Search results for: surgical innovations

Authors: Yessengeldy Kuanyshpayev

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Now in some countries of the world the cellular market is on the point of saturation, in others - positive dynamics of development kept on. The reasons for it are also different, but there are united by their general susceptibility to innovation changes, if they are really innovative. If to take as an example the cellular market of Kazakhstan it is defined by the low percent of smart phones at consumers, the low population density, undercapacity of the 3G channel, and absence of universal access to the LTE technology that limits dynamical growth of this branch. These moments are aggravated by failures of starting commercial projects by private companies which prevent to be implemented and widely adopted to a new product among consumers. The object of the research is possible integration of wireless and program technologies at which introduction the idea can regenerate in an innovation. The analysis of existing projects in the market and the possible union of the technologies through a prism of theoretical bases of innovative activity shows that efficiency of the company by development and introduction of innovations is possible only thanks to strict observance of all terms and conditions of the innovative process which main term is profit. Despite that fact that on a global scale the innovativeness issue of companies is very popular, there are no research about possibility of innovative breaks in the field of wireless access to the Internet in the cellular market of Kazakhstan.

Keywords: innovation, the effectiveness of company, commercialization, cellular market

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Authors: Esteban Tremoco

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This article aims to highlight some specificities of translating Science Fiction (SF literature) and, more particularly, its comic subgenre. Translating SF presupposes the translation of neologisms and gadget names of all kinds, while the translation of humor sometimes implies a need for the translator to slightly modify certain scenes or situations. In the French translation of Douglas Adams' Hitchhiker's Guide to the Galaxy by Jean Bonnefoy (Guide du routard galactique, 1982), the humorous dimension of the book is enhanced through certain choices made by the translator. One of the striking aspects of this translation is that almost all of the characters’ names have been translated, which is not the case in the German, Italian, Spanish and Portuguese translations. While there may be translations of characters’ names outside of the SF literature, there is no denying that by translating them, Jean Bonnefoy added a humorous layer to Adams' work. This work belongs to science fiction literature thanks to gadgets resulting from futuristic technological innovations, but also the presence of space travel, extra-terrestrials and mysterious worlds, which are central elements in SF. These names of planets, aliens, and other gadgets have also been translated, adapted, or at least reinvented, by Jean Bonnefoy in order to amuse the French-speaking readership.

Keywords: translation, translation studies, humour, science fiction

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Authors: Azzeddine Atibi, Khadija El Kababi, Salim Ahmed, Mohamed Radid

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The principal objective of this study is to undertake a comprehensive comparative analysis of distance learning and blended learning modalities, with a particular emphasis on evaluating their effectiveness during the confinement period mandated by the COVID-19 pandemic. This investigation is rooted in the firsthand experiences of educators at the high school and secondary levels within both private and public educational institutions. To acquire the requisite data, we meticulously designed and distributed a survey to these educators, soliciting detailed narratives of their professional experiences throughout this challenging period. The survey aims to elucidate the specific difficulties encountered by teachers, as well as to highlight the innovative pedagogical strategies they devised in response to these challenges. By synthesizing the insights garnered from this survey, our goal is to foster an exchange of experiences among educators and to generate informed recommendations that will inform future educational reforms. Ultimately, this study aspires to contribute to the ongoing discourse on optimizing educational practices in the face of unprecedented disruptions.

Keywords: distance learning, blended learning, covid 19, secondary/ high school, teachingperformance, evaluation

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Authors: Stefan Bradu, Daniel Siegel, Jameson Loyal, Andrea Leaf, Alana Kurtti, Usha Alapati, Jared Jagdeo

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Compared with all other variants of nodular melanoma, patients with polypoid nodular melanoma have the lowest 5-year survival rate. The pathophysiology and management of polypoid melanoma are scarcely reported in the literature. Although surgical excision is the cornerstone of melanoma management, treatment of polypoid melanoma is complicated by several negative prognostic factors, including early metastasis. This report demonstrates the successful treatment of a rapidly developing red nodular polypoid melanoma with metastasis using surgery and adjuvant nivolumab in a SARS-CoV-2-positive patient who delayed seeking care due to the COVID-19 pandemic. In addition to detailing the successful treatment approach, the immunosuppressive effects of SARS-2-CoV and its possible contribution to the rapid progression of polypoid melanoma are discussed. This case highlights the complex challenges of melanoma diagnosis and management during the COVID-19 pandemic.

Keywords: covid-19, dermatology, immunotherapy, melanoma, nivolumab

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Authors: Khadija Mushtaq, Mian Saqib Mehmood

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This paper attempts to determine the impact of leadership style and learning orientation on organizational performance in Pakistan. A sample of 158 middle managers selected from sports and surgical factories from Sialkot. The empirical estimation is based on a multiple linear regression analysis of the relationship between leadership style, learning orientation and organizational performance. Leadership style is measure through transformational leadership and transactional leadership. The transformational leadership has insignificant impact on organizational performance. The transactional leadership has positive and significant relation with organizational performance. Learning orientation also has positive and significant relation with organizational performance. Linear regression used to estimate the relation between dependent and independent variables. This study suggests top manger should prefer continuous process for improvement for any change in system rather radical change.

Keywords: transformational leadership, transactional leadership, learning orientation, organizational performance, Pakistan

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Authors: Heejin Song

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Employing a critical action research approach that rejects essentialist onto-epistemological orientations to research in English language teaching (ELT) and interrogates the hegemonic relations in the knowledge construction and reconstruction processes, this study illuminates how an action research-informed pedagogical practice can transform the English for academic purposes (EAP) teaching to be more culturally and linguistically inclusive and critically oriented for English language learners’ advancement in academic literacies skills. More specifically, this paper aims to showcase the action research-informed pedagogical innovations that emphasize multilingual learners’ multiliteracies engagement and experiential education-oriented learning to facilitate the development of learners’ academic literacies, intercultural communicative competence, and inclusive global citizenship in the context of Canadian university EAP classrooms. The pedagogical innovations through action research embarked in response to growing discussions surrounding pedagogical possibilities of plurilingualism in ELT and synchronous online teaching. The paper is based on two iterations of action research over the pandemic years between 2020 and 2022. The data includes student work samples, focus group interviews, anonymous surveys, teacher feedback and comments on student work and teaching reflections. The first iteration of the action research focused on the affordances of multimodal expressions in individual learners’ academic endeavors for their literacy skills development through individual online activities such as ‘my language autobiography,’ ‘multimodal expression corner’ and public speeches. While these activities help English language learners enhance their knowledge and skills of English-spoken discourses, these tasks did not necessarily require learners’ team-based collaborative endeavors to complete the assigned tasks. Identifying this area for improvement in the instructional design, the second action research cycle/iteration emphasized collaborative performativity through newly added performance/action-based innovative learning tasks, including ‘situational role-playing’, ‘my cooking show & interview’, and group debates in order to provide learners increased opportunities to communicate with peers who joined the class virtually from different parts of the world and enhance learners’ intercultural competence through various strategic and pragmatic communicative skills to collaboratively achieve their shared goals (i.e., successful completion of the given group tasks). The paper exemplifies instances wherein learners’ unique and diverse linguistic and cultural strengths were amplified, and critical literacies were further developed through learners’ performance-oriented multiliteracies engagement. The study suggests that the action research-informed teaching practice that advocates for collaborative multiliteracies engagement serves to facilitate learners’ activation of their existing linguistic and cultural knowledge and contributes to the development of learners’ academic literacy skills. Importantly, the study illuminates that such action research-informed pedagogical initiatives create an inclusive space for learners to build a strong sense of connectedness as global citizens with increased intercultural awareness in their community of language and cultural practices, and further allow learners to actively participate in the construction of ‘collaborative relations of power’ with their peers.

Keywords: action research, EAP, higher education, multiliteracies

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Sarah Bouayyad, Ajay Nigam, Meera Beena

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Acquired benign tracheoesophageal fistula is a rare medical condition that usually results from trauma, foreign bodies, or granulomatous infections. This is an unusual presentation of a male patient with a history of laryngectomy who had had over a period of several years inappropriately and vigorously used valve cleaning brushes to clean tracheal secretions, which had led to the formation of a tracheoesophageal fistula. Due to the patient’s obsessive habit, we couldn’t manage him using conventional surgical methods. Instead, we opted for the placement of a salivary bypass tube, which yielded good results and recovery. To the best of our knowledge, no other case of similar etiology has been published. We would like to highlight the importance of appropriate patient selection and education prior to performing a tracheoesophageal puncture to avoid developing life-threatening complications as demonstrated in our case report.

Keywords: tracheoesophageal fistula, speech valve, endoscopic insertion of salivary bypass tube, head and neck malignancies

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Authors: Shang Yee Chong

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Perioperative pain is a complex mechanism activated by various nociceptive, neuropathic, and inflammatory pathways. Opioids have long been a mainstay for analgesia in this period, even as we are continuously moving towards a multimodal model to improve pain control while minimising side effects. Dexmedetomidine, a potent alpha-2 agonist, is a useful sedative and hypnotic agent. Its use in the intensive care unit has been well described, and it is increasingly an adjunct intraoperatively for its opioid sparing effects and to decrease pain scores. We describe a case of a general surgical patient in whom minimal opioids was required with dexmedetomidine use. The patient was a 61-year-old Indian gentleman with a history of hyperlipidaemia and type 2 diabetes mellitus, presenting with rectal adenocarcinoma detected on colonoscopy. He was scheduled for a robotic ultra-low anterior resection. The patient was induced with intravenous fentanyl 75mcg, propofol 160mg and atracurium 40mg. He was intubated conventionally and mechanically ventilated. Anaesthesia was maintained with inhalational desflurane and anaesthetic depth was measured with the Masimo EEG Sedline brain function monitor. An initial intravenous dexmedetomidine dose (bolus) of 1ug/kg for 10 minutes was given prior to anaesthetic induction and thereafter, an infusion of 0.2-0.4ug/kg/hr to the end of surgery. In addition, a bolus dose of intravenous lignocaine 1.5mg/kg followed by an infusion at 1mg/kg/hr throughout the surgery was administered. A total of 10mmol of magnesium sulphate and intravenous paracetamol 1000mg were also given for analgesia. There were no significant episodes of bradycardia or hypotension. A total of intravenous phenylephrine 650mcg was given throughout to maintain the patient’s mean arterial pressure within 10-15mmHg of baseline. The surgical time lasted for 5 hours and 40minutes. Postoperatively the patient was reversed and extubated successfully. He was alert and comfortable and pain scores were minimal in the immediate post op period in the postoperative recovery unit. Time to first analgesia was 4 hours postoperatively – with paracetamol 1g administered. This was given at 6 hourly intervals strictly for 5 days post surgery, along with celecoxib 200mg BD as prescribed by the surgeon regardless of pain scores. Oral oxycodone was prescribed as a rescue analgesic for pain scores > 3/10, but the patient did not require any dose. Neither was there nausea or vomiting. The patient was discharged on postoperative day 5. This case has reinforced the use of dexmedetomidine as an adjunct in general surgery cases, highlighting its excellent opioid-sparing effects. In the entire patient’s hospital stay, the only dose of opioid he received was 75mcg of fentanyl at the time of anaesthetic induction. The patient suffered no opioid adverse effects such as nausea, vomiting or postoperative ileus, and pain scores varied from 0-2/10. However, intravenous lignocaine infusion was also used in this instance, which would have helped improve pain scores. Paracetamol, lignocaine, and dexmedetomidine is thus an effective, opioid-sparing combination of multi-modal analgesia for major abdominal surgery cases.

Keywords: analgesia, dexmedetomidine, general surgery, opioid sparing

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Authors: Manik Sharma

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Understanding the anatomy and normal anatomical variations of the lower limb arterial system is undeniably important not only to understand the pathology involving the vessels of the lower limb but also as a part of endovascular intervention and surgical planning in cases that demand them as a part of treatment. There have been very few cases of duplication of SFA cited in the literature, close to six worldwide and this being the seventh case in the world and first to be reported in the Indian population. We incidentally came across this normal variant during US lower limb (US-LL) duplex scan in a patient with claudicating pain in bilateral lower limbs hence suspected of having peripheral vascular disease. It was confirmed on CT-Peripheral Angiography (CT-PA), which was done successively.

Keywords: peripheral vascular disease, claudicating pain, normal anatomical variants, endovascular intervention, duplication, CT-peripheral angiography, duplex scan, Iohexol

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Authors: Joanna Drzeżdżon

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Polyvinyl alcohol and its derivatives such as 2-chloro-2-propen-1-ol have found application in many industries. They are mainly used for the production of adhesives, thickeners and stabilizers of emulsion paints, and surgical threads. Moreover, polyvinyl alcohol derivatives are indispensable reagents in the synthesis of hemiacetals. Polyolefins derived from polyvinyl alcohol are obtained by using catalysts belonging to complex compounds of transition metal ions. The aim of the studies is to the synthesis of a new complex, i.e. dipicolinate oxovanadium(IV) complex with 4,4’-dimethoxy-2,2’-bipyridyl, and to determine its catalytic activities. Moreover, the another aim of the studies was to set conditions for 2-chloro-2-propen-1-ol oligomerization. The catalytic system has been based on the dipicolinate complex of oxovanadium(IV) with 4,4’-dimethoxy-2,2’-bipyridyl and MMAO-12. The results of the studies showed that how a new oxovanadium(IV) complex compound effects on the 2-chloro-2-propen-1-ol oligomerization. Moreover, the results revealed that new catalytic material is a highly active catalyst for the investigated oligomerization.

Keywords: 2-chloro-2-propen-1-ol, oligomerization, dipicolinate, vanadium, methylaluminoxane

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Authors: Adrian J. Forca, Simeon J. Cainday III

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The Jordan Water District Interactive Billing and Accounting Information Systems is designed for Jordan Water District to uplift the efficiency and effectiveness of its services to its customers. It is designed to process computations of water bills in accurate and fast way through automating the manual process and ensures that correct rates and fees are applied. In addition to billing process, a mobile app will be integrated into it to support rapid and accurate water bill generation. An interactive feature will be incorporated to support electronic billing to customers who wish to receive water bills through the use of electronic mail. The system will also improve, organize and avoid data inaccuracy in accounting processes because data will be stored in a database which is designed logically correct through normalization. Furthermore, strict programming constraints will be plunged to validate account access privilege based on job function and data being stored and retrieved to ensure data security, reliability, and accuracy. The system will be able to cater the billing and accounting services of Jordan Water District resulting in setting forth the manual process and adapt to the modern technological innovations.

Keywords: accounting, bill, information system, interactive

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Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: Rodrigo Buaiz Boabaid

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Tokenization of Blue Bonds is an emerging Green Finance tool that has the potential to scale Blue Carbon Projects to fight climate change. This innovative solution has a huge potential to democratize the green finance market and catalyze innovations in the climate change finance sector. Switzerland has emerged as a leader in the Green Finance space and is well-positioned to drive the adoption of Tokenization of Blue & Green Bonds. This unique approach has the potential to unlock new sources of capital and enable global investors to participate in the financing of sustainable blue carbon projects. By leveraging the power of blockchain technology, Tokenization of Blue Bonds can provide greater transparency, efficiency, and security in the investment process while also reducing transaction costs. Investments are in line with the highest regulations and designed according to the stringent legal framework and compliance standards set by Switzerland. The potential benefits of Tokenization of Blue Bonds are significant and could transform the way that sustainable projects are financed. By unlocking new sources of capital, this approach has the potential to accelerate the deployment of Blue Carbon projects and create new opportunities for investors to participate in the fight against climate change.

Keywords: blue bonds, blue carbon, tokenization, green finance

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Authors: Emiliya Tsankova, Genoveva Zlateva, Violeta Kostadinova

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The challenges modern education faces undoubtedly require reforms and innovations aimed at the reconceptualization of existing educational strategies, the introduction of new concepts and novel techniques and technologies related to the recasting of the aims of education and the remodeling of the content and methodology of education which would guarantee the streamlining of our education with basic European values. Aim: The aim of the current research is the development of a didactic technology for the assessment of the applicability and efficacy of game techniques in pedagogic practice calibrated to specific content and the age specificity of learners, as well as for evaluating the efficacy of such approaches for the facilitation of the acquisition of biological knowledge at a higher theoretical level. Results: In this research, we examine the objectivity, reliability and validity of two newly introduced diagnostic parameters for assessing the durability of the acquired knowledge. A pedagogic experiment has been carried out targeting the verification of the hypothesis that the introduction of game techniques in biological education leads to an increase in the quantity, quality and durability of the knowledge acquired by students. For the purposes of monitoring the effect of the application of the pedagogical technique employing game methodology on the durability of the acquired knowledge a test-base examination has been applied to students from a control group (CG) and students form an experimental group on the same content after a six-month period. The analysis is based on: 1.A study of the statistical significance of the differences of the tests for the CG and the EG, applied after a six-month period, which however is not indicative of the presence or absence of a marked effect from the applied pedagogic technique in cases when the entry levels of the two groups are different. 2.For a more reliable comparison, independently from the entry level of each group, another “indicator of efficacy of game techniques for the durability of knowledge” which has been used for the assessment of the achievement results and durability of this methodology of education. The monitoring of the studied parameters in their dynamic unfolding in different age groups of learners unquestionably reveals a positive effect of the introduction of game techniques in education in respect of durability and permanence of acquired knowledge. Methods: In the current research the following battery of methods and techniques of research for diagnostics has been employed: theoretical analysis and synthesis; an actual pedagogical experiment; questionnaire; didactic testing and mathematical and statistical methods. The data obtained have been used for the qualitative and quantitative of the results which reflect the efficacy of the applied methodology. Conclusion: The didactic model of the parameters researched in the framework of a specific study of pedagogic diagnostics is based on a general, interdisciplinary approach. Enhanced durability of the acquired knowledge proves the transition of that knowledge from short-term memory storage into long-term memory of pupils and students, which justifies the conclusion that didactic plays have beneficial effects for the betterment of learners’ cognitive skills. The innovations in teaching enhance the motivation, creativity and independent cognitive activity in the process of acquiring the material thought. The innovative methods allow for untraditional means for assessing the level of knowledge acquisition. This makes possible the timely discovery of knowledge gaps and the introduction of compensatory techniques, which in turn leads to deeper and more durable acquisition of knowledge.

Keywords: objectivity, reliability and validity of pedagogical diagnostic parameters introduced in the framework of a specific research

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Authors: Arthi Ganapathy, Arithra Banerjee, Saroj Kaler

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Abdominal aorta is the sole purveyor of all organs in the abdomen. Anomalies of its main trunk or its branches are to be meticulously observed as it effects the perfusion of an organ. Varying patterns of the testicular artery is one of them. The origin and course of testicular arteries have to be identified carefully during various surgical procedures like renal transplant, intra abdominal surgeries and even in orthopedic surgery like spine surgery. With the advent of new intra-abdominal therapeutic and diagnostic techniques, the anatomy of testicular arteries has assumed much more significance. Though the variations of the testicular vein are well documented, the variations of the testicular artery are not so frequent in incidence. We report a case of the bilateral aberrant origin of the testicular artery from polar renal arteries. We also discuss its developmental basis. Such anomalies if left unnoticed will lead to serious intraoperative complications during procedures on retroperitoneal organs. Any damage to testicular arteries will compromise the function of the gonads.

Keywords: cadaver, gonadal, renal, surgery

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Authors: Azlina Binti Abu Bakar, Fahmi Zaidi Bin Abdul Razak, Wan Salihin Wong Abdullah

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Psychographic is a psychological study of values, attitudes, interests and it is used mostly in prediction, opinion research and social research. This study predicts the influence of performance expectancy, effort expectancy, social influence and facilitating condition on e-government acceptance among Malaysian citizens. The survey responses of 543 e-government users have been validated and analyzed by means of covariance-based Structural Equation Modeling. The findings indicate that e-government acceptance among Malaysian citizens are mainly influenced by performance expectancy (β = 0.66, t = 11.53, p < 0.01) and social influence (β = 0.20, t = 4.23, p < 0.01). Surprisingly, there is no significant effect of facilitating condition and effort expectancy on e-government continuance intention (β = 0.01, t = 0.27, p > 0.05; β = -0.01, t = -0.40, p > 0.05). This study offers government and vendors a frame of reference to analyze citizen’s situation before initiating new innovations. In case of Malaysian e-government technology, adoption strategies should be built around fostering level of citizens’ technological expectation and social influence on e-government usage.

Keywords: continuance intention, Malaysian citizen, media psychology, structural equation modeling

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Authors: Zahra Hatami, Hesham Ali, David Volkman

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Selecting a portfolio for investing is a crucial decision for individuals and legal entities. In the last two decades, with economic globalization, a stream of financial innovations has rushed to the aid of financial institutions. The importance of selecting stocks for the portfolio is always a challenging task for investors. This study aims to create a financial network to identify optimal portfolios using network centralities metrics. This research presents a community detection technique of superior stocks that can be described as an optimal stock portfolio to be used by investors. By using the advantages of a network and its property in extracted communities, a group of stocks was selected for each of the various time periods. The performance of the optimal portfolios compared to the famous index. Their Sharpe ratio was calculated in a timely manner to evaluate their profit for making decisions. The analysis shows that the selected potential portfolio from stocks with low centrality measurement can outperform the market; however, they have a lower Sharpe ratio than stocks with high centrality scores. In other words, stocks with low centralities could outperform the S&P500 yet have a lower Sharpe ratio than high central stocks.

Keywords: portfolio management performance, network analysis, centrality measurements, Sharpe ratio

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Authors: Diogo de Carvalho Cabral

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This article offers a non-declensionist account of tropical deforestation, arguing that, rather than social stamp upon the environment or ecological endgame, deforestation is part of social site-making and remaking, the process through which humans produce sociality by carrying out nature-mediated – and therefore nature-transforming – practices that inevitably reset the very conditions of those practices. Human landscape-shaping inadvertently alters other species’ habitats –most often decimating them, but sometimes improving them–, the outcomes of which always resonate back upon human inhabitation and land use. Despite the overall tendency of biotic homogenization resulting from modern deforestation processes, there are always winners, i.e., species that gain competitive advantages enabling them to thrive in the novel ecosystems. Here it is examined one such case of deforestation-boosted species, namely leafcutter ants, which wrought havoc in the rural landscapes of nineteenth-century Brazil by defoliating a wide range of crops. By combining Historical GIS analysis and qualitative interpretation, it is shown how agricultural deforestation might have changed the ant species' biogeographies, and how in turn these changes – construed as 'infestation' – stimulated social innovations and rearrangements such as technical ingenuity, legal-administrative practices, and even local electoral arenas.

Keywords: deforestation, leafcutter ants, nineteenth-century Brazil, socio-ecological change

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Authors: J. Gochermann

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German energy market is under historical change. Turning-off the nuclear power plants and intensive subsidization of the renewable energies causes a paradigm change from big central energy production and distribution to more local structures, bringing the energy production near to the consumption. The formerly big energy market with only a few big energy plants and grid operating companies is changing into a disperse market with growing numbers of small and medium size companies (SME) generating new value-added products and services. This change in then energy market, in Germany called the “Energiewende”, inverts also the previous innovation system. Big power plants and large grids required also big operating companies. Innovations in the energy market focused mainly on big projects and complex energy technologies. Innovation in the new energy market structure is much more dispersed. Increasing number of SME is now able to develop energy production and storage technologies, smart technologies to control the grids, and numerous new energy related services. Innovation is now regional distributed, which is a remarkable problem for the old big energy companies. The paper will explain the change in the German energy market and the paradigm change as well as the consequences for the innovation structure in the German energy market. It will show examples how SME participate from this change and how innovation systems, as well for the big companies and for SME, can be adapted.

Keywords: changing energy markets, disperse innovation, new value-added products and services, SME

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Authors: Devieta Romadhon Saendardy

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Introduction: The case of aneurysmal subarachnoid hemorrhage (SAH) associated with intraventricular hemorrhage (IVH) in many way. In general, the anterior communicating artery and posterior circulation aneurysms cause Intraventricular Hemorrhage. The development of intraventricular hemorrhage (IVH) in aneurysmal subarachnoid hemorrhage (aSAH) is linked with higher mortality and poor neurological recovery. Case: This case report presents a 51-year-old female patient who developed IVH following SAH. The patient's Glasgow Coma Scale score was 14, the patient has a severe headache, and there were right extremity hemipharese neurological deficits. A non-contrast head CT scan revealed a massive intraventricular haemorrhage. In an hour, the patient got her headache and pharese worse. Discussion: Intraventricular hemorrhage is a serious complication of subarachnoid hemorrhage, necessitating prompt recognition and management. This case highlights the importance of a time management, medical management and surgical intervention to optimize outcomes in patients with intraventricular hemorrhage caused by subarachnoid hemorrhage. Placement of a shunt system improves clinical outcome in intraventricular hemorrhage.

Keywords: Intraventricular hemorrhage, subarachnoid hemorrhage, shunt, time

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Authors: Najim Akorede Babalola

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Adult Education is a multi and interdisciplinary in nature that cut across different fields of study which includes education, social sciences, engineering even information technologies that dominate the contemporary world among others. In the past, Adult Education has been used as an instrument of civilization by teaching people how to read and write as well as earning a better living. The present world has witnessed a transition from industrial age to information age which is also known as knowledge society needs Adult Education for knowledge acquisition and update of existing knowledge. An individual needs Adult Education in either of its various forms (on-the-job-training, in-service training, extramural classes, vocational education, continuing education among others) in order to develop towards the information society trends; this is because Adult Education is a process of transforming an individual through acquisition of relevant skills and knowledge for personal as well as societal development. Evidence abounds in the literature that Adult Education has not only assisted people in the medieval period but still assisting people in this modern society in changing and transforming their lives for a better living. This study, therefore, raised a salient question that with different ideas and innovations brought by the contemporary world, is Adult Education relevant? It is on this basis that this study intends to examine the relevance of Adult Education in the past and present in order to determine its future relevance.

Keywords: adult education, multi and inter-disciplinary, knowledge society, skill acquisition

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Authors: Ramya Rathan, Miral N. F. Salama

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The variations in the arteries have been drawing attention of anatomists for a long time because of their clinical significance. The brachial artery is the principal artery of the arm which is the continuation of the axillary artery from the lower border of the Teres Major. It terminates into the radial and ulnar arteries below the elbow joint at the neck radius. The present study aims at exploring the clinical significance of the high termination of the brachial artery. During the routine cadaveric dissection of the arm, for the undergraduate students of medicine at our university, we observed a high bifurcation of the radial and the ulnar artery at the midshaft of the humerus. The median nerve was seen passing between these two junctions. Further, the course and the relations of this artery were studied. The accurate knowledge regarding these kinds of variation in the blood vessels is mandatory for planning of designing. General physicians, surgeons and radiologists should keep in mind the variations in the branching pattern of the arteries in their daily medical, diagnostic and therapeutic procedures to avoid complications in diagnostic and surgical procedures.

Keywords: brachial artery, high termination, radial artery, ulnar artery

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Authors: Abdullahi Marshal Idris, Murtala Mohammed Alamai, Adama Jummai Idris, Bello Mohammed Gwagwada

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The technological revolution of the 1990s have brought about many new opportunities and challenges for the tourism and hospitality industries mostly in Nigeria and with tourism having global industry information as its life-blood and technology becoming fundamental to the ability of the industry to operate effectively and competitively. The whole system of information technologies is being rapidly diffused throughout the tourism industry and no player will escape information technologies impacts. The paper gives an insight into the importance of destination branding and the application of information technologies and the use of Internet in tourism and hospitality industries in Nigeria giving strategic frameworks, providing analysis of the Internet and its impact on these sectors. It also aims to show how technological innovations and information system can be beneficial for destinations companies like game reserves national parks, and other resorts by using the literature of existing efforts in global industry players as well as documented evidences where recommendations for destinations and companies is made to seek to foster the development of this connection by investing considerable resources in marketing activities on social networks and by reinforcing the trust of users, because credibility and reliability are still critical in this area.

Keywords: branding, marketing, technology, tourism product

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Authors: Mehran Memari, Bita Asadi

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Second language (L2) classrooms in academic contexts usually consist of learners with diverse L2 proficiency levels. One solution for managing such heterogeneous classes and addressing individual needs of students is to improve learner autonomy by using technological innovations such as blogging. The focus of this study is on investigating the effects of blogging on improving the quality of Iranian university students' writings. For this aim, twenty-six Iranian university students participated in the study. Students in the experimental group (n=13) were required to blog daily while the students in the control group (n=13) were asked to write a daily schedule using paper and pencil. After a 3-month period of instruction, the five last writings of the students from both groups were rated by two experienced raters. Also, students' attitudes toward the traditional method and blogging were surveyed using a questionnaire and a semi-structured interview. The research results showed evidences in favor of the students who used blogging in their writing program. Also, although students in the experimental group found blogging more demanding than the traditional method, they showed an overall positive attitude toward the use of blogging as a way of improving their writing skills. The findings of the study have implications for the incorporation of computer-assisted learning in L2 academic contexts.

Keywords: blogging, computer-assisted learning, paper and pencil, writing

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Authors: Sithandazile Masuku

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Introduction: Public health approaches to offender mental health are driven by international policies and frameworks in response to the disproportionately large representation of people with mental health problems within the offender pathway compared to the general population. Public health service innovations include mental health courts in the US, restorative models in Singapore and, liaison and diversion services in Australia, the UK, and some other European countries. Mental health nurses are at the forefront of offender health service innovations. In the U.K. context, police custody has been identified as an early point within the offender pathway where nurses can improve outcomes by offering assessments and share information with criminal justice partners. This scope of nursing practice has introduced challenges related to skills and support required for nurses working at the interface of health and the criminal justice system. Parallel literature exploring experiences of nurses working in forensic settings suggests the presence of compassion fatigue, burnout and vicarious trauma that may impede risk harm to the nurses in these settings. Published research explores mainly service-level outcomes including monitoring of figures indicative of a reduction in offending behavior. There is minimal research exploring the experiences of liaison and diversion nurses who are situated away from a supportive clinical environment and engaged in complex autonomous decision-making. Aim: This paper will share qualitative findings (in progress) from a PhD study that aims to explore the experiences of liaison and diversion nurses in one service in the U.K. Methodology: This is a qualitative interview study conducted using an Interpretative Phenomenological Analysis to gain an in-depth analysis of lived experiences. Methods: A purposive sampling technique was used to recruit n=8 mental health nurses registered with the UK professional body, Nursing and Midwifery Council, from one UK Liaison and Diversion service. All participants were interviewed online via video call using semi-structured interview topic guide. Data were recorded and transcribed verbatim. Data were analysed using the seven steps of the Interpretative Phenomenological Analysis data analysis method. Emerging Findings Analysis to date has identified pertinent themes: • Difficulties of meaning-making for nurses because of the complexity of their boundary spanning role. • Emotional burden experienced in a highly emotive and fast-changing environment. • Stress and difficulties with role identity impacting on individual nurses’ ability to be resilient. • Challenges to wellbeing related to a sense of isolation when making complex decisions. Conclusion Emerging findings have highlighted the lived experiences of nurses working in liaison and diversion as challenging. The nature of the custody environment has an impact on role identity and decision making. Nurses left feeling isolated and unsupported are less resilient and may go on to experience compassion fatigue. The findings from this study thus far point to a need to connect nurses working in these boundary spanning roles with a supportive infrastructure where the complexity of their role is acknowledged, and they can be connected with a health agenda. In doing this, the nurses would be protected from harm and the likelihood of sustained positive outcomes for service users is optimised.

Keywords: liaison and diversion, nurse experiences, offender health, staff wellbeing

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Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

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Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

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Authors: Mehmet Kale, Ramazan Sencan, Sibel Yavru, Ahmet Ak, Nuri Mamak, Sibel Hasırcıoglu, Mesih Kocamuftuoglu, Yakup Yıldırım, Hasbi Sait Saltık

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Bovine Papilloma Virus (BPV)-induced warts can cause mastitis, teat blindness, reduction of milk yield, udder deformities, and a difficulty in getting the teats into the milking machine. Especially, surgical operations cannot be performed in BPV-induced teat warts because of the increased sensitivity of the breast region and small-sized papillomas. Thus, there is a need to find new topical treatment methods. We have developed a pomade for treatment of BPV in cattle. The pomade is consists of lanoline, snakeskin (two special kind of snake), alcohol, vaseline, and ether. Firstly, we determined 46 cattle with teat warts. In the study, BPV antigen was detected in 28 cattle blood samples (61%) by ELISA. The pomade was applied to all BPV infected animals. The regression and recovery of warts were 100% in all animals. We advised using the pomade for treatment of BPV-induced warts in teats.

Keywords: bovine papilloma virus, pomade, teat, udder

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Authors: Loreta Axhami

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Media literacy in the digital age emerges not only as a set of skills to generate true knowledge and information but also as a pedagogy methodology, as a kind of educational philosophy. In addition to such innovations as information integration and communication technologies, media infrastructures, and web usage in the educational system, media literacy enables the change in the learning methods, pedagogy, teaching programs, and school curriculum itself. In this framework, this study focuses on ICT's impact on teaching and learning methods and the degree they are reflected in the Albanian education system. The study is based on a combination of quantitative and qualitative methods of scientific research. Referring to the study findings, it results that student’s limited access to the internet in school, focus on the hardcopy textbooks and the role of the teacher as the only or main source of knowledge and information are some of the main factors contributing to the implementation of authoritarian pedagogical methods in the Albanian education system. In these circumstances, the implementation of media literacy is recommended as an apt educational process for the 21st century, which requires a reconceptualization of textbooks as well as the application of modern teaching and learning methods by integrating information and communication technologies.

Keywords: authoritarian pedagogic model, education system, ICT, media literacy

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Authors: Rodrigo Buaiz Boabaid

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Tokenization of Blue Bonds is an emerging Green Finance tool that has the potential to scale Blue Carbon Projects to fight climate change. This innovative solution has a huge potential to democratize the green finance market and catalyze innovations in the climate change finance sector. Switzerland has emerged as a leader in the Green Finance space and is well-positioned to drive the adoption of Tokenization of Blue & Green Bonds. This unique approach has the potential to unlock new sources of capital and enable global investors to participate in the financing of sustainable blue carbon projects. By leveraging the power of blockchain technology, Tokenization of Blue Bonds can provide greater transparency, efficiency, and security in the investment process, while also reducing transaction costs. Investments are in line with the highest regulations and designed according to the stringent legal framework and compliance standards set by Switzerland. The potential benefits of Tokenization of Blue Bonds are significant and could transform the way that sustainable projects are financed. By unlocking new sources of capital, this approach has the potential to accelerate the deployment of Blue Carbon projects and create new opportunities for investors to participate in the fight against climate change.

Keywords: blue carbon, blue bonds, green finance, Tokenization, blockchain solutions

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