and psychosocial support. The article provides recommendations for each aspect and discusses the factors that influence weight loss outcomes after bariatric surgery. Strategies for addressing psychological and emotional challenges are also explored, along with the role of support networks in achieving long-term success. The findings suggest that a comprehensive approach to postoperative care, including regular monitoring and follow-up, nutritional management, physical activity, and psychosocial support, is crucial for achieving optimal weight loss outcomes after bariatric surgery. The study has important implications for clinical practice, and future research should focus on identifying ways to improve postoperative care and outcomes for individuals who undergo bariatric surgery.

Wheat is a common staple crop in Pakistan and it is also a major component of most people's daily diets. Pakistan is ranked eighth in the world for wheat production. The fifth major factor affecting crop yields is a lack of micronutrient availability. A field experiment was carried to determine the impact of foliar application of boron on the productivity of different varieties of wheat at Agronomic Research Farm, University of Agriculture, Faisalabad during Rabi season in 2020-21. The crop was sown by hand drill in plots with a net size of 6.5 m × 1.8 m. The experiment was comprised of 12 treatments in randomized complete block factorial design with two factors i.e. V1: Ghazi 2019, V2: Akbar 2019, V3: Anaj 2017, and four boron levels i.e. B0: 0g ha-1, B1: 50g ha-1, B2: 60g ha-1 and B3: 70g ha-1. The source of boron was boric acid which contains 5% B. Significantly the plant height (7.46%), productive tillers (6.01%), spike length (24.18%), number of spikelets per spike (35.53%), number of grains per spike (42.32%), 1000-grain weight (19.44%), grain yield (22.15%), biological yield (24.33%), harvest index (3.63%) increased as compared to control in wheat variety Akbar 2019 where 70 g ha-1 boron was applied at booting, flowering and milking stages. Recommended from observations that 70g ha-1 boron at the booting, flowering and milking stages is helpful for achieving a higher economic yield of wheat.