Search results for: public inclusion

Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

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Authors: Abdellahi Cheikh

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With the emergence of quantum computers with very powerful capabilities, the security of the exchange of shared keys between two interlocutors poses a big problem in terms of the rapid development of technologies such as computing power and computing speed. Therefore, the Diffie-Hellmann (DH) algorithm is more vulnerable than ever. No mechanism guarantees the security of the key exchange, so if an intermediary manages to intercept it, it is easy to intercept. In this regard, several studies have been conducted to improve the security of key exchange between two interlocutors, which has led to interesting results. The modification made on our model Diffie-Hellman-RSA-AES (DRA), which encrypts the information exchanged between two users using the three-encryption algorithms DH, RSA and AES, by using stenographic photos to hide the contents of the p, g and ClesAES values that are sent in an unencrypted state at the level of DRA model to calculate each user's public key. This work includes a comparative study between the DRA model and all existing solutions, as well as the modification made to this model, with an emphasis on the aspect of reliability in terms of security. This study presents a simulation to demonstrate the effectiveness of the modification made to the DRA model. The obtained results show that our model has a security advantage over the existing solution, so we made these changes to reinforce the security of the DRA model.

Keywords: Diffie-Hellmann, DRA, RSA, advanced encryption standard

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Authors: Engku Haliza Engku Ibrahim, Isarji Sarudin, Ainon Jariah Muhamad

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It is generally agreed that many factors contribute to one’s reading comprehension and there is consensus that vocabulary size one of the main factors. This study explores the relationship between second language learners’ vocabulary size and their reading comprehension scores. 130 Malay pre-university students of a public university participated in this study. They were students of an intensive English language programme doing preparatory English courses to pursue bachelors degree in English. A quantitative research method was employed based on the Vocabulary Levels Test by Nation (1990) and the reading comprehension score of the in-house English Proficiency Test. A review of the literature indicates that a somewhat positive correlation is to be expected though findings of this study can only be explicated once the final analysis has been carried out. This is an ongoing study and it is anticipated that results of this research will be finalized in the near future. The findings will help provide beneficial implications for the prediction of reading comprehension performance. It also has implications for the teaching of vocabulary in the ESL context. A better understanding of the relationship between vocabulary size and reading comprehension scores will enhance teachers’ and students’ awareness of the importance of vocabulary acquisition in the L2 classroom.

Keywords: vocabulary size, vocabulary learning, reading comprehension, ESL

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Authors: Mahrukh Shehzadi

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Pakistan is a democratic republic but has spent much time under military rulers; after a few years of independence, Pakistan faced three martial laws in 1958, 1969, and 1977, and the latest in 1999 by General Musharraf. The purpose of this thesis is to analyze the politics, policies and overall performance of Pakistan People’s Party Government from 2008-2013. PPP won a significant victory in the elections of 2008. The co-chairman, Mr. Asif Ali Zardari, announced the end of the fourth dictatorship. It was for the first time in Pakistan’s history that an elected government completed its term (2008-2013). While the completion of its term is an achievement, the performance of the democratically-elected government – federal, provincial and local does not inspire much confidence. Poor governance, persistent confrontational relations between the executive and the judiciary, charges of corruption, and the incompetence of the political leadership to build consensus to combat terrorism continue to cast criticisms on the democratic process and the civilian regime’s capability to sustain democracy. In the present study, the researcher will try to describe and explain the public thinking pattern regarding the policies opted for by the PPP-led government and their impact on the people’s minds of Pakistan.

Keywords: democracy, performance, policies, state, manifesto

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Authors: Peng Guo

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Objective: This study investigates the clinical characteristics of sleep disorders (SD) in patients with Alzheimer's disease (AD) and their relationship with cognitive impairment. Methods: According to the inclusion and exclusion criteria of AD, 460 AD patients were consecutively included in Beijing Tiantan Hospital from January 2016 to April 2022. Demographic data, including gender, age, age of onset, course of disease, years of education and body mass index, were collected. The Pittsburgh sleep quality index (PSQI) scale was used to evaluate the overall sleep status. AD patients with PSQI ≥7 was divided into AD with SD (AD-SD) group, and those with PSQI < 7 were divided into AD with no SD (AD-nSD) group. The overall cognitive function of AD patients was evaluated by the scales of Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA), memory was evaluated by the AVLT-immediate recall, AVLT-delayed recall and CFT-delayed memory scales, the language was evaluated by BNT scale, visuospatial ability was evaluated by CFT-imitation, executive function was evaluated by Stroop-A, Stroop-B and Stroop-C scales, attention was evaluated by TMT-A, TMT-B, and SDMT scales. The correlation between cognitive function and PSQI score in AD-SD group was analyzed. Results: Among the 460 AD patients, 173 cases (37.61%) had SD. There was no significant difference in gender, age, age of onset, course of disease, years of education and body mass index between AD-SD and AD-nSD groups (P>0.05). The factors with significant difference in PSQI scale between AD-SD and AD-nSD groups include sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleeping medication and daytime dysfunction (P<0.05). Compared with AD-nSD group, the total scores of MMSE, MoCA, AVLT-immediate recall and CFT-imitation scales in AD-SD group were significantly lower（P＜0.01，P＜0.01，P＜0.01，P＜0.05）. In AD-SD group, subjective sleep quality was significantly and negatively correlated with the scores of MMSE, MoCA, AVLT-immediate recall and CFT-imitation scales (r=-0.277，P=0.000; r=-0.216，P=0.004; r=-0.253，P=0.001; r=-0.239, P=0.004), daytime dysfunction was significantly and negatively correlated with the score of AVLT-immediate recall scale (r=-0.160，P=0.043). Conclusion The incidence of AD-SD is 37.61%. AD-SD patients have worse subjective sleep quality, longer time to fall asleep, shorter sleep time, lower sleep efficiency, severer nighttime SD, more use of sleep medicine, and severer daytime dysfunction. The overall cognitive function, immediate recall and visuospatial ability of AD-SD patients are significantly impaired and are closely correlated with the decline of subjective sleep quality. The impairment of immediate recall is highly correlated with daytime dysfunction in AD-SD patients.

Keywords: Alzheimer's disease, sleep disorders, cognitive impairment, correlation

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Authors: Muhammad Akram, Qamar Naseem, Imtiaz Ahmad

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The purpose of this study was to correlate students’ perceptions of teacher effectiveness with their academic achievement in English and Mathematics at the secondary level (grade 9th) based on five national professional standards for teacher evaluation in Pakistan (subject matter knowledge, instructional planning and strategies, assessment, learning environment, effective communication. A Students’ Perceptions of Teacher Effectiveness Questionnaire (SPTEQ) was developed by the researchers to collect data from 2009 students from forty public girls and boys high/ higher secondary schools in district Khanewal, Pakistan. The overall reliability of the SPTEQ was α=.86. The study found a significant positive relationship among all the five factors of teacher effectiveness construct. The study also showed significant, positive relationship between teacher effectiveness factors and students’ achievement in English and mathematics. No significant differences were found between male and female students’ perceptions about their English teacher effectiveness. The implications include students’ personal attachments with their teachers that might convince them to overrate their teachers.

Keywords: communication, students’ achievement, teacher effectiveness, teaching strategies, teaching strategies

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Authors: Sarah E. Nelson, Casey Weiner, Alexander Sigmon, Jun Hua, Haris I. Sair, Jose I. Suarez, Robert D. Stevens

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Graph-theoretical information from structural connectomes indicated significant connectivity changes and improved acute prognostication in a Random Forest (RF) model in aneurysmal subarachnoid hemorrhage (aSAH), which can lead to significant morbidity and mortality and has traditionally been fraught by poor methods to predict outcome. This study’s hypothesis was that structural connectivity changes occur in canonical brain networks of acute aSAH patients, and that these changes are associated with functional outcome at six months. In a prospective cohort of patients admitted to a single institution for management of acute aSAH, patients underwent diffusion tensor imaging (DTI) as part of a multimodal MRI scan. A weighted undirected structural connectome was created of each patient’s images using Constant Solid Angle (CSA) tractography, with 176 regions of interest (ROIs) defined by the Johns Hopkins Eve atlas. ROIs were sorted into four networks: Default Mode Network, Executive Control Network, Salience Network, and Whole Brain. The resulting nodes and edges were characterized using graph-theoretic features, including Node Strength (NS), Betweenness Centrality (BC), Network Degree (ND), and Connectedness (C). Clinical (including demographics and World Federation of Neurologic Surgeons scale) and graph features were used separately and in combination to train RF and Logistic Regression classifiers to predict two outcomes: dichotomized modified Rankin Score (mRS) at discharge and at six months after discharge (favorable outcome mRS 0-2, unfavorable outcome mRS 3-6). A total of 56 aSAH patients underwent DTI a median (IQR) of 7 (IQR=8.5) days after admission. The best performing model (RF) combining clinical and DTI graph features had a mean Area Under the Receiver Operator Characteristic Curve (AUROC) of 0.88 ± 0.00 and Area Under the Precision Recall Curve (AUPRC) of 0.95 ± 0.00 over 500 trials. The combined model performed better than the clinical model alone (AUROC 0.81 ± 0.01, AUPRC 0.91 ± 0.00). The highest-ranked graph features for prediction were NS, BC, and ND. These results indicate reorganization of the connectome early after aSAH. The performance of clinical prognostic models was increased significantly by the inclusion of DTI-derived graph connectivity metrics. This methodology could significantly improve prognostication of aSAH.

Keywords: connectomics, diffusion tensor imaging, graph theory, machine learning, subarachnoid hemorrhage

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Authors: Adama NS Bah

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Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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Authors: Ly Quyet Tien

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Starting in the 1990s and growing in tandem with the LGBTQI movement in Vietnam, Modern Saigon Lottery Show is one of the most popular Vietnamese drag queen shows in Ho Chi Minh City, Vietnam. Transgender by nature, underprivileged by status, avoided by the family, and despised by society for decades, these queer artists came out of the closet and decided to change their own destiny by organizing lottery music shows. Unprofessionally in the start, they gradually appeared professionally on stage in big cities and won the heart of the larger public. Their success affirms themself, promotes their gender right, and assures their life in a proud way: honest, independent, and sustainable. This paper aims to give the readers a full portrait of Modern Saigon’s activities through musical bingo. It examines the background into which the drag queen show was born and developed: its styles, themes as well as own particularity. It also studies its identity, diversity in the entertainment industry, and its revolutionary role in the promotion of the welfare of Vietnamese transgender citizens and the local popular queer culture in Vietnam and Asia.

Keywords: transgender, lottery show, equality, culture

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Authors: Amina Bayazid, Habiba Fetati, Houari Toumi

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Introduction: The clinical value of vitamin K antagonists (VKA) has been widely demonstrated in numerous indications. Unfortunately, VKA are not devoid of drawbacks and risk of serious bleeding. The iatrogenic induced by these drugs is a major public health problem. Patients & Methods: We conducted a retrospective study period extending from February 2012 to August 2013 in the pharmacovigilance service of EHUO (clinical pharmacology unit). The prescription of painkillers was analyzed in patients on VKA followed at our level. The influence of these analgesics on the evolution of the INR is an important component in our work. Results: We counted a total of 195 patients, of whom 32 (or 16.41% of the total population) had received analgesic treatment. The frequencies of different categories of analgesics administered were: • Analgesics opioids: 0% • Analgesics weak opioids: Tramadol: 21.87% • The non-opioid analgesics: -AINS: 71.87% (indomethacin: 68.75% ibuprofen: 3.12%) - Paracetamol: 6.25% -Salicyles (Acetylsalicylic acid): 0%. Conclusion: The management of pain in patients under vitamin K antagonists has special features, given their many drug interactions with analgesics and their influence on the evolution of the INR which can have dramatic consequences. As such, special attention must be paid to the use of analgesics in this type of patient.

Keywords: vitamin K antagonists, pain killers, interactions, INR

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Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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Authors: Apedzan Emmanuel Kighir

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This research investigates dividends smoothing among non-financial companies trading on the Nigerian Stock Exchange in an era of unclaimed dividends from 2004 to 2013. There has been a raging controversy among Regulatory Authorities, Company Executives, Registrars of Companies, Shareholders and the general public regarding the increasing incidence of unclaimed dividends in Nigeria. The objective of this study is to find out if corporate earnings management through dividends smoothing is implicated in unclaimed dividends among Nigerian non-financial firms. The research used panel data and employed Generalized Method of Moment as method of analysis. The research finds evidence of dividends-smoothing in this era of unclaimed dividends in Nigeria. The research concludes that dividends-smoothing is a trigger and red flag for unclaimed dividends, an output of earnings management. If earnings management and hence unclaimed dividends in Nigeria is allowed to continue, it will lead to great consequences to the investors and corporate policy of government. It is believed that the research will assist investors and government in making informed decisions regarding dividends policy in Nigeria.

Keywords: dividends smoothing, non financial companies, Nigerian stock exchange, unclaimed dividends, corporate earnings management

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Authors: Khaing Su Su Than, Hibino Yo

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Seismic evaluation is needed upon the buildings in Myanmar. Microtremor measurement was conducted in the main cities, Mandalay and Yangon. In order to evaluate the seismic properties of buildings currently under construction, seismic information was gathered for six buildings in Yangon city and four buildings in Mandalay city. The investigated buildings vary from 12m-80 m in height, and mostly public residence structures. The predominant period obtained from frequency results of the investigated buildings were given by horizontal to vertical spectral ratio (HVSR) for each building. The fundamental period results have been calculated in the form of Fourier amplitude spectra of translation along with the main structure. Based on that, the height (H)-period(T) relationship was observed as T=0.012H-0.017H in the buildings of Yangon and, observed the relationship as T=0.014H-0.019H in the buildings of Mandalay. The results showed that the relationship between height and natural period was slightly under the relationship T=0.02H that is used for Japanese reinforced concrete buildings, which indicated that the results depend on the properties and characteristics of materials used.

Keywords: HVSR, height-period relationship, microtremor, Myanmar earthquake, reinforced concrete structures

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Authors: Atef Abdallah Abouelmaaty

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The aim of this paper is to study the theme of alienation in some contemporary novels of the most prominent Arab writers who live in Britain and write in English. The paper will focus on three female novelists of Arab origins who won wide fame among reading public, and also won international prizes for their literary creation. The first is the Egyptian Ahdaf Soueif(born in 1950) whose novel The Map of Love(1999) was shortlisted for the Man Booker Prize, and has been translated into twenty one languages and sold over a million copies. The second is the Jordanian Fadia Faqir (born in 1956) whose My Name is Salma(2007) was translated into thirteen languages, and was a runner up for the ALOA literary prize. The third is the Sudanese Leila Aboulela(born in 1964) who The Translator was nominated for the Orange Prize and was chosen as a a notable book of the year by the New York Times in 2006. The main reason of choosing the theme of alienation is that it is the qualifying feature of the above mentioned novels. This is because the theme is clearly projected and we can see different kinds of alienation: alienation of man from himself, alienation of man from other men, and alienation of man from society. The paper is concerned with studying this central theme together with its different forms. Moreover, the paper will try to identify the main causes of this alienation among which are frustrated love, the failure to adjust to change, and ethnic pride.

Keywords: alienation, Anglo-Arab, contemporary, novels

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Authors: Suraj Kumar Mukti

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Enterprise Resource Planning (ERP) system is a management tool to integrate all departments in an organization. It integrates business processes, manages resources efficiently and provides an appropriate decision support system to management. ERP system implementation is a typical and time taking process as well as money consuming process. Articles related to key success factors of ERP system implementation are available in the literature, but rare authors have focused on roadmap of successful ERP system implementation. Postponement is better if the organization is not ready to implement ERP system in better way; hence checking of organization’s preparation to adopt new system is an important prerequisite to ensure the success of ERP system implementation in an organization. Then comes what will be called as success of ERP system implementation. Benefits achieved by ERP system may be categorized into two categories; viz. tangible and intangible benefits. This research article presents a roadmap to ensure the success of ERP system implementation and benefits achieved through the new system as in success indicator. A case study is presented to evaluate the success and benefit achieved through the new system. The article gives a comprehensive approach to academicians and a roadmap to the organizations seeking to implement the ERP system.

Keywords: ERP system, decision support system, tangible, intangible

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Authors: Yixiu Liu, Yunzhou Zhang, Jianning Chi, Hao Chu, Rui Zheng, Libo Sun, Guanghao Chen, Fangtong Zhou

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In the last few years, large-scale person re-identification has attracted a lot of attention from video surveillance since it has a potential application prospect in public safety management. However, it is still a challenging job considering the variation in human pose, the changing illumination conditions and the lack of paired samples. Although the accuracy has been significantly improved, the data dependence of the sample training is serious. To tackle this problem, a new strategy is proposed based on bag of visual words (BoVW) model of designing the feature representation which has been widely used in the field of image retrieval. The local features are extracted, and more discriminative feature representation is obtained by cross-view dictionary learning (CDL), then the assignment map is obtained through k-means clustering. Finally, the BoVW histograms are formed which encodes the images with the statistics of the feature classes in the assignment map. Experiments conducted on the CUHK03, Market1501 and MARS datasets show that the proposed method performs favorably against existing approaches.

Keywords: bag of visual words, cross-view dictionary learning, person re-identification, reranking

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Authors: Eftychia Damaskou

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This article intends to place the question of the adequate approach for teaching multilingualism within the public education. Linguistic education, as it is defined by the Common European Framework of Reference for the Languages, is no longer the proficiency in one or two languages. It’s about the development of a linguistic repertoire, where all linguistic skills find their place. In fact, the linguistic theories that frame the development of plurilingual competence point out the affective and intercultural aspect of such a process, insisting on an awareness of linguistic diversification, rather than an acquisition of communicative competence in many languages. In this spirit, our article attempts to go beyond a mere plurilingual awareness, present a research based on an experience in class, within 115 pupils, aiming at the development of plurilingual competence in five unknown foreign languages. This experience was held through a teaching unit personally conceived and applied, and consisted of a series of 6 activities based on a cross-linguistic content approach. The data analysis proves to be very interesting, as it reveals the development of plurilingual competences, as well as positive attitudes towards less common languages by the majority of our sample.

Keywords: multilingual awareness, multilingual teaching material, plurilingual competence

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Authors: Osamu Igawa, Hiroshi Kouchiwa, Yuji Ito

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In recent years, a reconstruction project for sewer pipelines has been progressing in Japan with the aim of renewing old sewer culverts. However, it is difficult to secure a sufficient base area for shafts in an urban area because many streets are narrow with a complex layout. As a result, construction in such urban areas is generally very demanding. In urban areas, there is a strong requirement for a safe, reliable and economical construction method that does not disturb the public’s daily life and urban activities. With this in mind, we developed a new construction method called the 'shield switching type micro-tunneling method' which integrates the micro-tunneling method and shield method. In this method, pipeline is constructed first for sections that are gently curved or straight using the economical micro-tunneling method, and then the method is switched to the shield method for sections with a sharp curve or a series of curves without establishing an intermediate shaft. This paper provides the information, features and construction examples of this newly developed method.

Keywords: micro-tunneling method, secondary lining applied RC segment, sharp curve, shield method, switching type

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Authors: Martonovich Noa, Maman David, Alfandari Liad, Behrbalk Eyal.

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Introduction: The human body is designed for upright standing and walking, with the lower extremities and axial skeleton supporting weight-bearing. Constant weight-bearing on joints not meant for this action can lead to various pathologies, as seen in wheelchair users. Handstand practitioners use their wrists as weight-bearing joints during activities, but little is known about wrist injuries in this population. This study aims to investigate the epidemiology of wrist pain among handstand practitioners, as no such data currently exist. Methods: The study is a cross-sectional online survey conducted among athletes who regularly practice handstands. Participants were asked to complete a three-part questionnaire regarding their workout regimen, training habits, and history of wrist pain. The inclusion criteria were athletes over 18 years old who practice handstands more than twice a month for at least 4 months. All data were collected using Google Forms, organized and anonymized using Microsoft Excel, and analyzed using IBM SPSS 26.0. Descriptive statistics were calculated, and potential risk factors were tested using asymptotic t-tests and Fisher's tests. Differences were considered significant when p < 0.05. Results: This study surveyed 402 athletes who regularly practice handstands to investigate the prevalence of chronic wrist pain and potential risk factors. The participants had a mean age of 31.3 years, with most being male and having an average of 5 years of training experience. 56% of participants reported chronic wrist pain, and 14.4% reported a history of distal radial fracture. Yoga was the most practiced form, followed by Capoeira. No significant differences were found in demographic data between participants with and without chronic wrist pain, and no significant associations were found between chronic wrist pain prevalence and warm-up routines or protective aids. Conclusion: The lower half of the body is meant to handle weight-bearing and impact, while transferring the load to upper extremities can lead to various pathologies. Athletes who perform handstands are particularly prone to chronic wrist pain, which affects over half of them. Warm-up sessions and protective instruments like wrist braces do not seem to prevent chronic wrist pain, and there are no significant differences in age or training volume between athletes with and without the condition. Further research is needed to understand the causes of chronic wrist pain in athletes, given the growing popularity of sports and activities that can cause this type of injury.

Keywords: handstand, handbalance, wrist pain, hand and wrist surgery, yoga, calisthenics, circus, capoeira, movement.

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Authors: Walaa W. Diab

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The present paper offers a fundamental critique of the macroeconomic effects of fiscal policy after it surveys the theoretical and empirical literature on the macroeconomic effects of fiscal policy. It emphasizes the importance of the fiscal policy after reviewing the revolution of almost all economic schools and bringing them in one summarized figure; the paper links the developmental role of the fiscal policy with the objectives and measures of the economic transformation. Thus, the importance of this study can be seen from several perspectives: First, it reviews the theoretical harvest of fiscal policy and provides a comparison between the main revolutionary Economic thoughts; the classical school, Keynesian school, and monetarist school. Then it turns to conclude the fiscal policy from the new consensus mainstream economic schools. Finally, the study presents grouped and classified empirical pieces of evidence as it divides those empirical studies into two groups; the first for developed economies and the second for developing ones. So the study is important also for the policymakers as well as scholars as it gives its recommendations upon the last analysis in the form of ‘policy implications’. The paper also presents a deeper look into the evaluation approaches of the macroeconomic effects of fiscal policy at the empirical level. Thus it is useful for both researchers and decision makers.

Keywords: economic transformation, fiscal policy, macroeconomic effects, public spending

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Authors: Myles Frederick McLellan

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When errors in the criminal justice process lead to wrongful convictions and miscarriages of justice, it falls upon the State to make reparation for the egregious harms brought to innocent individuals. Of all the remedies available to seek compensation, private and public law litigation against the police and prosecution services is the most widely used. Unfortunately, all levels of court including the Supreme Court of Canada have explicitly endorsed the prospect of striking out or dismissing these claims at the outset on an expedited basis. The burden on agents of the State as defendants to succeed on motions for such relief is so low that very few actions will survive to give an innocent accused his or her day in court. This paper will be a quantitative and qualitative analysis on the occurrence and success of motions to strike and dismiss to forestall financial recovery for the damage caused when a criminal investigation and prosecution goes wrong. This paper will also include a comparative component on the private law systems at common law (e.g. USA, UK, Australia and New Zealand) with respect to the availability of a similar process to pre-emptively terminate litigation for the recovery of compensation to an innocent individual.

Keywords: compensation, innocence, miscarriages of justice, wrongful convictions

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Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

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Authors: Jalal Abdulkareem Sultan, Abdulhakeem Luqman Hasan

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With the development of health care systems competition, hospitals face more and more pressures. Meanwhile, resource allocation has a vital effect on achieving competitive advantages in hospitals. Selecting the appropriate number of beds is one of the most important sections in hospital management. However, in real situation, bed allocation selection is a multiple objective problem about different items with vagueness and randomness of the data. It is very complex. Hence, research about bed allocation problem is relatively scarce under considering multiple departments, nursing hours, and stochastic information about arrival and service of patients. In this paper, we develop a fuzzy multiobjective bed allocation model for overcoming uncertainty and multiple departments. Fuzzy objectives and weights are simultaneously applied to help the managers to select the suitable beds about different departments. The proposed model is solved by using Artificial Bee Colony (ABC), which is a very effective algorithm. The paper describes an application of the model, dealing with a public hospital in Iraq. The results related that fuzzy multi-objective model was presented suitable framework for bed allocation and optimum use.

Keywords: bed allocation problem, fuzzy logic, artificial bee colony, multi-objective optimization

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Authors: Cathryn Robinson, Bernard McKenna, David Rooney

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This paper argues that the application of values-based leadership increasingly challenges leaders in rules-based organisations, particularly in bureaucratic organisations such as the military, public service, police, and emergency services. Leaders are grappling to reconcile how to enact values-based leadership and decision-making when they are bound by rules, policies, and procedures. This interpretive study used a multi-faceted vignette (critical incident) as the basis of an interview with air force officers at three levels: executive, senior, and junior. In this way, practice is forced to intersect with discourse. The findings revealed a shared set of discourse themes (legal; rules; safety and risk; operational practice/theatre discourses), but also clear dialectical tensions. These tensions were evident in executive officers and senior leaders emphasizing rules and information themes, whereas junior officers emphasized decision making, collateral, and situation. These findings reveal discourse and practice incommensurability that could have grave implications in the conduct of war.

Keywords: critical incident, discourse analysis, rules-based, values-based

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Authors: Nareshkumar Harale, B. B. Meshram

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The continued exponential growth of successful cyber intrusions against today’s businesses has made it abundantly clear that traditional perimeter security measures are no longer adequate and effective. We evolved the network trust architecture from trust-untrust to Zero-Trust, With Zero Trust, essential security capabilities are deployed in a way that provides policy enforcement and protection for all users, devices, applications, data resources, and the communications traffic between them, regardless of their location. Information exchange over the Internet, in spite of inclusion of advanced security controls, is always under innovative, inventive and prone to cyberattacks. TCP/IP protocol stack, the adapted standard for communication over network, suffers from inherent design vulnerabilities such as communication and session management protocols, routing protocols and security protocols are the major cause of major attacks. With the explosion of cyber security threats, such as viruses, worms, rootkits, malwares, Denial of Service attacks, accomplishing efficient and effective intrusion detection and prevention is become crucial and challenging too. In this paper, we propose a design and analysis model for next generation network intrusion detection and protection system as part of layered security strategy. The proposed system design provides intrusion detection for wide range of attacks with layered architecture and framework. The proposed network intrusion classification framework deals with cyberattacks on standard TCP/IP protocol, routing protocols and security protocols. It thereby forms the basis for detection of attack classes and applies signature based matching for known cyberattacks and data mining based machine learning approaches for unknown cyberattacks. Our proposed implemented software can effectively detect attacks even when malicious connections are hidden within normal events. The unsupervised learning algorithm applied to network audit data trails results in unknown intrusion detection. Association rule mining algorithms generate new rules from collected audit trail data resulting in increased intrusion prevention though integrated firewall systems. Intrusion response mechanisms can be initiated in real-time thereby minimizing the impact of network intrusions. Finally, we have shown that our approach can be validated and how the analysis results can be used for detecting and protection from the new network anomalies.

Keywords: network intrusion detection, network intrusion prevention, association rule mining, system analysis and design

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Authors: Elriena Eksteen, Yolandi Willemse, Dawie D. J. Malan, Suria Ellis

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It is important to understand which competencies are needed for managerial and administrative effectiveness of school sport managers with regard to the design, delivery and direction of school sport programmes. The purpose of this study was to determine the competencies and training needs for secondary school sport managers in the North West Province. Data were gathered from 79 school sport managers in the North West Province by means of a validated self-compiled questionnaire. Descriptive statistics, factor analysis and a dependent t-test were used to compare which competencies school sport managers perceive as important in their work with the competencies they actually perform. Functional competencies and core competencies were both found to be important for managing school sport effectively. There were statistically significant differences between the perceived importance of competencies and the frequency with which competencies were actually performed. Respondents attached greater importance to functional and core competencies than the proportion of time spent actually performing them. Furthermore, results indicated the need to train teachers in managing sport finance, sport facilities and human resources, as well as presenting workshops in public relations, sport marketing and sport organisation.

Keywords: competencies, functional competencies, core competencies, school sport manager, training needs

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Authors: Olga Castiblanco, Diego Vizcaíno

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Changing the traditional way of using experimentation in science teaching is quite a challenge. This research results talk about the characterization of physics experiments, not because of the topic it deals with, nor depending on the material used in the assemblies, but related to the possibilities it offers to enrich interaction in the classroom and thereby contribute to the development of scientific thinking skills. It is an action-research of type intervention in the classroom, with four courses of Physics Teaching undergraduate students from a public university in Bogotá. This process allows characterizing typologies such as discrepant, homemade, illustrative, research, recreational, crucial, mental, and virtual experiments. Students' production and researchers' reports on each class were the most relevant data. Content analysis techniques let to categorize the information and obtain results on the richness that each typology of experiment offers when interacting in the classroom. Results show changes in the comprehension of new teachers' role, far from being the possessor and transmitter of the truth. Besides, they understand strategies to engage students effectively since the class advances extending ideas, reflections, debates, and questions, either towards themselves, their classmates, or the teacher.

Keywords: physics teacher training, non-traditional experimentation, contextualized education, didactics of physics

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Authors: Michael Ubale Cyril

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Challenges of embedding entrepreneurship in tertiary institutions in Nigeria requires a consistent policy for equipping schools with necessary facilities like establishing incubating technology centre, the right calibres of human resources, appropriate pedagogical tools for teaching entrepreneurship education and exhibition grounds where products and services will be delivered and patronised by the customers. With the death of facilities in public schools in Nigeria, educators are clamouring for a way out. This study investigated the challenges of embedding entrepreneurship education in Modibbo Adama University of Technology Yola, Nigeria. The population for the study was 201 comprising 34 industrial entrepreneurs, 76 technical teachers and 91 final year undergraduates. The data was analysed using means of 3 groups, standard deviation, and analysis of variance. The study found out, that technical teachers have not been trained to teach entrepreneurship education, approaches to teaching methodology, were not varied and lack of infrastructural facilities like building was not a factor. It was recommended that technical teachers be retrained to teach entrepreneurship education, textbooks in entrepreneurship should be published with Nigerian outlook.

Keywords: challenges, embedding, entrepreneurship pedagogical, technology incubating centres

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Authors: Samantha Ramachandra, Avanthi Rupasinghe

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Demographic transition from lower to higher percentage of elderly population eventually coupled with epidemiological transition from communicable to non-communicable diseases (NCD). Higher percentage of NCD overload the health system as NCD survivors claims continuous health care. The demands are challenging to a resource constrained setting but reorganizing the system may find solutions. The study focused on the facilities available and their utilization at outpatient department (OPD) setting of the public hospitals of Sri Lanka for continuous medical care. This will help in identifying steps of reorganizing the system to provide better care with the maximum utilization of available facilities. The study was conducted as a situation analysis with secondary data at hospital planning units. Variable were identified according to the world health organization (WHO) recommendation on continuous health care for elders in “age-friendly primary health care toolkit”. Data were collected from secondary and tertiary care hospitals of Sri Lanka where most of the continuous care services are available. Out of 58 secondary and tertiary care hospitals, 16 were included in the study to represent each hospital categories. Average number of patient attending for episodic treatment at OPD and Clinical follow-up of chronic conditions shows vast disparity according to the category of the hospital ranging from 3750 – 800 per day at OPD and 1250 – 200 per clinic session. Average time spent per person at OPD session is low, range from 1.54 - 2.28 minutes, the time was increasing as the hospital category goes down. 93.7% hospitals had special arrangements for providing acute care on chronic conditions such as catheter, feeding tube and wound care. 25% hospitals had special clinics for elders, 81.2% hospitals had healthy lifestyle clinics (HLC), 75% hospitals had physical rehabilitation facilities and 68.8% hospitals had facilities for counselling. Elderly clinics and HLC were mostly available at lower grade hospitals where as rehabilitation and counselling facilities were mostly available at bigger hospitals. HLC are providing health education for both patients and their family members, refer patients for screening of complication but not provide medical examinations, investigations or treatments even though they operate in the hospital setting. Physical rehabilitation is basically offered for patients with rheumatological conditions but utilization of centers for injury rehabilitation and rehabilitation of survivors following major illness such as myocardial infarctions, stroke, cancer is not satisfactory (12.5%). Human Resource distribution within hospital shows vast disparity and there are 103 physiotherapists in the biggest hospital where only 36 physiotherapists available at the next level hospital. Counselling facilities also provided mainly for the patient with psychological conditions (100%) but they were not providing counselling for newly diagnosed patients with major illnesses (0%). According to results, most of the public-sector hospitals in Sri Lanka have basic facilities required in providing continuous care but the utilization of services need more focus. Hospital administration or the government need to have initial steps in proper utilization of them in improving continuous health care incorporating team approach of rehabilitation. The author wishes to acknowledge that this paper was made possible by the support and guidance given by the “Australia Awards Fellowships Program for Sri Lanka – 2017,” which was funded by the Department of Foreign Affairs and Trade, Australia, and co-hosted by Monash University, Australia and the Sri Lanka Institute of Development Administration.

Keywords: continuous care, outpatient department, non communicable diseases, rehabilitation

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Authors: Eftah Bte. Moh Hj Abdullah, Izazol Binti Idris, Abd Aziz Bin Abd Shukor

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This study aims to identify the understanding expectations of school administrators concerning school assessment. The researcher utilized a qualitative descriptive study on 19 administrators from three secondary schools in the North Kinta district. The respondents had been interviewed on their understanding expectations of school assessment using the focus group discussion method. Overall findings showed that the administrators’ understanding expectations of school assessment was weak; especially in terms of content focus, articulation across age and grade, transparency and fairness, as well as the pedagogical implications. Findings from interviews indicated that administrators explained their understanding expectations of school assessment from the aspect of school management, and not from the aspect of instructional leadership or specifically as assessment leaders. The study implications from the administrators’ understanding expectations may hint at the difficulty of the administrators to function as assessment leaders, in order to reduce their focus as manager, and move towards their primary role in the process of teaching and learning. The administrator, as assessment leaders, would be able to reach assessment goals via collaboration in identifying and listing teacher assessment competencies, how to construct assessment capacity, how to interpret assessment correctly, the use of assessment and how to use assessment information to communicate confidently and effectively to the public.

Keywords: assessment leaders, assessment goals, instructional leadership, understanding expectation of assessment

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