Background: Lupus nephritis (LN) is a significant manifestation of systemic lupus erythematosus (SLE) that affects the kidneys. Differentiating between active and inactive LN is essential for determining disease activity, tailoring treatment strategies, and monitoring patient outcomes. The clinical and laboratory status of LN patients provides valuable insights into the severity of renal involvement, response to treatment, and the potential for disease progression. Objective: To asses clinical and laboratory status of active and inactive LN patients. Method: This cross sectional study was conducted in the Department of Nephrology, Dhaka Medical College Hospital, Dhaka from January, 2017 to June, 2018. This cross sectional study was performed on 60 biopsy proven lupus nephritis patients and 30 age and sex matched apparently healthy control subjects. All the patients were recruited as per inclusion and exclusion criteria. Diagnosed SLE patients who had renal involvement and undergone renal biopsy for standard clinical indications were recruited by purposive sampling and divided into two groups of active and inactive LN as per operational definition. Results: During the study, Mean age of the lupus nephritis patients in active and inactive LN was 26.60 ± 8.36 years and 28.80 ± 9.18 years respectively. Most of the patients in both groups were female. Anaemia and edema was observed significantly higher in active than that of inactive lupus nephritis. Systolic and diastolic blood pressure was significantly higher in active lupus nephritis than that of inactive lupus nephritis patients. Hb, serum C3 and eGFR were significantly lower in active LN than that of inactive LN. RBC, WBC, platelet count were also lower in active LN than that of inactive LN but no significant difference was observed between two groups. ESR, serum creatinine, proteinuria, Anti ds DNA Ab titre and uMCP-1 were significantly higher in active LN than that of inactive LN. There was no difference between active and inactive LN patients with regards the use of medications. There was no difference in renal biopsy classes in between two groups. Conclusion: According to our study findings, active lupus nephritis (LN) patients exhibited elevated systolic and diastolic blood pressure compared to those with inactive LN. Additionally, active LN patients displayed lower levels of hemoglobin, serum C3, and estimated glomerular filtration rate (eGFR) compared to inactive LN patients. While red blood cell (RBC), white blood cell (WBC), and platelet counts were also lower in active LN patients, the difference between the two groups did not reach statistical significance. Furthermore, there were no notable differences in medication usage between active and inactive LN patients, and the distribution of renal biopsy classes was similar in both groups.

One of the specific objectives of the United States President Joe Biden’s Middle East visit, in July 2022, was the intent of Saudi Arabia normalization of diplomatic relations with Israel. However, this was largely unachieved despite the fact that Israel and Saudi Arabia had long been in secret cooperation, without formal diplomatic relations between them, since Israel attained nationhood in 1948. This article sought to examine the concrete barriers to normalization of relations, extolling cooperation and disentangling the cyclic ambivalences of Saudi government towards Israel. Certain barriers could be removed, aimed at strengthening normal peaceful co-existence between the two countries. The neorealist and neoliberal theoretical perspectives are adopted as framework of analysis. Data were derived from both primary and secondary sources, made up of interview, government official documents and independent mediascape. Findings showed that the Israeli-Palestinian conflict remained the concrete barrier to normalized Saudi-Israeli relations. But areas of cooperation between the two countries, albeit covertly, include trade and common stance against security concerns. These and other areas of cooperation could be broadened to strengthen peaceful co-existence between the two neighbours. And more determined diplomatic efforts must continue, to resolve the generational and intractable Israeli-Palestinian conflict on ‘two-state’ solution basis. In conclusion, the ambivalences that have characterized relations between Israel and Saudi Arabia need be discarded. A Palestinian statehood is attainable, with rights of mutual co-existence between the parties and removing nuclear threat and need for balance of power, all necessary to make the Middle East relatively stable and peaceful.

Independent learning is a concept of learning that creates an atmosphere of free and independent learning for students. In addition, the independent curriculum also implements the development of soft skills and character through a project to strengthen the profile of Pancasila students. One of the schools that implements the Independent Curriculum is SMP Negeri 1 Tanah Grogot. The purpose of this research is to 1)Describe the application of science learning using the Independent Curriculum at SMP Negeri 1 Tanah Grogot. (2) Describe students' responses to learning science. (3) Describe the factors that support science learning. (4) Describe the factors that hinder science learning. This type of research uses qualitative research with descriptive methods. Based on the research results, there were 3 strategies implemented at Tanah Grogot 1 Public Middle School, namely the Education Unit Operational Curriculum (KOSP), learning processes and tools in science subjects (Intracurricular), and the application of projects to strengthen Pancasila student profiles (p5). Internal supporting factors, namely the majority of young teachers who want to train themselves, master the use of information technology, as well as motivation within the teacher to be able to provide a fun learning experience for students. While the external supporting factors include the existence of independent training for teachers and the presence of fellow teachers, principals, and school supervisors who are members of the learning community. As for the inhibiting factors, namely the teacher still does not understand how to implement the Independent Curriculum in schools, especially the implementation of the Pancasila Student Profile Strengthening Project, the small number of teachers, as well as obstacles in adjusting teaching schedules and differences in the learning system between grade 7 using the Independent Curriculum and grades 8 and 9 which is still gradual.

Cardiovascular disease is a significant and ever-growing problem in the United Kingdom, accounting for nearly one-third of all deaths and leading to significant morbidity. It is also of particular and pressing interest as developing countries experience a change in lifestyle which introduces novel risk factors for cardiovascular disease, leading to a boom in cardiovascular disease risk throughout the developing world. The burden of cardiovascular disease can be ameliorated by careful risk reduction and, as such, primary prevention is an important priority for all developers of health policy. Strong consensus exists between international guidelines regarding the necessity of smoking cessation, weight optimisation and the importance of exercise, whilst guidelines vary slightly in their approach to hypertension and considerably regarding their approach to optimal lipid profile which remains a contentious issue. Previously fashionable ideas such as the polypill appear devoid of in-vivo efficacy, but there remain areas of future interest such as the benefit of serum urate reduction and utility of reduction of homocysteine levels. The purpose of this review has been to summarize the causes of common cardiovascular diseases and prophylactic measures.

This study aims to develop learning modules for science subjects to determine the feasibility, practicality, and effectiveness of using science learning modules for class IX in junior high school. This research is a type of research and development conducted at SMP Negeri 1 Paringin. The selected development model is the ADDIE model. The object of research is the development of science learning modules on the topic of biotechnology. Data collection using questionnaires and questions (pretest-posttest). The result of this research is the development of science learning modules. The modules that have been developed are declared good, based on material experts with an average score of 3.64 or 91.08 with the criteria "Very Valid", assessments from media experts with an average of 3.79 or 94.83% with the criteria "Very Valid". Modules that have been assessed as good are then tested for their effectiveness on students. Based on the results of research conducted by learning with the Science module that the effectiveness of student learning has increased in class IX B which can be seen in the N-Gain result of 0.73 with the "High" criterion. According to the data on student responses to the Science module as a whole it was stated "Very Practical", this can be seen from the results of the average score from the respondent's trial of 3.37 with a percentage of 84.21%. Based on the research results, the product in the form of a science learning module on the topic of biotechnology for differentiation learning is declared valid, effective, and practical and can be used as a support for learning in science lessons on the topic of biotechnology.

Media applications that can overcome learning difficulties, one of which is by using powtoon-based learning videos. This study aims to: determine the validity of video media, the practicality of video media and the effectiveness of student learning outcomes after using Powtoon-based learning video media on Environmental Pollution material at SMPN 1 Daha Selatan. This study used the Research and Development method which was carried out at SMPN 1 Daha Selatan in class VII A with the ADDIE model which consisted of five steps namely Analysis, Design, Development, Implementation. ), and Evaluation (evaluation). Data collection techniques using questionnaires, pretest results, and posttest results. The research results obtained were: (1) The results of the expert validity of the animation learning media material obtained were 81.57% and the media expert validity was 85.14% or valid or usable but needed minor revisions as supporting media for science learning. (2) The results of the validator's response questionnaire were 75.83% and the students' response questionnaires were 94.22% or practical so that the media was very interesting to use as a supporting medium for learning science. (3) The results of the pretest and posttest percentages based on the normalized gain (N-gain) value of 0.92 are included in the high criteria so that the powtoon video learning media seen from the student learning outcomes test is effectively used and influences student learning outcomes at SMPN 1 Daha Selatan.

To ascertain if regional economic integration insulates member countries from external spillovers, this work studied the transmission of trade shocks between ECOWAS and the global economy. It adopted the Diebold and Yilmaz (2009) network approach using quarterly data from 1986Q1to 2019Q4 for selected countries. Data were subjected to preliminary tests using the Phillip-Peron unit root test to establish the order of statonarity and Johansen co-integration test to establish existence of co-integration among variables. Following results of preliminary tests, the underlying VAR model was estimated in error correction form. The forecast error variance decompositions (FEVDs) were subsequently generated and used to build generalized trade linkage measures for analysis. Result of the analysis show that ECOWAS economies are highly linked to the global economy, and are net receivers of trade shocks. The study recommends ECOWAS countries diversify to heavy industrial manufacturing, fashion out uniform trade policies to insulate the region from potential trade shocks.

The purpose of this study is to determine whether a structured exercise program can improve students' motor skills. Everyday activities, including academic and professional ones, necessitate strong motor skills. In any case, numerous understudies need assistance with their coordinated movements which can influence their general exhibition. An experimental design with a randomized control group was used in this study. There were two groups of 100 students in the research sample: the exploratory gathering, which went through an organized actual activity program, and the benchmark group, which got no mediation. Before and after the intervention, students' motor skills were assessed using a tested that was proven to work. The outcomes showed that the organized actual activity program altogether further developed understudies' coordinated abilities contrasted with the benchmark group. Motor coordination, agility, and movement accuracy all improved significantly in the experimental group. They also said they performed better on tasks that required motor skills. This study's findings show that students' motor skills can be improved with a structured exercise program. This study's practical implications include the need to incorporate structured physical activity into higher education curriculum to ensure that students have sufficient motor skills for life success.

Boxing, wrestling, and bodybuilding are sports that require athletes to be highly conditioned from both endurance and strength perspective. Hence, the temptation to use performance enhancing substance has become rampant among athletes from these sports. Some of the athletes have tested positive for inadvertent doping after use of performance enhancing substances. This can be blamed on lack of knowledge, as well as attitudes developed by athletes. The purpose of this study was to establish knowledge levels, attitudes towards the use of performance enhancing substances (PES), among athletes from boxing, wrestling, and bodybuilding federations in Kenya. The study utilized cross-sectional analytical research design. The study population comprised of 1900 athletes from the three sports disciplines with a sample size of 384 athletes. Close ended questionnaires were used as the data collection instrument. Data obtained from the respondents was coded and organized for analysis by use of SPSS version 25. Hypotheses were tested using one-way ANOVA and t-test at confidence level of 0.05. Post hoc analysis was carried out using Duncan Multiple Range Test where differences were found to be significant. Results on knowledge indicated that 44.8% of respondents reported that ADAK can advise them on which performance enhancing substances were safe to use. 14.3% reported that they thought PES bought from a pharmacy (over the counter) was safe. In addition, 90% reported that an athlete can be sanctioned for testing positive after taking a performance enhancing substance which they thought was safe. With regards to attitudes, 61.5% of the respondents disagreed that athletes are pressured to take performance enhancing substances. Majority of the respondents (81.5%) disagreed that performance enhancing substances and food supplements should be legalized. Many respondents (95.8%) disagreed that athletes have no alternative career choices except sports, which was a positive attitude. Inferential results on one way ANOVA indicated significant differences in knowledge levels at F (2, 381) = 19.631, p<0.001 and attitudes at F (2, 381) = 25.605, p<0.001 three sports disciplines. In conclusion, knowledge and attitudes of athletes from the three sports disciplines were significantly different. The study recommended that sports federation officials from boxing, wrestling and bodybuilding should have a put proper structures for imparting knowledge and proper attitude on use of performance enhancing substances among athletes.

Background: Chronic kidney disease (CKD) is a non-communicable disease that includes a range of different physiological disorders that are associated with abnormal renal function and progressive decline in the glomerular filtration rate (GFR). Chronic kidney disease (CKD) is the 16th leading cause of years of life lost worldwide. Like other developing countries, the prevalence of chronic disease is increasing trends in Bangladesh. Prior conception regarding the socio-demographic status of patients with chronic kidney diseases may be helpful for respective health professionals and researchers. Aim of the study: This study aimed to evaluate the socio-demographic status of patients with chronic kidney diseases. Methods: This was a descriptive cross-sectional study that was conducted in the Department of Medicine and Nephrology, Dhaka Medical College & Hospital (DMCH), Dhaka, Bangladesh during the period from January March 2018 to September 2020. A total of 150 diagnosed cases of CKD were enrolled in this study as a study population. Properly written consent was taken from all the participants before data collection. All data were processed, analyzed, and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, male participants were dominant in number and the male-female ratio was 1.7:1. The mean age of the respondents was 53.31±10.28 years. The highest number of our participants were unemployed 65(43.3%) and the majority of our respondents 106(70.7%) were married. Among the total participants 83(55.3%) patients were with hypermagnesemia whereas 10(6.7%) with hypomagnesemia. In this current study, among the total respondents 51(34%) had CKD stage 5, 42(28%) had CKD stage 4, 38(25.3%) had CKD stage 3, 14(9.4%) had CKD stage 2 and only 5(3.3%) had CKD stage 1. Conclusion: As per the findings of this study, we can conclude that male people are prone to chronic kidney diseases (CKD). Early investigation and proper treatment can decrease the occurrence of CKD as well as the mortality and morbidity of such theses.

This study investigated the effects of ethanolic extract of Earth ball (Icacina mannii) tuber on the testes. Icacina mannii is a well-known plant in Africa due to its unique ball-shaped underground tuber. The extract was prepared by washing the tuber, cutting it into pieces, sun drying it, and extracting it with 80% ethanol. Four-week-old male Wistar rats were used in the experiment and were randomly assigned to four groups. Group A served as the control and received distilled water, while groups B, C, and D received low, intermediate, and high doses of the extract, respectively. The rats were fed for 28 days. On the twenty-eighth day, the animals' final weight was taken, and blood samples were obtained by cardiac puncture for testosterone level analysis. The testes were recovered for histology. The results showed a significant increase in testosterone level in the low and medium dose groups and a significant decrease in the high dose group when compared with the control. The histologic section of the testes of rats in groups B and C revealed hypochromic sections of seminiferous tubules with swollen germinal cells and spermatogenic lining cells and irregular alignment of myoid cells when compared to the control group. The testicular histologic section of rats in group D showed atrophied and necrotic testicular cells. This study shows that Icacina mannii tuber could be a potential plant for research in the management of infertility in men due to testosterone deficiency, but high doses could be necrotic and atrophic to the testes.

The purpose of the study was to evaluate the impact of Total Quality Management (TQM) practices on employees' satisfaction in the Saudi Arabian health sector. It aimed to contribute to economic development from a microeconomic perspective. The research used primary cross-sectional data from various companies in the Saudi health sector to address major research hypotheses. A semi-structured questionnaire was used to capture the information. A five-point Likert-type scale was used. Data analysis was done using SPSS version 21. Scale validity was determined, and the scale of reliability was estimated by the Cronbach alpha scale. Regression and correlation analysis were used. The findings showed customer focus, continuous improvement, process management, employee involvement, leadership, good vision, communication, and integrated systems are positively and significantly linked with employee satisfaction. In conclusion, the health sector in Saudi Arabia has a high level of various TQM practices, a high level of customer focus, a high level of continuous improvement, a high level of process management, a high level of employee involvement, leadership, a good vision, a high level of communication, and a high level of integrated systems. The study also concludes that the higher the level of TQM practices, the more the employees’ satisfaction level has increased by 0.204%, and the higher the level of customer focus, continuous improvement, process management, employee involvement, leadership with a good vision, communication, and integrated systems. It was recommended that leaders and managers in the health sector utilize more interactive technologies to promote improved employee engagement with the institutions.

Background: Despite a long history of safety, spinal anesthesia (SA) is still seldom used outside of specialist pediatric institutions and is sometimes debated as a primary anesthetic approach for children. To lessen the risk of postoperative apnea, it is often used on previously preterm newborns who have not yet reached viability (60 weeks post- conception) (GA). There is, however, a wealth of evidence indicating its safety and effectiveness for appropriate operations in adolescents. Objective: The primary purpose of this investigation is to assess the efficacy of Caudal anesthesia pediatric surgery. Method: Tertiary care hospital was the setting for this prospective investigation. 200 children, ages 4 to 10, were included in the research because they were all given different types of anesthesia for infraumbilical or lower extremities surgery during the study's 1-year time frame. The research participants had a thorough preoperative assessment. During the study 50 patients of each were given different anesthesia including Endotracheal intubation, LMA, Caudal block and local anesthesia. Results: Majority was belonged to 4-6 years age group, 70% and 60% were male. Plus, majority of the patients were undergone circumcision, 35% and Herniorrhaphy, 28%. Followed by 20% undergone appendectomy and 5% undergone hypospadias repair. Besides, anesthesia induction and recovery on the operating room table, was lowest in the local anesthesia group (P = 0.015), whereas the results were comparable in the other groups. However, patients with caudal and local anesthesia spent significantly less time in the postoperative recovery unit (P < 0.001). In fact, patients who got Caudal block had less complication where only 1% had Convulsions, Bloody puncture and vomiting. Conclusion: Caudal anesthesia as a sole method for pediatric subumbilical surgery is a relatively safe method. Patients having operation under caudal anesthesia have faster discharge times from postoperative recovery units, compared with general anesthesia. This probably reduces recovery unit expenditures.

This development research aims to find out: (1) how the implementation of learning to news writing is currently being carried out by students of the PBSI Study Program, University of PGRI Semarang, (2) how the effectiveness of the implementation of project-based learning models through a contextual approach in the ability to news writing for students of the PBSI Study Program, University of PGRI Semarang. , and (3) how to develop a project-based learning model through a contextual approach to improve the ability to news writing for students of the PBSI Study Program, University of PGRI Semarang. This research method is the Research and Development (R&D) method. The population of this research is the students of the PBSI Study Program, University of PGRI Semarang. Data was collected through observation, interviews, questionnaires, and tests. To develop the learning model, a preliminary study was carried out, model design, trials, revisions, and final modeling. After the final model is obtained, it is tested on students and summarizes the responses given by students. To analyze the statistical assessment in the process of implementing the test, the t-test was applied. Based on the results of the research, it is known that the students' views on how to learn to write news show that the learning that is mostly done by students is writing on their own either on campus, at home, and discussing with friends. After testing the hypothesis with the rule of t arithmetic > t table or 11.473 > 2.042, there is a significant difference between student learning outcomes in the first treatment and the second treatment. At the development stage this model was analyzed based on the concept of learning to news writing including, material, methods, attitudes, steps, and learning design.

The purpose of this study is mainly to analyze the influence of sports volunteers’ participation motivation and job satisfaction on re-participation intention. Students who volunteer to participate in the volunteer work of the 2023 National Intercollegiate Athletic Games are the research objects. A questionnaire survey is conducted at each site during the competition. 200 questionnaires are distributed, with 13 invalid questionnaires and 187 valid questionnaires collected. The effective questionnaire recovery rate is 93%. This research is analyzed by statistical methods, such as narrative statistics and multiple regression, and so forth. The study has the following findings: In the volunteer service of the National Intercollegiate Athletic Games, the participation motivation of the university sports volunteers is the highest in “the method and techniques of learning to do things”. In terms of job satisfaction, the highest is “Feel that I am part of the school". Therefore, in the process of volunteering service, sports volunteers feel a high degree of job satisfaction, and their intention to participate in volunteer service in the future is consequently higher. Based on the above results, this study not only provides specific suggestions for planning volunteer services for large-scale sports events in the future, but also proposes directions for future research.