Search results for: clinical nursing practice guideline

Authors: Yukiko Fujiwara

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As a language learning methodology, Content and Language Integrated Learning (CLIL) has become increasingly prevalent in Japan. Most CLIL classroom practice and its research are conducted in EFL fields. However, much less research has been done in the Japanese language learning setting. Therefore, there are still many issues to work out using CLIL in the Japanese language teaching (JLT) setting. it is expected that more research will be conducted on both authentically and academically. Under such circumstances, this is one of the few classroom-based CLIL researches experiments in JLT and aims to find an effective course design for a class with students at different proficiency levels. The class was called ‘Japanese culture A’. This class was offered as one of the elective classes for International exchange students at a Japanese university. The Japanese proficiency level of the class was above the Japanese Language Proficiency Test Level N3. Since the CLIL approach places importance on ‘authenticity’, the class was designed with materials and activities; such as books, magazines, a film and TV show and a field trip to Kyoto. On the field trip, students experienced making traditional Japanese desserts, by receiving guidance directly from a Japanese artisan. Through the course, designated task sheets were used so the teacher could get feedback from each student to grasp what the class proficiency gap was. After reading an article on Japanese culture, students were asked to write down the words they did not understand and what they thought they needed to learn. It helped both students and teachers to set learning goals and work together for it. Using questionnaires and interviews with students, this research examined whether the attempt was effective or not. Essays they wrote in class were also analyzed. The results from the students were positive. They were motivated by learning authentic, natural Japanese, and they thrived setting their own personal goals. Some students were motivated to learn Japanese by studying the language and others were motivated by studying the cultural context. Most of them said they learned better this way; by setting their own Japanese language and culture goals. These results will provide teachers with new insight towards designing class materials and activities that support students in a multilevel CLIL class.

Keywords: authenticity, CLIL, Japanese language and culture, multilevel class

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Authors: Asma AlQahtani, Jumana AlHadad, Maryam AlQallaf, Shoug AlHasan

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New product development (NPD) is the complete process of bringing a new product to the customer by integrating the two broad divisions; one involving the idea generation, product design and detail engineering; and the other involving market research and marketing analysis. It is a common practice for companies to undertake some of these tasks simultaneously (concurrent engineering) and also consider them as an ongoing process (continuous development). The current study explores the framework and methodology for a new product development process utilizing the Quality Function Deployment (QFD) tool for bringing the customer opinion into the product development process. An elaborate customer survey with focus groups in the region was carried out to ensure that customer requirements are integrated into new products as early as the design stage including identifying the recognition of need for the new product. A QFD Matrix (House of Quality) was prepared that links customer requirements to product engineering requirements and a feasibility study and risk assessment exercise was carried out for a Small and Medium Enterprise (SME) in Kuwait for development of the new product. SMEs in Kuwait, particularly in manufacturing sector are mainly focused on serving the local demand, and often lack of product quality adversely affects the ability of the companies to compete on a regional/global basis. Further, lack of focus on identifying customer requirements often deters SMEs to envisage the idea of a New Product Development. The current study therefore focuses in utilizing QFD Matrix right from the conceptual design to detail design and to some extent, extending the link this to design of the manufacturing system. The outcome of the project resulted in a development of the prototype for a new molded product which can ensure consistency between the customer’s requirements and the measurable characteristics of the product. The Engineering Economics and Cost studies were also undertaken to analyse the viability of the new product, the results of which was also linked to the successful implementation of the initial QFD Matrix.

Keywords: Quality Function Deployment, QFD Matrix, new product development, NPD, Kuwait SMEs, prototype development

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Authors: Inna V. Krotova

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The study pays special attention to the definition of the psychological potential of a specialist-defectologist, which determines his desire to increase the level of his or her professional competence. The group included participants of the educational environment – an additional professional program 'Technologies of psychological and pedagogical assistance for children with complex developmental disabilities' implemented by the department of defectology and clinical psychology of the KFU jointly with the Support Fund for the Deafblind people 'Co-Unity'. The purpose of our study was to identify the psychological aspects of the readiness of the specialist-defectologist to his or her professional development. The study assessed the indicators of psychological preparedness, and its four components were taken into account: motivational, cognitive, emotional and volitional. We used valid and standardized tests during the study. As a result of the factor analysis of data received (from Extraction Method: Principal Component Analysis, Rotation Method: Varimax with Kaiser Normalization, Rotation converged in 12 iterations), there were identified three factors with maximum factor load from 24 indices, and their correlation coefficients with other indicators were taken into account at the level of reliability p ≤ 0.001 and p ≤ 0.01. Thus the system making factor was determined – it’s a 'motivation to achieve success'; it formed a correlation galaxy with two other factors: 'general internality' and 'internality in the field of achievements', as well as with such psychological indicators as 'internality in the field of family relations', 'internality in the field of interpersonal relations 'and 'low self-control-high self-control' (the names of the scales used is the same as names in the analysis methods. In conclusion of the article, we present some proposals to take into account the psychological model of readiness of specialists-defectologists for their professional development, to stimulate the growth of their professional competence. The study has practical value for all providers of special education and organizations that have their own specialists-defectologists, teachers-defectologists, teachers for correctional and ergotherapeutic activities, specialists working in the field of correctional-pedagogical activity (speech therapists) to people with special needs who need true professional support.

Keywords: psychological readiness, defectologist, professional development, psychological factors, special education, professional competence, innovative educational environment

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Authors: Ishfaq A. Bukhari, Bassem Yousef Sheikh, Abdulrahman Almotrefi, Osama Yousaf, Amer Mahmood

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Olive oil is the primary source of fat in the Mediterranean diet which is associated with a low mortality for cardiovascular disease. Olive oil is rich in monounsaturated fatty acids, and has been reported for variety of beneficial cardiovascular effects including blood pressure lowering, anti-platelet, anti-diabetic and anti-inflammatory effects. Growing number evidences from preclinical and clinical studies have shown that olive oil improves insulin resistance, decrease vessels stiffness and prevent thromboembolism. We evaluated the effects of olive against streptozotocin-induced physiological disorders in the animal models of diabetes and ischemia and reperfusion (I/R)- induced cardiac arrhythmias. Diabetes was induced in male rats with a single intraperitoneal injection of streptozotocin (60 mg/kg), rats were treated for two months with olive oil (1 ml/kg p.o). Control animals received saline. Blood glucose, body weight were monitored every 14 days. At the end of the treatment rats were sacrificed hearts were isolated for mounting on langedorff’s apparatus. The blood glucose and body weight was not significantly different in the control and olive treated animals. The control diabetic animals exhibited 100% incidence of I/R –induced ventricular fibrillation which was reduced to 0% with olive oil, treatment. The duration of ventricular fibrillation reduced from 98.8± 2.3 (control) to 0 seconds in the olive oil treated group. Diltiazem, a calcium channel blocker (1 µm/L) showed similar results and protected the I/R-induced cardiac disorders. The biochemical analysis of the cardiac tissues showed that diabetes and I/R produce marked pathological changes in the cardiomyocytes including decreased glutathione (GSH) and increased oxidative stress (Malondialdehyde; MDA). Pretreatment of animals with olive oil (1 ml/kg p.o) increased GSH and MDA levels. Olive oil also improved the diabetic-induced histopathological changes in the cardiomyocytes. These finding indicates that olive possesses cardiac protective properties. Further studies are under way in our lab to explore the mechanism of the cardio-protective effect of olive oil.

Keywords: diabeties, ischemia-reperfusion, olive oil, rats heart

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Authors: Mohammed Sani Abdulai

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Public sector budgeting, all over the world, is underpinned by some universally accepted principles of sound budget management such as budget unity, universality, annuality, and a balanced budget. These traditional principles, though fundamental, had, in recent years, been augmented by the more modern principles of budgeting within fiscal objective, alignment with medium-term strategic plans as well as the observance of such related concepts as transparency, openness and accessibility. In this paper, we have endeavored to shed light, from literature and practice, on the meaning and purposes of such fundamental budgeting principles. We have also assessed the extent to which the Government of Ghana’s budget complies with the four traditional principles of budget unity, universality, annuality, and a balanced budget and the three out of the ten modern principles of budgetary governance of Organisation for Economic Co-operation and Development (OECD). We did so by using a qualitative method of review and analysis of existing documents and the performance assessment reports on Ghana’s Public Financial Management (PFM) measured using such frameworks as the Public Expenditure and Financial Accountability (PEFA), the Open Budget Survey (OBS) and its Index (OBI), the reports and action plans of Open Government Partnership (OGP) and the Global Initiative for Fiscal Transparency (GIFT). Other performance assessment reports that were relied on included, but not limited to, the Joint Evaluation Report of PFM in Ghana, 2001-2010, and the Joint Evaluation of Budget Support to Ghana, 2005-2015. We have, through this paper, brought to the fore the lessons that could be learned on how those budgetary principles undergird the Government of Ghana’s budget formulation, execution, accounting, control, and oversight. These lessons include, but are not limited to, the need for both scholars and practitioners in the PFM space to be aware of the impact of those principles on public sector budgeting.

Keywords: annulaity, balanced budget, budget unity, budgetary principles, OECD’s principles on budgetary governance, open budget index, public expenditure and financial accountability, universality

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Authors: Li Shihao, Dieter Trau

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Bilirubin is a yellow substance that is made when the body breaks down old red blood cells. High levels of bilirubin can cause jaundice, a condition that makes the newborn's skin and the white part of the eyes look yellow. Jaundice is a serial-killer in developing countries in Southeast Asia such as Myanmar and most parts of Africa where jaundice screening is largely unavailable. Worldwide, 60% of newborns experience infant jaundice. One in ten will require therapy to prevent serious complications and lifelong neurologic sequelae. Limitations of current solutions: - Blood test: Blood tests are painful may largely unavailable in poor areas of developing countries, and also can be costly and unsafe due to the insufficient investment and lack of access to health care systems. - Transcutaneous jaundice-meter: 1) can only provide reliable results to caucasian newborns, due to skin pigmentations since current technologies measure bilirubin by the color of the skin. Basically, the darker the skin is, the harder to measure, 2) current jaundice meters are not affordable for most underdeveloped areas in Africa like Kenya and Togo, 3) fat tissue under the skin also influences the accuracy, which will give overestimated results, 4) current jaundice meters are not reliable after treatment (phototherapy) because bilirubin levels underneath the skin will be reduced first, while overall levels may be quite high. Thus, there is an urgent need for a low-cost non-invasive device, which can be effective not only for caucasian babies but also Asian and African newborns, to save lives at the most vulnerable time and prevent any complications like brain damage. Instead of measuring bilirubin on skin, we proposed a new method to do the measurement on the sclera, which can avoid the difference of skin pigmentations and ethnicities, due to the necessity for the sclera to be white regardless of racial background. This is a novel approach for measuring bilirubin by an optical method of light reflection off the white part of the eye. Moreover, the device is connected to a smart device, which can provide a user-friendly interface and the ability to record the clinical data continuously A disposable eye cap will be provided avoiding contamination and fixing the distance to the eye.

Keywords: Jaundice, bilirubin, non-invasive, sclera

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Authors: Sadiah Baharom, Che Nidzam Che Ahmad, Saipol Barin Ramli, Asmayati Yahaya, Sopia Md Yassin

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The early childhood care and education (ECCE) in Malaysia aspire to develop children who are intellectually, emotionally, physically and spiritually balanced. This aspiration can only materialise if the early childhood program developed comprehensive and is of high quality comparable to international standards. As such, there is a pressing need to assess the quality of the program in an all-encompassing manner. The overall research project aims at developing a comprehensive and integrated model of high-quality Malaysian ECCE. One of the major objectives of this project is to assess and evaluate the scope and quality of the existing ECCE programs in Malaysia. To this end, a specific aspect of this objective is to develop and validate an instrument to assess and evaluate the ECCE curriculum of the country. Thus this paper describes the development and validation of an instrument to explore the quality of early childhood care and education curriculum currently implemented in the country’s ECCE centres. The generation of the constructs and items were based on a set of criteria mapped against existing ECCE practice, document analyses, expert interviews and panel discussions. The items went through expert validation and were field tested on 597 ECCE teachers. The data obtained went through an exploratory factor analysis to validate the constructs of the instrument followed by reliability studies on internal consistency based on the Cronbach Alpha values. The final set of items for the ECCE curriculum instrument, earmarked for the main study, consists of four constructs namely philosophy and core values, curriculum content, curriculum review and unique features. Each construct consists of between 21 to 3 items with a total of 36 items in all. The reliability coefficients for each construct range from 0.65 to 0.961. These values are within the acceptable limits for a reliable instrument to be used in the main study.

Keywords: early childhood and care education, instrument development, reliability studies, validity studies

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Authors: Celeste Lawson

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Learning to embrace and value teamwork assessment at a university level is critical for students, as graduates enter a real-world working environment where teamwork is likely to occur virtually. Student disdain for teamwork exercises is an area often overlooked or disregarded by academics. This research explored the implementation of an online teamwork assessment approach at a regional Australian university with a significant cohort of Distance Education students. Students had disliked teamwork for three reasons: it was not relevant to their study, the grading was unfair amongst team members, and managing the task was challenging in a virtual environment. Teamwork assessment was modified so that the task was an authentic task that could occur in real-world practice; team selection was based on the task topic rather than randomly; grading was based on the individual’s contribution to the task, and students were provided virtual team management skills as part of a the assessment. In this way, management of the team became an output of the task itself. Data was gathered over three years from student satisfaction surveys, failure rates, attrition figures, and unsolicited student comments. In one unit where this approach was adopted (Advanced Public Relations), student satisfaction increased from 3.6 (out of 5) in 2012 to 4.6 in 2016, with positive comments made about the teamwork approach. The attrition rate for another unit (Public Relations and the Media) reduced from 20.7% in 2012 to 2.2% in 2015. In 2012, criticism of teamwork assessment made up 50% of negative student feedback in Public Relations and the Media. By 2015, following the successful implementation of the teamwork assessment approach, only 12.5% of negative comments on the student satisfaction survey were critical of teamwork, while 33% of positive comments related to a positive teamwork experience. In 2016, students explicitly nominated teamwork as the best part of this unit. The approach is transferable to other disciplines and was adopted by other academics within the institution with similar results.

Keywords: assessment, distance education, teamwork, virtual

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Authors: Ningfei Xiao, Simon Twose, Hannah Hopewell

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In urban settings worldwide, artists and researchers have drawn from shamanic healing, providing insightful responses to the environment. This project is a transdisciplinary creative research project where architecture and art practice draw from shamanic healing and provide the potential to expand knowledge of public space and inspire more aesthetic explorations of public spatial visions. The research started from the encounters with the Ewengki/Evenki shaman tribe in settlement areas of northern China in 2019 and extended through the partnerships with Maori artists in Poneke Aotearoa, New Zealand, in 2023. Based on the learnings and collaborations with female indigenous tradition practitioners and the healing that the researcher received from the land, a spatial installation exhibition was developed in this project. Indigenous practices are intricately woven with contemporary technology, merging visuals, soundscapes, and other non-visual aesthetics influenced by the researcher's personal experiences of embodied shamanic healing with brainwave generative technology. This synthesis seeks to ritualize and reimagine future public spaces, encompassing streetscapes and greenscapes from China to Aotearoa, and fostering connections between urbanized human body, mind, spirit, and land. In doing so, the project presents a feminist posthuman inquiry into how individuals perceive materiality within the context of a future city. Grounded in creative research and embodied methodologies, this paper focuses on the conceptual and autoethnographic aspects of visual-non-visual aesthetics and their creative representation. Through the exploration of aesthetics beyond the visual realm within urban and spatial contexts, this project showcases the spatial installation exhibition as an example of shamanic influence and related response to public space through embodied artistry and transdisciplinary creative inquiry.

Keywords: aesthetic, embodiment, visual and/or non-visual, spatial installation, shamanic healing, public space

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Authors: Sher Ali

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Organic agriculture has gained significant momentum globally as a sustainable and environmentally friendly farming practice. In Pakistan, amidst growing concerns about food security, environmental degradation, and health issues related to conventional farming methods, the adoption of organic agriculture presents a promising pathway for agricultural development. This abstract aims to provide an overview of the status, opportunities, challenges, and future directions of organic agriculture in Pakistan. It delves into the current state of organic farming practices, including the extent of adoption, key crops cultivated, and the regulatory framework governing organic certification. Furthermore, the abstract discusses the unique opportunities that Pakistan offers for organic agriculture, such as its diverse agro-climatic zones, rich biodiversity, and traditional farming knowledge. It highlights successful initiatives and case studies that showcase the potential of organic farming to improve rural livelihoods, enhance food security, and promote sustainable agricultural practices. However, the abstract also addresses the challenges hindering the widespread adoption of organic agriculture in Pakistan, ranging from limited awareness and technical know-how among farmers to inadequate infrastructure and market linkages. It emphasizes the need for supportive policies, capacity-building programs, and investment in research and extension services to overcome these challenges and promote the growth of the organic agriculture sector. Lastly, the abstract outlines future directions and recommendations for advancing organic agriculture in Pakistan, including strategies for scaling up production, strengthening certification mechanisms, and fostering collaboration among stakeholders. By shedding light on the opportunities, challenges, and potential of organic agriculture in Pakistan, this abstract aims to contribute to the discourse on sustainable farming practices at the upcoming Agro Conference in the USA. It invites participants to engage in dialogue, share experiences, and explore avenues for collaboration toward promoting organic agriculture for a healthier, more resilient food system.

Keywords: agriculture, challenges, organic, Pakistan

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Authors: B. A. Alwahaby

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Background: The number of Total Knee Replacement (TKR) and Anterior Cruciate Ligament Reconstruction (ACLR) performed every year is increasing. The main aim of physiotherapy early recovery rehabilitation after these surgeries is to control pain and edema and regain Range of Motion (ROM) and physical activity. All of these outcomes need to be managed by safe and effective modalities. Kinesiotaping (KT) is an elastic non-invasive therapeutic tape that has become recognised in different physiotherapy situation as injury prevention, rehabilitation, and performance enhancement and been used with different conditions. However, there is still clinical doubt regarding the effectiveness of KT due to inconclusive supporting evidence. The aim of this systematic review is to collate all the available evidence on the effectiveness of KT in the early rehabilitation of ACLR and TKR patients and analyse whether the use of KT combined with standard rehabilitation would facilitate recovery of postoperative outcome than standard rehabilitation alone. Methodology: A systematic review was conducted. Medline, EMBASE, Scopus, AMED PEDro, CINAHL, and Web of Science databases were searched. Each study was assessed for inclusion and methodological quality appraisal was undertaken by two reviewers using the JBI critical appraisal tools. The studies were then synthesised qualitatively due to heterogeneity between studies. Results: Five moderate to low quality RCTs were located. All five studies demonstrated statistically significant improvements in pain, swelling, ROM, and functional outcomes (p < 0.05). Between group comparison, KT combined with standardised rehabilitation were shown to be significantly more effective than standardised rehabilitation alone for pain and swelling (p < 0.05). However, there were inconstant findings for ROM, and no statistically significant differences reported between groups for functional outcomes (p > 0.05). Conclusion: Research in the area is generally low quality; however, there is consistent evidence to support the use of KT combined with standardised post-operative rehabilitation for reducing pain and swelling. There is also some evidence that KT may be effective in combination with standardised rehabilitation to regain knee extension ROM faster than standardised rehabilitation alone, but further primary research is required to confirm this.

Keywords: anterior cruciate ligament reconstruction, ACLR, kinesio taping, KT, postoperative, total knee replacement, TKR

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Authors: Canan Duzan

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For most language learners, mastery of the speaking skill is the proof of the mastery of the foreign language. On the other hand, the speaking skill is considered as the most difficult aspect of language learning to develop for both learners and teachers. Especially in countries like Turkey where exposure to the target language is minimum and resources and opportunities provided for language practice are scarce, teaching and learning to speak the language become a real struggle for teachers and learners alike. Data collected from students, instructors, faculty members and the business sector in needs analysis studies conducted previously at Middle East Technical University (METU) consistently revealed the need for addressing the problem of lack of confidence in speaking English. Action was taken during the design of the only EAP speaking course offered in Modern Languages Department since lack of confidence is considered to be a serious barrier for effective communication and causes learners to suffer from insecurity, uncertainty and fear. “Confidence building” served as the guiding principle in the syllabus design, nature of the tasks created for the course and the assessment procedures to help learners become more confident speakers of English. In order to see the effectiveness of the decisions made during the design phase of the course and whether students become more confident speakers upon completion of the course, a case study was carried out with 100 students at METU. A questionnaire including both Likert-Scale and open-ended items were administered to students to collect data and this data were analyzed using the SPSS program. Group interviews were also carried out to gain more insight into the effectiveness of the course in terms of building speaking confidence. This presentation will explore the specific actions taken to develop students’ confidence based on the findings of program evaluation studies and to what extent the students believe these actions to be effective in improving their confidence. The unique design of this course and strategies adopted for confidence building are highly applicable in other EAP contexts and may yield similar positive results.

Keywords: confidence, EAP, speaking, strategy

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Authors: Hadiza Abdullahi

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Sialic Acids and sialidases have been implicated in many disease states particularly bacterial and viral infections which are common opportunist infections of HIV disease. Their role in HIV/AIDS is contemplated. A study was carried out to determine Sialic Acid profile and Sialidase Activity in HIV infected and Apparently Healthy individuals, and also determine the relationship between the sialic acid levels and sialidase activity. Blood samples were collected from 200 subjects (150 HIV infected individuals and 50 apparently healthy individuals divided into four groups- HIV ART Naïve, HIV Stable (on ART but have been stable with no clinical episodes), HIV-OI (on ART with opportunistic infections), and Apparently Healthy). Complete Blood Count, Erythrocyte Surface Sialic Acid (ESSA), Free Serum Sialic Acid (FSSA) concentrations and Sialidase activity were determined for all 200 subjects. Analysis of variance (ANOVA) was used to compare the results of the different groups of HIV infected individuals as well as controls. The mean haemoglobin (HGB), Packed Cell Volume (PCV) and Red Blood Cells (RBC) concentrations were significantly lower (P ≤ 0.05) in the HIV groups compared with the apparently healthy groups. Anaemia and neutropaenia were the most common heamatological abnormalities observed in this study with highest prevalence of anaemia found in the ART naive group. The mean FSSA was 0.4±0.4mg/ml. There was a significant difference (p ≤ 0.05) between some groups. The highest levels of FSSA was observed in the HIV ART naïve (0.65±0.5mg/ml). The mean ESSA value for the study population was 0.54±0.35mg/ml with no significant difference (p ≤ 0.05) between groups. The mean sialidase activity values were 0.52±0.1 µmol/min/µl, 0.40±0.1 µmol/min/µl, 0.45±0.1 µmol/min/µl and 0.41±0.1 µmol/min/µl for the HIV ART naïve, HIV stable, HIV/OIs and apparently healthy groups respectively. No significant difference (p ≤ 0.05) was found between groups and also in gender and age. The finding in this study of higher mean sialidase activity and FSSA levels in the ART naïve HIV group compared with other groups indicate that the virus and other opportunistic pathogens may be sialidase producers in vivo which cleave off sialic acids from erythrocytes surface, leading to high levels of FSSA, anaemia and neutropaenia seen in this group. The higher ESSA concentration found in the HIV stable group along with lowest FSSA concentration in the group suggests the presence of sialyltransferases.

Keywords: erythrocyte surface sialic acid, free serum sialic acid, HIV, sialidase

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Authors: Teris Cheung, Joyce Yuen Ting Lam, Kwan Hin Fong, Calvin Pak-Wing Cheng, Julie Sittlington, Yu-Tao Xiang, Tim Man Ho Li

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Insomnia is one of the most common health problems in the general population. Insomnia can be acute, intermittent, and become chronic, often due to comorbidity with other physical and mental health conditions. Although there are conventional pharmaceutical and psychotherapeutic treatments to treat symptoms of insomnia, however; there is no robust and novel randomized controlled trial (RCT) using transdermal neurostimulation on individuals with insomnia symptoms. This gives us the impetus to execute the first nationwide RCT. Aim: To evaluate the efficacy of Electrical Vestibular Stimulation (VeNS) on individuals with insomnia in Hong Kong. Design: This study was a two-armed, double blinded, randomized, sham-controlled trial. Sampling: 60 community-dwelling adults aged 18 and 60 years with moderate insomnia symptoms or above (Insomnia Severity Index > 14) were recruited. All subjects were computerized randomized into either the active VeNS group or the sham VeNS group on a 1:1 ratio. Intervention: All participants received a home-use VeNS device and used 30-min VeNS sessions during five consecutive days across a 4-week period (total treatment hours: 10). Baseline measurements and post-VeNS evaluation of the psychological outcomes, including 1) insomnia severity, 2) sleep quality, and 3) quality of life were investigated. The short-and long-term sustainability of the VeNS intervention was assessed immediately after poststim and at a 1-month and 3-month follow-up period. Data analysis: A mixed GEE model was used to analyze the repeated measures data. Missing data were managed by multiple imputations. The level of significance was set to p < 0.05. Significance of the study: This is the first trial to examine the efficacy and safety of VeNS among adults with insomnia symptoms in Hong Kong. Findings that emerged were used to determine whether this VeNS device can be considered a self-help technological device to reduce the severity of insomnia in the community setting and to reduce the global disease burden. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT04452981.

Keywords: adults, insomnia, neuromodulation, rct, vestibular stimulation

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Authors: Anu S. Nair, V. Anantha Subramanian

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This paper presents a surface development and fairing technique combining the features of a modern computer-aided design tool namely the Non-Uniform Rational Basis Spline (NURBS) with an algorithm to obtain a rapidly faired hull form. Some of the older series based designs give sectional area distribution such as in the Wageningen-Lap Series. Others such as the FORMDATA give more comprehensive offset data points. Nevertheless, this basic data still requires fairing to obtain an acceptable faired hull form. This method uses the input of sectional area distribution as an example and arrives at the faired form. Characteristic section shapes define any general ship hull form in the entrance, parallel mid-body and run regions. The method defines a minimum of control points at each section and using the Golden search method or the bisection method; the section shape converges to the one with the prescribed sectional area with a minimized error in the area fit. The section shapes combine into evolving the faired surface by NURBS and typically takes 20 iterations. The advantage of the method is that it is fast, robust and evolves the faired hull form through minimal iterations. The curvature criterion check for the hull lines shows the evolution of the smooth faired surface. The method is applicable to hull form from any parent series and the evolved form can be evaluated for hydrodynamic performance as is done in more modern design practice. The method can handle complex shape such as that of the bulbous bow. Surface patches developed fit together at their common boundaries with curvature continuity and fairness check. The development is coded in MATLAB and the example illustrates the development of the method. The most important advantage is quick time, the rapid iterative fairing of the hull form.

Keywords: computer-aided design, methodical series, NURBS, ship design

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Authors: Hamed Seddighi Khavidak

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Voluntary work has a lot of economic and social benefits for a country, but the economic value is ignored because it is voluntary. The aim of this study is reviewing Monetary Value of Voluntary Work methods and comparing opportunity cost method and replacement cost method both in theory and in practice. Beside monetary value, in this study, we discuss cost-benefit analysis of health and safety plan in the New Year that conducted by young volunteers of Red Crescent society of Iran. Method: We discussed eight methods for monetary value of voluntary work including: Alternative-Employment Wage Approach, Leisure-Adjusted OCA, Volunteer Judgment OCA, Replacement Wage Approach, Volunteer Judgment RWA, Supervisor Judgment RWA, Cost of Counterpart Goods and Services and Beneficiary Judgment. Also, for cost benefit analysis we drew on 'value audit and volunteer investment' (VIVA) technique that is used widely in voluntary organizations like international federation of Red Cross and Red Crescent societies. Findings: In this study, using replacement cost approach, voluntary work by 1034 youth volunteers was valued 938000000 Riyals and using Replacement Wage Approach it was valued 2268713232 Riyals. Moreover, Yazd Red Crescent Society spent 212800000 Riyals on food and other costs for these volunteers. Discussion and conclusion: In this study, using cost benefit analysis method that is Volunteer Investment and Value Audit (VIVA), VIVA rate showed that for every Riyal that the Red Crescent Society invested in the health and safety of New Year's travelers in its volunteer project, four Riyals returned, and using the wage replacement approach, 11 Riyals returned. Therefore, New Year's travelers health and safety project were successful and economically, it was worthwhile for the Red Crescent Society because the output was much bigger than the input costs.

Keywords: voluntary work, monetary value, youth, red crescent society

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Authors: Maryam Bahreini, Mostafa Talebi Garekani, Fatemeh Rasooli, Atefeh Abdollahi

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Introduction: Procedural sedation and analgesia have been desirable to handle painful procedures. The trend to find the agent with more efficacy and less complications is still controversial; thus, many sedative regimens have been studied. This study tried to assess the effectiveness and adverse effects of thiopental sodium-fentanyl with the known medication, ketamine-propofol for procedural sedation in the emergency department. Methods: Consenting patients were enrolled in this randomized double-blind trial to receive either 1:1 ketamine-propofol (KP) or thiopental-fentanyl (TF) 1:1 mg: Mg proportion on a weight-based dosing basis to reach the sedation level of American Society of Anesthesiologist class III/IV. The respiratory and hemodynamic complications, nausea and vomiting, recovery agitation, patient recall and satisfaction, provider satisfaction and recovery time were compared. The study was registered in Iranian randomized Control Trial Registry (Code: IRCT2015111325025N1). Results: 96 adult patients were included and randomized, 47 in the KP group and 49 in the TF group. 2.1% in the KP group and 8.1 % in the TF group experienced transient hypoxia leading to performing 4.2 % versus 8.1 % airway maneuvers for 2 groups, respectively; however, no statistically significant difference was observed between 2 combinations, and there was no report of endotracheal placement or further admission. Patient and physician satisfaction were significantly higher in the KP group. There was no difference in respiratory, gastrointestinal, cardiovascular and psychiatric adverse events, recovery time and patient recall of the procedure between groups. The efficacy and complications were not related to the type of procedure or patients’ smoking or addiction trends. Conclusion: Ketamine-propofol and thiopental-fentanyl combinations were effectively comparable although KP resulted in higher patient and provider satisfaction. It is estimated that thiopental fentanyl combination can be as potent and efficacious as ketofol with relatively similar incidence of adverse events in procedural sedation.

Keywords: adverse effects, conscious sedation, fentanyl, propofol, ketamine, safety, thiopental

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Authors: Hadas Hirsch

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Clothing is aimed at concealing and revealing the body, protecting it, and manifesting religious, political, and social declarations. The material and symbolic meanings of clothing and its raw materials are evaluated through the context of their social, cultural, and religious systems. The raw materials for clothing that were frequent and familiar in the 7th century Arab Peninsula were wool, leather, cotton, and some kinds of silk. The spread of the Muslim empire and the intersections with other religions and cultures enable the trickling of new raw materials that were unknown to Muslims or unaccepted. The sources for this research are hadith collections that discuss in details various kinds of textiles and their origin, together with a legal explanation that permits or prohibits its use. The paper will describe and analyze this discussion by contextualizing it in social, religious, and cultural reality that creates a structure of socio-religious dependency. The aim is not to identify, catalogue, and technically analyze fabrics but to reveal their role in Muslims’ life as a means of creating dependency for the community and setting borders inside and outside. The analysis is built upon a scale that starts with the most recommended raw materials, then comes the permitted ones and, in the end, the prohibited raw materials. This mapping will provide an insight into the ways textiles, as a cultural medium, help to shape and redefine identities and, at the same time, enable a sphere for creative expression within socio-cultural and religious limits and context. To sum up, hadith literature has the main role is characterizing Muslim clothing, from garments to textiles and colors, including multiple variations and contradicting aspects. The Muslim style of clothing and, in particular, textiles is a manifestation of the socio-religious structure of dependency that creates differentiated Muslim identity together with subdivision of gendered groups. Some other aspects are the tension between authenticity and imitation and the jurists’ pragmatic and practice attitude that enables an individual sphere of expression within the limits of jurisprudence.

Keywords: Hadith, jurisprudence, medieval Islam, material culture

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Authors: Rihab Gamaoun, Cynthia El Hage, Laura Ruiz, Erin Prosk, Antonio Vigano

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Introduction: Santé Cannabis (SC), a Canadian medical cannabis-specialized group of clinics based in Montreal and in the province of Québec, has served more than 5000 patients seeking cannabis-based treatment prescription for medical indications over the past five years. Within a research frame, data on the use of medical cannabis products from all the above patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to gather information on the profiles of both patients and prescribed medical cannabis products at SC clinics and to assess the safety of medical cannabis among Canadian patients. Methods: Using a retrospective analysis of the database, records of 2585 patients who were prescribed medical cannabis products for therapeutic purposes between 01-November 2017 and 04-September 2019 were included. Patients’ demographics, primary diagnosis, route of administration, and chemovars recorded at the initial visits were investigated. Results: At baseline: 9% of SC patients were female, with a mean age of 57 (SD= 15.8, range= [18-96]); Cannabis products were prescribed mainly for patients with a diagnosis of chronic pain (65.9% of patients), cancer (9.4%), neurological disorders (6.5%), mood disorders (5.8 %) and inflammatory diseases (4.1%). Route of administration and chemovars of prescribed cannabis products were the following: 96% of patients received cannabis oil (51% CBD rich, 42.5% CBD:THC); 32.1% dried cannabis (21.3% CBD:THC, 7.4% THC rich, 3.4 CBD rich), and 2.1% oral spray cannabis (1.1% CBD:THC, 0.8% CBD rich, 0.2% THC rich). Most patients were prescribed simultaneously, a combination of products with different administration routes and chemovars. Safety analysis is undergoing. Conclusion: Our results provided initial information on the profile of medical cannabis products prescribed in a Canadian population and the experienced adverse events over the past three years. The Santé Cannabis database represents a unique opportunity for comparing clinical practices in prescribing and titrating cannabis-based medications across different centers. Ultimately real-world data, including information about safety and effectiveness, will help to create standardized and validated guidelines for choosing dose, route of administration, and chemovars types for the cannabis-based medication in different diseases and indications.

Keywords: medical cannabis, real-world data, safety, pharmacovigilance

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Authors: Md. Rezaul Karim, Andreas Thiel

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Bangladesh is known as one of the most climate vulnerable countries in the world. Innovative technologies are always the key responses to the management of climate impacts. The objectives of this study are to determine the farmer’s perception of climate variability, to compare farmers’ perceptions with metrological data, and to explore the determinants that affect the likelihood of adoption of the selected Climate Smart Agricultural (CSA) technologies. Data regarding climate change perception, determinants and adoption were collected based on the household survey from stratified and randomly selected 365 farmers of the Biral sub-district under Dinajpur district in drought-prone northern Bangladesh. The likelihood of adoption of CSA technologies was analyzed following a multivariate probit model. The findings show that about 82.5% of the farmers perceived increasing temperature, and 75.1 % of farmers perceived decreasing dry season rainfall over the years, which is similarly relevant to metrological data. About 76.4.7% and 80.85% of farmers were aware of the drought tolerance crops and vermicompost, respectively; more than half of the farmers adopted these practices. Around 70.7% of farmers were aware of perching for insect control, but 46.3% of farmers adopted this practice. Although two-thirds of farmers were aware of crop diversification and pheromone trap, adoption was lower compared to the other three CSAs. Results also indicate that the likelihood of adoption of the selected CSAs is significantly influenced by different factors such as socio-economic characteristics, institutional factors and perceived technological or innovation attributes. The likelihood of adopting drought tolerance crops is affected by 11, while crop diversification and perching method by 7, pheromone trap by 9 and vermicompost by 8 determining factors. Lack of information and unavailability of input appear to be major obstacles to the non-adoption of CSA technologies. This study suggests that policy implications are necessary to promote extension services and overcome the obstacles to the non-adoption of individual CSA technologies. It further recommends that the research study should be conducted in a diverse context, nationally or globally.

Keywords: determinants, adoption, climate smart agriculture, northern Bangladesh

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Authors: Amol Rakhunde, Namdeo Hedaoo

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Cold bituminous emulsion mixes (CBEM) are preferred due to their low cost for the construction of low volume roads in India. Due to the low strength of CBEM’s, the strength is generally increased by the addition of Ordinary Portland Cement (OPC) and hydrated lime. To improve the performance of CBEM’s, the use of industrial waste material is also an alternative. Steel slag is by product of steel industry which is sustainable construction material. Due to limited modes of practice of utilization steel slag, huge amount of steel slag dumped in yards of each steel industry and engaging of important agricultural land and gave pollution to whole environment. The effective use of steel slag as additives in CBEM’s has ultimate benefits such improvement in strength of CBEM’s, waste disposal steel slag, saving natural aggregate and lowering cost of roadways. Studies carried out in the past have shown a significant improvement in the strength of CBEM’s prepared with the replacement of natural aggregate with industrial waste materials such as fly ash and ground granulated blast furnace slag. In this study, effect of modified mix which is mixes prepared with steel slag compared with the control mix and the mixes prepared with OPC. Experimental work was carried out on the sample of control mix, OPC mix, and modified mix. For modified mix, aggregate was replaced with steel slag by 10%, 20%, 30% and 40% of weight of aggregate of same size as of steel slag in aggregate gradation. For OPC mix, filler was replaced by 1%, 2% and 3% of weight of total aggregate with OPC. Optimum emulsion content of each mix obtained by using Marshall stability test and comparison of stability values were carried out. Marshall stability, indirect tensile strength test, and retained stability tests are performed on control mixes, OPC mixes and modified mixes. Significant improvement in Marshall stability retained stability and indirect tensile strength of modified mix compared to control mix and OPC mix.

Keywords: CBEM, indirect tensile strength test, Marshall stability test, OPC, optimum emulsion content, retained stability test, steel slag

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Authors: Zsuzsanna Schnell, Francesca Ervas

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Background: Our study aims to clarify how language fosters further cognitive development and how we eventually arrive at the complex human specific skill of pragmatic competence and reveal what levels of mentalization and theory of mind are in place before language. Method: Our experimental pragmatic investigation maps the interaction of mentalization and pragmatic competence. We map the different levels of mentalization that empower different levels of pragmatic meaning construction and evaluate the results with statistical analysis (MannWhitney and ANOVA). Analyzing the comprehension of literal and non-compositional (figurative) utterances, we apply linguistic trials, among them metaphor-, irony-, irony with surface cue-, humor- and the recognition of maxim infringements trial in neurotypical (NT) preschoolers with a coherent and comparative methodology. Results: The findings reveal the relationship and direction of interaction between Language and theory of mind. On the one hand social-cognitive skills enhance, facilitate and provide a basis for language acquisition, and in return linguistic structures (DeVilliers 2000, 2007) provide a framework for further development of mentalizing skills. Conclusions: Findings confirm that this scaffolding becomes a mutually supportive system where language and social cognition develops in interaction. Certain stages in ToM development serve as a precursor of understanding grammatically complex sentences, like embedded phrases which mirror embedded mental states; which, in turn, facilitates the development of pragmatic competence, thus, the social use of language, integrating social, cognitive, linguistic and psychological factors in discourse. Future implications: Our investigation functions as a differential-diagnostic measure, with typically developing results thus serve as a baseline in further empirical research for atypical cases. This enables the study of populations where language and ToM development is disturbed, reveals how language and ToM are acquired and interact, and gives an insight into what this has to do with clinical symptoms. This in turn can reveal the causal link to the syndrome at hand, which can set directions for therapeutic development and training.

Keywords: theory of mind, language development, mentalization, language philosophy, experimental pragmatics

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Authors: Li-Fang CHou, Chun-Jung Tseng, Sung-Chun Tsai

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Zhong-Yong represents unique values and cognitive beliefs of Chinese culture. Zhong-Yong thinking emphasizes (a) holistic thinking and perspective taking, (b) tolerance of contradictions, and (c) pursuance of a person’s interpersonal and inner harmony. With a unique way of naïve dialectical thinking based on Chinese culture, previous studies have found that people with higher Zhong-Yong thinking have more cognitive resources and resilience to make decision for dilemmas and cope stresses. Creativity is defined as the behavior to create novel and value products and viewed as the most important capital for individuals and enterprises. However, the relationship between Zhong-Yong thinking and creativity is still remaining to be unexplored. Three studies were conducted to explore the effects of Zhong-Yong thinking on creativity. In Study1, with 87 undergraduate students from a university in southern Taiwan as participants, we used questionnaire to measure Zhong-Yong thinking and processed creative task (unusual uses task) to get indicators of fluency and flexibility. After controlling background and openness to experience of Big five, the results showed that Zhong-Yong thinking had significant positive effects on fluency and flexibility. In Study 2, 97 undergraduate students were recruited to do Zhong-Yong thinking task and creative task. The result showed that, compared with control group, the participants had higher creative performance after being primed with Zhong-Yong thinking. In Study 3, we adopted questionnaire survey and took 397 employees from private enterprises in Taiwan as sample. Besides the main effects of Zhong-Yong thinking, the moderating effects on the relationship between leadership behavior and employee’s creative performance were also investigated. We found that (a) Zhong-Yong thinking was positively associated to creative performance; (b) Zhong-Yong thinking strengthened the positive effects of transformational and authoritative leadership on creative performance. Finally, the implications of theory/practice and limitations/future directions were also discussed.

Keywords: Zhong-Yong thinking, creativity and creative performance, unusual uses task, transformational leadership, authoritative leadership

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Authors: Jeffrey Chase

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Historically the profession of Occupational Therapy was closely tied to the treatment of those suffering from mental illness; more recently, and especially in the U.S., the percentage of OTs identifying as working in the mental health area has declined significantly despite the estimate that by 2020 behavioral health disorders will surpass physical illnesses as the major cause of disability worldwide. In the U.S. less than 10% of OTs identify themselves as working with the mentally ill and/or practicing in mental health settings. Such a decline has implications for both those suffering from mental illness and the profession of Occupational Therapy. One reason cited for the decline of OT in mental health has been the limited research in the discipline addressing mental health practice. Despite significant advances in technology and growth in the field of neuroscience, major institutions and funding sources such as the National Institute of Mental Health (NIMH) have noted that research into the etiology and treatment of mental illness have met with limited success over the past 25 years. One major reason posited by NIMH is that research has been limited by how we classify individuals, that being mostly on what is observable. A new classification system being developed by NIMH, the Research Domain Criteria (RDoc), has the goal to look beyond just descriptors of disorders for common neural, genetic, and physiological characteristics that cut across multiple supposedly separate disorders. The hope is that by classifying individuals along RDoC measures that both reliability and validity will improve resulting in greater advances in the field. As a result of this change NIH and NIMH will prioritize research funding to those projects using the RDoC model. Multiple disciplines across many different setting will be required for RDoC or similar classification systems to be developed. During this shift in research methodology OT has an opportunity to reassert itself into the research and treatment of mental illness, both in developing new ways to more validly classify individuals, and to document the legitimacy of previously ill-defined and validated disorders such as sensory integration.

Keywords: global mental health and neuroscience, research opportunities for ot, greater integration of ot in mental health research, research and funding opportunities, research domain criteria (rdoc)

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Authors: Nizamuddin Khan

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Integrated livestock and cropping system is very old agricultural practice since antiquity. It is an eco-friendly and sustainable farming system in which both the resources are optimally and rationally utilized through the recycling and re-utilization of their by-products. Indian farmers follow in- farm integrated farming system unlike in developed countries where both farm and off-farm system prevailed. The data on different components of the integrated farming system is very limited and that too is not widely available in published form. The primary source is the only option for understanding the mechanism, process, evaluation and performance of integrated livestock cropping system. Researcher generated data through the field survey of sampled respondents from sampled villages from Bulandshahr district of Uttar Pradesh. The present paper aims to understand the component group of system, degree, and level of integration, level of generation of employment, income, improvement in farm ecology, the economic viability of farmers and check in rural-urban migration. The study revealed that area witnessed intra farm integration in which both livestock and cultivation of crops take place on the same farm. Buffalo, goat, and poultry are common components of integration. Wheat, paddy, sugarcane and horticulture are among the crops. The farmers are getting 25% benefit more than those who do not follow the integrated system. Livestock husbandry provides employment and income through the year, especially during agriculture offseason. 80% of farmers viewed that approximately 35% of the total expenditure incurred is met from the livestock sector. Landless, marginal and small farmers are highly benefited from agricultural integration. About 70% of farmers acknowledged that using wastes of animals and crops the soil ecology is significantly maintained. Further, the integrated farming system is helpful in reducing rural to urban migration. An incentive with credit facilities, assured marketing, technological aid and government support is urgently needed for sustainable development of agriculture and farmers.

Keywords: integrated, recycle, employment, soil ecology, sustainability

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Authors: Anshar Ajatasatru

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The decline of coal prices over past years have been significantly increasing the awareness of effective mining operation. A viable step must be undertaken in becoming more cost competitive while striving for best mining practice especially at Melak Coal Mine in East Kalimantan, Indonesia. This paper aims to show how effective dozer push measurement method can be implemented as it is controlled by contract rate on the unit basis of USD ($) per bcm. The method emerges from an idea of daily dozer push activity that continually shifts the overburden until final target design by mine planning. Volume calculation is then performed by calculating volume of each time overburden is removed within determined distance using cut and fill method from a high precision GNSS system which is applied into dozer as a guidance to ensure the optimum result of overburden removal. Accumulation of daily to weekly dozer push volume is found 95 bcm which is multiplied by average sell rate of $ 0,95, thus the amount monthly revenue is $ 90,25. Furthermore, the payment mechanism is then based on push distance and push grade. The push distance interval will determine the rates that vary from $ 0,9 - $ 2,69 per bcm and are influenced by certain push slope grade from -25% until +25%. The amount payable rates for dozer push operation shall be specifically following currency adjustment and is to be added to the monthly overburden volume claim, therefore, the sell rate of overburden volume per bcm may fluctuate depends on the real time exchange rate of Jakarta Interbank Spot Dollar Rate (JISDOR). The result indicates that dozer push measurement can be one of the surface mining alternative since it has enabled to refine method of work, operating cost and productivity improvement apart from exposing risk of low rented equipment performance. In addition, payment mechanism of contract rate by dozer push operation scheduling will ultimately deliver clients by almost 45% cost reduction in the form of low and consistent cost.

Keywords: contract rate, cut-fill method, dozer push, overburden volume

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Authors: Ana Cristina Lindsay, Sherrie Wallington, Faith Lees, Mary Greaney

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Purpose: Latino children in low-income families are at elevated risk of becoming overweight or obese. The purpose of this study was to examine low-income Latino parents’ beliefs, parenting styles and practices related to their children’s eating and physical activity behaviors while at home. Design and Methods: Qualitative study using focus group discussions with 33 low-income Latino parents of preschool children 2 to 5 years of age. Transcripts were analyzed using thematic analysis. Results: Data analyses revealed that most parents recognize the importance of healthy eating and physical activity for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. Conclusions: This study provides information about how the home environment influences low-income Latino preschool children’s eating and physical activity habits. This information is useful for pediatric nurses in their health promotion and disease prevention efforts with low-income Latino families with young children, and for the development of home-based and parenting interventions to prevent and control childhood obesity among this population group. Practice Implications: Pediatric nurses can facilitate communication, provide education, and offer guidance to low-income Latino parents that support their children’s development of early healthy eating and physical activity habits, while taking into account daily life barriers faced by families. Moreover, nurses can play an important role in the integration and coordination of home-visitation to complement office-based visits and provide a continuum of care to low-income Latino families.

Keywords: home environment, Latino, obesity, parents, healthy eating, physical activity

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Authors: Saima Murtaza

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Ethics and aesthetics have invariably remained the two closely integrated artistic appurtenances for the production of any work of art. These artistic devices configure themselves into a complex synthesis in our contemporary literature. The labyrinthine integration of ethics and aesthetics, operating in the lives of human characters, to the extent of transcending all limits has resulted in an artistic puzzle for the readers. Art, no doubt, is an extrinsic expression of the intrinsic life of man. The use of aesthetics in literature pertaining to human existence; aesthetic solipsism, has resulted in the artistic objectification of these characters. The practice of the like aestheticism deprives the characters of their souls, rendering them as mere objects of aesthetic gaze at the hands of their artists-creators. Artists orchestrate their lives founding it on a plot which deviates from normal social and ethical standards. Their perverse attitude can be seen in dealing with characters, their feelings and the incidents of their lives. Morality is made to appear not as a religious construct but as an individual’s private affair. Furthermore, the idea of beauty incarnated, in other words hedonistic aesthetic does not placate a true aesthete. Ethics and aesthetics are the two most recurring motifs of our contemporary literature, especially of Nabokov’s world. The purpose of this study is to peruse these aforementioned motifs in Nabokov’s most enigmatic novel Lolita, a story of pedophilia, which is in fact reflective of our complex individual psychic and societal patterns. The narrative subverts all the traditional and hitherto known notions of aesthetics and ethics. When applied to literature, aesthetic does not simply mean ‘beautiful’ in the text. It refers to an intricate relationship between feelings and perception and also incorporates within its range wide-ranging emotional reactions to text. The term aesthetics in literature is connected with the readers whose critical responses to the text determine the merit of any work to be really a piece of art. Aestheticism is the child of ethics. Morality sets the grounds for the production of any work and the idea of aesthetics gives it transcendence.

Keywords: ethics, aesthetics and hedonistic aesthetic, nymphet syndrome, pedophilia

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Authors: Mohamed Salah El-Din Mahmoud, Heba Radi Atta Allah

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Background: Our study assesses the safety profile and efficacy of toric Implantable Collamer Lens (T-ICL) and toric implantable phakic contact lens (IPCL) for the correction of high myopia with astigmatism. Methods: A prospective interventional randomized comparative study included 60 myopic eyes divided into 2 groups, group A including 30 eyes that were implanted with T-ICL, and group B including 30 eyes that were implanted with toric IPCL. The refractive results, visual acuity, corneal endothelial cell count, and intraocular pressure (IOP) were evaluated at baseline and at 1, 6, and 9 months post-surgery. Any complications either during or after surgery were assessed. Results: A significant reduction in both spherical and cylindrical refractive errors with good predictability was reported in both groups compared with preoperative values. Regarding the predictability, In T-ICL group (A), the median spherical and cylindrical errors were significantly improved from (-10 D & -4.5 D) pre-operatively to (-0.25 D & - 0.3 D) at the end of 9 months follow up period. Similarly, in the toric IPCL group (B), the median spherical and cylindrical errors were significantly improved from (-11 D & -4.5 D) pre-operatively to (-0.25 D & - 0.3 D) at the end of 9 months follow up period. A statistically significant improvement of UCDVA at 9 months postoperatively was found in both groups, as median preoperative Log Mar UCDVA was 1.1 and 1.3 in groups A and B respectively, which was significantly improved to 0.2 in both groups at the end of follow-up period. Regarding IOP, no significant difference was found between both groups, either pre-operatively or during the postoperative period. Regarding the endothelial count, no significant differences were found during the pre-operative and postoperative follow-up periods between the two groups. Fortunately, no intra or postoperative complications as cataract, keratitis or lens decentration had occurred. Conclusions: Toric IPCL is a suitable alternative to T-ICL for the management of high myopia with astigmatism, especially in developing countries, as it is cheaper and easier for implantation than T-ICL. However, data over longer follow-up periods are needed to confirm its safety and stability.

Keywords: T-ICL, Toric IPCL, IOP, corneal endothelium

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Authors: Chen ChihYu, Tang Wen Tzu, Chen Kuang Hui

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Aim —To compare the dismount skill between Taiwanese and elite international gymnastics in parallel bars following the 2017-2020 code of points. Methods—The gymnasts who advanced to the parallel bars event finals of these four competitions including World Championships, Universiade, the National Games of Taiwan, and the National Intercollegiate Athletic Games of Taiwan both 2017 and 2019 were selected in this study. The dismount skill of parallel bars was analyzed, and the average difficulty score was compared by one-way ANOVA. Descriptive statistics were applied to present the type of dismount skill and the difficulty of each gymnast in these four competitions. The data from World Championships and Universiade were combined as the international group (INT), and data of Taiwanese National Games and National Intercollegiate Athletic Games were also combined as the national group (NAT). The differences between INT and NAT were analyzed by the Chi-square test. The statistical significance of this study was set at α= 0.05. Results— i) There was a significant difference in the mean parallel bars dismount skill in these four competitions analyzed by one-way ANOVA. Both dismount scores of World Championships and Universiade were significantly higher than in Taiwanese National Games and National Intercollegiate Athletic Games (0.58±0.08 & 0.56±0.08 > 0.42±0.06 & 40±0.06, p < 0.05). ii) Most of the gymnasts in World Championships and Universiade selected the 0.6-point skill as the parallel bars dismount element, and for the Taiwanese National Games and the National Intercollegiate Athletic Games, most of the gymnasts performed the 0.4-point dismount skill. iii) The result of the Chi-square test has shown that there was a significant difference in the selection of parallel bars dismount skill. The INT group used the E or E+ difficulty element as the dismount skill, and the NAT group selected the D or D- difficulty element. Conclusion— The level of parallel bars dismount in Taiwanese gymnastics is inferior to elite international gymnastics. It is suggested that Taiwanese gymnastics must try to practice the F difficulty dismount (double salto forward tucked with half twist) in the future.

Keywords: Artistic Gymnastics World Championships, dismount, difficulty score, element

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