Comprehensive Plan Research Articles

Endonasal surgery high-risk carotid injury timeout checklist: implementation, institutional protocol and experience.

Carotid artery injury is a rare, but major complication of endonasal operations. The morbidity and mortality of such a complication can be mitigated by preparedness and a clear plan set in place to address the hemorrhage expeditiously. This study examines the implementation of such a carotid injury timeout checklist and demonstrates its effectiveness in a patient with possible arterial injury. A carotid injury timeout checklist was implemented for high risk endonasal procedures. The case selection was left to the surgeon, with guidelines including prior surgery, prior radiation, invasive tumors, and certain pathologies such as meningioma or chordoma. Factors affecting implementation were analyzed including tumor characteristics and patient history. Over a 12-month period, 103 endonasal operations were performed since the carotid artery injury timeout checklist was implemented, with 21 (20.4%) having a carotid artery injury timeout performed. Tumor characteristics that were associated with performing this timeout included Knosp grade (for pituitary adenomas, p = 0.002), carotid artery encasement (p < 0.001), extended approach (p < 0.001), tumor size (p = 0.05) and diagnosis (p < 0.001). Re-operation and prior radiation were not factors for this cohort. The single carotid artery branch (hypertrophic vidian artery) injury that was sustained was easily and successfully managed, aided by preparation established via this protocol. The additional time necessary for this timeout to be performed was negligible with respect to the overall surgery length. A carotid artery injury timeout can and should be successfully implemented for extended endonasal operations for pituitary and parasellar tumors with high risk factors including, but not limited to, carotid injury encasement, large tumor size and non-adenomatous diagnoses. A comprehensive plan for both intraoperative and perioperative management of the carotid injury is necessary to minimize the risk of morbidity and to deliver care expeditiously.

Remote sensing and GPS tracking reveal temporal shifts in habitat use in nonbreeding Black‐tailed Godwits

Abstract Knowledge of the habitat requirements for migratory species throughout their full annual cycle is necessary for comprehensive species protection plans. By describing seasonal shifts of space‐use patterns in a key nonbreeding area, the Senegal Delta (Mauritania, Senegal), this study addresses a significant knowledge gap in the annual cycle of the rapidly declining continental Black‐tailed Godwit Limosa limosa limosa. We fitted continuous‐time stochastic‐process movement models with GPS location data to describe the core areas used by 22 GPS‐tagged godwits over the 2022–2023 nonbreeding period. We mapped key habitat types, such as floodplain wetlands and rice fields, via supervised classification of satellite imagery. Godwits in the Senegal Delta show a distinct shift in habitat use over the nonbreeding period. The core areas of godwits in the early stages of the nonbreeding period (the wet season) were primarily in natural wetlands and fields with newly planted rice. As the rice crop matured and became too dense, godwits moved towards more recently sown rice fields. Later, as floodwaters receded and rice fields dried out, godwits abandoned rice fields and shifted towards natural wetlands with fewer invasive plants, particularly within the marshes and shallow floodplains of nature‐protected areas in the lower Delta. Synthesis and applications: Our findings illustrate the shifting importance of natural and agricultural wetlands for godwits at different stages of the nonbreeding season. Protected areas in the Senegal Delta, particularly the Djoudj National Bird Sanctuary (Senegal) and Diawling National Park (Mauritania), are crucial habitats during the dry season as godwits prepare for their northward migration, whilst rice fields take a key role during the wet season. Conservation efforts should prioritize eradicating invasive plants from the Djoudj and Diawling, as well as promote agroecological management in specific rice production complexes indicated in this study.

A Prediction Method for Calculating Fracturing Initiation Pressure Considering the Modification of Rock Mechanical Parameters After CO2 Treatment

The establishment of a more realistic CO2 fracturing model serves to elucidate the intricate mechanisms underlying CO2 fracturing transformation. Additionally, it furnishes a foundational framework for devising comprehensive fracturing construction plans. However, current research has neglected to consider the influence of CO2 on rock properties during CO2 fracturing, resulting in an inability to precisely replicate the alterations in the reservoir post-CO2 injection into the formation. This disparity from the actual conditions poses a substantial limitation to the application and advancement of CO2 fracturing technology. This work integrates variations in the physical parameters of rocks after complete contact and reaction with CO2 into the numerical model of crack propagation. This comprehensive approach fully acknowledges the impact of pre-CO2 exposure on the mechanical parameters of reservoir rocks. Consequently, it authentically restores the reservoir state following CO2 injection, ensuring a more accurate representation of the post-fracturing conditions. In comparison with conventional numerical simulation methods, the approach outlined in this paper yields a reduction in the error associated with predicting fracturing pressure by 9.8%.

Dengue Outbreak Control and Prevention: A Case Study of Gampaha District, Sri Lanka

Dengue fever remains a persistent public health challenge in Gampaha District, Sri Lanka. Despite ongoing efforts by the Ministry of Healthcare, Nutrition &amp; Indigenous Medicine, the district reported 10,212 cases in 2022, with significant hospital admissions and deaths in high-risk areas like MC Negombo, Gampaha, and Minuwangoda. The study examines Dengue control and prevention strategies implemented from November 2022 to March 2023. Data was collected from existing records, interviews with key informants, and field observations. Major challenges were identified and prioritised using evidence-based methodologies, including the "Five Whys" root cause analysis. The analysis revealed significant challenges categorised into program-related and non-program-related issues. Key issues include inadequate use of existing data, insufficient evidence-based control measures, and operational inefficiencies. The root cause analysis identified core problems such as lack of funding, poor planning, and limited community engagement. The study highlights the critical need for data-driven decision-making and enhanced collaborative efforts. Establishing a technical body, develop context-specific programs, and improve community involvement. Resource mobilisation for research and forecasting epidemics was also emphasised. This case study provides valuable insights into the challenges and strategic interventions necessary for effective Dengue control in the Gampaha District. Emphasising evidence-based decision-making and a comprehensive action plan underscores the importance of collaborative efforts to combat Dengue in the region.

An assessment of household solid waste management in Mainpuri, Uttar Pradesh, India

&lt;p&gt;Rapid industrialization, urbanization, population growth, and migration from rural areas have resulted in increased solid waste generation in developing cities, which is commonly regarded as the most significant urban issue. The improper disposal of waste and inefficient collection methods is a significant problem in most of the municipalities in Indian cities. This challenge is further compounded by unscientific waste treatment practices, lack of modern technology, and limited resources. This study aims to assess the status of solid waste generation and disposal across different household income groups and to evaluate how Mainpuri manage and handles the solid waste management system. The study is based on primary data collected through a household survey in Mainpuri city, covering a sample of 1,836 households from various income groups. The data used in this assessment was collected from household surveys and government records. Although there is a recycling plant in operation, its capacity is inadequate to address the increasing waste generation and demands of the community. This shortfall underscores the need for enhanced waste management strategies and infrastructure to effectively cope with the rising volumes of solid waste. As a result, large quantities of solid waste accumulate in low-lying areas near the Isan River and the proximity of the plant. Without a comprehensive solid waste management plan in the municipality, the situation is likely to deteriorate further. Mainpuri City urgently needs a sustainable strategy to effectively manage its solid waste, addressing both current challenges and future demands. Implementing such a strategy is essential for improving public health, environmental conditions, and overall quality of life in the city.&lt;/p&gt;

Current Concepts of the Management of Painful Traumatic Peripheral Nerve Neuromas

Painful neuromas are a complex clinical condition that results in notable disability and functional impairment after injury to a peripheral nerve. When regenerating axons lack a distal target, they form a stump neuroma. Up to 60% of neuromas are painful because of mechanical sensitivity and crosstalk between nerve fibers. Clinical evaluation includes a thorough history and physical examination followed by directed diagnostic imaging and procedures to assess pain generators and their effect on quality of life. Nonsurgical management options may include pharmacological interventions, desensitization strategies, injections, and therapies to reduce pain perception and improve function. Surgical interventions, such as nerve reconstruction by direct repair or grafting, redirection to alternative targets, and containment of regenerating axons by relocation into innervated tissues or in grafts, are considered when conservative measures fail. A comprehensive and individualized treatment plan is crucial for optimizing patient outcomes with painful neuromas. The plan should consider the underlying pathology, pain generators, and psychosocial factors contributing to the patient's pain.

Research-Based Islamic Education Curriculum Management

This study examines the management and implementation of a research-based curriculum to understand how Islamic education can integrate contemporary scientific knowledge with traditional religious teachings. Using a qualitative approach, case study design at Madrasah Tsanawiyah (MTs) Zainul Hasan Balung, data were collected through in-depth interviews, observation, and documentation. The validity of the findings used triangulation techniques, and data analysis followed the three steps of data reduction, presentation, and conclusion/verification. The study findings indicate that the curriculum was developed through a comprehensive planning process, including needs assessment and stakeholder collaboration to align with madrasah education's vision, mission, and goals. Its implementation involved structured research activities by forming Youth Scientific Groups (KIR) and Innovative Product Groups, which provided students with hands-on experience in scientific research and inquiry. This approach effectively fostered critical thinking, problem-solving, and research skills among students. Teachers received ongoing training to guide students' research activities, ensuring effective curriculum delivery. The study also identified challenges, such as the need for adequate teacher preparation and appropriate learning materials, which were addressed through training programs and the development of research pocketbooks. The evaluation process used authentic assessments, such as portfolios and research proposals, to ensure continuous improvement and adaptation of the curriculum. Research-based curriculum management at MTs Zainul Hasan Balung shows that integrating research-oriented learning can improve Islamic education and prepare students for modern challenges while maintaining Islamic values. These findings provide valuable insights for Islamic educational institutions that want to implement research-based curricula effectively.

Detailed statistical analysis plan for a guided self-determination intervention versus an attention control for outpatients with type 2 diabetes in the randomised OVERCOME trial

BackgroundAutonomy-supporting interventions may be a prerequisite to achieve better long-term management of type 2 diabetes. Evidence suggests that the guided self-determination (GSD) method might improve haemoglobin A1c and diabetes distress in people with type 1 diabetes. The evidence of an effect of a GSD intervention compared with an attention control group in adults with type 2 diabetes is unknown.Methods/designThe trial is designed as a pragmatic, investigator-initiated, dual-centre, randomised, parallel-group, assessor-blinded, superiority clinical trial of persons with type 2 diabetes. A nurse will administer GSD intervention versus an attention control. The primary outcome is diabetes distress, and secondary outcomes are quality of life, depressive symptoms, and non-serious adverse events. Exploratory outcomes are haemoglobin A1c, motivation, and serious adverse events. Participants are assessed at baseline, 5-, and 12-month follow-up. Here, we present a detailed, comprehensive plan of all statistical analyses, including methods to handle missing data, and assessments of the underlying statistical assumptions. The statistical analyses will be conducted independently by two statisticians following the present plan.DiscussionTo mitigate the risk of analysis bias and increase the validity of the OVEROME trial, this statistical analysis plan was developed prior to unblinding of the trial results in concordance with the Declaration of Helsinki and the Conference on Harmonization of Good Clinical Practice Guidelines.Trial registrationClinicalTrials.gov NCT 04601311. Registered on October 2020.

Optimizing shutdown and startup procedures in oil facilities: A strategic review of industry best practices

Shutdown and startup procedures in oil facilities are critical processes that significantly impact operational efficiency, safety, and environmental compliance. This strategic review examines industry best practices for optimizing these procedures to minimize downtime and enhance productivity. Effective shutdown and startup operations are essential not only for maintaining equipment integrity but also for ensuring the safety of personnel and compliance with regulatory standards. The complexities of oil facility operations necessitate a thorough understanding of the interdependencies between various systems and processes during these phases. This review identifies key factors that contribute to successful shutdown and startup procedures. First, comprehensive planning and preparation are vital. Establishing a detailed shutdown/startup plan that outlines specific tasks, timelines, and responsibilities helps mitigate risks associated with unplanned events. This includes conducting risk assessments and ensuring that all personnel are adequately trained to execute their roles effectively. Second, the implementation of advanced monitoring and control technologies is crucial. Utilizing automation and real-time data analytics allows for precise control over processes during shutdowns and startups, enabling quicker responses to anomalies. This technological integration can significantly reduce the time required for these operations while enhancing safety measures. Third, collaboration and communication among teams are essential components of successful operations. Encouraging a culture of open communication fosters teamwork and ensures that all stakeholders are aligned throughout the shutdown and startup phases. Regular debriefings and feedback sessions post-operations also play a vital role in continuous improvement. In conclusion, optimizing shutdown and startup procedures in oil facilities is paramount for enhancing operational efficiency and safety. By adopting industry best practices, including thorough planning, leveraging technology, and promoting effective communication, organizations can achieve significant improvements in their operational performance. This review serves as a resource for industry stakeholders aiming to refine their shutdown and startup strategies to achieve operational excellence. Keywords: Shutdown Procedures, Startup Procedures, Oil Facilities, Operational Efficiency, Safety, Environmental Compliance, Risk Assessment, Automation, Real-Time Data Analytics, Industry Best Practices.

О государственном регулировании развития инклюзивного образования и создания специальных условий для обучения детей с ограниченными возможностями здоровья в Российской Федерации

&lt;p&gt;The article summarizes the results of the implementation of measures to ensure the educational rights of students with disabilities and special educational needs. We present the results of the implementation of interdepartmental comprehensive plans (for 2015, 2016-2017, 2018-2020) approved by the Government of the Russian Federation . It was revealed that over 10 years, more than 8 thousand kindergartens and more than 10 thousand schools participated in the special events to create accessibility in educational organizations. It was a part of the state program &amp;ldquo;Accessible Environment.&amp;rdquo; In accordance with the federal statistical observation form OO-1, in the 2023/24 academic year, psychological and pedagogical support for students with disabilities in general educational organizations was provided by 32466 educational psychologists, 21703 speech therapists, 9530 special education teachers, and 8888 tutors. show that there were 3123 educational psychologist vacancies, 2378 speech therapist vacancies, 1740 special education teacher vacancies, and 1389 tutor vacancies in 2023 in the constituent entities of the Russian Federation. The article highlights th importance of the Complex of measures for the modernization of defectological education in the Russian Federation through 2030 (dated February 7, 2024, No. SK-1/07vn), and the all-Russian competition &lt;em&gt;The Best Inclusive School in Russia&lt;/em&gt;. This article reflects the results of scientific research conducted by the Institute of Correctional Pedagogics, Moscow State University of Psychology and Education, Moscow State Pedagogical University, Russian State Pedagogical University named after A.I. Herzen. Based on the provisions of the Plan of the Main Events held within the framework of the Decade of Childhood for the period up to 2027, the main tool is a study of the subjective well-being of adolescents, including those with disabilities and special needs. We emphasize the high importance of the Interdepartmental Comprehensive Action Plan for the Development of Inclusive General and Additional Education, Children's Recreation, and the Creation of Special Conditions for Students with Disabilities and Limited Health Opportunities up to 2030. In this article we define the directions of the Russian methodology of inclusive education as the main basis for ensuring the rights and opportunities of any child.&lt;/p&gt;

Integrated AI Medical Emergency Diagnostics Advising System

The application of AI (Artificial Intelligence) in emergency medicine helps significantly improve the quality of diagnostics under limitations of resources and time constraints in emergency cases. We have designed a comprehensive AI-based diagnostic and treatment plan decision-support system for emergency medicine by integrating the available LLMs (Large Language Models), like ChatGPT, Gemini, Claude, and others, and tuning them up with additional training on actual emergency cases. There is a special focus on early detection of life-threatening and time-sensitive diseases like sepsis, stroke, and heart attack, which are the major causes of death in emergency medicine. Additional training was conducted on a total of 600 cases (300 sepsis; 300 non-sepsis). The collective capability of the integrated LLMs is much stronger than each individual engine. Emergency cases can be predicted based on information from multiple sensors and streaming sources combining traditional IT (Information Technology) infrastructure with Internet of Things (IoT) schemes. Medical personnel compare and validate the AI models used in this work.

Interdisciplinary participation in climate-adapted urban land-use planning – findings of two gaming simulations in the city of Bottrop, Germany

Purpose Sustainable and climate-adapted urban development requires integrative governance approaches and forms of collaboration between different disciplinary actors in urban society. Integrative approaches are a particular challenge for those planning cultures in which they are not yet sufficiently established. This also applies to formal urban land-use planning in Germany, which forms the governance setting of this study. This study aims to examine how interdisciplinary participation in formal urban land-use planning contributes to the consideration of climate adaptation in the planning process. Design/methodology/approach This paper traces the process of two differently designed interdisciplinary participation formats based on the methodological framework of a gaming simulation, each in the context of a formal urban land-use planning procedure in Bottrop, Germany. The gaming simulations are designed as performance simulations in which we involved several representatives from different public authorities. Findings The gaming simulations show that interdisciplinary participation can lead to an increased awareness of climate adaptation requirements in particular and a mutual understanding of different logics of action in the context of comprehensive and sustainable urban planning in general. In addition, this paper provides recommendations as to how and under what conditions the benefits of the simulations can be transferred to municipal practice. Originality/value While integrative and interdisciplinary formats are increasingly being used in the context of informal urban planning, this does not apply to formal urban land-use planning. Participation in formal urban land-use planning procedures is classically linear and multidisciplinary in Germany. Using two simulated interdisciplinary participation formats, this paper tested to what extent the consideration of climate adaptation requirements as a cross-sectoral task can benefit from interdisciplinarity in the context of two formal urban land-use planning procedures.

Development of National Emission Factor for Rice Production System in Malaysia: A Step Toward Achieving Sustainable Development Goals

Objective: Currently, methane (CH4) emissions from rice cultivation in Malaysia are calculated using the regional’s methane emission factor (EF) of 1.60 kg CH₄ ha⁻¹ day⁻¹, as Malaysia has not yet developed a national emission factor. The objective of this study is to generate a country-specific EF of CH4 emission from rice cultivation in Malaysian rice fields. The EF generated would then be used in future emission estimates and the country’s greenhouse gas (GHG) inventory reports to the United Nations Framework Convention on Climate Change (UNFCCC). Theoretical Framework: The establishment of a national GHG emission factor for rice cultivation in Malaysia is critical for accurate GHG inventory reporting and effective climate change mitigation. This study utilizes the Intergovernmental Panel on Climate Change (IPCC) guidelines to derive a country-specific emission factor, enhancing Malaysia’s compliance with international climate obligations and promoting sustainable agricultural practices. Method: A new national EF was developed from eleven rice planting seasons in rice granary areas (IADA Pulau Pinang, IADA Barat Laut Selangor, MADA and KADA) and non-granary area (Sik, Kedah). The EF was calculated from methane emissions from the new data sets, published journals and unpublished data from MARDI. For the new data set, methane gas (CH4) was measured using a static chamber method (Minamikawa et al., 2015). Sampling of GHG from the gas chamber is carried out in the field every 2 weeks and gas was analysed by a GC System Agilent 7890A gas chromatography. The daily methane flux and methane emission follow the methods by Habib et al. (2007), Fauzi et al. (2023) and the Guidelines for National Greenhouse Gas Inventories for Cropland (IPCC, 2006a). Results and Discussion: The national EF calculated from CH4 gas emissions over eleven rice planting seasons in Malaysia between 2012-2024 was 1.80 kg CH4 ha-1 day-1, which is higher than the current regional EF used (1.60 kg CH4 ha-1 day-1). However, the value is within the range of the default value of 1.30 kg CH4 ha-1 day-1 by the Intergovernmental Panel on Climate Change (IPCC) 2006 and 2.00 kg CH4 ha-1 day-1 (IPCC, 1996). Research Implications: The use of this new EF resulted in 12.49% increase in the national GHG inventory from the rice cultivation sub-sector as compared to using the current regional EF. This initiative is part of a comprehensive plan to enhance and strengthen GHG inventory reporting for Malaysia's agriculture sector, aiming to meet IPCC requirements and progress to Tier 2 status.

A DEVICE-BASED (GAITON) SAGITTAL PLANE KINEMATICS ANALYSIS OF LOWER EXTREMITY JOINTS AMONG PATIENTS WITH KNEE OSTEOARTHRITIS – A METHODOLOGICAL APPROACH.

Background: Gait assessment is an effective method for identifying functional limitations associated with knee Osteoarthritis and understanding the relationship between disease symptoms and gait quality. Objective: To evaluate the mean difference in the kinematics of lower extremity joints among patients with knee osteoarthritis. Methods: A total of 20 people living with Knee OA were recruited as of 25th September 2024 in this prospective cross-sectional design study. The eligible participants were conveniently recruited from the SRM physiotherapy OPD based on voluntary participation after signing the informed consent. Adult participants aged 18 years and above, both sexes and able to walk independently without mobility aids were recruited and the joint kinematics were measured using the GaitOn Software, 2-dimensional analysis, and sagittal kinematic parameters of stance phase. Results: The mean age of the patients was 53.6 ± 7.3, and the mean BMI was 29.1±4.6. The one sample t-test demonstrated a statistically significant difference between kinematic angles of the lower extremity joint in sagittal plane of population mean (reference value) and sample mean (measured by GaitOn); Initial contact phase (hip: mean diff -4.06, p&lt;0.01, ankle: mean diff 34.1, p &lt; 0.0001), Loading response (hip: mean diff -5.8. p &lt;0.001, knee: mean diff 9.6, p &lt; 0.001, ankle: mean diff 32.4, p &lt; 0.001). Midstance (hip: mean diff 11.06, p &lt;0.001, ankle: 31.4, p&lt; 0.001). Terminal stance (hip: mean diff 28.3, p&lt; 0.004, ankle: mean diff 31.4, p&lt; 0.001) and Pre-swing (hip: mean diff 16.5, p&lt; 0.001, ankle: mean diff 31.4, p&lt; 0.001). Conclusions: The hip and ankle joints equally share knee kinematic compensations. By acknowledging the complex interactions between the hip, ankle, and knee joints, healthcare providers can develop more comprehensive and effective treatment plans for individuals with knee OA.

A Review of Marketing Stratergies for Promoting Sustainable Tourism Destinations in India

Sustainable tourism for Indian destinations is promoted and marketed by utilizing marketing strategies to gain interest from travelers. However, the promotion of sustainable tourism destinations is achieved in a manner that does not jeopardize the environment or community conservation. Sustainable tourism is promoted by increasing the destination's visibility, which includes social media marketing, search engine optimization, and content marketing, one such example is the scheme of Swadesh Darshan, which was launched by the Indian tourism and it aims for the development of sustainable tourism destinations. Furthermore, enhancing cultural and community features in marketing might help to attract and retain tourists' interest, thereby strengthening sustainable tourism. To entice people to visit sustainable tourist places, the tourism sector is focusing on proper selling factors, physical improvements to attractions and accessibility, and proximity to other tourist sites. Overall, the current study reveals that a comprehensive Destination Management action plan can help accelerate India's green tourism transition. This study aims to understand some of the marketing strategies employed by Indian Tourism Industry on environmentally sustainable vacation spots. The Indian travel industry is impacted by sustainable tourism, one of the topics discussed in this article. This study is descriptive and relies only on books and periodicals covering a wide range of topics that are relevant to sustainable tourism destinations in India. Moreover, the present study also highlights, the importance of online marketing strategies for marketing sustainable Indian travel destinations which is discussed to have a better understanding of the future of the tourism sector in India. The particulars of the study are emerging from the SWOT analysis model for the assessment as well as the scrutinization of the potential of the Indian tourism industry.

Design and evaluation of comprehensive rehabilitation plan for functional recovery of tennis players’ knee joint injuries

Design and evaluation of comprehensive rehabilitation plan for functional recovery of tennis players’ knee joint injuries

Cephalometric Evaluation of Facial Height Ratios and Growth Patterns: A Retrospective Cohort Study

(1) Background: This retrospective cohort study aimed to investigate the cephalometric evaluation of facial height ratio (FHR) and growth patterns. (2) Methods: We assessed facial height ratios, the y-axis to SN angle, and growth patterns in 94 participants from Timis County using digital cephalograms. Angle’s classification guided the categorization of participants. We digitally traced and analyzed cephalograms using the WebCeph imaging software. We conducted the statistical analysis using Python version 3.11.9. We performed the following statistical tests: Welch’s t-test or ANOVA (analysis of variance), Mann–Whitney U test or the Kruskal–Wallis test, χ2 test or Fisher’s, and logistic regression. (3) Results: Significant correlations were observed between FHR and craniofacial development, especially in hypodivergent growth patterns. Among the molar classes, the most predominant growth pattern in Class I was normodivergent (61.5%), followed by hypodivergent (33.3%). In Class II, hypodivergent growth was the most common (52%), with a smaller proportion of normodivergent cases (30.8%). Class III was characterized by a mix of growth patterns, with hypodivergent being predominant (14.7%). Across all groups, the y-axis to SN angle remained within normal limits, and a strong negative correlation with Jarabak’s ratio was found (r = −0.72, p &lt; 0.001). This shows the importance of using holistic assessment methods in orthodontic practice. (4) Patients from Timis County mostly have a hypodivergent growth pattern across all types of malocclusions. Understanding these patterns is essential for comprehensive orthodontic treatment planning. We need to conduct further research to investigate the implications of these findings on treatment outcomes and patient care.

The Predictive Effect of the Level of Psychological Resilience on the Level of Readiness for Discharge in Patients Undergoing Orthopaedic Surgery.

The aim of this study is to establish the correlation between the degree of psychological resilience and readiness for discharge in patients undergoing orthopaedic surgery. This study is of a descriptive correlational type. This study comprised a cohort of 190 patients who were admitted to the orthopaedics and traumatology department and had surgical procedures performed between November 2023 and April 2024. The study data were gathered via completion of the Introductory Information Form, the Psychological Resilience Scale and the Hospital Discharge Readiness Scale. IBM SPSS 25 package program was used to analyse the research data. In this study, 34.2% of the participants stated that they did not feel ready for discharge. Predictors of Readiness for Hospital Discharge were identified as being male (β = 0.118, p = 0.003), living alone (β = 0.222, p < 0.001), having undergone prosthesis, fracture or amputation surgery (β = 0.161, p < 0.001), not having received discharge training (β = 0.122, p = 0.001), not feeling ready for discharge (β = 0.442, p < 0.001) and resilience (β = 0.246, p < 0.001). These variables were found to explain 88.7% of Readiness for Hospital Discharge (adjusted R2 = 0.773). The findings of this study emphasise that including patients in their healthcare and creating comprehensive discharge plans tailored to their specific care requirements have a beneficial impact on their readiness for discharge. Additionally, the study demonstrates that enhancing psychological resilience plays a mediating role in facilitating discharge readiness. Patients who feel ready for discharge are less likely to be hospitalised and their recovery may be faster. Including the patient in the discharge plan, taking individual needs into consideration and disseminating programmes to increase resilience should be an integral part of holistic care. The STROBE checklist was applied in the reporting of the finding.

Patient Teaching Plan for Type II Diabetes: Addressing Genetic Predisposition and Hypertension

Type II diabetes, characterized by insulin resistance and eventual beta-cell dysfunction, is a global health crisis exacerbated by genetic predisposition and comorbidities such as hypertension. This review proposes a patient teaching plan aimed at managing Type II diabetes in individuals with genetic risk factors and concurrent hypertension. Recognizing that genetic predisposition significantly heightens the risk of developing Type II diabetes, the review underscores the necessity of incorporating genetic insights into patient education and care strategies. Hypertension, prevalent among those with Type II diabetes, complicates disease management and increases the risk of severe complications, necessitating a dual focus on both conditions. The review outlines a comprehensive teaching plan that includes education on the genetic aspects of diabetes, lifestyle modifications, and strategies for managing hypertension. It emphasizes the importance of a balanced diet, regular physical activity, weight management, stress reduction, and medication adherence. The plan also highlights the role of continuous monitoring through tools such as blood glucose logs and blood pressure measurements to track progress and adjust treatment as needed. Family involvement and support systems are identified as critical components of the teaching plan, providing emotional support and reinforcing healthy behaviors. By integrating personalized education, lifestyle changes, and ongoing support, the plan aims to improve patient outcomes, enhance quality of life, and effectively manage the combined challenges of Type II diabetes and hypertension. Keywords: Patient Teaching Plan, Type II Diabetes, Genetic Predisposition, Hypertension.

MODELING TOURIST ARRIVALS IN THE ISLAND GARDEN CITY OF SAMAL: IMPLICATIONS TO BUSINESS OPERATIONS OF TOURISM-RELATED INDUSTRY

&lt;p&gt;This study aimed to model the tourist arrivals in the Island Garden City of Samal (IGaCoS) by utilizing the autoregressive integrated moving average (ARIMA) method. Specifically, this paper sought to determine whether there was a statistically appropriate forecasting model using the ARIMA approach, based on which it would be possible to reasonably forecast the number of tourist arrivals in IGaCoS. Quantitative secondary data were analyzed by employing the Box-Jenkins ARIMA. The time series plot was characterized by an apparent increasing trend combined with intermittent sinusoidal oscillations. The time series revealed a steady, gradual increase up until 2020. Next, a sharp decline was observed midway through 2020, indicative of the ill effects of the COVID-19 pandemic. A gradual increase was noted once more, starting in 2021, with some fluctuations. The Augmented Dickey-Fuller (ADF) test revealed that the time series was non-stationary at level— but was made stationary after differenced twice. The ARIMA (1,2,1) model was found to be statistically significant. The fitted model initially showed some notable deviations from the original data, but, with time, converged closely to the actual values, proving it is a reliable way to represent underlying patterns. The ARIMA (1,2,1) model, selected for having the lowest AIC and BIC values and a MAPE within the acceptable range for reasonable forecasting, was used to predict tourist arrivals in IGaCoS over the next six months. The forecasted values suggested a mix of fluctuations and stability. There was a noticeable upward trajectory at the beginning, which was followed by a slight decline at the end that yet remained stable. The forecasted results from the ARIMA (1,2,1) model may provide businesses with a roadmap for comprehensive planning in terms of operational and strategic concerns. This study helped address Sustainable Development Goal (SDG) No. 8, Decent Work and Economic Growth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;JEL:&lt;/strong&gt; L83, R11, C53&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0776/a.php" alt="Hit counter" /&gt;&lt;/p&gt;