Background: Vitamin D (VD) deficiency is significantly prevalent in Saudi Arabia, despite the country's plentiful sunlight, and has been increasingly linked to metabolic disorders, particularly type 2 diabetes mellitus (T2DM). This review aims to integrate recent evidence on the clinical ramifications of VD deficiency in Saudi populations, with a focus on diabetes and related metabolic complications. Methods: A comprehensive search of the literature was carried out on PubMed, Scopus, Web of Science, and Google Scholar for studies published from 2010 to 2025. The inclusion criteria encompassed studies that reported VD status in Saudi populations and their associations with diabetes, glycemic control, or cardiometabolic outcomes. Forty-three studies—including observational studies, systematic reviews, and meta-analyses—were included. Data on serum 25-hydroxyvitamin D [25(OH)D], the prevalence of deficiency, metabolic parameters, and clinical outcomes were extracted and synthesized narratively. Results: VD deficiency prevalence has been reported to range from 50% to 85%, affecting children, adolescents, and adults, with women being disproportionately affected. This deficiency was consistently linked to elevated fasting glucose levels, HbA1c, insulin resistance, dyslipidemia, obesity, and an increased risk of cardiovascular issues. The pediatric and adolescent demographics showed signs of impaired bone mineralization and a heightened risk for rickets. Mechanistically, VD deficiency leads to β-cell dysfunction, reduced insulin secretion, peripheral insulin resistance, and systemic inflammation. Some urban areas have seen modest improvements in deficiency rates due to supplementation and awareness initiatives, yet the deficiency remains widespread. Conclusion: Vitamin D deficiency is significantly prevalent in Saudi Arabia and is closely associated with T2DM, cardiometabolic disorders, and skeletal complications. It is advisable to implement routine screening for high-risk groups, targeted supplementation, lifestyle modifications, and public health strategies to alleviate deficiency and its clinical ramifications. Tackling VD deficiency is a clinically actionable strategy to lessen the burden of metabolic and skeletal disorders within Saudi populations.

Endometriosis is a chronic, estrogen-dependent inflammatory disorder that affects nearly 10% of individuals of reproductive age worldwide. It is associated with severe pelvic pain, infertility, and profound psychosocial burden. Despite the absence of a definitive cure, recent evidence underscores the importance of prevention, early intervention, and comprehensive management. Strategies such as lifestyle modification, dietary interventions, hormonal suppression, and early diagnostic practices have shown potential in reducing disease incidence, severity, and recurrence. This review integrates current insights into pathophysiology, preventive measures, systemic effects, infertility, and therapeutic approaches, highlighting the need for a holistic, multidisciplinary framework spanning primary, secondary, and tertiary prevention.

Sorafenib (SR), a liver cancer drug, is an antineoplastic agent that belongs to the group of drugs known as kinase inhibitors. It functions by preventing the aberrant protein that stimulates cancer cells to proliferate. In this study, we investigated the toxicological implications of SR on the kidneys in male Wistar rats. A total of 10 male rats were assigned equally into two groups. Group 1 served as control (received corn oil) while group 2 received SR (10 mg/kg). The SR was administered orally thrice a week for seven consecutive weeks. The blood and kidneys were processed for hematological, histological, and biochemical analyses. Results showed that the administration of SR decreased the body weight gained by 42% while the organo-somatic weight of the kidney increased by 13%, respectively. Administration of SR caused significant decreases in antioxidant activities of catalase and superoxide dismutase by 34% and 31%, respectively, when compared to controls. On the contrary, levels of lipid peroxidation significantly (P<0.05) increased by 53% while nitric oxide decreased by 54% in SR-administered rats. Furthermore, the levels of electrolyte concentration decreased in SR-administered rats. Precisely, sodium, potassium, and chloride ions decreased by 4%, 73%, and 17% respectively. Also, the white blood count drastically (P<0.05) decreased by 48.3% in SR-administered rats. Histology of kidney tissues revealed normal kidney cells and interstitial spaces with no inflammatory cells in both control and SR groups. In conclusion, the administration of Sorafenib induced oxidative stress with a concomitant decrease in the activities of first-line antioxidant enzymes.

The accelerating impacts of climate change, including rising global temperatures, extreme weather events, and increasing carbon emissions, are intensifying the demand for sustainable and climate-adaptive construction practices. Conventional construction materials such as cement, steel, and concrete, while critical for modern infrastructure, contribute significantly to greenhouse gas emissions and exacerbate the environmental footprint of the built environment. This paper explores the potential of green and low-carbon construction materials as foundational elements in designing climate-adaptive civil structures. Specifically, it examines the life-cycle environmental performance of alternative materials such as geopolymer concrete, recycled aggregates, cross-laminated timber (CLT), bamboo composites, and phase change material (PCM)-enhanced concretes. These materials not only reduce embodied carbon but also improve thermal efficiency, resilience, and adaptability under climate stressors. The paper integrates insights from life-cycle assessment (LCA), material innovation research, and adaptive design strategies to propose a holistic framework for sustainable construction. Furthermore, digital technologies such as Building Information Modeling (BIM) and material passports are discussed as enablers of circularity and low-carbon supply chains. By analyzing recent advances and case studies, this study demonstrates how climate-adaptive materials can reduce construction-related CO₂ emissions by up to 40%, extend service life under extreme conditions, and support global carbon neutrality targets. The findings underscore the urgency of mainstreaming low-carbon materials into infrastructure planning, highlighting their role in transitioning toward resilient, sustainable, and climate-conscious civil engineering practices.

Circuit training involves transitioning quickly between various exercise stations, completing a set number of repetitions or working for a specific duration at each station. It is a type of high-intensity training that combines elements of resistance and aerobic exercises, primarily aimed at enhancing both strength and muscular endurance. A full round of the exercises in a session is referred to as an "exercise circuit. "This training method was introduced in 1953 by R.E. Morgan and G.T. Anderson at the University of Leeds, England. It is widely regarded as an effective way to improve multiple components of physical fitness, including muscular strength, muscular endurance, explosive power, cardiovascular endurance, anaerobic capacity, agility, and flexibility. Morgan and Anderson’s model typically include six to twelve different exercise stations, targeting overall body conditioning. A full workout usually comprises two to three rounds of the circuit, with rest periods between 15 to 30 seconds between stations or sets. Circuit training programs can be tailored to fit individual fitness goals by adjusting the duration, intensity, or number of exercises. In a study involving 45 district-level football players, participants were divided to undergo either traditional circuit training or cardio-based circuit training. A pretest was conducted to assess selected motor fitness components. After a 12-week training period, a post-test was administered to evaluate improvements. Statistical methods such as the paired ‘t’ test and Analysis of Covariance (ANCOVA) were used to analyze the data. Where significant differences were found using the F-ratio, Scheffe’s post hoc test was employed to determine specific group differences. All statistical analyses were performed using SPSS software. The results indicated that both forms of circuit training produced significant improvements in motor fitness variables, particularly in muscular strength and muscular endurance, among the football players.

As China moves increasingly closer to the center of the world stage, "telling China's stories well and spreading China's voice effectively" has become an important mission entrusted to foreign language education in the new era. Foreign language textbooks, serving as vehicles for talent cultivation, utilize deliberate metaphors to provide cognitive pathways for telling China's stories well, fulfilling significant communicative functions. This study selects Unit 9 "Whither Civilization" from the textbook Understanding Contemporary China: A Reading and Writing Course, as its research subject. Based on Deliberate Metaphor Theory (DMT), it analyzes the types of deliberate metaphors, their discursive construction mechanisms, and communicative functions. The study identifies seven types of deliberate metaphors in this unit, such as food and cultural metaphors, which play important roles in conveying diplomatic concepts, mobilizing emotions, and fostering moral education. This research not only verifies the applicability of DMT in textbook analysis but also provides theoretical support and practical reference for the study of foreign language textbooks with Chinese characteristics.

Background: Subclinical hypothyroidism during pregnancy, though often asymptomatic, has been associated with a range of maternal and fetal complications in various studies. The purpose of this study is to assess the impact of subclinical hypothyroidism on pregnancy complications in a tertiary care hospital setting. Aim of the study: The aim of the study was to evaluate the impact of subclinical hypothyroidism on pregnancy complications in a tertiary care hospital setting. Methods: This case-control study was conducted from September 2015 to February 2016 at the Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Dhaka. Fifty pregnant women (25 subclinical hypothyroid, 25 euthyroid) were enrolled based on set criteria. Data on demographics, clinical history, and thyroid function were collected and participants were followed through pregnancy to assess maternal and neonatal outcomes. Data were analyzed with SPSS v20. Results: Among 50 pregnant women, subclinical hypothyroidism cases were older (29.16±6.45 vs. 26.16±4.85 years) with lower socioeconomic status (p=0.035). Obstetric (preeclampsia 24% vs. 4%) and medical complications (GDM 32% vs. 12%) were more frequent but not significant. Cases showed more anemia (48% vs. 44%), oedema (28% vs. 8%), and hypertension (28% vs. 16%). Fetal outcomes included 4% intrauterine death in cases. Low Apgar scores, low birth weight (36% vs. 20%), and neonatal complications like asphyxia (36% vs.16%) were higher in cases, without significant differences. Conclusion: Subclinical hypothyroidism in pregnancy is associated with increased risks of maternal and fetal complications, underscoring the importance of vigilant monitoring.

National Defense and Security Education (NDSE) constitutes an essential element in all educational curricula of universities in Vietnam. Its fundamental purpose is to cultivate patriotism, solidarity, and foundational military skills among the populace. This paper's scope includes the design and analytical assessment of a teaching model for NDSE aimed at university students in Vietnam, while also suggesting prospective enhancements to improve its efficacy in the future. The research utilizes both theoretical methodologies and empirical research on the current state. The findings may provide a significant reference for universities globally in the organization and implementation of NDSE for their students.

A sustainable and reliable railway transport system is quite pertinent in instigating production and distribution of goods and services especially in far-off enclave areas. However, the operation of this transport sector in Cameroon is yet to come to its prime. It is bogged down by a wide range of challenges which cuts across delays, poor infrastructure, and accidents occurrences linked to poor management which sometimes results from the use of old-fashioned and worn-out engines/wagons. This is in sharp contrast with other developing countries who uses Metro and TVG (Train à Grande Vitesse). This study was therefore designed to investigate into these challenges and point out key areas to ameliorate. Methodology used involved secondary and primary sourced data. Secondary data was germane from published and unpublished sources such as the Cameroon National Railway Mater Plan, Camrail website, related articles amidst others. Primary data was gotten from field studies where observations and interviews were conducted to draw insights about the Cameroon railway sector in view of the sustainability and challenges. The processed data revealed that, in terms of management, delays and late arrivals of trains based on time schedules was common. More so, frequent occurrences of accident results from poor management (overloading) the case of Eseka on October 21, 2016, along the Yaoundé-Douala railway line. Apart from overloading and accidents, infrastructure is poor especially railway tracks which lacks sufficient maintenance. More so, it was observed that, rail infrastructure since 1999 when Camrail began its operation under Boloré African Logistics, infrastructure have been a deteriorating base on observations and comparison before Camrail emerged. This study, however, strongly recommends, increase investments in Cameroon railway lines through upgrading of infrastructure, and most importantly the introduction of electric trains such as TVG and Metro which are efficient and swift to meet the needs of increasing population and to meet agenda 2035.

In the context of prompt and imminent digital acceleration and the rise of generative artificial intelligence (AI), leadership theory is shifting toward what this study defines as Syncretic Leadership. This emerging framework integrates and combines cognitive agility, algorithmic collaboration, and a culturally fused workforce as foundational attributes for navigating hybrid human-machine environments. Moving beyond classical paradigms embedded in human-centred rationality, cultural or emotional intelligence, Syncretic leadership reflects a convergence of artificial knowledge, digital fluency, data-informed judgment, and transcultural adaptability, within a fast and continuously changing environment. Through a comparative conceptual analysis and bibliometric mapping of recent scholarly discourse on AI-enabled decision-making and cross-cultural leadership dynamics—conducted using the VOSviewer software —this paper identifies key thematic clusters and intellectual trajectories that signal the formation of this new and unique model. The conclusions point to a growing consensus that effective leadership in the AI era requires harmonising human intuition with machine precision while cultivating inclusive, globally resonant management practices and a new approach to knowledge dynamics. This article contributes to the continuous academic and business debates by articulating the ontological boundaries and ethical tensions posed by the newly launched syncretic leadership model, offering a forward-looking perspective for scholars and practitioners.

Sickle cell anemia (SCA) is a hereditary hemoglobinopathy marked by episodic vaso-occlusive crises, chronic hemolytic anemia, and multi-organ involvement. In regions such as central India, its prevalence is substantial, imposing significant health and socioeconomic challenges. Routine laboratory investigations including Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR), C - reactive protein (CRP), and serum electrolytes are pivotal in diagnosis, monitoring, and assessing prognosis. The identification of long-term complications, particularly avascular necrosis (AVN), necessitates timely radiological and laboratory screening. This manuscript systematically reviews and interprets the clinical utility of these markers in the assessment of disease status, crisis severity, and complications, with commentary on their rational integration into routine protocols and implications for personalized management.

Background: Adherence to treatment is crucial for achieving effective glycaemic control and preventing complications in Type 2 Diabetes Mellitus (T2DM). However, poor adherence to pharmacological and non-pharmacological interventions remains a significant barrier worldwide. Objectives: This study aimed to assess the prevalence of treatment non-adherence among patients with T2DM, identify socio-demographic and clinical factors influencing adherence, and examine its impact on glycaemic control. Methods: A cross-sectional study was conducted at a secondary care hospital in King Koti, Hyderabad, from March to August 2025. One hundred patients with T2DM were randomly recruited. Data were collected via structured questionnaires assessing sociodemographic information, treatment adherence (pharmacological and lifestyle), glycaemic monitoring practices, comorbidities, and barriers to adherence. Descriptive statistics were used for analysis. Results: The mean age of the participants was 54.66 years for males and 53.69 years for females. A majority (93%) resided in urban areas. Obesity was prevalent in 91% of participants, higher among females (53%) than males (38%). Hypertension was the most common comorbidity (45%). Pharmacological adherence was better, with 63% on dual therapy; however, 15% reported medication non-adherence, which was more common in females (11%). Non-pharmacological adherence was poor, with only 53% following dietary recommendations and a mere 15% engaging in regular exercise. HbA1c testing was performed in 34%, mostly showing abnormal values. Forgetfulness, lack of awareness, and neglect of lifestyle modifications were the principal reasons for non-adherence. Conclusion: Non-adherence to treatment, especially lifestyle modification, remains a critical barrier to effective glycaemic control in T2DM. Along with general physician, pharmacist-led personalized counselling and structured education programs are recommended to improve adherence and diabetes outcomes in secondary care settings. In summary, the study findings validate and extend previous research emphasizing that medication adherence alone is insufficient to achieve optimal glycaemic control without concurrent lifestyle adherence and adequate monitoring. Addressing these multifactorial barriers requires a holistic, multidisciplinary, and patient-centered approach to diabetes management.

This study examines the implications of Thin Capitalization, Transfer Pricing, and Foreign Ownership on Tax Avoidance within LQ45 companies during the period from 2019 to 2023. A purposive sampling method was employed to obtain a sample of 180 observations from a total of 225 companies. Panel data regression analysis was conducted utilizing Stata 18. The results indicate that Thin Capitalization exerts a negative influence on Tax Avoidance, whereas Transfer Pricing demonstrates a positive effect. Additionally, Foreign Ownership was found to have no significant impact on Tax Avoidance. This study offers a new insight into tax avoidance among Indonesian companies, highlighting how the corporate governance structure can influence tax strategies. It finds that the thin capitalization strategy and transfer pricing of a company are more influenced by management factors than by the structure of its shareholders. Investors should focus on the transparency of company tax policies, as managerial decisions have a greater impact on tax avoidance than ownership structure. Meanwhile, stricter oversight and clearer regulations are needed to prevent tax avoidance and profit shifting.

Given that employees in petrochemical industries are exposed to various pollutants and are exposed to serious risks, the need for a comprehensive risk assessment program to determine hazardous chemicals that affect the health of exposed individuals and also to determine hazardous processes and tasks seems essential. Study Method: This cross–sectional–case study was conducted in 3 stages. The first stage included identifying hazardous substances and determining the risk factor of chemicals, the second stage included assessing exposure to benzene, and the third stage included estimating the relative risk of COVID–19 due to exposure to benzene through epidemiological studies. Findings: According to the risk assessment method, 40 chemicals were identified in the entire petrochemical company studied. Benzene was introduced as the most hazardous chemical. The results of the second stage showed that people in the main site during the noon shift and in the aromatic site with an average exposure of 4.29 ppm had the highest exposure to benzene. According to the results of the estimation stage of relative risk of COVID–19 in exposure to benzene, the highest relative risk in workers at my site was found to be related to workers in the aromatic unit, who had a cumulative exposure of 149.4 ppm–years (ppm–years) and a relative risk of 3.2. The statistical test result also showed that there was a significant relationship between the level of exposure to benzene and different work groups (P<0.001). Discussion and Conclusion: This study showed that benzene achieved a risk level of 5 with a risk coefficient of 4.5–5, indicating that corrective measures for this highly hazardous and carcinogenic chemical should be initiated as soon as possible. Schematic of the mechanism analysis and impact of the COVID–19 pandemic and outbreak on petrochemistry and petroleum mechanics.

Poverty remains a persistent challenge in Indonesian urban centers, including Tasikmalaya City in West Java Province. This study investigates the determinants of poverty by employing per capita Gross Regional Domestic Product (GRDP), average years of schooling, and the open unemployment rate as explanatory variables. Using multiple linear regression analysis based on 13 years of data (2012–2024) from the Central Bureau of Statistics (BPS) of Tasikmalaya City, the findings reveal that per capita GRDP significantly reduces poverty, whereas education and unemployment show no significant effects. These results underscore the critical role of economic growth, while education and labor market conditions exhibit only limited short-term influence on poverty alleviation, particularly in urban economies with large informal sectors. The study provides policy recommendations for local governments to design more effective poverty alleviation strategies aligned with the SDGs and regional development agendas.