Background: Non-small cell lung cancer (NSCLC) represents nearly 85% of lung cancer cases globally and remains a major cause of cancer mortality. Although immune checkpoint inhibitors improve survival, durable responses occur in a limited number of patients, highlighting the urgent need for reliable, minimally invasive predictive biomarkers. Objective: To evaluate whether specific serum protein signatures can predict clinical response to immune checkpoint inhibitors in patients with NSCLC. Methods: This prospective cohort study was conducted at National Institute of Cancer Research and Hospital, Dhaka, Bangladesh from January 2024 to December 2024. A total of 67 histologically confirmed NSCLC patients receiving ICI therapy were enrolled using purposive sampling. Baseline serum samples were obtained before treatment and analyzed for selected protein biomarkers related to immune regulation and inflammation. Clinical response was evaluated at 12 weeks using the RECIST criteria. Data were processed in SPSS 23.0, applying logistic regression and ROC curve analyses. Results: Of the 67 patients, 29 (43.3%) achieved partial response or stable disease, whereas 38 (56.7%) experienced disease progression. Higher baseline pro-inflammatory protein levels were significantly associated with poor response (p<0.05), while elevated immune-activating proteins predicted favorable outcomes (p<0.01). The combined serum protein signature showed strong predictive accuracy (AUC=0.81; 95% CI: 0.70–0.91). Conclusion: Distinct serum protein signatures may serve as non-invasive predictive biomarkers for clinical response to ICIs in NSCLC patients. These findings support further validation in larger, multicenter studies to optimize personalized immunotherapy strategies.

This study aims to determine the effectiveness of the Discovery Learning model in analyzing the structure and language of biographical texts for grade X students of SMK Al-Falah Tanjungjaya in the 2025/2026 academic year. The research method used was a quasi- experimental method. Data collection techniques used were interviews and tests. The sample of this study was 10th-grade students at TJKT 1 as the experimental class and 10th-grade students at TJKT 2 as the control class. Based on the results, the average score obtained by students in the experimental class was 90.24 and the average score obtained by the control class was 80.63. This indicates that the Discovery Learning model significantly influenced the learning outcomes of 10th-grade students at SMK Al-Falah Tanjungjaya in the 2025/2026 academic year in analyzing the structure and language of biographical texts.

Background: Pilonidal sinus is a chronic disease of the sacrococcygeal region, commonly seen in young adults, and is characterized by midline pits in the natal cleft associated with hair. This study was conducted to evaluate the outcomes of the Limberg flap procedure in the treatment of primary pilonidal sinus, including postoperative complications, duration of hospital stay, and time to return to work. Methods: This prospective observational study at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh (July 2019–August 2020), included 18 adults with primary pilonidal sinus. Excluding acute abscess and recurrent cases, patients underwent Limberg flap surgery under spinal anesthesia. Demographic, clinical, and outcome data were recorded, with follow-up at 2 weeks, and 1st, 3rd, 6th, and 9th months. Data were analyzed using SPSS® 24. Results: Among 18 patients undergoing Limberg flap repair, mean age was 26.9 ± 5.2 years, 88.9% were male, and most had BMI 18.5–24.9 kg/m². Single external opening was present in 83.3%. Mean operative time was 88.8 ± 12.7 minutes, hospital stay 4.17 ± 0.7 days, drain removal 3.4 ± 0.7 days, suture removal 12.9 ± 1.7 days, and return to work 12.7 ± 1.8 days. Postoperative complications occurred in 5 patients (27.7%), with no recurrences. Four of 5 overweight patients developed complications (r = 0.93, p < 0.001). Conclusion: The Limberg flap is a safe and effective treatment for sacrococcygeal pilonidal sinus, offering low recurrence, minimal complications, and rapid recovery.

Background: Saddle block anesthesia is widely used for perianal surgeries; however, postoperative analgesia remains limited when local anesthetics are used alone. This study aimed to compare the effects of intrathecal dexmedetomidine and fentanyl as adjuvants to hyperbaric bupivacaine in saddle block for perianal surgeries Methods: This observational study in the Department of Anaesthesia, Analgesia, and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University Hospital enrolled 64 adults (ASA I–II, 40–60 years) undergoing perianal surgery under saddle block, randomly receiving hyperbaric bupivacaine 7.5 mg with fentanyl 15 μg or dexmedetomidine 5 μg; outcomes included duration of analgesia, pain, sensory and motor block, hemodynamics, patient satisfaction, and adverse events, analyzed using SPSS v23.0. Results: Among 64 patients (mean age 45.3 ± 8.5 years; 48 males, 75%), postoperative VAS scores were lower in the dexmedetomidine group at all time points (peak 4 h: 2.75 vs 3.75). Duration of analgesia was longer with dexmedetomidine (278.5 ± 16.2 min) than fentanyl (198.7 ± 25.2 min, P = 0.0001). Motor and sensory block durations were also prolonged (162.5 vs 126.5 min and 292.1 vs 205.6 min, respectively). Hemodynamics remained stable, and adverse events were minimal (hypotension 2/32 vs 0/32; nausea/vomiting 5/32 vs 8/32; pruritus 4/32 vs 0/32). Conclusion: Dexmedetomidine as an adjuvant to hyperbaric bupivacaine in perianal surgeries under saddle block offers longer analgesia, lower pain scores, and faster sensory block onset than fentanyl.

Cleft lip and/or palate (CLP) involves a multidisciplinary and longitudinal care paradigm that provides a rational climate within which collaborative AI systems can buttress clinical decision-making. This study seeks to summarize how Artificial Intelligence AI has been integrated into CLP management by reviewing relevant publications over the past decade while focusing on the deployment of AI into CLP care along the entire care continuum. A pre-existing systematic review analyzing AI in children with CLP was a Foundational Evidence for the study and narratively updated with more recent pediatric craniofacial and orthognathic literature involving CLP subgroups. Other eligible studies had to have leveraged AI or machine learning for CLP-related tasks including diagnosis, landmarking, segmentation, surgical prediction, presurgical orthopedics, or functional outcome evaluation. The results are summarized by clinical domain. Twelve CLP-preferential studies from the prior systematic review, with a number of related craniofacial studies were reported. Across the domains, models tended to record clinically acceptable errors or good classification, reduced clinician’s manual workload, and provided standardized (and readily shareable) outcomes for multidisciplinary participation. The majority of publications were retrospective and single-center with small sample sizes and scant external validation. Collaborative AI in CLP care has advanced to early clinical workflows along the care continuum, essentially augmenting clinician’s expertise. Equity, ethics, and scalability of implementation will require robust multicenter validation, diverse datasets, governance frameworks, and clinician AI literacy

This study focuses on the significant challenges China's Intangible Cultural Heritage (ICH) faces in global dissemination, such as limited accessibility, passive reception, and cultural barriers, by empirically investigating the efficacy of a generative AI-enhanced Virtual Reality (VR) experience titled "Yunyue Shanhai · Zhihui Dongfang" in fostering interest and understanding among foreign university students. Employing a quasi-experimental design with 50 international students from five universities, the research utilized a VR system featuring multi-modal interaction, virtual inheritor dialogues, and real-time English translation to bridge linguistic gaps, measuring outcomes through pre- and post-experience surveys on interest levels, knowledge acquisition, and cross-cultural communication willingness. The study is grounded in the concept of "embodied cognition," which posits that learning is enhanced when users physically interact with virtual environments rather than passively observe them [1]. Quantitative analysis revealed a statistically significant increase in participants' interest, with mean scores rising from a baseline of approximately 3.57 to 4.53 (p<0.05), while 64% of participants reported increase in accurately named ICH items, 78% expressed willingness to engage in offline activities, and 86% indicated they would recommend the experience; qualitative feedback further identified immersion, interactivity, and cultural adaptability as key engagement drivers. This approach aligns with the broader trend of "blending AI and tradition to bridge cultures," as identified in recent reports on cultural preservation [2]. These findings demonstrate that integrating VR technology with generative AI effectively transforms passive observation into active, embodied participation, providing robust empirical support for utilizing immersive digital technologies as vital tools for the global revitalization and transmission of intangible cultural heritage.

We present the forty-ninth edition of the Handbook of the Jewish Question. It constitutes the most substantial compendium of data available up to 1944 concerning German Jewry. Everything predicted by Fritsch and others has come to pass: the US has been colonized by international Jewry. It remains unclear to me whether the US considers Israel its 51st state or whether Israel considers the US a client state. Colloquially on social media, people refer to it as the Jewish United States of America and the Zionist-Owned Government (ZOG). Given this case and the vast amount of information available, a new edition of the Handbook of the Jewish Question, this time dedicated to the US, is necessary. The fact that Trump's USA is fighting the Jewish wars is a trivial fact that needs no proof. What is curious is Trump's clear desperation to cooperate in the creation of what is called 'Greater Israel' and to provide the weapons for the genocide of the Palestinian people. To match nuclear weapons, the use of biological weapons is seen on the horizon.

Aim of the study was to find out the upshot of Cloistered Pilates Exercises, Cloistered Yogic practices and coalesce of Pilates exercises and Yogic practices on Genu varum Blemish of Ambipedal Jock. For this study sixty (N=60) school level male jocks who were studying various schools in Virajpet Kodagu, Karnataka were selected as subjects. The age of the subjects was ranged between 12 to 14 years. Group-I underwent cloistered Pilates exercises (CPEG), Group-II underwent cloistered yogic practices (CYPG), Group-III underwent Coalesce of Pilates exercises and Yogic practices (CPEYPG) and Group-IV was acted as CG (CG). Genu varum Blemish was selected as dependent variable and it was assessed by Postural Grid Chart. The duration of the training period was restricted to twelve weeks and number of sessions is five days per week. The data was collected prior to and immediately after the training period of twelve weeks. The data obtained from the experimental groups before and after the experimental period were analyzed by using the statistical technique with depended ‘t’ test and Analysis of Covariance (ANCOVA). Whenever, the obtained ‘F’ ratio for the adjusted post-test was found to be significant the Scheffe's Post hoc test was used to access the paired mean differences. In all cases, 0.05 level is fixed as level of confidence to test the significance which is considered as appropriate. The results of the study observed that there is a significant difference among cloistered Pilate’s exercises group, cloistered CYPG and coalesce of Pilate’s exercises and CYPG and control group. Further the results of the study concluded that coalesce of Pilate’s exercises and CYPG is better than groups.

This study presents a one-step solvothermal approach for the preparation of Electric Arc Furnace steel slag nanocomposite (EAF-SSNC) aimed at converting CO2 into hydrogen and methanol. The EAF-SSNC was characterized using scanning electron microscopy (SEM), transmission electron microscopy (TEM), and energy-dispersive X-ray spectroscopy (EDX). The SEM analysis revealed a spherical and heterogeneous structure with macropores, while EDX results indicated a composition of 26.3 wt% O, 32.4 wt% Fe, 11.94 wt% Si, 0.27 wt% Ti, 3.26 wt% Al, 2.93 wt% Mg, 20.43 wt% Ca, and 2.47 wt% Mn. X-ray diffraction (XRD) analysis confirmed the presence of multiple crystalline phases, including Andradite, Hematite, and Calcite. The photocatalytic performance of the EAF-SSNC was evaluated under varying dosages (10-60 mg/L) at a reactor temperature of 30°C and a flow rate of 500 μl/min, with a total water volume of 60 ml. The total organic carbon (TOC) levels were quantitatively assessed using a TOC analyzer, and gas chromatography-mass spectrometry (GC-MS) was employed to analyze the liquid products, which revealed that methanol (CH3OH) was the predominant product, whereas HCHO was the minor one. The findings suggest that EAF-SSNC can serve as an effective catalyst for CO2 reduction, addressing environmental concerns associated with steel slag disposal while contributing to sustainable carbon management strategies. This research highlights the potential of utilizing industrial by-products in innovative ways to mitigate environmental impact and promote resource recovery.

Pleomorphic adenoma is the most common benign salivary gland tumor, predominantly affecting the parotid gland. Despite its benign nature, surgical excision carries significant risks, notably facial nerve injury and postoperative complications such as Frey’s syndrome. This case report discusses the presentation, diagnosis, surgical management, and postoperative challenges of a long-standing parotid tumor in a male patient, emphasizing the delicate balance between complete tumor removal and preservation of facial nerve function. A 58-year-old male, Mr. Toslim Ali, presented with a ten-year history of a slowly enlarging, painless left parotid swelling extending from the preauricular region to the upper neck. Clinical and imaging findings were consistent with a parotid mass. Fine needle aspiration cytology (FNAC) suggested a benign lesion. A superficial parotidectomy was performed under general anesthesia. Intraoperative findings revealed a well-encapsulated mass adherent to the parotid fascia but without evidence of deep lobe invasion. Facial nerve branches were carefully dissected and preserved. Histopathology confirmed pleomorphic adenoma. Postoperatively, the patient recovered without major complications, experiencing only mild transient facial weakness that resolved within four weeks. This case underscores the clinical importance of early surgical intervention in pleomorphic adenoma, meticulous intraoperative dissection for facial nerve preservation, and the need for patient counseling regarding potential complications. The discussion integrates literature on surgical approaches, risk factors, and preventive techniques for parotidectomy-related complications such as facial nerve injury and Frey’s syndrome.

Background: Biomedical waste (BMW) generated in healthcare settings poses serious health and environmental risks if not managed properly. Nurses play a pivotal role in biomedical waste management; therefore, adequate knowledge among staff nurses is essential for effective implementation of biomedical waste management rules. Objective: To assess the knowledge regarding biomedical waste management among staff nurses working at Noor Hospital, Warudi, Jalna, and to determine the association between knowledge levels and selected demographic variables. Methods: A quantitative descriptive research design was adopted. Thirty staff nurses were selected using a non-probability purposive sampling technique. Data were collected using a structured knowledge questionnaire during January 2025. Descriptive and inferential statistics were used for data analysis. Results: The study revealed that 90% of staff nurses had average knowledge, 6.67% had good knowledge, and 3.33% had poor knowledge regarding biomedical waste management. A statistically significant association was found between knowledge levels and years of experience as well as designation (p < 0.05). Conclusion: Although most staff nurses demonstrated an average level of knowledge, gaps remain in comprehensive understanding of biomedical waste management. Regular training programs, continuous monitoring, and strict adherence to guidelines are recommended to improve compliance and ensure safe waste handling practices.

The legal and ethical aspects of software reverse engineering discussed in this paper are in the context of security research. Reverse engineering is now essential to vulnerability assessment and system interoperability, but it exists in a large gray area of the law. We have thoroughly examined the legal frameworks of various jurisdictions and discovered that more than 70 per cent of security professionals are not certain about the legal boundaries of work (Dasgupta et al., 2024). Comparative analysis shows that the EU offers clear Article 6 exception to interoperability with five conditions to the situation, whereas the DMCA Section 1201(f) in the U.S. is more restrictive in its protection, which does not include security research. We single out eight significant legal grey areas in terms of conflicts on jurisdiction, safe harbor, and disclosure. This paper will consolidate the existing law, test case law of the recent cases (2023-2025) and examine industry practice in order to record the chilling effects and the specific legal risks posed by these frameworks. As our discussion reveals, the current laws tend to be out of sync with the advancement in technology and this may make doing genuine security a hindrance. We make timely suggestions to researchers, organizations, and policymakers in order to promote a balance in protection of intellectual property and the required security research.

Grade III furcation involvement presents a significant periodontal challenge due to complete interradicular bone loss and limited regenerative potential. This case report described the management of a Grade III furcation defect using guided bone regeneration (GBR) and evaluated over a 9-month follow-up period. Following meticulous debridement, the defect was treated with a bone graft and barrier membrane to facilitate selective cell repopulation. Progressive improvement in probing depth, clinical attachment level, and radiographic bone fill was observed. The findings suggested that GBR may offer a predictable regenerative approach for selected Grade III furcation defects when proper case selection and surgical protocols were employed.

Hair loss in women represents a complex clinical challenge with profound psychosocial implications. We present the case of a young woman from Qatar who experienced severe diffuse hair fall for three years despite consulting eight dermatologists across private and public healthcare sectors. She underwent multiple interventions including hair transplantation, topical minoxidil therapy, and experimental exosome injections without adequate diagnostic workup or blood testing. Despite these treatments, her condition showed no improvement, and she experienced significant psychosocial distress compounded by harsh communication from some physicians. Subsequently, she pursued DNA-guided intervention with nutrigenomics through a specialized trichologist, representing a paradigm shift toward precision medicine in hair loss management. This case highlights critical gaps in conventional diagnostic approaches, the importance of comprehensive metabolic and genetic assessment, and the potential of personalized genomic-guided interventions in chronic hair loss. The case underscores the necessity of patient-centered care, multidisciplinary collaboration, and compassionate communication in managing conditions with significant psychological burden.

Tooth brushing is the most common mechanical measure amongst the recommended contemporary oral hygiene procedures engaged in preventive dental therapy. This is to determine the prevalence of toothbrushing habits and their efficacy in the removal of tooth deposits and resultant clinical periodontal health of the participants. This study, involved 250 first-time patients the Family Medicine Department at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos. Data collection was conducted using a self-administered questionnaire to obtain the sociodemographic data and the participants' toothbrushing habits. The efficacy of toothbrushing was assessed by evaluating the Oral hygiene index (OHI) and the periodontal status of the participants. Appropriate descriptive statistics were carried out. Pearson’s chi-square analysis was done to determine the bivariate relationship of the covariates and their efficacy, while regression analysis was done to assess the multivariate relationship. Statistical significance was determined at p≤ 0.05. The mean age of the participants was 40.1 ± 18.4 years; the 20-29-year-olds had the highest percentage with good oral hygiene, 20(30.3%). Those who brush their teeth more than twice daily had the highest percentage with good oral hygiene,4(66.7%) (p=0.002) and healthy periodontium, 4(66.7%) (p=0.03). Toothbrushing duration was significantly associated with the oral hygiene status (p=0.001). Those who brush their teeth >120 seconds had the highest percentage with good oral hygiene, 44(65.7%), and healthy periodontium, 39(58.2%) (p=0.001). Toothbrushing duration was the only habit that was independently associated with the oral hygiene status (p=0.001). Toothbrushing duration, age groups and male sex were independently associated with the periodontal status (p<0.05). Oral health education and counselling have to be holistic, as many of the factors and habits operate jointly in the provision of healthy oral hygiene and periodontal health. Brushing for up to 3 minutes will be more beneficial for the overall health of individuals.