Search results for: manual review

Authors: Nida Iftikhar, Jamaluddin Thaheem, Bilal Iftikhar

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In the construction industry, adequate and effective decision-making can mean the difference between success and failure. Bidding is the most important element of the construction business since it is a mean by which contractors obtain work. This is probably the only option for any contractor firm to sustain in the market and achieve its objective of earning the profits by winning tenders. The capability to select most appropriate ventures not only defines the success and wellbeing of contractor firms but also their survival and sustainability in the industry. The construction practitioners are usually on their own when it comes to deciding on bidding for a project or not. Usually, experience-based solutions are offered where a lot of subjectivity is involved. This research has been opted considering the local construction industry of Pakistan in order to examine the critical success factors from contractors’ perspective while making bidding decisions, listing and evaluating critical factors in order of their importance, categorization of these factors into decision support & decision oppose groups and to develop a framework to help contractors in the decision-making process. Literature review, questionnaires, and structured interviews are used for identification and quantification of factors affecting bid/no bid decision-making. Statistical methods of ranking analysis and analytical hierarchy process of multi-criteria decision-making method are used for analysis. It is found that profitability, need for work and financial health of client are the most decisive factors in bid/no bid decision-making while project size, project type, fulfilling the tender conditions imposed by the client and relationship, identity & reputation of the client are least impact factors in bid/no bid decision-making. Further, to verify the developed framework, case studies have been conducted to evaluate the bid/no bid decision-making in building procurement. This is the first of its nature study in the context of the local construction industry and recommends using a holistic decision-making framework for such business-critical deliberations.

Keywords: bidding, bid decision-making, construction procurement, contractor

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Authors: Rimel Mwamba, Mohan Gundeti

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Introduction: The use of robot-assisted laparoscopic surgeries (RALS) has largely increased in recent years, offering faster and safer treatment options for pediatric patients. In the field of urology, RALS has shown a significant advantage over laparoscopic and open surgeries but continues to be controversial in pediatric cases due to limited comprehensive data on its use. Methods: In this review, we aim to summarize the factors associated with RALS use in pediatric cases involving pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction. We used PubMed, EMBASE, and the Cochrane Database of Systematic Reviews to systematically search for literature on the topic. We then critically assessed and compiled data on RALS outcomes, complications, and associated factors. Results: To date, numerous comparative studies have been conducted on pediatric RALS, with only one randomized control trial investigating the nuances of robotic use against standard of care treatments. These robotic approaches have shown promise in post-surgical outcomes for pediatric patients undergoing upper and lower urinary tract reconstruction. Barriers to use still persist, however, showcasing a need to increase access to the technology, refine instruments for pediatric use, address cost barriers, and provide proper training for surgeons. Conclusion: RALS providesan opportunity to improve pediatric patient outcomes for numerous urologic complications. Additional studies are required to better compare the use of RALS with current standard practices. Due to the difficult nature of conducting randomized control trials, additional prospective observational studies are needed.

Keywords: pediatric urology, robot-assisted laparoscopic surgeries (RALS), pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction

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Authors: Shulamit Sternin

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Athletes experience injuries that can have both a physical and psychological impact on the individual. In such instances, athletes are able to rely on the established field of sports psychology to facilitate holistic rehabilitation. Musicians, like athletes rely on their bodies to perform in much the same way athletes do and are also susceptible to injury. Due to the similar performative nature of succeeding as an athletes or a musician, these careers share many of the same primary psychological concerns and therefore it is reasonable that athletes and musicians may require similar rehabilitation post-injury. However, musicians face their own unique psychological challenges and understanding the needs of an injured athlete can serve as a foundation for understanding the injured musician but is not enough to fully rehabilitate an injured musician. The current research surrounding musicians and their injuries is primarily focused on physiological aspects of injury and rehabilitation; the psychological aspects have not yet received adequate attention resulting in poor musician rehabilitation post- injury. This review paper uses current models of psychological response to injury in athletes to draw parallels with the psychological response to injury in musicians. Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as psychological response, injury, athlete, and musician. Studies that focused on post-injury psychology of either the musician or the athlete were included. Within the literature there is evidence to support psychological responses, unique to the musician, that are not accounted for by current models of response in athletes. The models of psychological response to injury in athletes are inadequate tools for application to the musician. Future directions for performance arts research that can fill the gaps in our understanding and modeling of musicians’ response to injury are discussed. A better understanding of the psychological impact of injuries on musicians holds significant implications for health care practitioners working with injured musicians. Understanding the unique barriers musicians face post-injury, and how support for this population must be tailored to properly suit musicians’ needs will aid in more holistic rehabilitation and a higher likelihood of musician’s returning to pre-injury performance levels.

Keywords: athlete, injury, musician, psychological response

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Authors: Gonul Kurt, Semra Aciksoz

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All types of interventions that increase the knowledge and awareness of youths about Sexually Transmitted Diseases (STD) are considered to be important for safe sex life and sexual health. The aim of this study was to determine the knowledge levels of nursing students about STD and evaluate the effectiveness of peer education and brochure methods to increase the knowledge and awareness about STD. This interventional study was carried out by participation of nursing students attending the first and second grade in a school of nursing on February–May 2015. The study participants were 200 undergraduate nursing student volunteers. The students were given education by peer trainers and brochure methods. First-grade students were divided into five groups with block randomization method and each group were given education by five peer trainers. Second-grade students were given education with brochure by the researchers. The knowledge level of study groups was evaluated before and after educational intervention. The data were collected using the “Data Collection Form” and “Sexually Transmitted Diseases Information Form”. The questionnaire forms developed by the researchers after the literature review. The SPSS 15.0 package software was used for the evaluation of the data obtained from the study. Data were analyzed by Mann-Whitney-U-Test, Wilcoxon Signed Ranks Test and Mc Nemar Test. A p value of <0.05 was regarded as statistically significant. All of participants in the study were female nursing students. The mean age of students was 18.99±0.32 years old in the peer education group and 20.04±0.37 in the brochure education group. There was no statistically significant difference between knowledge levels of the students in both groups before the education (p>0.05). It was determined that an increase in knowledge levels of the students in both groups after the education. This increase was statistically significant (p<0.05). It was determined that knowledge level of the students about STD in brochure group was higher than the peer education group (p<0.001). The results of this study indicate that brochure education method was more effective than the peer education method in both increasing knowledge and awareness about STD.

Keywords: education method, knowledge, nursing students, sexually transmitted diseases

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Authors: Wuqi Yang, Sufeng Li, Linda Zhai, Zhizhong Yuan, Shengli Wang

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How to assess and evaluate a not-for-profit (NFP) organisation’s performance should be of concern to all stakeholders because, amongst other things, without correctly evaluating its performance might affect an NFP being not able to continue to meet its service objectives. Given the growing importance of this sector in China, more and more existing and potential donors, governments and others are starting to take an increased interest in the financial conditions and performance of NFPs. However, when these various groups look for ways (methods) to assess the performance of NFPs, they find there has been relatively little research conducted into methods for assessing the performance of NFPs in China. Furthermore, there does not appear to have been any research to date into the performance evaluation of Chinese NFPs. The focus of this paper is to investigate how the Chinese government manages and evaluates not-for-profit (NFP) organisations' performances in China. Through examining and evaluating the NFPs in China from different aspects such as business development, mission fulfillment, financial position and other status, this paper finds some institutional constraints currently facing by the NFPs in China. At the end of this paper, a new regulatory framework is proposed for regulators’ considerations. The research methods are based on a combination of a literature review; using Balanced Scorecard to assess NFPs in China; Case Study method is employed to analyse a charity foundation’s performance in Hebei Province and proposing solutions to resolve the current issues and challenges facing by the NFPs. These solutions include: formulating laws and regulations on NFPs; simplifying management procedures, introducing tax incentives, providing financial support and other incentives to support the development of non-profit organizations in China. This study provides the first step towards a greater understanding of the NFP performance evaluation in China. It is expected that the findings and solutions from this study will be useful to anyone involved with the China NFP sector; particularly CEOs, managers, bankers, independent auditors and government agencies.

Keywords: Chinese non-profit organizations, evaluation, management, supervision

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Authors: B. Adini, M. Oren

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Introduction: Communicable diseases and pandemics pose a growing threat to the well-being of the global population. A vital component of protecting the public health is the creation and sustenance of a continuous preparedness for such hazards. A joint Israeli-German task force was deployed in order to develop an advanced tool for self-evaluation of emergency preparedness for variable types of biological threats. Methods: Based on a comprehensive literature review and interviews with leading content experts, an evaluation tool was developed based on quantitative and qualitative parameters and indicators. A modified Delphi process was used to achieve consensus among over 225 experts from both Germany and Israel concerning items to be included in the evaluation tool. Validity and applicability of the tool for medical institutions was examined in a series of simulation and field exercises. Results: Over 115 German and Israeli experts reviewed and examined the proposed parameters as part of the modified Delphi cycles. A consensus of over 75% of experts was attained for 183 out of 188 items. The relative importance of each parameter was rated as part of the Delphi process, in order to define its impact on the overall emergency preparedness. The parameters were integrated in computerized web-based software that enables to calculate scores of emergency preparedness for biological events. Conclusions: The parameters developed in the joint German-Israeli project serve as benchmarks that delineate actions to be implemented in order to create and maintain an ongoing preparedness for biological events. The computerized evaluation tool enables to continuously monitor the level of readiness and thus strengths and gaps can be identified and corrected appropriately. Adoption of such a tool is recommended as an integral component of quality assurance of public health and safety.

Keywords: biological events, emergency preparedness, bioterrorism, natural biological events

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Authors: Yousef Alqaryouti, Mariam Al Suwaidi, Raed Mohmood AlKhuwaildi, Hind Kolthoum, Issa Youssef, Mohammed Al Imam

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The UAE has experienced rapid economic growth due to its mature oil production industry, leading to a surge in urbanization and infrastructure development in the construction sector. Sustainable development practices are becoming increasingly important, and the UAE government has taken proactive measures to promote them, including the introduction of sustainable building codes, energy-efficient technologies, and renewable energy sources. Initiatives such as the Masdar City project and the Emirates Green Building Council further demonstrate the government's commitment to a cleaner and healthier environment. By adopting sustainable practices, the UAE can reduce its carbon footprint, lessen its reliance on fossil fuels, and achieve cost savings in the long run. The purpose of this paper is to conduct a thorough review of the current state of sustainability in the construction industry of the UAE. Our research methodology includes a local market survey and qualitative observational analysis of executed housing construction projects by the Mohammed Bin Rashid Housing Establishment. The market survey assesses eleven different challenging factors that affect sustainable construction project delivery. The qualitative observational research is based on data collected from three projects, including construction progress, bill of quantity, and construction program. The study concludes that addressing these challenges requires a collaborative team approach, incentivized contracts, traditional project management practices, an integrated project team, and an increase in sustainability awareness among stakeholders. The recommendations proposed in this study aim to promote and improve the application of sustainability in the UAE's construction industry for the future.

Keywords: sustainability, construction, challenges, opportunities, case study, market survey

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Authors: Sarra Kitanou

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Water recycling and reuse is an effective measure to solve the water stress problem. The sustainable use of water resource has become a national development strategy in Morocco. A key aspect of improving overall sustainability is the potential for direct wastewater effluent reuse. However, the hybrid technology membrane bioreactors (MBR) have been identified as an attractive option for producing high quality and nutrient-rich effluents for wastewater treatment. It is based on complex interactions between biological processes, filtration process and rheological properties of the liquid to be treated. Currently, with the evolution of wastewater treatment projects in Morocco, the MBR technology can be used as a technology treating different types of wastewaters and to produce effluent with suitable quality for reuse. However, the energetic consumption of this process is a great concern, which can limit the development and implementation of this technology. In this investigation, the electric energy consumption of an ultrafiltration membrane bioreactor process in domestic wastewater treatment is evaluated and compared to some MBR installations based on literature review. Energy requirements of the MBR are linked to operational parameters and reactor performance. The analysis of energy consumption shows that the biological aeration and membrane filtration are more energy consuming than the other components listed as feed and recirculation pumps. Biological aeration needs 53% of the overall energetic consumption and the specific energy consumption for membrane filtration is about 25%. However, aeration is a major energy consumer, often exceeding 50% share of total energy consumption. The optimal results obtained on the MBR process (pressure p = 1.15 bar), hydraulic retention time (15 h) showed removal efficiencies up to 90% in terms of organic compounds removal, 100% in terms of suspended solids presence and up to 80% reduction of total nitrogen and total phosphorus. The effluent from this MBR system could be considered as qualified for irrigation reuse, showing its potential application in the future.

Keywords: hybrid process, membrane bioreactor, wastewater treatment, reuse

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Authors: V. Suganya, V. Balasuriya

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The functioning of Micro and Small Scale (MSS) businesses in the northern part of Sri Lanka was vulnerable due to three decades of internal conflict and the subsequent post-war economic openings has resulted new market prospects for MSS businesses. MSS businesses survive and operate with limited resources and struggle to access finance, raw material, markets, and technology. This study attempts to identify the manner in which entrepreneurial orientation puts into practice by the business operators to overcome these business challenges. Business operators in the traditional food processing sector are taken for this study as this sub-sector of the food industry is developing at a rapid pace. A review of the literature was done to recognize the concepts of entrepreneurial orientation, defining MMS businesses and the manner in which business performance is measured. Direct interview method supported by a structured questionnaire is used to collect data from 80 respondents; based on a fixed interval random sampling technique. This study reveals that more than half of the business operators have opted to commence their business ventures as a result of identifying a market opportunity. 41 per cent of the business operators are highly entrepreneurial oriented in a scale of 1 to 5. Entrepreneurial orientation shows significant relationship and strongly correlated with business performance. Pro-activeness, innovativeness and competitive aggressiveness shows a significant relationship with business performance while risk taking is negative and autonomy is not significantly related to business performance. It is evident that entrepreneurial oriented business practices contribute to better business performance even though 70 per cent prefer the ideas/views of the support agencies than the stakeholders when making business decisions. It is recommended that appropriate training should be introduced to develop entrepreneurial skills focusing to improve business networks so that new business opportunities and innovative business practices are identified.

Keywords: Micro and Small Scale (MMS) businesses, entrepreneurial orientation (EO), food processing, business operators

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Authors: Pradeep Kulshrestha, Maulana Ayoub Ali

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The concept of financial inclusion has been tabled in the whole world where practitioners, academicians, policy makers and economists are working hard to look for the best possible opportunities in order to enable the whole society to be in the banking cycle. The Islamic banking system is considered to be one of the said opportunities. Countries like the United Kingdom, United States of America, Malaysia, Saudi Arabia, the whole of the United Arab Emirates and many African countries have accommodated the aspect of Islamic banking in the conventional banking system as one of the financial inclusion strategies. This paper tries to analyse the current state of affairs of the Islamic Banking system in Tanzania in order to understand the improvement of the provision of Islamic banking products and services in the said country. The paper discusses the historical background of the banking system in Tanzania, the level of penetration of banking products and services and the coming of the Islamic banking system in the country. Furthermore, the paper discusses banking regulatory bodies, legal instruments governing banking operations as well as number of legal challenges facing Islamic banking operations in the country. Following a critical literature review, the paper discovered that there is no legal instrument which talks about the introduction and provision of Islamic banking system in Tanzania. Furthermore, the Islamic banking system was considered as a banking product which is absolutely incorrect because Islamic banking is considered to be as a banking system of its own. In addition to that, it has been discovered that lack of a proper regulatory system and legal instruments to harmonize the conventional and Islamic banking systems has resulted in the closure of one Islamic window in the country, which in the end affects the credibility of the newly introduced banking system. In its conclusive remarks, the paper suggests that Tanzania should work on all legal challenges affecting the smooth operations of the Islamic banking system. This can be in a way of adopting various Islamic banking legal models which are used in countries like Malaysia and others, or a borrowing legal harmonization process which has been adopted by the UK, Uganda, Nigeria and Kenya.

Keywords: Islamic banking, Islamic windows, regulations, banks

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Authors: Mahdi PourAsghar, Abbas Mas'udzadeh, Abdulhakim Tirgari, Saeed Dabiri Roushan, Hooman Rashidi, Fariba Salehi

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Objective: One of the major objectives in sports areas is to achieve maximum athletic performance. Physical and psychological preparations are the basic factors for achieving maximum performance in athletes. Unfortunately, in the field of physical preparation, we can see maximum attention and planning of trainers and sports officials. But despite the importance of psychological preparation of athletes and its serious and profound effect on athletic performance, the results of sports competitions show that less attention is paid to this topic, and it is less under the control of counselors and psychologists in different areas of our sport. Therefore, this study aimed to evaluate the attitude of athletes and coaches to sport psychology. Materials and methods: A descriptive study with a sample size of 234 elite athletes and 216 skilled coaches was conducted in different areas of sports, in Sari, Mazandaran in 2015.The instrument was a questionnaire consisting of two parts of demographic data and Martin questionnaire, assessing the attitude to sport psychology. The data from this study were analyzed using Spss version 18, descriptive statistics tests, and Chi-square test. Results: In this study, positive attitudes of participants in need and confidence towards sport psychology consultation in athletes and coaches group were 55/1 and 56/5 percent, respectively. The positive attitude of female athletes in belief to psychology consultation was more than male athletes. Athletes with higher education had more positive attitude towards the presence of psychologists and psychiatrists in fields of sports. Conclusion: According to the findings based on the need to the psychology consultation in different areas of sports, it is recommended that through training of specialists in the field of sport psychology and review of sports programs in different fields of sports, the presence of these counselors to maintain the psychological preparation of athletes to achieve maximum athletic performance and reduce anxiety and stress be used.

Keywords: Keywords: Athletes, Eliteathletes, Coaches, Attitude, Sport psychology.

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Authors: Rosario Carmona

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This article aims to discuss the importance of indigenous people participation in climate change mitigation and adaptation. Specifically, it analyses different understandings of climate vulnerability among diverse actors involved in climate change policies in Chile: indigenous people, state officials, and academics. These data were collected through participant observation and interviews conducted during October 2017 and January 2019 in Chile. Following Karen O’Brien, there are two types of vulnerability, outcome vulnerability and contextual vulnerability. How vulnerability to climate change is understood determines the approach, which actors are involved and which knowledge is considered to address it. Because climate change is a very complex phenomenon, it is necessary to transform the institutions and their responses. To do so, it is fundamental to consider these two perspectives and different types of knowledge, particularly those of the most vulnerable, such as indigenous people. For centuries and thanks to a long coexistence with the environment, indigenous societies have elaborated coping strategies, and some of them are already adapting to climate change. Indigenous people from Chile are not an exception. But, indigenous people tend to be excluded from decision-making processes. And indigenous knowledge is frequently seen as subjective and arbitrary in relation to science. Nevertheless, last years indigenous knowledge has gained particular relevance in the academic world, and indigenous actors are getting prominence in international negotiations. There are some mechanisms that promote their participation (e.g., Cancun safeguards, World Bank operational policies, REDD+), which are not absent from difficulties. And since 2016 parties are working on a Local Communities and Indigenous Peoples Platform. This paper also explores the incidence of this process in Chile. Although there is progress in the participation of indigenous people, this participation responds to the operational policies of the funding agencies and not to a real commitment of the state with this sector. The State of Chile omits a review of the structure that promotes inequality and the exclusion of indigenous people. In this way, climate change policies could be configured as a new mechanism of coloniality that validates a single type of knowledge and leads to new territorial control strategies, which increases vulnerability.

Keywords: indigenous knowledge, climate change, vulnerability, Chile

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Authors: Yusif Habib

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The Volta River Basin (VRB) is a transboundary resource shared by Six (6) the West African States. It’s utilization spans across irrigation, hydropower generation, domestic/household water use, transportation, industrial processing, among others. Simultaneously, mineral resources such as gold are mined within the VRB catchment. Typically, the extraction/mining operation is earth-surface excavation; known as Artisanal and Small-scale mining. We developed a conceptual framework in the context of Water-Energy-Food (WEF) Nexus to delineate the trade-offs and synergies between the mineral extractive operation’s impact on Agricultural systems, specifically, cereal crops (e.g. Maize, Millet, and Rice) and the environment (water and soil quality, deforestation, etc.) on the VRB. Thus, the study examined the trade-offs and synergies through the WEF nexus lens to explore the extent of an eventual overarching mining preference for gold exploration with high economic returns as opposed to the presumably low yearly harvest and household income from food crops production to inform intervention prioritization. Field survey (household, expert, and stakeholder consultation), bibliometric analysis/literature review, scenario, and simulation models, including land-use land cover (LULC) analyses, were conducted. The selected study area(s) in Ghana was the location where the mineral extractive operation’s presence and impact are widespread co-exist with the Agricultural systems. Overall, the study proposes mechanisms of the virtuous cycle through FEW Nexus instead of the presumably existing vicious cycle to inform decision making and policy implementation.

Keywords: agriculture, environmental sustainability, gold Mining, synergies, trade-off, water-energy-food nexus

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Authors: Renga Rao Krishnamoorthy, Raihan Tahir

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The quality of classroom learning and teaching delivery has been and will continue to be debated at various levels worldwide. The regional cooperation programme to improve the quality and labour market orientation of the Technical and Vocational Education and Training (RECOTVET), ‘Deutsche Gesellschaft für Internationale Zusammenarbeit’ (GIZ), in line with the sustainable development goals (SDG), has taken the initiative in the development of quality TVET in the ASEAN region by developing the Quality Toolbox for Better TVET Delivery (Quality Toolbox). This initiative aims to provide quick and practical materials to trainers, instructors, and personnel involved in education and training at an institute to shape the quality of classroom learning and teaching. The Quality Toolbox for Better TVET Delivery was developed in three stages: literature review and development, validation, and finalization. Thematic areas in the Quality Toolbox were derived from collective input of concerns and challenges raised from experts’ workshops through moderated sessions involving representatives of TVET institutes from 9 ASEAN Member States (AMS). The sessions were facilitated by professional moderators and international experts. TVET practitioners representing AMS further analysed and discussed the structure of the Quality Toolbox and content of thematic areas and outlined a set of specific requirements and recommendations. The application exercise of the Quality Toolbox was carried out by TVET institutes among ASM. Experience sharing sessions from participating ASEAN countries were conducted virtually. The findings revealed that TVET institutes use two types of approaches in shaping the quality of learning and teaching, which is ascribed to inductive or deductive, shaping of quality in learning and teaching is a non-linear process and finally, Q-tools can be adopted and adapted to shape the quality of learning and teaching at TVET institutes in the following: improvement of the institutional quality, improvement of teaching quality and improvement on the organisation of learning and teaching for students and trainers. The Quality Toolbox has good potential to be used at education and training institutes to shape quality in learning and teaching.

Keywords: AMS, GIZ, RECOTVET, quality tools

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Authors: David Ssekamate

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The study which is work in progress examines the opportunities and challenges for universities in Africa in addressing climate change issues in their programmes. Specifically, the study attempts to examine the current academic, research and community engagement programmes on climate change implemented by the Universities; the key challenges faced by the implementing units in carrying out these programmes and; the success factors that would support universities to adequately address climate change issues in their programmes. The researcher adopted a qualitative comparative case study design with Makerere University (Uganda) and University of Dar es Salaam (Tanzania) as comparative cases. Data will be collected using semi-structured in-depth interviews, Focus Group Discussions (FDGs) and Document review. A total of 12 semi-structured in-depth interviews and 4 Focus Group Discussions will be undertaken, collecting data from 36 respondents in both Uganda and Tanzania. The data will be analyzed using content and thematic analysis methods with the help of Nvivo software. The findings are envisaged to make a significant contribution to scholarly literature on climate change education and the role of higher education in addressing climate change issues, inform policy making in the sector and development planning to strengthen the academic, research and community engagement programmes on climate change by universities in Africa. The implications of the findings may go beyond the focus on climate change but also other related sustainable development issues incorporated in academic and research programmes of universities in Africa. The results may enable universities to re-think their approaches and practices and also deal with challenges effectively in addressing climate change related issues in their programmes.

Keywords: climate change, climate change education, African universities, challenges

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Authors: Elena Mugarza, Stephanie Glendinning, Ross Stirling, Colin Davies

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The effects of climate change and increased rainfall events on UK-based infrastructure are observable, with an increasing number being reported on in the national press. The fatal derailment at Stonehaven in 2020 prompted a wider review of Network Rail-owned earthworks assets. The event was indicated by the Rail Accident Investigation Branch (RAIB) to be caused by mis-installed drainage on the adjacent cutting. The slope failure on Snake Pass (public highway A57) was reportedly caused by significant water ingress following numerous storm events and resulted in the road’s closure for several months. This problem is only projected to continue with greater intensity and more prolonged rainfall events forecasted in the future. Subsequently, this project is designed to evaluate effective drainage trench design within infrastructure embankments, considering the capillary barrier phenomenon that may govern their deterioration and resultant failure. Theoretically, the differential between grain sizes of the embankment clays and gravels, customarily used in drainage trenches, would have a limiting effect on infiltration. As such, it is anticipated that the inclusion of an additional material with an intermediate grain size should improve the hydraulic conductivity across the drainage boundary. Multiple drainage designs will be studied using instrumentation within the drain and surrounding clays. Data from the real-world installation at the BIONICS embankment will be collected and compared with laboratory and Finite Element (FE) simulations. This research aims to reduce the risk of infrastructure slope failures by improving the resilience of earthwork drainage and lessening the consequential impact on transportation networks.

Keywords: earthworks, slope drainage, transportation slopes, deterioration, capillary barriers, field study

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Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

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Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

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Authors: P. T. Ngan

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Purpose: The study aims to answer the question what are motivational conditions that have great influences on employees’ innovative work behaviors by investigating the case of SATAMANKULMA/ Anya Productions Ky in Kuopio, Finland. Design/methodology: The main methodology utilized was the qualitative single case study research, analysis was conducted with an adapted thematic content analysis procedure, created from empirical material that was collected through interviews, observation and document review. Findings: The paper highlights the significance of combining relevant synergistic extrinsic and intrinsic motivations into the organizational motivation system. The findings show that intrinsic drives are essential for the initiation phases while extrinsic drives are more important for the implementation phases of innovative work behaviors. The study also offers the IDEA motivation model-interpersonal relationships & networks, development opportunities, economic constituent and application supports as an ideal tool to optimize business performance. Practical limitations/ implications: The research was only conducted from the perspective of SATAMANKULMA/Anya Productions Ky, with five interviews, a few observations and with several reviewed documents. However, further research is required to include other stakeholders, such as the customers, partner companies etc. Also the study does not offer statistical validity of the findings; an extensive case study or a qualitative multiple case study is suggested to compare the findings and provide information as to whether IDEA model relevant in other types of firms. Originality/value: Neither the innovation nor the human resource management field provides a detailed overview of specific motivational conditions might use to stimulate innovative work behaviors of individual employees. This paper fills that void.

Keywords: employee innovative work behaviors, extrinsic motivation, intrinsic motivation, organizational innovativeness

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Authors: M. Shokry Rashwan

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This study follows a number of experiments conducted at Red River College (RRC) to investigate the short term properties of tire derived aggregate (TDA) produced from shredding off-the-road (OTR) wasted tires in a proposed new application. The application targets replacing natural material used under concrete slabs and as backfills for residential homes’ basement slabs and walls, respectively, with TDA. The experimental work included determining: compressibility, gradation distribution, unit weight, hydraulic conductivity and lateral pressure. Based on the results of those short term properties; it was decided to move forward to study the long-term performance of this otherwise waste material through on-site demonstration. A full-scale basement replicating a typical Manitoba home was therefore built at RRC where both TDA and Natural Materials (NM) were used side-by-side. A large number of sensing and measuring systems are used to compare between the performances of each material when exposed to the typical ground and weather conditions. Parameters monitored and measured include heat losses, moisture migration, drainage ability, lateral pressure, relative movements of slabs and walls, an integrity of ground water and radon emissions. Up-to-date results have confirmed part of the conclusions reached from the earlier laboratory experiments. However, other results have shown that construction practices; such as placing and compaction, may need some adjustments to achieve more desirable outcomes. This presentation provides a review of both short-term tests as well as up-to-date analysis of the on-site demonstration.

Keywords: tire derived aggregate (TDA), basement construction, TDA material properties, lateral pressure of TDA, hydraulic conductivity of TDA

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Authors: Babatunde Joel Todowede

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It is a public knowledge that lack of quality and qualitative education breeds problems besetting Nigeria as a nation today. This paper entitled “Quality and Qualitative Education for all, panacea for insecurity and political unrest in Nigeria” seeks to explore how quality and qualitative education for all will tends to put an end to insecurity and political unrest in Nigeria as a Nation. It may be pertinent to note at this juncture that the development of any modern society or nation is primarily hinged on the functionality of its educational system. There is no developed nation in the world today, which does not owe its advancement to quality and qualitative education. In other words, Education is a vital instrument in the nation’s economic competitiveness, in its people, and in its communities. Hence, Education is not luxury to be cut in difficult economic times – it is an essential element of growth. In fact, education is the bedrock of any society that hopes to be numbered among the developed economies in the world. Nigeria, as a nation, has made continual efforts to assume its rightful place in education on the African continent, but has not been quite lucky. Interestingly however, Quality and Qualitative Education for all will come about if all stakeholders in the Education Sector perform their roles with skill and efficiency. Education is a very sensitive area, hence, needs to be passionate about education, and focused on building a future for the sector.” Quality and qualitative education instill significant core values in every student, which shape them into mature, caring and independent individuals. These values include commitment, collaboration, integrity, responsibility and respect. By imbibing these values in every aspect of their life, they are able to contribute their skills and talents while supporting each other in attaining their lifelong goals. This paper identified lack of proper education as the bane of insecurity and political unrest in the Country and urged the government to review the policy in a way that there will be quality and standard to check insurgency in the Country. More so, until the fallen standard of education in Nigeria is fixed to engage out of school children, the incessant attack on innocent Nigerians, particularly in the North East may get worse.

Keywords: quality and qualitative education, panacea, insecurity, political unrest

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Authors: Farusil Najeeb Mullaveettil, Rolanas Dauksevicius

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Cellular structures produced by additive manufacturing have earned wide research attention due to their unique specific strength and energy absorption potentiality. The literature review concludes that pattern type and density are vital parameters that affect the mechanical properties of parts formed by additive manufacturing techniques and have an influence on printing time and material consumption. Fused deposition modeling technique (FDM) is used here to produce Polyvinylidene fluoride (PVDF) parts. In this work, patterns are based on triply periodic minimal surfaces (TPMS) produced by PVDF-based filaments using the FDM technique. PVDF homopolymer filament Fluorinar-H™ and PVDF copolymer filament Fluorinar-C™ are printed with three types of TPMS patterns. The patterns printed are Gyroid, Schwartz diamond, and Schwartz primitive. Tensile, flexural, and compression tests under quasi-static loading conditions are performed in compliance with ISO standards. The investigation elucidates the deformation mechanisms and a study that establishes a relationship between the printed and nominal specimens' dimensional accuracy. In comparison to the examined TPMS pattern, Schwartz diamond showed a higher relative elastic modulus and strength than the other patterns in tensile loading, and the Gyroid pattern showed the highest mechanical characteristics in flexural loading. The concluded results could be utilized to produce informed cellular designs for biomedical and mechanical applications.

Keywords: additive manufacturing, FDM, PVDF, gyroid, schwartz primitive, schwartz diamond, TPMS, tensile, flexural

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Authors: Joana Margarida Bôto, Belmira Neto, Vera Miguéis, Manuela Meireles, Ada Rocha

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The Mediterranean diet has been recognized as a sustainable model of living with benefits for the environment and human health. However, a complete assessment of its sustainability, encompassing all dimensions and aspects, to our best knowledge, has not yet been realized. This systematic literature review aimed to fill this gap by identifying and describing the indicators used to assess the sustainability of the Mediterranean diet, looking at several dimensions, and presenting the results from their application. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines methodology was used, and searches were conducted in PubMed, Scopus, Web of Science, and GreenFile. There were identified thirty-two articles evaluating the sustainability of the Mediterranean diet. The environmental impact was quantified in twenty-five of these studies, the nutritional quality was evaluated in seven studies, and the daily cost of the diet was assessed in twelve studies. A total of thirty-three indicators were identified and separated by four dimensions of sustainability, specifically, the environmental dimension (ten indicators, namely carbon, water, and ecological footprint), the nutritional dimension (eight indicators, namely Health score and Nutrient Rich Food Index), the economic dimension (one indicator, the dietary cost), the sociocultural dimension (six indicators – with no results). Only eight of the studies used combined indicators. The Mediterranean diet was considered in all articles as a sustainable dietary pattern with a lower impact than Western diets. The carbon footprint ranged between 0.9 and 6.88 kg CO₂/d per capita, the water footprint between 600 and 5280 m³/d per capita, and the ecological footprint between 2.8 and 53.42 m²/d per capita. The nutritional quality was high, obtaining 122 points using the Health score and 12.95 to 90.6 points using the Nutrient Rich Food Index. The cost of the Mediterranean diet did not significantly differ from other diets and varied between 3.33 and 14.42€/d per capita. A diverse approach to evaluating the sustainability of the Mediterranean diet was found.

Keywords: Mediterranean diet, sustainability, environmental indicators, nutritional indicators

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Authors: Gertraud Koch, Teresa Stumpf, Alejandra Tijerina García

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Discourse analysis research approaches belong to the central research strategies applied throughout the humanities; they focus on the countless forms and ways digital texts and images shape present-day notions of the world. Despite the constantly growing number of relevant digital, multimodal discourse resources, digital humanities (DH) methods are thus far not systematically developed and accessible for discourse analysis approaches. Specifically, the significance of multimodality and meaning plurality modelling are yet to be sufficiently addressed. In order to address this research gap, the D-WISE project aims to develop a prototypical working environment as digital support for the sociology of knowledge approach to discourse analysis and new IT-analysis approaches for the use of context-oriented embedding representations. Playing an essential role throughout our research endeavor is the constant optimization of hermeneutical methodology in the use of (semi)automated processes and their corresponding epistemological reflection. Among the discourse analyses, the sociology of knowledge approach to discourse analysis is characterised by the reconstructive and accompanying research into the formation of knowledge systems in social negotiation processes. The approach analyses how dominant understandings of a phenomenon develop, i.e., the way they are expressed and consolidated by various actors in specific arenas of discourse until a specific understanding of the phenomenon and its socially accepted structure are established. This article presents insights and initial findings from D-WISE, a joint research project running since 2021 between the Institute of Anthropological Studies in Culture and History and the Language Technology Group of the Department of Informatics at the University of Hamburg. As an interdisciplinary team, we develop central innovations with regard to the availability of relevant DH applications by building up a uniform working environment, which supports the procedure of the sociology of knowledge approach to discourse analysis within open corpora and heterogeneous, multimodal data sources for researchers in the humanities. We are hereby expanding the existing range of DH methods by developing contextualized embeddings for improved modelling of the plurality of meaning and the integrated processing of multimodal data. The alignment of this methodological and technical innovation is based on the epistemological working methods according to grounded theory as a hermeneutic methodology. In order to systematically relate, compare, and reflect the approaches of structural-IT and hermeneutic-interpretative analysis, the discourse analysis is carried out both manually and digitally. Using the example of current discourses on digitization in the healthcare sector and the associated issues regarding data protection, we have manually built an initial data corpus of which the relevant actors and discourse positions are analysed in conventional qualitative discourse analysis. At the same time, we are building an extensive digital corpus on the same topic based on the use and further development of entity-centered research tools such as topic crawlers and automated newsreaders. In addition to the text material, this consists of multimodal sources such as images, video sequences, and apps. In a blended reading process, the data material is filtered, annotated, and finally coded with the help of NLP tools such as dependency parsing, named entity recognition, co-reference resolution, entity linking, sentiment analysis, and other project-specific tools that are being adapted and developed. The coding process is carried out (semi-)automated by programs that propose coding paradigms based on the calculated entities and their relationships. Simultaneously, these can be specifically trained by manual coding in a closed reading process and specified according to the content issues. Overall, this approach enables purely qualitative, fully automated, and semi-automated analyses to be compared and reflected upon.

Keywords: entanglement of structural IT and hermeneutic-interpretative analysis, multimodality, plurality of meaning, sociology of knowledge approach to discourse analysis

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Authors: Alonge Isaac Olusola

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Taking a cue from countries such as China and Japan, there is no doubt that the teaching and learning of Mother Tongue ( MT) or Language of Immediate Environment (LIE) is a potential source of development in every country. The engine of economic, scientific, technological and political advancement would be more functional when the language of instruction for teaching and learning in schools is in the child’s mother tongue. The purpose of this paper therefore, is to delve into the genesis of the official recognition given to the teaching and learning of Nigerian languages at national level with special focus on Yoruba language. Yoruba language and other Nigerian languages were placed on a national pedestal by a Nigerian Educational Minister, Late Professor Babatunde Fafunwa, who served under the government of General Ibrahim Babangida (1985 – 1993). Through his laudable effort, the teaching and learning of Nigerian languages in schools all over the nation was incorporated officially in the national policy of education. Among all the Nigerian languages, Hausa, Igbo and Yoruba were given foremost priorities because of the large population of their speakers. Since the Fafunwa era, Yoruba language has become a national subject taught in primary, secondary and tertiary institutions in Nigeria. However, like every new policy, its implementation has suffered several forms of criticisms and impediments from governments, policy makers, curriculum developers, school administrators, teachers and learners. This paper has been able to arrive at certain findings through oral interviews, questionnaires and evaluation of pupils/students enrolment and performances in Yoruba language with special focus on the South-west and North central regions of Nigeria. From the research carried out, some factors have been found to be responsible for the successful implementation or otherwise of Yoruba language instruction policy in some schools, colleges and higher institutions in Nigeria. In conclusion, the paper made recommendations on how the National Policy of Education would be implemented to enhance the teaching and learning of Yoruba language in all Nigerian schools.

Keywords: language of immediate environment, mother tongue, national policy of education, yoruba language

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Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

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Musculoskeletal disorders (MSDs) are a major cause of pain and disability. It is likely to become a greater economic and public health burden that is unnecessary. Thus, reliable prevalence figures are important for both clinicians and policy-makers to plan health care needs for those affected with the disease. This study estimated hospital based real-world prevalence of MSDs in Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out to identify common MSDs including low back pain (LBP), cervical spondylosis (CSD), post immobilization stiffness (PIS), sprain, osteoarthritis (OA), and other conditions. Occupational class of the patients was determined using the International Labour Classification (ILO). Data were analysed using descriptive statistics of frequency and percentages. Overall, medical charts of 3,340 patients were reviewed within the span of ten years (2009 to 2018). Majority of the patients (62.8%) were in the middle class, and the remaining were in low class (25.1%) and high class (10.5%) category. An overall prevalence of 47.35% of MSD was found within the span of ten years. Of this, the prevalence of LBP, CSD, PIS, sprain, OA, and other conditions was 21.6%, 10%, 18.9%, 2%, 6.3%, and 41.3%, respectively. The highest (14.2%) and lowest (10.5%) prevalence of MSDs was recorded in the year of 2012 and 2018, respectively. The prevalence of MSDs is considerably high among Nigerian patients attending outpatient a physiotherapy clinic. The high prevalence of MSDs underscores the need for clinicians and decision makers to put in place appropriate strategies to reduce the prevalence of these conditions. In addition, they should plan and evaluate healthcare services to improve the health outcomes of patients with MSDs. Further studies are required to determine the economic burden of the condition and examine the clinical and cost-effectiveness of physiotherapy interventions for patients with MSDs.

Keywords: musculoskeletal disorders, Nigeria, prevalence, real world

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Authors: Jianghe Niu, Mu-Qing Huang

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This research applies qualitative approach to conduct literature review to explore and analyze the relationship between three pairs of female Chinese public figure with high levels of education and social recognitionto understand the role of male admiration in driving hostile response from the female pairs. Commonalities in the cases were found. Hong Huang and SuMang, both are coaches in the Chinese fashion industry, and their contemporaries are also editors-in-chief of major fashion publications. Lin Huiyin and XieBingxin are successful women in the field of literature and architecture. They are of similar age and share similar place of origin and family background; the former received high levels of male admiration, while the latter did not. Zhang Ailing and Su Qing, they are both highly established in the field of literature with very similar style, and they shared great admiration for each other’s talent once upon a time. Zhang’s husband used to be Su Qing's lover, and it was only through Su Qing that He met Zhang Ailing. Conclusion: The relationship between Chinese women, especially women with high levels of education and social recognition, the degree of similarities, and the closeness of relationship of these attributes (such as age, family background, education level, peer similarity, appearance, family, marriage) is positively correlated with increased level of discord, hostility, and hostility. This is observed across the three samples. The relationship between Chinese women, especially women with high levels of education and social recognition - if there are men romantically involved and the levels of male admiration is not equal between the two females - the imbalance of male admiration will act as a leverage that further drives up the levels of negative relationship between the women. This is the case with the first two examples above. The relationship between Chinese women, especially women with high levels of education and social recognition - if there is a man romantically involved and if he’s a previous lover to one woman - the transfer of male romantic interest from the first women to the second women, the new union will bring the hostile and negative relationship with the two females to a peak.

Keywords: Chinese, gender, relationship, women

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Authors: Alberto Piatto, Zaza Nadja Lee Hansen, Peter Jacobsen

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This paper examines the quantitative and qualitative factors influencing the buyer-supplier relationship. Understanding and acting on the right factors influencing supplier relationship management is crucial when a company outsource an important part of its business as it can be for engineering to order (ETO) company executing only the designing part in-house. Acting on these factors increase the quality of the relationship obtaining for both parties what they want and expect from an improved relationship. Best practices in supplier relationship management are considered and a case study of a large global company, called Cement A/S, operating in the cement business is carried out. One study is conducted including a large international company and hundreds of its suppliers. Data from the company is collected using semi-structured interviews and data from the suppliers is collected using a survey. Based on these inputs and an extensive literature review a classification of factors influencing the relationship buyer-supplier is presented and discussed. The results show that different managers among the company are assessing supplier from various perspectives, a standard approach to measure the performance of suppliers does not exist. The factors used nowadays in the company to measure performances of the suppliers are mostly related to time and cost. Quality is a key factor, but it has not been addressed properly since no data are available in the system. From a practical perspective, managers can learn from this paper which factors to consider when applying best practices of Supplier Relationship Management. Furthermore, from a theoretical perspective, this paper contributes with new knowledge in the area as limited research in collaboration with the company has been conducted. For this reason, a company, its suppliers and few studies for this type of industry have been conducted. For further research, it is suggested to define the correlation of factors to the profitability of the company and calculate its impact. When conducting this analysis it is important to focus on the efficient and effective use of factors that can be measurable and accepted from the supplier.

Keywords: buyer-supplier relationship, cement industry, classification of factors, ETO

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Authors: Reza Mehrafarin, Nafiseh Mirshekari, Mahyar Mehrafarin

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In 25 km southeast of Zabul (center of Sistan, in the east of Iran), a large hill can be seen. This hill, which is located next to the bend of the Sistan river, is known as the Tappeh Shahrestan. The length of the Tappeh Shahrestan is 1350 meters, its width is 360 meters, and its height is 20 meters, which in total reaches to 48 hectares. The capital of Sistan province was Ram Shahrestan in the Sassanid period, according to Iranian historical texts and Sassanid Pahlavi traditions. The city was abandoned because the nearby river dried up. Then another capital was built in Sistan called Zarang. But due to the long passage of time since the destruction of the city, its real location was forgotten and and some archaeologists have suggested different areas as the main location of the Ram Shahrestan. In 2018, the first archaeological field activities took place on and around the hillin order to answer this question: was Tappe Shahristan the same as Ram Shahristan, the capital of Sistan, during the Sassanid period? In order to answer this question, archaeological field activities were carried out on and around the hill. The field activities of the first season included the followings: 1- Preparation of hill topography and plan metric 3-Archaeogeophysics studies 3-Methodical study of archeology 4-Determining the range of the hill by soundings5-Documentation of the hill 6-Classification, typology, and comparison of pottery typology. The results of archaeological field activities in the first phase of Tappeh Shahrestan showed that this ancient site was the same city of Ram Shahrestan, the capital of Sistan, during the Sassanid period. The beginning of settlement in this city was the third century BC and the time of leaving was the end of the third century AD. The most important factors in the creation of the city was the abundant water of the Sistan River and its convenient location, and the most important reason for the abandonment of the city was the Sistan River, whose water completely dried up.

Keywords: archaeological surveys, archaeological soundings, ram shahrestan, sistan, tappeh shahrestan

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Authors: Igor Vishnevskyi

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Introduction: The urinary bladder undergoes repeated strain during its working cycle, suggesting the presence of an efficient support system, force transmission, and mechanical amplification. The concept of a "hydrostatic skeleton" (HS) could contribute to our understanding of the functional relationships among bladder constituents. Methods: A multidisciplinary literature review was conducted to identify key features of the HS and to gather evidence supporting its applicability in urinary bladder biomechanics. The collected evidence was synthesized to propose a framework for understanding the potential hydrostatic properties of the urinary bladder based on existing knowledge and HS principles. Results: Our analysis revealed similarities in biomechanical features between living fluid-filled structures and the urinary bladder. These similarities include the geodesic arrangement of fibres, the role of enclosed fluid (urine) in force transmission, prestress as a determinant of stiffness, and the ability to maintain shape integrity during various activities. From a biomechanical perspective, urine may be considered an essential component of the bladder. The hydrostatic skeleton, with its autonomy and flexibility, may provide insights for researchers involved in bladder engineering. Discussion: The concept of a hydrostatic skeleton offers a holistic perspective for understanding bladder function by considering multiple mechanical factors as a single structure with emergent properties. Incorporating viewpoints from various fields on HS can help identify how this concept applies to live fluid-filled structures or organs and reveal its broader relevance to biological systems, both natural and artificial. Conclusion: The hydrostatic skeleton (HS) design principle can be applied to the urinary bladder. Understanding the bladder as a structure with HS can be instrumental in biomechanical modelling and engineering. Further research is required to fully elucidate the cellular and molecular mechanisms underlying HS in the bladder.

Keywords: hydrostatic skeleton, urinary bladder morphology, shape integrity, prestress, biomechanical modelling

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Authors: Aikaterini Amanatidou

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We describe the case of a 20-year-old female patient diagnosed with Ehlers-Danlos Syndrome (EDS) who was scheduled to undergo a wisdom teeth extraction in outpatient surgery. EDS is a hereditary connective tissue disorder characterized by joint hypermobility, skin hyper-extensibility, and vascular and soft tissue fragility. There are six subtypes of Ehlers-Danlos, and in our case, the patient had EDS hyper-mobility (HT) type disorder. One important clinical feature of this syndrome is chronic pain, which is often poorly understood and treated. Our patient had a long history of articular and lumbar pain when she was diagnosed. She was prescribed analgesic treatment for acute and neuropathic pain and had multiple sessions of psychotherapy and physiotherapy to ease the pain. Unfortunately, her extensive medical history was underrated by our anesthetic team, and no further measures were taken for the operation. Despite an uneventful intra-operative phase, the patient experienced several episodes of hyperalgesia during the immediate post-operative care. Management of pain was challenging for the anesthetic team: initial opioid treatment had only a temporary effect and a paradoxical reaction after a while. Final pain relief was eventually obtained with psycho-physiologic treatment, high doses of ketamine, and patient-controlled analgesia infusion of morphine-ketamine-dehydrobenzperidol. We suspected an episode of Opioid-Induced hyperalgesia. This case report supports the hypothesis that anti-hyperalgesics such as ketamine as well as lidocaine, and dexmedetomidine should be considered intra-operatively to avoid opioid-induced hyperalgesia and may be an alternative solution to manage complex chronic pain like others in neuropathic pain syndromes.

Keywords: Ehlers-Danlos, post-operative management, hyperalgesia, opioid-induced hyperalgesia, rare disease

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