Systemic onset juvenile idiopathic arthritis (SoJIA) is a rare inflammatory disorder. It is the severest form of juvenile idiopathic arthritis, and complications occur most commonly in this type. Non-responsiveness to standard therapy with corticosteroids and disease-modifying antirheumatic drugs is not uncommon. Interleukin-1 beta (Il-1β) has been shown to be a main contributor to the pathogenesis of SoJIA. Anakinra, a recombinant Il-1β receptor antagonist, was shown to be effective in small cohorts of therapy-resistant adult and pediatric still's patients. This study aimed to evaluate the real-world efficacy, steroid-sparing effect, and safety profile of anakinra in patients with SoJIA at a tertiary care center in Libya. A retrospective case series was conducted on patients with SoJIA treated with anakinra at the Tripoli Children's Hospital between 2010 and 2017. Data on demographic characteristics, disease activity, corticosteroid dosage, concomitant medications, and adverse events were collected at baseline and at 1-, 3-, 6-, and 12-month post-treatment. 13 patients were treated with anakinra with a mean age of 9.4±4.6 years at anakinra initiation and a female-to-male ratio of 2: 1. All patients were on corticosteroids and 92.3% on methotrexate at treatment initiation. The proportion of patients achieving inactive disease (Jadas 10=0) increased over time. A marked steroid-sparing effect was observed: the number of patients requiring high-dose steroids (>0.5 mg/kg/day) decreased from 100% at baseline to 7.6% at 12 months, and 53.8% successfully discontinued corticosteroids entirely. All patients experienced injection site reaction, and macrophage activation syndrome occurred in 15.4% as a side effect after treatment initiation. But no severe infections or fatalities occurred. Reasons for discontinuation included remission (46.1%), drug unavailability (23.0%), inefficacy (15.3%), and side effects (15.3%). Anakinra demonstrated significant efficacy in inducing rapid disease control and reducing corticosteroid dependence in patients with refractory SoJIA, with a manageable safety profile

Mediterranean journal of pharmacy and pharmaceutical sciences

The main aim of rehabilitation is vocational independence and community integration. Rehabilitation is complete with the person being a productive member within the community. But this is quite a challenging task as can be vouched by any of the professionals working in this field. What are the barriers and facilitators towards employment or return to work in case of persons living with mental illness? Literature shows that multiple factors are governing the ability to take up gainful employment. Most of this literature is about the western world where the social fabric is more supportive of individual autonomy. India lags in its rehabilitation efforts for mental illness. There is still stigma and lack of awareness about mental illnesses. This increases the problem of unemployment within persons living with mental illness manifold. There are very few detailed investigations into the vocational status of persons with mental illness and almost negligent literature existing in the Indian context. Hence, the current review article tries to examine the factors prevailing in the Indian scenario that influences the employment status.

Gita

Indoor thermal comfort and air quality are essential for occupant well-being, while simultaneously optimizing energy consumption in buildings. Achieving a balance between these factors presents a significant challenge, as indoor environments are dynamic and energy demands fluctuate. By modifying ventilation rates in response to real-time data, demand-controlled ventilation systems can reduce energy consumption and enhance indoor comfort and air quality. However, optimizing these systems with advanced predictive models remains a complex task. To address this challenge, this publication proposes a Dual-Stream Multi-Dependency Graph Neural Network (DMGNN)-based energy-efficient ventilation management technique that maximizes indoor air quality and thermal comfort. The suggested method seeks to enhance thermal comfort and air quality by maximizing heating, ventilation, and air conditioning (HVAC) operations while reducing energy consumption. Initially data are collected from an Indoor Air Quality Monitoring Dataset. The DMGNN is employed to capture the complex dependencies between environmental factors such as temperature, humidity, and CO2 concentrations, considering both temporal and spatial relationships. Implementing the proposed system and evaluating it through simulations in various building environments demonstrates notable improvements in thermal comfort, indoor air quality, and energy economy. The suggested system’s performance is contrasted with that of other current methods, showing superior energy efficiency and optimization of both indoor air quality and occupant comfort. This study presents an innovative, scalable framework for smart building management, promoting sustainable energy solutions.

Dr h shaheen

Sulfur dioxide, a noxious air pollutant, can cause health and environmental effects, and its emissions should be controlled. Nonthermal plasma is one of the most effective technologies in this area. This study evaluated the efficiency of a packed-bed plasma reactor (PBR) and in-plasma catalysis (IPC) in SO2 removal process which were finally optimized and modeled by the use of the central composite design (CCD) approach. In this study, SO2 was diluted in zero air, and the NiCeMgAl catalyst was selected as the catalyst part of the IPC. The effect of three main factors and their interaction were studied. ANOVA results revealed that the best models for SO2 removal efficiency and energy yielding were the reduced cubic models. According to the results, both PBR and IPC reactors were significantly energy efficient compared with the nonpacked plasma reactor and had high SO2 removal efficiency which was at least twice larger than that of the nonpacked one. Based on the results, the efficiency of IPC was better than in PBR, but its performance decreased over time. However, the PBR had relatively high SO2 removal efficiency and energy efficiency compared to the nonpacked reactor, and its performance remained constant over the studied time. In optimization, the maximum SO2 removal efficiency and energy efficiency were 80.69% and 1.04 gr/kWh, respectively (at 1250 ppm, 2.5 L/min, and 18 kV as the optimum condition) obtained by the IPC system which were 1.5 and 1.24 times greater than PBR, respectively. Finally, the model’s predictions showed good agreement with the experiments.

Niloofar

Mano Matram Jagat; Mano Kalpitam Jagat - (“the world is as the mind sees and feels it; the world is as the mind thinks of it” (as qtd. by T.N.Sethumadhavan, 2010). So, our life is in the way we feel and perceive it. Humans are a mixture of emotions and reasons. Reasoning enables them to analyze and judge things with mathematical precision, while emotions help them to understand and empathize others that make them human. Traditionally, people with a high degree of logic and reasoning were believed to be intelligent and. The purpose of the IQ tests was designed to ascertain a person’s intelligence based on the reasoning and the logical aptitude of the person. IQ tests were found to be effective when a person is ‘not’ scared or angry or intrigue about specific things that aroused emotions. Emotions were considered disruptive in nature, which influences the process of thinking of a person (Woodworth, 1940). Mowrer (1960) opined that “emotions are of quite extraordinary importance in the total economy of living organisms and do not deserve being put into opposition with intelligence‟. The emotions are, it seems, themselves a higher order of intelligence.”

Aurora lyrics

Background: In a Benghazi medical center, this observational study assessed the role of laparoscopic cholecystectomy (LC) in the early stages of acute gallbladder illness. Materials and Methods: From January 2022 to December 2022, all emergency and urgent admissions for acute gallbladder disease were identified, and additionally, data from hospital medical records were then evaluated retrospectively. Results: Out of a total of 334 patients with gallstone diseases, we found 321 individuals (206 with acute biliary colic, 115 with acute calculous cholecystitis), and 13 with acalculous cholecystitis. Early laparoscopic surgery for acute calculous cholecystitis had a greater conversion rate than procedures for acute biliary discomfort (19% vs. 4%; p=0.002). When surgery was performed 72 h from the onset of the symptoms for patients with acute calculous cholecystitis, the conversion rate was considerably lower (one out of 25) than when surgery was postponed past 72 h (14 out of 53) or later performed electively (seven out of 23) (p=0.014). In comparison to elective surgery for acute biliary colic (three of 66), elective surgery for prior acute cholecystitis was linked to a higher conversion rate (seven of 22 patients) (p=0.002). Conclusion: LC for acute calculous cholecystitis needs to be done within 72 h of the onset of symptoms, and it is worthwhile.

Karishma

The soil samples were collected from Melia dubia plantations in two different locations in Tamil Nadu. A total of twenty five actinomycetes isolates were isolated and they were screened for melanin pigment production using different culture media. Only two isolates were able to produce melanin pigment under in vitro study and one isolate showed positive reaction to L-tyrosine substrate. Based on morphological and bio-chemical characters the isolate was identified as Streptomyces sp. The DNA of the isolate was isolated and its 16S rDNA gene was amplified and sequenced. The phylogenetic analysis of Streptomyces puniciscabiei was carried out.

Dr. saranya devi k

A 33-year-old young male patient with a history of uncontrolled hypertension was referred to my clinic due to a 2-week fever, generalized body aches, shortness of breath, and easy fatigue. Clinical examination showed a toxic dyspneic patient, but conscious and well-oriented. His blood pressure was 170/100 mm Hg, pulse 90 beat/min, respiratory rate 15/min, and the temperature was 38.6°C. Cardiac examination showed a harsh systolic murmur at the mitral area radiating to the axilla. Abdomen examination revealed moderate splenomegaly and mild hepatomegaly. The rest of the examination was unremarkable.

Karishma

Cystic fibrosis is a challenging disease which creates many complications. The impact caused from cystic fibrosis on an adolescent is a challenging phase for their lives. Negative impacts like the society’s pressure, anxiety and depression are few common reasons that are being unspoken and ignored due to complexity of the disease. This study is aimed to identify the necessary gaps and educate the necessary policy makers and CF center health care team to have a better understanding about the context of the aftermath of cystic fibrosis and enhance better patient care. More over this systematic review also points out the main trends in this field of study. Qualitative study and quantitative are prominently used research methods to gain an understanding the about the gaps in the research. However, there is still a scarcity of quantitative and mixed research methods. Furthermore, limitations such as language, cultural influences were identified whilst going through the analysis. Overall through the information given in the following in this study more information regarding that warrants answers can be identified which will lead to proper care towards the teenagers who suffers from cystic fibrosis.

Chanitha pemasena

In Libya, pharmacy education and practice have a similar pattern to medical education and practice. Both sectors of public and private pharmacy education and pharmacy practice still significantly unchanged for more than forty years. It is a traditional pharmacy style of education and practice with a limited change of education and practice. Now, there are more than ten public pharmacy colleges and more than five private colleges established in Libya for a population of seven millions. In addition, there are several intermediate pharmacy institutes which provide a middle degree in pharmacy practice with a very limited knowledge in pharmaceutical sciences and training. Practice of pharmacy in Libya is still a classical mode with only dispensing medicines directly in almost a nonprofessional way and an old fashion way. However, the situation is old and complicated that needs a great deal of attention from different health policymakers and authorities such as Ministry of High Education and Ministry of Health, National Pharmaceutical Union and Libyan Association for Pharmacists.

Mediterranean journal of pharmacy and pharmaceutical sciences

The study was conducted on glass slides to observe the growth patterns of urinary calcium oxalate monohydrate crystals and their inhibition using 5, 10 and 15% Phaseolus vulgaris seed infusion. For this purpose, a drop of gel medium (sodium metasilicate of 1.06 specific gravity and 3M acetic acid solution) at pH 5.02-5.17 was placed in the middle of the glass slide and converted into gel. A single drop of 1 M oxalic acid was dropped to the left, and 1 M calcium chloride and magnesium acetate (1:1) solution fell to the right side of the adequately formed gel. The glass slide was observed under microscope till it was completely dried. In the case of the crystal inhibition study, a drop of Phaseolus vulgaris infusion was also added on the right side just after adding calcium chloride and magnesium acetate solution. The results without infusion showed detailed morphology and aggregation patterns of observed crystals as donut, dumbbells, needles, platy, prismatic, rosette, round edges, and loose and compact aggregates. All infusions of Phaseolus vulgaris showed defective crystals. 5 % infusion inhibited crystals of all morphologies with their loose and compact aggregates except rosettes. Whereas 10 and 15 % infusion converted the rosette crystals into ineffective calcium oxalate dihydrate crystals of tetragonal bipyramidal and elongated rod shape. The microscopic study of calcium oxalate crystal growth and its inhibition is simple and provides rapid qualitative analysis of antiurolithiatic activity.

Dr. salman ahmed

Giving stimulus from educators in the form of giving appreciation and punishment will greatly affect the way of thinking and behavior of students in achieving the goals of character education that have been set. This study aims to describe the implementation of reward and punishment in shaping the character of students' discipline. This research uses a qualitative approach with the type of case study. Methods of data collection using interviews, observation and documentation. The validity of the data used source triangulation and technical triangulation. The results of this study indicate: (1) The implementation of rewards in shaping the discipline character of students is done by giving rewards in the form of praise and giving appreciation in the form of gifts. (2) The implementation of punishment in shaping the disciplinary character of students is carried out by giving gradual warnings, giving spontaneous warnings and written warning letters. (3) Evaluation of the implementation of rewards and punishments in shaping the character of students' discipline is using process evaluation, which is an assessment carried out during the learning process by observing the attitudes of students everyday when they are in the madrasa environment.. Pemberian stimulus dari pendidik berupa pemberian apresiasi dan hukuman akan sangat mempengaruhi cara berpikir dan tingkah laku peserta didik dalam mencapai tujuan pendidikan karakter yang sudah ditetapkan. Penelitian ini bertujuan untuk mendeskripsikan implementasi reward dan punishment dalam membentuk karakter disiplin peserta didik. Penelitian ini menggunakan pendekatan kualitatif dengan jenis studi kasus. Metode pengumpulan data menggunakan wawancara, observasi dan dokumentasi. Keabsahan data menggunakan triangulasi sumber dan triangulasi tehnik. Hasil penelitian ini menunjukkan: (1) Implementasi reward dalam membentuk karakter kedisiplinan peserta didik dilakukan dengan memberikan reward dalam bentuk pujian serta memberikan apresiasi dalam bentuk hadiah. (2) Implementasi punishment dalam membentuk karakter kedisiplinan peserta didik dilakukan dengan cara memberi peringatan secara bertahap, memberi teguran spontan dan surat peringatan tertulis. (3) Evaluasi implementasi reward dan punishment dalam membentuk karakter kedisiplinan peserta didik adalah menggunakan evaluasi proses, yaitu penilaian yang dilakukan di saat proses pembelajaran berlangsung dengan mengamati dari sikap peserta didik sehari-hari ketika berada di lingkungan madrasah.

Educare: journal of primary education

Service quality is a key factor for success in any hotel. Many researchers have conducted studies on service quality, but only a few studies have been conducted on internal service quality (ISQ) in general, and in the hotel industry in particular. Since there is no general agreement among researchers on the measurement of ISQ, many studies have used SERVQUAL instrument to measure the employees’ perceptions of ISQ. The purpose of this study is to explore the influence of ISQ on employee’s job satisfaction in five-star hotels in Jordan. The current study was carried out by measuring the data gathered through a seven-point Likert scale. The quantitative survey method was applied, and therefore the SERVQUAL instrument was used to measure ISQ, and the Job Satisfaction Survey (JSS) was used to measure job satisfaction. Data obtained from a sample of 238 respondents drawn from 14 five-star hotels in Jordan were analysed with the SPSS software based on descriptive statistics. The study’s findings indicated that the ISQ of five-star hotels in Jordan has a significantly positive influence on an employee’s job satisfaction. These findings support the hypothesis that there is a positive relationship between ISQ in the hotel industry and industry employees’ job satisfaction.

Mukhles m. al-ababneh

: About 12% of the world population is affected by different forms of urolithiasis, the recurrence rate of which is 47-60% in females and 70-80% in males. According to WHO, 75% of people rely on traditional medicines to prevent and cure different ailments. Similarly, the majority of the world population uses several plants to treat problems related to the urinary tract system, of which urolithiasis is the primary cause. The review aims to collect data on the plants used in different parts of the world and cultures against urolithiasis, including their parts, mode of preparation, dosage, and administration. A literature review was conducted for traditionally used antiurolithiatic plants. The articles mentioning plant, parts, mode of preparation, dose and route of administration were selected. This information was extracted to compose Mono and Polyherbal antiurolithiatic formulations used in Appalachia (a region in the Eastern United States), Canada, India, Iran, Israel, Italy, Jordan, Latin America, Pakistan, Turkey and Yemen. The review provides essential data about plants used as antiurolithiatic in different parts of the world. The information is not only useful for ordinary people but also for the scientific community to carry out further phytochemical, pharmacological and toxicological studies for discovering new, effective, safer molecules against urolithiasis.

Dr. salman ahmed

This study demonstrates main reasons for choosing The National University of Malaysia (UKM) by international students and their needs and expectations toward the University. The study also shows the obstacles faced by those students and their satisfaction towards UKM. A total of 108 questionnaires were distributed in the main campus to the respondents who came from ten diffident countries. The main reasons for choosing UKM were its high ranking, reasonable tuition fees, faculty, programmes, and lecturers respectively. The results revealed that the main obstacles faced international students were tough visa procedures, improper hostels, social isolation and discrimination, and bureaucracy. Both the facilities and services of UKM and the studying approach have met the expectations satisfaction of international students. Yet, both social relationship and participation in activities and living conditions in UKM hostels have disappointed international students and did not meet their satisfaction. This study suggested that UKM should establish counselling unit and organise regular meetings to listen to the problems and suggestions of those students. Volunteer and pre-enrolment activities should be organised to introduce the Malaysian culture and gather international students with their local peer. Moreover, international students should be provided upon their arrival to UKM by hostels that combine proper conditions of living at a reasonable price.

Mohammed fadel arandas

Attempts have been made to formulate controlled release drug dosage forms using chitosan as a release controlling polymer. Granules of combination of chitosan, hydroxylpropyl cellulose, lactose, starch and Ibuprofen were prepared by wet granulation method using 1.0% lactic acid solution. The granules were physico-chemically characterized in terms of density, porosity, angle of repose, carr’s index and housner ratio and was found to be free flowing with good compressibility. FTIR spectroscopy was used and confirmed that there is no interaction between the drug and the added polymers. In vitro release of Ibuprofen, in phosphate buffer at pH 7.4, showed a steady and slow increase in the percentage of drug released over 24 hours as the percentage of chitosan was increased in the formulations compared to that from commercial tablets which released over 80.0% of their content in only two hours. The kinetic analysis using different mathematical models of the data revealed that the release kinetics of the drug form these formulations is somewhere between diffusion controlled, Fickian (anomalous) and non-Fickian which refers to a combination of diffusion and erosion controlled release. Thus, the high correlation coefficient of the data of drug release from most granules when zero order kinetics was applied revealed that there is a constant drug release with time for 24 hours.

Mediterranean journal of pharmacy and pharmaceutical sciences

Cerebrospinal fluid (CSF) is critical in maintaining brain interstitial fluid balance and providing hydromechanical protection. Lumbar puncture (LP) is a common invasive procedure for obtaining CSF samples to evaluate central nervous system infections and cancers and measure intracranial pressure. While LP is generally considered safe, it is associated with both minor and major complications. Post-LP meningitis occurs in approximately 50% of spinal anesthesia cases and 9% of diagnostic LPs. Additionally, over 70% of diagnostic LPs result in minor bleeding, which can lead to serious outcomes such as spinal epidural hematoma, nerve damage, or paralysis. Significant consequences of LP include headaches and hearing loss; however, other rare complications, such as cerebral herniation and CSF leak syndrome, must be considered carefully. This review synthesizes findings from multiple studies published in PubMed, Google Scholar, and Scopus, highlighting the need for further research on the complications and interventions related to this commonly performed procedure.

Karishma

In an era where technology prevails, entrepreneurs as well as marketers see the need to keep up with the fast pace of change or risk being outdated. Gone are the days when a pure-bricks business model will thrive well in current market scenario. It is practically impossible to design a marketing strategy without considering social networks. Social media had become really important gradient in today’s marketing mix in general and in promotion mix in particular. Adapting some form of marketing online through social media is a key node for all businesses, especially in an industry where trends constantly change such as fashion and handicrafts. The paper carries out empirical research to understand the effectiveness of social media as a marketing tool and an effort has been made to analyze the extent social media helps consumers in buying decision making. In addition strategies have been suggested for maximizing the effectiveness. Various statistical tests have been applied to support the research hypothesis.

Abu bashar

Background: Idiopathic Parkinson's disease (PD) is a central nervous system degenerative disorder with an unknown etiology. PD is the second leading cause of neurological impairments. Exercise therapy treatment is commonly used for PD to improve health and decrease the functional limitations. Exercise therapy includes Strengthening, aerobic, agility etc.. Objective: To investigate the evidence on efcacy and limits of strength training in rehabilitation of Parkinson's disease Method: A comprehensive search on pubmed, clinical keys database using keywords Parkinson's disease, physical therapy, strength training ,resistance training. The studies including Randomized controlled trails and systematic reviews published since 2005 are reviewed. Results: 36 studies identied through database searching. 25 studies are excluded due to duplicates, irrelevance, based on titles, outcome diversity. 5 systemic reviews and Meta analysis, 6 RCT are included. Review and analysis of articles is going on Conclusion : The result of this review suggests that strength training program can be effective in people with mild and moderate parkinson's disease. It can improve functional independency with increased muscle strength, gait parameters, posture and balance, all of these positive role on participation and quality of life.

Nagarjuna narayanasetti

The space-time dynamics of chlorophyll a concentration and seawater excess viscosity has been investigated in the hydrographically contrasting inshore and offshore water masses of the eastern English Channel. This was done during the phytoplankton spring bloom dominated by Phaeocystis globosa before and after the very large-scale formation of foam induced by an increase in wind-driven turbulence and the related wave breakings. The results suggest that the dynamics of chlorophyll a concentration and seawater excess viscosity are differentially controlled by the formation of foam through the intensity of the spring bloom and wind-generated turbulence.

Irma kesaulya