The twenty-first century has resulted in many challenges for educational systems. One such challenge is integrating learning experiences in educational institutions with practical realities and requirements. Implementing Competency-Based Curriculum (CBC) models for various disciplines would reduce the gap between theoretical knowledge acquired in the educational system and expenses needed in the labor market. This study, therefore, sought to establish the effect of availability and use of instructional resources on the implementation of the competency-based curriculum by grades 1, 2 and 3 teachers in public primary schools in Migori County. A descriptive survey design methodology was adopted. The study targeted 604 head-teachers, 1812 grade 1-3 teachers, and 8 sub-county quality assurance and standards officers from all the Sub-counties in Migori County. The sample size for the study was180 head teachers, 8 Sub County Quality Assurance Officers (SQAOs), and 544 grade 1-3 teachers. The researcher used 30 percent to get a sample size for 180 out of 604 head-teachers and grade 1-3 teachers respectively and saturated sampling, 100 percent to include all the 8 SQASOs in the final sample resulting to a sample size of 732 out of the 2424. Questionnaires and interview schedules were used to collect data. The validity of the instrument was subjected to expert opinions; further the questionnaire was pre-tested for coherency and comprehensiveness. Reliability was tested using a questionnaire duly completed in a pilot study. Internal consistency was determined by Cronbach’s Alpha Coefficient and it yielded reliability coefficient of 0.704, and 0.690 and 0.671 respectively for teachers and principals respectively. The study applied quantitative analysis techniques using descriptive and inferential statistics to analyze data. The research was carried out ethically. The findings showed a strong positive correlation significant at a 5% level of significance between the adequacy of the Teaching-Learning (T/L) resources and CBC implementation, as indicated by a Pearson’s correlation coefficient of 0.593. The study recommended increase of number of CBC in-service training sessions and use more competent facilitators, mandatory training for all teachers. The findings will be used by national education managers, the principles in the county and county education officers, Boards of Management and the community. They will contribute to the existing knowledge on teachers' preparedness to implement a competency-based curriculum.

This review's objective is to provide you with the most recent data about POEMS syndrome. The authors reviewed, compared, and assessed key findings after conducting a literature search of the accessible sources explaining POEMS syndrome. According to the results of this study, POEMS syndrome is related to a class of diseases called monoclonal gammopathies or plasma cell dyscrasias. The unchecked growth of a single clone (monoclonal) of plasma cells causes an abnormal buildup of M-proteins (also known as immunoglobulin) in the blood, which has a detrimental effect on the quality of life for both the patients and their family. To minimize or even eliminate the symptoms, early and appropriate diagnosis and therapy/Treatment are necessary.

This study examined the influence of Good Corporate Governance, Corporate Social Responsibility, and Diversity on Boards of Directors on Firm Value. This study uses secondary data from the IDX website. The population of this quantitative study is the annual report of Property and Real Estate companies listed on the Indonesia Stock Exchange from 2017 to 2020. The sample consisting of the annual reports of Property and Real Estate companies listed on the Indonesia Stock Exchange from 2017 to 2020 was obtained through purposive sampling. The data was collected on March 1, 2022. Multiple linear regression analysis was used to analyze the data. The results of the study prove that the existence of independent commissioners has a significant influence on firm value, audit committee has a significant influence on firm value, and corporate social responsibility disclosure has a significant influence on firm value. The proportion of women and people over 40 on the board of directors has no influence on firm value. The education level of the board of directors has no influence on the firm value.

We report a case of late pregnancy following in vitro fertilization, complicated by severe early preeclampsia in a 45-year-old primigravida. The treatment was conservative for two weeks and then the pregnancy was terminated by caesarean section in view of the worsening of the clinical and biological parameters. The maternal prognosis was favorable. As for the perinatal prognosis, it resulted in prematurity, intrauterine growth retardation and neonatal respiratory distress requiring transfer to neonatal intensive care. Thus, when a couple wishes to have recourse to IVF or ICSI for a late pregnancy, health professionals must inform them of the probable increases in the risks for the woman but also for the child.

In recent years, many research groups have begun to utilize bioengineered in vitro models of cancer to study mechanisms of disease progression, test drug candidates, and develop platforms to advance personalized drug treatment options. Due to advances in cell and tissue engineering over the last few decades, there are now a myriad of tools that can be used to create such in vitro systems. In this review, we describe the considerations one must take when developing model systems that accurately mimic the in vivo tumor microenvironment (TME) and can be used to answer specific scientific questions. We will summarize the importance of cell sourcing in models with one or multiple cell types and outline the importance of choosing biomaterials that accurately mimic the native extracellular matrix (ECM) of the tumor or tissue that is being modeled. We then provide examples of how these two components can be used in concert in a variety of model form factors and conclude by discussing how biofabrication techniques such as bioprinting and organ-on-a-chip fabrication can be used to create highly reproducible complex in vitro models. Since this topic has a broad range of applications, we use the final section of the review to dive deeper into one type of cancer, glioblastoma, to illustrate how these components come together to further our knowledge of cancer biology and move us closer to developing novel drugs and systems that improve patient outcomes. Glioblastomas are universally fatal cancers and contain self-renewing glioblastoma stem cells (GSCs) that initiate tumors. Traditional anticancer drug development based on in vitro cultures tends to select targets with low therapeutic indices and fails to effectively represent the tumour microenvironment's impacts. Glioblastoma multiforme (GBM) is the most common and aggressive form of brain cancer, with treatment options often constrained due to inherent resistance of malignant cells to conventional therapy. We investigated the impact of triggering programmed cell death (PCD) by using BH3 mimetic drugs in human GBM cell lines. Glioblastoma multiforme (GBM) has been characterized by the high incidence, therapy tolerance and relapse. The molecular events controlling GBM resistant to chemotherapy temozolomide (TMZ) remain to be elusive. Here, we identified WNT signaling was amplified by TMZ and mediated drug response in GBM. We found O6-methylguanine DNA methyltransferase (MGMT) was redundant to WNT-mediated chemoresistance, which was highly associated with p53 mutation status. In GBM with p53 mutation, loss of function of p53 downregulated miR-34a expression, which represses transcription of WNT ligand 6 (WNT6) by directly binding to 3′ UTR of WNT6 mRNA, leading to activation of WNT signaling, and the eventual WNT-mediated chemoresistance to TMZ. Combined treatment of TMZ with WNT inhibitor or miR34a mimic induced drug sensitivity of p53-mutant GBM cells and extended survival in xenograft mice in vivo. Our findings provide insight into understanding the molecular mechanism of GBM chemoresistance to TMZ and facilitating to develop novel treatment strategy to combat p53-mutant GBM by targeting miR-34a/WNT6 axis. Advantages and drawbacks of dexamethasone in glioblastoma multiforme: Dexamethasone has been used for many years to treat brain edema and inflammation caused by GBM.Several investigations have shown that dexamethasone also exerts antitumoral effects against GBM.Unfortunately, steroids are associated with various undesirable side effects. Herein, we review pre-clinical and clinical applications of Dexamethasone in GBM. The most widespread, malignant, and deadliest type of glial tumor is glioblastoma multiforme (GBM). Despite radiation, chemotherapy, and radical surgery, the median survival of afflicted individuals is about 12 months. Unfortunately, existing therapeutic interventions are abysmal. Dexamethasone (Dex), a synthetic glucocorticoid, has been used for many years to treat brain edema and inflammation caused by GBM. Several investigations have recently shown that Dex also exerts antitumoral effects against GBM. On the other hand, more recent disputed findings have questioned the long-held dogma of Dex treatment for GBM. Unfortunately, steroids are associated with various undesirable side effects, including severe immunosuppression and metabolic changes like hyperglycemia, which may impair the survival of GBM patients. Current ideas and concerns about Dex's effects on GBM cerebral edema, cell proliferation, migration, and its clinical outcomes were investigated in this study. Glioblastoma multiforme (GBM) is one of the most common, most formidable, and deadliest malignant types of primary astrocytoma with a poor prognosis. At present, the standard of care includes surgical tumor resection, followed by radiation therapy concomitant with chemotherapy and temozolomide. New developments and significant advances in the treatment of GBM have been achieved ..........

Function Analysis System Technique (FAST) diagraming is a key component of Function Analysis. It contributes to Value Engineering (VE) teams’ understanding of the scope of VE studies and maximizes the number of identified VE alternatives. This paper identified some of the challenges encountered by university students in constructing FAST diagrams. This was accomplished through the assessment of 36 FAST diagrams constructed by 36 students and five FAST diagrams constructed by five teams of 24 students. The assessment found less flaws in FAST diagrams when students work as a team rather than as individuals. The analysis also found difficulties associated with understanding and linking functions in the When logic or same time functions. To overcome this issue, the paper is suggesting the use of a “Function Block” approach to facilitate the understanding and construction of FAST diagrams. The new approach was tested by three teams of 13 students to identify its advantages and disadvantages.

Based on the theoretical framework of POA, this paper intends to evaluate an English textbook—Going Global (Elementary) through three criteria: "appropriateness of output objectives"，"effectiveness of facilitation activities" and "achievement of output goals". By means of interviews and a questionnaire, the research results show that Going Global (Elementary) fit the evaluation criteria of POA in general. However, this textbook also has some limitations which needs further improvement.

Background: De Quervain's thyroiditis is an inflammatory thyroid disorder. The new coronavirus is incriminated as the causative agent. Aims: We describe two cases of subacute thyroiditis, the first is linked to covid-19 infection, and the second is secondary to the SARS-CoV-2 vaccine. Methods: A 48-year-old female, presented with severe anterior neck pain, and thyroid dysfunction; the thyroid ultrasound showed an enlarged gland, with external hypoechoic areas. The RT-PCR was positive, the patient was treated according to the protocol of covid-19. A 49-year-old female, consulted for intense neck pain, one month after receiving the first dose of vaccination (Astrazeneca); the cervical ultrasound showed an external hypoechoic areas. Results: In first case, neck pain and other signs disappeared in one week. In second case, neck pain disappeared within two weeks. Conclusion: Clinicians should be aware of the possibility of thyroiditis in patients infected with Sars-COV-2.

With the conversion of traditional energy sources to new energy sources, the dissemination of informative texts on energy is increasing. The book Energy Transition, written by a famous French energy expert Bertrand Cassoret, has a strong reference effect on China's current energy transition. As one of the three major text types, the importance of informative texts is self-evident. This type of text is characterized by its strong practicality and contains many technical terms and complex sentences. Communicative translation theory focuses on the dissemination of information and the reader's response and is suitable for guiding the translation of informative texts. Guided by communicative translation theory, this paper explores different translation techniques in conjunction with the translation examples in Chapters 6 and 7 of this book. In terms of vocabulary, the method of part-of-speech conversion is used to convert nouns into verbs. In terms of sentences, the translation skills of voice conversion, inversion, addition and subtraction are adopted. According to communicative translation theory, the translator tries to make the language easier for the target readers to understand, thus achieving the purpose of information dissemination.

Based on 2030 vision of the Kingdom of Saudi Arabia (KSA), improving the quality of preventive and therapeutic health care services is one of the targets that set out by the National Transformation Program (NTP). Clinical Audit (CA) is one of the great tools of quality improvement worldwide. Although a CA program was initiated just a while ago in Saudi Arabia, in this short duration the maturity of this practice in this country is evident in various documentations. However, it is still a long path to go in this practice as many health professionals are not yet mindful about the positive implications and benefits of this concept. In this consideration, this article was attempted to highlight the concepts, broad principles of and the mandatory stages in implementing CA practice to a success. Apart from that the leadership role in materializing CA, the barriers to its success, as well as, the pattern of CA practice in Saudi Arabian health care system in achieving its maturity have also been outlined.

Oral cancer considered one of the most 10 cancer among world population [1]. In the period between 1995- 2015 Saudi cancers registries detect 172,424 cancer cases, 3184 were oral cancer cases. 1.5 Per 100000 for female population and 1.4 per 100000 among male population, the majority of cases are from jazan region [2, 3]. The aim of this review is to explain the basic and essential aspects of oral cancer focusing on squamous cell carcinoma , starting from its definition to epidemiology in Saudi Arabia as well world wild as well addressing carcinogenesis , potential malignant diseases , and premalignant lesions. As oral cancer is preventable disease, prevention will be addressed as well.

Currently, both job stress and presenteeism are critical problems. Job stress carries enormous costs for healthcare workers and nurses in terms of overall wellbeing, presenteeism, and turnover, which in turn affect the quality of patient healthcare services. The objectives of this research were to uncover the extent of presenteeism and job stress among nurses in hospitals in Hafr Al-Batin, a city in the Kingdom of Saudi Arabia. A descriptive, correlational, cross-sectional study was conducted. The study sample included 146 nurses working in Hafr Al-Batin hospitals. Data were collected from May to June 2020. For analysis, the researcher used two tools, the Expanded Nursing Stress Scale (ENSS) and the Stanford Presenteeism Scale-6 (SPS-6). The data was subsequently analyzed by descriptive statistics and Spearman’s correlation coefficient. Study results showed that the mean values of job stress and presenteeism were both high. Furthermore, there was a relationship between the overall presenteeism and overall job stress experienced among staff nurses. The results of this research would aid both nursing administrators and hospital managers in designing effective strategies to reduce job stress and manage presenteeism among staff nurses in the hospitals of Hafr Al-Batin.

This study moderates firm characteristics with key monetary variables (inflation rate and exchange rate) and examine their effect on the financial performance of fifteen (15) listed consumer goods manufacturing firms in Nigeria using an annual panel dataset from 2004 to 2020. The dependent variable (financial performance) is measured as return on assets while the independent variables are capital structure, dividend policy, managerial efficiency and firm size. In addition, the study used fixed and random effects regressions as techniques of data analysis. The results of this study are categorized into two parts namely; regression results without moderators and regression results with moderators (inflation and exchange rate). The result from the model without moderators shows that there is a positive and statistically relationship between capital structure, managerial efficiency and firm size and financial performance while dividend policy has no significant effect on financial performance. However, the results moderated with both the inflation and exchange rate indicate that capital structure and firm size have a significant negative effect on financial performance while dividend policy and managerial efficiency have a significant positive effect on financial performance. Thus, this study recommends the need for an increase in both dividend policy and managerial efficiency and limiting the increase in capital structure and firm size since they adversely affect financial performance. Finally, there is a need for consumer goods manufacturing firms to put into consideration the trends in monetary variables before making any investment decision.

The new SARS-CoV-2 virus has become a worldwide emergency. It is recognized as a multiorgan disease and post-acute sequalae are seen in many systems. Many oral symptoms have been reported in relation to COVID-19. Cause- effect relationship between coronavirus and the appearance of such oral lesions still cannot be established. Immunosuppression state of positive cases could explain appearance of oral lesions. Oral hygiene is an aspect that should not be left aside, and it is of great importance to encourage the patient to reinforce hygiene techniques.

Due to its ambiguous nature, culture is one of the most difficult human phenomenons to define. Sociologists and Linguists are continuously expanding the aspects of what constitutes culture in an effort to understand how our individual identities can coexist as simultaneous members of a global community. This paper analysed various theories and literature in relation to the concept of culture in an effort to determine the effect it has on English as a second language (ESL) students. It discovered that although spoken and written discourse is integral to succeeding in a community, there are several non-linguistic methods of communication that can help ESL students to participate and become accepted members of their chosen second language society. This paper also compared the differences between individual and collective cultures and the social and environmental impact they can have on its participants.