When foreign substances enter our body, such as infectious microorganisms, macromolecules, and others, a collective and organized response from our body occurs to resolve this situation. Many studies of the immune response have already been conducted by scientists, but there are many other mechanisms to be understood due to the complexity of the immune system. Therefore, the great challenge of multidisciplinary studies is to understand and manage the immune system. This manuscript aims to study the immune system, emphasizing immunological memory, neuroimmunology, immunological placebo effect, and therapeutic updates of the immune system. In this study, a systematic review of the literature was carried out to investigate immunological memory, neuroimmunology, immunological placebo effect, emotional autoimmune response, and therapeutic updates of the immune system. The research included an analysis of experimental studies and reviews that discuss new diagnostic techniques and therapies in the management of these conditions. Recognized databases such as PubMed, Medline, SciELO, and Google Scholar were used for data collection. This methodological approach allowed the compilation and analysis of quality and relevant scientific literature, ensuring a broad and updated view of emerging practices in the immune system.

This study evaluates the indirect tensile strength (ITS) of rice husk ash (RHA)-based geopolymer-stabilized deltaic clay soil, characterized by high plasticity (liquid limit 76.5%, plasticity index 35.3%) and low bearing capacity (CBR 3.99%). Using a quarter fractional factorial design with 32 runs, seven key mix parameters were screened: alkaline activator-to-RHA ratio (0.20–0.40), sodium silicate-to-sodium hydroxide ratio (1–3), sodium hydroxide concentration (8–14 M), curing period (4–72 hours), curing temperature (40–120°C), water-to-solid ratio (20–25%), and compaction delay (0–180 minutes). After 28 days curing, ITS ranged from 0.49 to 0.66 MPa, indicating substantial improvement over untreated soil. Effect analysis revealed compaction delay had a significant negative impact on ITS (effect = –0.0869, t = –9.379), while sodium silicate-to-sodium hydroxide ratio (effect = 0.0220, t = 2.381) and sodium hydroxide concentration (effect = 0.0210, t = 2.237) positively influenced strength. Among interactions, only the alkaline activator-to-RHA ratio combined with sodium silicate-to-sodium hydroxide ratio was significant (effect = 0.0230, t = 2.453), highlighting the critical synergy between precursor content and activator composition. These findings underscore the importance of optimizing compaction delay, activator composition, and precursor ratio to enhance geopolymerization and tensile strength through sodium aluminosilicate hydrate (N-A-S-H) gel formation. This research addresses a crucial gap in tensile strength characterization of geopolymer-treated deltaic clays and supports sustainable agro-industrial waste valorization for geotechnical applications.

The main objective of this study is to examine the effect of entrepreneurial orientation on business performance of women own enterprises in North-West region of Nigeria. Data were collected from the women own enterprises operating in North-West region of Nigeria using a cross-sectional study design. The study adopted convenient and simple random sampling techniques to select the sample by using Krejcie and Morgan formula to selected 234 respondents. Questionnaires were distributed and collected through the personally-administered method. In analyzing the relationship among the study variables, Partial Least Squares Structural Equation Modelling (PLS-SEM) was used to test the study hypotheses. This study finds that risk taking, competitive aggressiveness, and autonomy are important strategic orientations for the performance of women own enterprises in North-West region of Nigeria. Therefore, drawing upon liberal feminist theory, this study examined the roles of entrepreneurial orientation is buffering the influence entrepreneurial orientation on survival of women own enterprises. The also revealed that innovativeness does not support this expectation as innovativeness has a significant negative influences on business performance. Interestingly, entrepreneurial orientation has a significant positive relationship with business performance. Finally, this study has succeeded in validating the aforementioned conceptualization as well as advancing significant theoretical and practical contributions to both researchers and business owners/managers for further understanding on the influence of entrepreneurial orientation on the business performance. This study propose that this kind of study could be extended to microfinance bank services on business survival of women own enterprises.

Background: The management of ureteral calculi is constantly evolving, and advances in technology, new medications and the application of pharmacotherapy continue to alter our approach to ureterolithiasis. The optimal clinical management of patient with ureterlithiasis requires knowledge of the diagnostic procedures, the rational treatment of acute stone colic, stone expulsive treatment and the modern principles of stone removal. The aim of this study was to explore the clinical characteristics and management of ureterolithiasis. Methods: This cross-sectional descriptive study was conducted in the Department of Surgery and Urology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from December 2013 to May 2014. Fifty eight patients with ureterolithiasis fulfilling the inclusion and exclusion criteria were selected. Results: The mean age of the patients was 36.0 ± 13.2 years, with the majority aged 31–40 years. All patients presented with abdominal pain, and 84.2% reported radiation of pain to the groin or genitalia. Other symptoms included nausea/vomiting (39.6%), hematuria (36.2%), and burning micturition (27.6%). Most stones (89.7%) measured between 1–2 cm. Treatments included ESWL (36.2%), ICPL (22.4%), open ureterolithotomy (31.0%), and expectant management (10.3%). Postoperative urinary tract infection occurred in 17.2% of cases; wound infection occurred in 11.1% of open surgery cases. Overall stone clearance was 86.2%, with the highest clearance in open ureterolithotomy (100%). Conclusion: With the availability of better facilities like Extracorporeal Shockwave Lithotripsy, the requirement for open surgery and interventional procedures may decrease.

The utilization of technology-enhanced learning (TEL) has proven to enhance the learning experience for learners by increasing learner engagement and learning outcomes in many countries including Kenya. Despite the benefits of TEL resources in teaching and the government's effort to avail the necessary TEL resources, there is still low uptake of TEL by history and government teachers. The purpose of this study therefore was to assess teachers’ experiences on the integration of technology-enhanced learning in teaching history and government in national schools in Western region Kenya. The study used a mixed concurrent method approach and adopted Pragmatism as the ideal paradigm. Cross-sectional Research Survey design was employed. Purposive sampling was used to select 8 national schools, the target population was 43 form four teachers of history and government and used the Krejcie and Morgan table to arrive at a sample size of 40 teachers who were selected using stratified random sampling. Research instruments included questionnaires, document analysis, and observation schedules. Quantitative data was analyzed through descriptive statistics such as frequencies, percentages and standard deviations and presented through tables and pie charts. Qualitative data was organized into themes, thematically analyzed and presented through narration. The study established that gender 28(70%), age 21(52.5%), highest level of education 29(72.5%), basic training in technology 33(82.5%), level of training in basic technological skills 27(67.5%), and technological training program attended by teachers 23(57.5%) influenced their attitude towards the integration of TEL resources in teaching history and government. This study recommends that there is need for school management in consultation with parents to set aside funds to train teachers on technological skills.

The article is devoted to one of the main problems of the evolution of the earth's crust, where from the position of the concept of the dynamics of the evolution of the earth's crust (CDEEC) the nature of numerous geological processes is clarified. Including the origin of geodynamic forces and those geotectonic processes that directly occur under the influence of these forces: such as volcanoplutonic; seismotectonic processes; global deep fault networks; divergent and convergent zones; active and passive margins; riftogenic processes; the origin of arc systems, etc. The origin, mechanism of formation, as well as their distribution patterns on the face of the Earth and other characteristic features of these natural processes are clarified from the position of CDEEC. From the position of this concept, geodynamic forces are formed during the rotation of the Earth around its axis and they are distributed on the face of the Earth with certain patterns, which are predetermining factors in the development of geological processes. These geological processes, both in scale and in form of distribution, have their own specific features, which are important in the formation of various genetic types of mineral deposits. Therefore, the study of these processes is one of the priority areas of geological research.

Background: A near-miss obstetric morbidity means a woman who almost died but survived by chance due to any pregnancy related complication. Postpartum hemorrhage has been the leading cause of maternal mortality and morbidity worldwide. The near-miss morbidity due to PPH is an important indicator of maternal care and could be used to compare improvements in treatments more accurately than mortality rate alone. Objective: To evaluate the near miss cases due to PPH in MMCH. Methods: It will be a cross-sectional descriptive study on near miss patients admitted in the Department of Obst& Gynae of MMCH during six months study period. 50 patients will be purposively enrolled according to inclusion and exclusion criteria. Socio demographic character of the patients, clinical presentation, risk factors, mode of delivery, extent of morbidity, amount of blood transfusion, duration of hospital stay, need of ICU support, incidence of peripartum hysterectomy or other surgical interventions will be considered as major variable of the study. Results: Among 50 patients of near miss cases, 21-25 years group belonged to the highest (40%) 30 (60%) patients came from poor class. 32(64%) patients underwent irregular ANC. 27(54%) patients were multipara. 15(30%) had our hospital and 35(70%) patients had delivery in outside hospital. Besides, 27(54%) and 23(46%) patients had vaginal delivery and cesarean delivery respectively. Regarding clinical presentation 17(34%) and 8(16%) patients came with atonic uterus and retained placenta respectively. 32(64%) patients were managed conservatively and 18(36%) patients needed surgical management. 21(40.36%), 9(18%), 8(16%), 5(10%) patients required >3 unit blood transfusion, ICU admission, hysterectomy and laparotomy respectively. Conclusion: 'Near miss' events are important indicators for monitoring the quality of maternity services in health care facilities. Maternal near miss in association with PPH shows better results in case of our hospital managed patients whereas the worse outcome was observed in case of patients who were managed outside hospital.

Background: The management of ectopic pregnancy has undergone a revolution in the past few decades. Evidence suggests that the incidence of ectopic pregnancies has been rising. Earlier diagnosis also plays a role by identifying ectopic pregnancies that would have spontaneously resolved. Objectives: The aim of the present study is to describe the presentation and different modalities of management of ectopic pregnancies admitted to the Gynecology ward over the study period. Methods: This was a cross-sectional study was done in the Obs & Gynae Department, Shaheed Suhrawardi Medical College Hospital. Fifty patients who were clinically suspicious of ectopic pregnancy and also supported by positive urinary pregnancy tests, beta hCG and no intrauterine gestational sac in ultrasonography was included for the study. Data were collected in a preformed questionnaire and analyzed by SPSS (version 22.0). Results: Maximum respondents (60.0%) age 21-30 years, mean age 27.71±5.3 years. The past history of pelvic inflammatory disease (PID) forms the major bulk of the risk factors of ectopic pregnancy. Patients had H/O pelvic inflammatory disease was 54% of the study population. Patients had H/O of menstrual regulation 16.0% and history of abortion (spontaneous and induced) 20.0%. Most of the patients 56% having history of < 8 wks. of amenorrhoea, 6% having no history of amenorrhoea and least (4%) having more than 10 weeks amenorrhoea. All (100%) of the patients having history of Abdominal pain; Amenorrhoea was found in (94%), Vaginal bleeding was found in (82%) and general weakness was found in (90%). On the other hand less than 40% had symptoms of fainting attack (36%) and early pregnancy sign-symptoms (38%). Among 50 patients 43(86%) undergone surgical operation,5(10%) receive medical treatment and 2(4%) are managed expectantly, 93.02% cases of ectopic pregnancy occurred in the fallopian tube, 4.6% cornual, 2% ovarian among the study population undergone laparotomy. Right tube was found to be involved more often (55%) than left (45%) and in most of cases (93.02%) the tube was found to be ruptured. Out of 43 cases of laparotomy 37 (86.04%) cases unilateral salpingectomy, 3(6.9%) cases unilateral salpigectomy with contralateral tubectomy and 1(2.3%) cases unilateral salpingo-oophorectomy were done. one case removal of cornu and repair done. Small number of patients had developed minor complications like pyrexia alone 23.25%, Pyrexia with lower abdominal pain (18%), wound gap (2.3%), mild abdominal distension (4.6%), UTI with pyrexia (6.9%) and loose motion (4.6%) among the study population. Conclusion: Pelvic inflammatory disease and multiple induced abortions and menstrual regulations are the strongest risk factors of ectopic pregnancy. Prevention of PID may not only reduce the ectopic pregnancy but also reduce adverse effects on tubal patency. Child birth in total aseptic conditions by a skilled birth attendant to prevent incidence of pelvic infection.

This study explores the historical roots and cultural significance of Female Genital Mutilation (FGM) in ancient Egyptian civilization and its persistence in modern times. It examines how ancient cultural practices were transmitted and adapted across generations, influencing contemporary societal norms. It should be noted that cultural exchanges play a significant role in shaping attitudes towards Female Genital mutilation. Cultural exchange facilitates the sharing of experiences, promotes understanding, and fosters a sense of community actions. The transfer of ancient traditions, including Female Genital Mutilation, through trade, exchange of cultures and many others, is complex. Historically, trade routes and cultural exchanges, spread ideas and practices. This paper highlights the complex interplay between cultural heritages, how cultural exchanges influence the transmission of FGM from communities to communities beyond Egypt, Egyptian life and the mode of transmission.

Antimicrobial resistance (AMR) represents a profound and escalating global health crisis, threatening to dismantle the foundations of modern medicine. In response, healthcare systems worldwide have implemented antimicrobial stewardship programs (ASPs) to optimize antimicrobial use, improve patient outcomes, and curb the emergence of resistant pathogens. This review article explores the central thesis that the efficacy and success of contemporary ASPs in tertiary care settings are not merely enhanced by but are fundamentally dependent on the synergistic and deeply integrated collaboration of pharmacists, laboratory specialists, and nurses. We dissect the unique and indispensable contributions of each profession: the pharmacist's expertise in medication optimization, prospective audits, and formulary management; the laboratory specialist's foundational role in rapid diagnostics, susceptibility testing, and data-driven guidance; and the nurse's critical frontline position in timely administration, clinical monitoring, and patient education. By examining the intricate workflows and communication pathways that bind these roles, we present a model for an ideal "stewardship handshake," illustrating how their combined efforts lead to targeted, effective, and safe antimicrobial therapy. Furthermore, this review addresses the significant barriers to effective interprofessional collaboration—such as communication silos, hierarchical structures, and workflow inefficiencies—and proposes evidence-based solutions to overcome them. We also delineate key performance indicators for measuring the collective impact of this collaborative model. Finally, we look toward the future, considering the integration of emerging technologies like artificial intelligence and telehealth into stewardship, and conclude with a call to action for healthcare institutions to recognize, foster, and invest in these interprofessional teams as the primary defense in preserving the viability of antimicrobials for generations to come.

Background: Tapentadol having both mu-opioid receptor agonist and norepinephrine reuptake inhibitor characteristics has better GI profile and analgesic efficacy in acute and chronic including neuropathic pains. Post operative pain using tapentadol nasal spray with quicker recovery helps in minimizing the amount of time required for patient to be on bed rest, reduced hospital day, hospital expenditure and overall patient satisfaction. Objectives: We conducted this study to compare the efficacy of Tapentadol Nasal Spray and Diclofenac IV in the Post operative patients of Laparoscopic Cholecystectomy by using VAS (Visual Analogue Scale), to compare tapentadol and diclofenac in terms of safety of administration and to study the cost effectiveness. Methods: Using randomized, prospective study design, half of post-operative cases were prescribed tapentadol nasal spray and were assigned Group A. The second half of the postoperative cases received intravenous diclofenac and were assigned Group B. Scheduled dose of tapentadol nasal spray was 22.5 mg in each nostril and for intravenous diclofenac dose was 75 mg. Results: It was observed that the mean pain score in the subjects of the tapentadol nasal spray group was comparatively lower than intravenous diclofenac group by VAS (p<0.05). Conclusion: Tapentadol nasal spray at 22.5 mg in each nostril was found to be effective in managing the post operative pain with minimal side effects.

Magnetohydrodynamic (MHD) flow past a flat plate over an outer flow turbulence subjected to a defect-layer has been examined. It finds a novel approach to a Blasius equation with a view to analyze outer flow turbulence by analytical method, neglecting numerical method to describe the physical situation on outer flow which does not seems to appeared in the literature. In a defect-layer it is rigorously stated that outer flow in a defect layer is independent of Reynolds number. To solve Blasius equation subject to boundary conditions it is stated that numerical results are obtained by analytical method. A graphical representation shows that the velocity distribution is merged with different values of Hartmann number (magnetic pressure) so that velocity increases with indefinite period. In this situation, outer flow turbulence in a defect layer holds stress free so that the existence of a magnet field dominates the entire outer flow situation. In relating to the physical situation of interest, the universe is expanding slowly and slowly subject to a Hot Big Bang with a decisive importance to a microwave background of radiation.

Capturing data for both operating machinery and its environment is of priority in most industries especially heavy industries. Some industries need to continuously and simultaneously monitor physical quantities such as temperature, pressure and speed of various parts of different equipment used in other to maintain and improve the quality of products and the efficiency of the process. The common and oldest system used to gather data is the wired sensor systems. This paper looks at wireless sensor technologies that can be used in heavy industries to capture much-needed data for analysis and logging. A few of the technologies were looked at. Challenges and advantages of each were highlighted. It was concluded that ZigBee communication technology has a better chance in the industrial environment.

The floral diversity contributes to invaluable ecosystem services and habitat values in a rich forested area. The Hirikatu Oya sub-watershed in the southwestern central mountain area of Sri Lanka is also one of the important forested areas with many recent challenges. This study aims to examine current changes in floral species in the Hirikatu Oya sub-watershed from the year 2000 to 2022. For the study, primary data were collected from a field survey of 25 stratified purposive sample sites (20 m × 20 m plots), along with 30 questionnaire surveys and 14 interviews. Primary-level findings were blended with secondary data sources. A mixed-methods strategy was employed to analyze the data. The study area is home to a diverse range of plant species, including woody, medicinal, tree species as well as, endemic and invasive plant species. Notably, the study revealed that 7 invasive plant species are available, while 4 plant species are already extinct and about 14% of tree species and 50% of vines are threatened. The outcome of the study highlights the need for effective management strategies and continuous efforts need to be made to strengthen management techniques, enforce relevant rules, encourage community involvement, and implement targeted initiatives for the sustainability of the forested area in the Hirikatu Oya sub-watershed in Sri Lanka.

This paper analyzes the effects of tariff policies on international trade flows and national competitiveness between 2018 and 2024, a time of revival of protectionism, the COVID-19 crisis, and a general surge in supply-chain disruptions. Using harmonized data sources provided by the WTO, UNCTAD, World Bank, and IMF, we implement a two-way fixed-effects gravity model in order to provide a rigorous assessment of the effect of tariff changes on trade flows between developed and developing economies. To help counter the possibility of endogeneity, we create a weighted tariff shock variable and apply system GMM regressions. We further expand the study with multidimensional measures of competitiveness such as export sophistication, logistics efficiency, and innovation capacity in order to confirm the consistency of our findings. The findings are consistent with the conclusion that increased tariffs reduce the performance of exports, and the negative effect is most pronounced in developing economies that are defined by a small industrial base and low technological potential. On the other hand, those economies that have high regional trade relations and sophisticated digital infrastructure have greater resilience to tariff shocks due to diversifying supply chains and updating technology. In our analysis, we find that there are always negative impacts on the performance of exports due to higher tariffs, but the most negative impacts were observed in developing countries that are not technologically developed and whose industrial bases are small. This paper provides practical policy advice on the need to balance short-term industrial security with long-term economic sustainability in a more globalized economy.