Background: Cardiovascular diseases (CVDs) disproportionately affect conflict zones like Yemen, where diagnostic limitations persist. This meta-analysis evaluated the global prognostic utility of the red cell distribution width (RDW) and the neutrophil-to-lymphocyte ratio (NLR) as predictors of CVD and aimed to establish region-specific thresholds for low-resource settings. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines, we analyzed 75 prospective cohort studies (2014–2025) that included 201,604 adults from 142 countries. Random-effects models were used to pool hazard ratios (HRs) and the area under the curve (AUC). Results: NLR > 3.0 (HR, 2.2 [95% CI, 1.8–2.7]) independently predicted an elevated CVD risk (p < 0> 14% was associated with increased CVD risk in unadjusted analyses (HR, 2.3 [95% CI, 1.9–2.8]), this association became non-significant after adjusting for ferritin (HR, 1.02 [95% CI, 0.98–1.07]). This indicates that RDW primarily reflects iron status, emphasizing the need to measure ferritin before attributing high RDW to CVD risk. The combined RDW + NLR showed superior discriminative power (AUC, 0.82 vs. 0.71–0.74 for individual markers). Subgroup analyses revealed higher NLR cutoffs (>3.8) in HIV-endemic African populations (reflecting chronic immune activation). Sensitivity analyses revealed attenuated NLR effects in rural populations (HR, 1.9) and non-significant RDW-CVD associations when adjusting for ferritin (HR, 1.02), highlighting contextual limitations. Conclusions: While NLR stands as an independent CVD predictor, RDW > 14% must be interpreted with concurrent ferritin measurement. This is crucial to avoid misattributing CVD risk in malnutrition-endemic regions, such as Yemen, where an RDW > 15% is common. The RDW primarily reflects iron status and requires iron-status validation, especially in these high-malnutrition areas. However, caution is warranted when generalizing findings to rural settings where the CVD burden is rising fastest, given the underrepresentation of rural populations (only 16% of included studies). We strongly recommend standardized automated hematology analyzers (k > 0.85).

Karishma

The rate of aging is rapidly increasing and the term of geriatric refers to offer a medical care to elderly people. Drug consumption study on geriatric population is a vital issue since this group is totally neglected in Libya. The aim of this study was to assess drug utilization pattern among elderly patients in terms of world health organization core prescribing indicators and to evaluate the treatment cost. A total of 106 prescriptions were randomly collected from different community pharmacies located in Tripoli during the summer 2019, and were evaluated (total number of prescribed drugs is 359) for their clinical efficacy and safety. The findings revealed that 60 drugs acting on GIT (16.7%), 50 antimicrobial drugs (13.9%), 31 antihypertensive drugs (8.6%) and 30 drugs for respiratory diseases (8.4%) were prescribed to patients who are 65 years old or more. With regard to disease pattern in the elderly Libyan patients, 27 drugs were prescribed for diabetes mellitus (7.5%), 24 drugs for cardiovascular drugs (6.7%) and 14 drugs for anti-hyperlipidemia (3.9%). According to the WHO core drug use indicator pattern, the average number of drugs prescribed per encounter was 3.3. Prescription by generic name was low (41.5%). Antibiotics were 36.8% while injections were 26.6%. Thus, this study suggest that geriatric medicine and rational drug use should strongly be implanted in medical schools and teaching hospitals. Besides, a drug pattern use of the Libyan community is urgently required to avoid drug prescribing errors.

Mediterranean journal of pharmacy and pharmaceutical sciences

Intensively cultivated rice-wheat cropping system of the Indo Gangetic plain (IGP) is a potential source of greenhouse gas (GHG) emissions.Agriculture sector emits GHGs like methane (CH4) and nitrous oxide (N2O). The total amount of GHGs emitted by a product is known as its carbon footprint (CFP).Quantification of CFP of crops will help in identifying management practices to reduce CFP of crop production. Studies related to assessing of CFP of agricultural products are lacking. The present review paper was aimed to discuss about the studies done on GHG emission from rice-wheat cropping system of the Indo Gangetic plains. The paper elaborates on what is CFP, how to calculate CFP of rice-wheat cropping system with the help of different case studies. The paper provides insights about certain agricultural management practices which can help in reducing CFP of rice-wheat cropping system. Discussion from this paper signifies the importance of carbon footprint assessment in maintaining the sustainability of rice wheat cropping system.

Dr.renu dhupper

The primary objective of this study is to conduct a comprehensive analysis of the relationships between liquid- ity (LIQ), capital structure (LEV), and fnancial performance (FIP). Additionally, we seek to investigate the indirect efect of liquidity (LIQ) on fnancial performance (FIP) by examining the intermediary role of the capital structure (LEV) of non-fnancial-listed companies in the Vietnamese stock market. This study utilizes PLS-SEM with a robust sample of 644 non-fnancial-listed companies in the Vietnamese stock market. The fndings suggest that liquidity positively infuences fnancial performance but negatively impacts capital structure. Conversely, capital structure negatively afects fnancial performance. Thus, liquidity indirectly enhances fnancial performance through capital structure mediation. This research result can provide suggestions for non-fnancial enterprises in making fnancial decisions to increase fnancial efciency by increasing the holdings of highly liquid assets to prevent risks and take advantage of new investment opportunities in the future. In addition, increasing the holding of highly liquid assets also reduces debt pressure and reduces interest costs, thereby increasing fnancial efciency. Our research shows that the relationship between economic factors is extremely complex; specifcally, our research shows the true nature of the positive impact of liquidity on fnancial performance, including direct positive efects and indirect positive efects through capital structure. In addition, our research results also show that non-fnancial enterprises that want to increase fnancial efciency need to pay attention to revenue growth, and non-fnancial companies with larger total assets (size) will have more advantages in increasing fnancial performance.

Nam nguyen hoang phi

Behavioral finance theory highlights how psychological factors can lead to poor investment decisions, which may threaten investors' trust in the stock market, discourage investments, and hinder economic growth. This study aims to examine how behavioral finance factors, particularly herding bias and overconfidence bias, influence investment decision on the Indonesia Stock Exchange through risk perception. The research was conducted using an online questionnaire distributed to 120 Gen Z stock investors and analyzed using PLS-SEM. The results show that herding and overconfidence biases have a significant positive influence on risk perception. Both herding and overconfidence biases have indirect positive influences on investment decision through risk perception. Although overconfidence bias and risk perception can directly affect investment decision, herding bias fails to do so. These findings highlight the importance of considering an individual's behavioral biases and risk perception, while policymakers should devise strategies to mitigate their impacts; so that investors can benefit from investing, which may eventually lead to the growth of the national economy.

L

The purpose of this study is to look at development trends and patterns of structural change in India's rural and labour markets. The rural labour strength have been moving from agricultural sector to non-agricultural sector for a living, after a long period of change (due to pain and growth-induced motives). Although the manufacturing sector lags, the building industry is a significant growing sector that employs rural people. Some improvements in rural areas have been made since the implementation of the MGNREGA rural employment development programme, but it has its own set of problems that experts are discussing. Furthermore, the rural labour market is plagued by high unemployment as a result of both the agricultural and non-farm sectors' failure to absorb rural employees. Nonetheless, the continuing COVID-19 epidemic has worsened its situation by causing a job-loss catastrophe. The rural labour market's future will become more unclear as a consequence of Covid pandemic-induced opposite migration of city workers to their villages, which has worsened food security and poverty issues in rural regions.

Dr. amarjeet singh

Creative tourism has been stimulated as new form of tourism by more skilled forms of tourism activities, by the growth of new consumption patterns, and by changes in the production of tourism products. It can solve that problems experienced by tourists in the conventional tourism. Creativity has many definitions and that based on the function of creativity, it was historically related to creative person, but the recent research in creativity focused on creative product. However, creativity can be located in four areas, and they are: creative person, creative product, creative process, and creative environment. Creativity means “the production of novel and useful ideas in any domain”, which refers to the generation of ideas. Today, creativity becomes as a strategy that promoting individual skill development and innovation, this strategy has been followed by many cities and regions around the world in order to obtain the growth throughout commodification, knowledge development, globalization and increasing competition. Creativity can play a significant role in the mainstream tourism experiences that can be added to the places’ atmosphere, creativity is considered as an attractive policy for stimulating other creative activities and outcomes of social, economic and cultural through spilling knowledge and networking. Indeed, creativity can impact tourism in many ways such as: tourism itself as a creative area, tourism products, skills development and performance development. Thus, the important role of creativity in tourism has been incarcerated in many trends

Mukhles m. al-ababneh

The application of clinical pharmacokinetic is the responsibility of all pharmacists providing pharmaceutical care. An appropriately applied clinical pharmacokinetic is expected to result in improved patient outcomes: decreased mortality, reduced length of treatment, reduced length of hospital stays and cost-savings. Data on the extend of pharmacokinetic application in Libyan hospitals remain scarce but available subjective evidence suggests that services related to clinical pharmacokinetic are mostly provided and performed by professionals other than clinical pharmacists. To explore the training background and perceptions of pharmacists on the pharmacokinetic course contents they received during their undergraduate pharmacy programs. Also, to determine the attitudes and barriers experienced by the pharmacists when applying pharmacokinetic principles in their current practice. This is a cross-sectional, descriptive study that was conducted between July 2018 and November 2019 using a self-administered survey. The study targeted hospital pharmacists practicing in different hospitals in Libya. A total of 104 pharmacists completed the questionnaire and submitted it back. The majority of participants learned pharmacokinetic courses as a mandatory course during undergraduate courses 81.0% with 37.0% selecting that course was taught as a separate course or courses. Around 80.0% of the participants agreed or strongly agreed that pharmacokinetic courses received in undergraduate studies are useful in pharmacy practice with over 75.0% of the participants agreeing or strongly agreeing on relevance of those course to their current clinical practice. About 40.0% of the participants described their current skills in allowing optimal patient care as can be better. Different barriers were highlighted by the participants to allow sufficient clinical pharmacokinetic practice including lack of sufficient information, lack of awareness of pharmacists’ role and skills in applying clinical pharmacokinetic by other pharmacists and by other health care providers. Thus, this study shows that most practicing pharmacists showed a positive attitude of current pharmacokinetic practice and to the impact of their undergraduate studies on their successful practice. However, they have clearly addressed the room for improvement.

Mediterranean journal of pharmacy and pharmaceutical sciences

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

Environmental factors are known to influence carcinogenesis. Pollutants, such as heterocyclic amines (HAs) and polycyclic aromatic hydrocarbons (PAHs) are examples of environmental borne procarcinogens. Procarcinogens are not active carcinogens although, they require bio-activation, via enzymes such as cytochrome P450 (CYP) to transform to active product. CYP1A1 isoform, regulated by aryl hydrocarbon receptor (AhR) plays a significant role in the bio-activation of PAHs and HAs. AhR has multiple co-activators and co-repressors for AhR that have been identified S remarkably. Silencing mediator for retinoid and thyroid hormone receptors (SMRT) was designated as a major co-repressor for AhR. In the present study, it is examined the effect of SMRT over expression on the cyp1a1 mRNA levels in murine hepatoma Hepa 1c1c7 cell line. Hepa 1c1c7 cells were maintained in Dulbecco’s Modified Eagle Medium (DMEM) and competent cells have successfully been produced using calcium chloride method. Cells were transformed using plasmid DNA and Lipofectamine. TCDD (2, 3, 7, 8-tetrachlorodibenzo-p-dioxin) was employed as an inducing agent for CYP1A1. The total cellular RNA was isolated and real-time PCR of Cyp1a1 was conducted. A statistical analysis was conducted by using one-way analysis of variance followed by Student-Newman-Keuls test. The results showed that cells transfected with the co-repressor SMRT has lower TCDD-mediated induction of cyp1a1 mRNA without affecting constitutive Cyp1a1 mRNA levels, i.e., SMRT was able to significantly decrease inducible Cyp1a1 mRNA levels in Hepa 1c1c7 cells. The present findings also demonstrated that calcium chloride is a convenient method for routine transformation. Thus, this study opens a new avenue for the management of carcinogenesis involving CYP1A1 inducing carcinogens.

Mediterranean journal of pharmacy and pharmaceutical sciences

The unprecedented global effort to develop and distribute COVID-19 vaccines has highlighted remarkable scientific achievements and persistent inequities in access across populations. Analyzing of regional vaccine deployment patterns reveals critical insights into pandemic response dynamics, shaped by manufacturing capacity, regulatory frameworks, procurement strategies, and regional health priorities. Data from WHO regions (Africa, the Americas, Eastern Mediterranean, Europe, and Western Pacific) demonstrate significant disparities in vaccine types and suppliers, underscoring the complexity of global vaccination efforts. (Figure 1) illustrates this regional vaccine distribution by WHO regions.

Karishma

Since 2006, multiple outbreaks of avian influenza (AI) have been reported in Nigeria involving different subtypes. Surveillance and molecular epidemiology have revealed the vital role of live bird markets (LBMs) in the dissemination of AI virus to commercial poultry farms. To better understand the ecology and epidemiology of AI in Nigeria, we performed whole-genome sequencing of nineteen H9N2 viruses recovered, from apparently healthy poultry species, during active surveillance conducted in nine LBMs across Nigeria in 2019. Analyses of the HA gene segment of these viruses showed that the H9N2 strains belong to the G1 lineage, which has zoonotic potential, and are clustered with contemporary H9N2 identified in Africa between 2016 and 2020. We observed two distinct clusters of H9N2 viruses in Nigeria, suggesting different introductions into the country. In view of the zoonotic potential of H9N2 and the co-circulation of multiple subtypes of AI virus in Nigeria, continuous monitoring of the LBMs across the country and molecular characterization of AIVs identified is advocated to mitigate economic losses and public health threats.

Bitrus inuwa

In an era of rapid technological advancement, the digital divide between rural and urban communities has become increasingly apparent. This study aims to investigate consumer awareness towards cyber security in both rural and urban settings, recognizing its critical importance in safeguarding personal and sensitive information. The study underscores the urgent need for targeted interventions to bridge the digital divide in cyber security awareness. Policymakers, educators, and community leaders must collaborate to implement initiatives tailored to the unique needs of rural populations, including improving access to technology, enhancing digital literacy programs, and fostering a culture of cyber security consciousness. By addressing these disparities, we can strive towards a more inclusive and resilient digital society where all individuals, regardless of their geographic location, are empowered to navigate the digital landscape securely. This research paper delves into the awareness and attitudes of consumers regarding cyber security in both rural and urban settings. With the increasing prevalence of online activities, particularly e-commerce, understanding the level of awareness and concerns about cyber security is crucial. The study analyzes data collected from 100 respondents, examining demographics, online shopping behavior, encounters with security issues, familiarity with safety measures, and sources of information about cyber security. The findings provide insights into the digital divide between rural and urban communities and offer recommendations for enhancing cyber security awareness and education.

Dr. kishor bholane

Trace elements are minerals present in living tissues in small amounts. Some of them are known to be nutritionally essential, others may be essential, and the remainder are considered to be nonessential. Trace elements such as zinc, copper, selenium, iron, chromium and, others are essential elements for growth and body health. They form an integral part of many enzymes and bioactive centers that are responsible for biochemical reactions such as metabolism, protein and, DNA synthesis. They are said to contribute to the development of cancer based on epidemiologic evidence. The blood level of trace elements in the human body is affected by cancer and drug treatment. The low trace elements level is a sign of leukemia patients, where cancer cells consume body nutrients and essential elements for growth. The Libyan patients were divided into four age groups and were either newly or old diagnosed with leukemia, including patients with acute leukocyte leukemia, acute myeloid leukemia, chronic myelogenous leukemia, and aplastic anemia. The samples were tested for direct aspiration onto inductively coupled plasma spectrometry at specific wave lengths. The findings showed the blood level of trace elements in leukemia patients is lower than in the healthy individuals. A negative correlation between copper and zinc levels in leukemia patients was found. The copper level increases in leukemia patients as they get older.

Mediterranean journal of pharmacy and pharmaceutical sciences

Computer as a revolution left no area of life untouched in the present world. It is of tremendous help in all field of life. Hence, the knowledge of computer is a necessity for existence of everybody in this global village. The invention of computer has transformed our simple manual works to sophisticated life of automated works to meet the global demand for the higher productivity and increased efficiency with high precision. Computer is increasingly becoming compulsory in nearly all fields of studies, not because of anything but its accuracy and versatility in processing data. Many tasks at home or office are being automated rapidly with computer. Thus it is becoming apparent that in whatever discipline or working sector, the computer is now a very vital tool for efficiency improvement and precision of job or task execution. This is designed to meet the prerequisite need of everybody that are interested and wish to know about computers science and computing in general. A computer is an electronic device, operating under the control of instructions stored in its own memory. These instructions tell the achine what to do. The computer is capable of accepting data (input), processing data arithmetically and logically, producing output from the processing, and storing the results for future use. Most computers that sit on a desktop are called Personal Computers (PCs). The "computer" is an ensemble of different machines that you will be using to get your job done. A computer is primarily made of the Central Processing Unit (usually referred to as the computer), the monitor, the keyboard, and the mouse. Other pieces of hardware are commonly referred to as peripherals. In everyday life activities, we process data or encounter cases of data processing. A typical example of data processing is the generation of statement of student result from the marks score in an examination and continuous assessment. It is essential to know that information is as good as the data from which it is derived, and the transformation process which they are subjected to. Meaningless data or inappropriate processing produces wrong information. Thus computer gives you results corresponding to what data you supply and how you process it (i.e. ëgabbage- in, gabbage-outí) Summarily, the intelligent performance of a computer depends on correctness of input data and the intelligence performance of the human being that drives it.

Kamal singh

In addition to predatory journals and publishers, researchers now need to be wary of predatory conferences as well with the checklist given here to really check yourself.Because the predatory journals and publishers make target to the new researchers there must be need of that type of articles

Dr.ved nath jha

Introduction Ataque de nervios (ADN) is a cultural syndrome prevalent in Puerto Ricans characterized as an episode of intense emotional upset due to overwhelming stress. Methods The Ataque de Nervios Questionnaire , developed at the Center for the Study and Treatment for Fear and Anxiety (CETMA), served as the diagnostic tool for this retrospective secondary data analysis. We evaluated three models regarding ADN’s function as a marker of (1) sociodemographic vulnerability, (2) health history risk, and (3) psychological vulnerability. This last model was subdivided to assess the scores of screening tests regarding anxiety (Anxiety Sensitivity Inventory, Beck Anxiety Inventory, and State-Trait Anxiety Inventory), affect (Beck Depression Inventory, Emotional Dysregulation Scale, Positive and Negative Affective Schedule), personality (NEO Five-Factor Inventory), and trauma (considering the responses to the Childhood Trauma Questionnaire and the Life Event Checklist). Results Our study sample had a total of 121 Puerto Rican adult patients from CETMA out of which 75% had ADN. We differentiated subjects according to their ADN status with t-tests and Mann-Whitney U tests and evaluated our models using logistic regressions. People with ADN showed more anxiety, depressive symptoms, emotional dysregulation, and negative affect than those without ADN. They also revealed lower positive affect and agreeableness. Highly extraverted but minimally agreeable personalities related to ADN. Living with a partner and being employed were risk factors for ADN. Having higher educational levels showed the strongest effect size: it greatly reduced the odds of an ataque . Discussion These characteristics suggest a distinct profile of ADN seen in employed, educated, adult Puerto Ricans living on the Island experiencing anxiety. Our study provides clinical tools to comprehend our patients’ ADN experience, enriching our practice as culturally competent health providers.

Alisha m subervi vázquez

Territorial disputes in the South China Sea have long been one of the most critical and complex issues of security between south-east Asian states and China. The competition for maritime rights has emerged as the most important security issue in the east Asia. The powerful states have a tendency for domination. The smaller states may not show their dominating behavior over other states, but they have tendency to maximize their relative power by making alliance with great power or by other means. Since the smaller states are not capable enough individually to ensure their own security or to use military force against threatening power, they have tendencies to join in alliances or in other words to create balance of power to ensure their own security. This study attempts to analyze the behavior of small states and to find out which theory matches with the behavior. The behavior of small states like Vietnam and the Philippines cannot be well-explained by the realist approach. They behave to make their existent clear and safeguard themselves only. Making allies with great powers as well as economic ties simultaneously with other economic powers render their behavior of having peaceful coexistent with everyone.

Muhammad faruq-uz-zaman

Natural products play a major role in maintaining healthy people and animals and in preventing sickness. Experiments have shown that these natural compounds have several biological properties, including anti-inflammatory, anti-apoptotic, and antioxidant effects. Using Google Scholar, PubMed, and Science Direct database searches, current recorded information was incorporated in this review. The databases listed above were searched using the following Medical Subject Headings (MeSH) terms for data extraction: preventative, natural product, phytoconstituents, natural products for Parkinson's illness, Alzheimer's disease, and natural products for the brain. The effectiveness of natural products in a variety of preclinical models of neurodegenerative diseases has been demonstrated by in vitro and in vivo studies. Phytoconstituents, such as polyphenolic antioxidants, are present in freshwater and marine flora, as well as in fruits, vegetables, nuts, and herbs. These phytoconstituents may help the brain's memory and cognitive processes while preventing neurodegeneration. Moreover, they are essential in the prevention and treatment of various neurodegenerative diseases, including Parkinson's disease, epilepsy, Alzheimer's disease, and other neurological conditions. This review briefly highlights a few neurodegenerative diseases, emphasizing how natural products and nutraceuticals function against neurological disorders.

Mediterranean journal of pharmacy and pharmaceutical sciences

This abstract provides an overview of the critical role of academic leadership and governance in higher education institutions. As the landscape of higher education undergoes profound transformations, academic leaders and governance structures play a pivotal role in shaping the direction, quality, and effectiveness of educational institutions. This abstract highlights key themes, challenges, and considerations related to academic leadership and governance, emphasizing the need for adaptability, transparency, and inclusivity in the decision-making processes. The abstract begins by acknowledging the evolving nature of higher education and the increasing complexity of issues facing institutions, including technological advancements, changing student demographics, and shifting funding models. It underscores the central importance of academic leadership and governance in addressing these challenges and promoting institutional excellence.

Dr gedam kamalakar