Full Success Research Articles

Redefining Law Enforcement: Policy Innovations for Gender Equality in South African Law Enforcement

This study examines the ongoing issue of gender inequality within South African law enforcement, emphasizing the urgent need for comprehensive policy reforms to establish an equitable and supportive environment for female officers. Despite the existing efforts to address these disparities, women in policing continue to face significant challenges, including systemic gender bias, limited opportunities for career advancement, and inadequate support structures. The research explored the perspectives of 18 current and retired women officers, who were identified as key informants due to their experience and understanding of the challenges faced by female officers. Using semi-structured interviews, the study uncovered four major themes which are leadership and attrition, factors contributing to the underrepresentation of women in law enforcement, perceived barriers to career progression, and challenges encountered at police academies that affect women’s ability to complete their training. The findings suggest that systemic barriers, lack of mentorship, and inadequate institutional policies remain critical issues that hinder women’s full participation and success in law enforcement careers. The study highlights the need for law enforcement agencies to implement targeted policies that promote gender diversity in recruitment, provide equal access to professional development opportunities, and create a workplace culture that values and supports female officers. By addressing these key areas, law enforcement agencies can foster a more inclusive and effective organizational framework. This research contributes to the broader scholarship on gender inequality in policing by providing valuable insights into the specific challenges women face and recommending policy reforms that can help create a more gender-inclusive law enforcement sector. Keywords: Leadership, Training, Gender, Attrition, Law Enforcement

Efficacy and Safety of Keratosept Eye Drops in Patients with Punctate Keratitis: Clinical and Microbiological Evaluation on 50 Eyes.

We evaluated the efficacy and safety of eye drops with antiseptic and re-epithelizing properties (Keratosept®, Bruschettini, Genova, Italy) on 50 eyes affected by punctate keratitis of suspected microbial origin. A biomicroscopic examination, fluorescein dye staining test (Fluotest), tear break-up time test (TBUT), and the ocular surface disease Index (OSDI) questionnaire were used to assess treatment efficacy. Treatment success was defined as a negative Fluotest and an OSDI score <12 on the 15th day of treatment. According to this definition, Keratosept®, either alone or in combination with antibiotics, was effective in over 80% of microbial and nonmicrobial forms. Conjunctival swabs were taken from all patients for culture examination with an antibiogram and sensitivity test for Keratosept®; 32/43 (74.4%) forms with positive culture for the bacteria were sensitive to Keratosept®. A total of 35/38 (92%) eyes treated with this product alone achieved full treatment success without any apparent adverse effects. These results suggest the use of Keratosept® eye drops in punctate keratitis as an alternative or in combination with established antibiotic therapies. Further studies are needed to evaluate its efficacy in different infectious forms and identify other indications for using this product.

A FDA-based multi-robot cooperation algorithm for multi-target searching in unknown environments

Target search using a swarm of robots is a classic research topic that poses challenges, particularly in conducting multi-target searching in unknown environments. Key challenges include high communication cost among robots, unknown positions of obstacles, and the presence of multiple targets. To address these challenges, we propose a novel Robotic Flow Direction Algorithm (RFDA), building upon the modified Flow Direction Algorithm (FDA) to suit the characteristics of the robot’s motion. RFDA efficiently reduces the communication cost and navigates around unknown obstacles. The algorithm also accounts for scenarios involving isolated robots. The pipeline of the proposed RFDA method is outlined as follows: (1). Learning strategy: a neighborhood information based learning strategy is adopted to enhance the FDA’s position update formula. This allows swarm robots to systematically locate the target (the lowest height) in a stepwise manner. (2). Adaptive inertia weighting: An adaptive inertia weighting mechanism is employed to maintain diversity among robots during the search and avoid premature convergence. (3). Sink-filling process: The algorithm simulates the sink-filling process and moving to the aspect slope to escape from local optima. (4). Isolated robot scenario: The case of an isolated robot (a robot without neighbors) is considered. Global optimal information is only required when the robot is isolated or undergoing the sink-filling process, thereby reducing communication costs. We not only demonstrate the probabilistic completeness of RFDA but also validate its effectiveness by comparing it with six other competing algorithms in a simulated environment. Experiments cover various aspects such as target number, population size, and environment size. Our findings indicate that RFDA outperforms other methods in terms of the number of required iterations and the full success rate. The Friedman and Wilcoxon tests further demonstrate the superiority of RFDA.

Case study: Evaluating deep-water start techniques and training demands in seated slalom waterskiing for an athlete with paraplegia.

Recreational and competitive slalom waterskiing is increasingly popular among individuals with spinal cord injuries (SCI), particularly for those with paraplegia using sit-skis. A key component of slalom skiing is the deep-water start (DWS), yet little is known about the physiological and physical demands of this activity when the athlete is seated. This study aims to fill this gap by focusing on the training requirements for a seated slalom athlete. Focusing on a young male athlete with paraplegia, this case study evaluates the effectiveness and efficiency of traditional (TDWS) and alternative (ADWS) DWS techniques during seated slalom waterskiing sessions. It assesses internal training load (TL) through heart rate (HR) zones and session rating of perceived exertion (sRPE), alongside pre- and post-session handgrip strength measurements to gauge peripheral muscle fatigue. Performing the ADWS, achieving a full success rate, proved more effective but slightly more time-consuming than TDWS, which had limited success. HR during DWS maneuvers ranged from 63.2 to 81.3% of maximal HR, with most sessions occurring below the ventilatory threshold, thus perceived as hard effort. A moderate yet non-significant correlation was found between HR and sRPE-based TL. A significant reduction in handgrip strength post-session underscores the activity's demands. These insights illuminate the technical, physiological, and physical challenges in mastering DWS for seated slalom athletes with SCI, providing valuable guidance for the development of tailored training programs and techniques in this sport.

Vocational Personality Profile Based on Where Students Live and School Popularity: Classification of the Holland Model in Lampung Society, Indonesia

The role of the vocational personality to determine an individual's full success in his or her career is so long recognized. It has significant effect to job satisfaction of people's careers. Becase of that, helping the student to understand his or her vocational personality pattern is an important part of the career counseling and guidance service in the schools. This study has investigated Vocational Personality Profile Based on Where Students Live and School Popularity using Holland's categories: Realistic, Investigative, Artistic, Social, Enterprising, and Conventional (RIASEC). The results of the study were indicating that in general students' vocational personality patterns are: Artistic type (25%)—Social (23.4%)—Enterprising (14%)—Investigative (13.5%)—Conventional (12.4%)— Realistic (11.7%). In detail, students' personality profiles vary according to their residential grouping and the popularity of their school. Further discussion of the research findings are presented in this article.

PRESERFLO™ Microshunt: 1-Year Results of a 25-Gauge vs. 27-Gauge Needle Tract.

Background: The purpose of this study was to evaluate the effectiveness and safety of the PreserFlo™ microshunt (PMS) using a 25-Gauge vs. 27-Gauge needle tract. Methods: This is a prospective postoperative examination of 60 glaucoma eyes that received a PMS. The main outcome measures were intraocular pressure (IOP), glaucoma drug score (GDS), Kaplan-Meier success rates, complications, and secondary intervention rates. Two subgroups were formed for data comparison: 27-Gauge (27G), and 25-Gauge (25G). Success was defined as IOP < 18 mmHg together with ≥20% IOP reduction with medication allowed (qualified success = QS18) or not (full success = FS18). Results: IOP and GDS were reduced from baseline to the 1-year study visit as follows: All eyes from 23.4 ± 8.6 mmHg (3.1 ± 0.9) to 15.1 ± 5.9 mmHg (0.8 ± 1.1); 25G from 24.2 ± 7.3 mmHg (3.0 ± 0.8) to 12.7 ± 2.7 mmHg (0.5 ± 0.8); and 27G from 23.1 ± 9.2 mmHg (3.1 ± 1.0) to 16.2 ± 6.7 mmHg (0.9 ± 1.2). IOP at one year was lower in the 25G group compared to the 27G group (p = 0.035). Bleb needling was required in eight (13.3%) eyes and open bleb revisions in three (5.0%). Transient hypotony occurred in 21% and choroidal effusion in 8% of all eyes. Choroidal effusions were more frequent in the 25G group (21%) compared to the 27G group (2%, p = 0.031). One-year success rates were significantly higher in the 25G group compared to the 27G group for both QS18 (25G: 67.9% vs. 27G: 35.7%, p = 0.002) and FS18 (25G: 63.6% vs. 27G: 29.2%, p = 0.007). Conclusions: The PreserFlo microshunt is an effective and safe glaucoma surgery with a low rate of bleb revisions or needlings. We show that the 25G needle tract might be more efficient for IOP control at the cost of increased IOP-related complications compared to 27G.

Медіація як альтернативний метод вирішення конфліктів у кримінальних справах: світовий огляд

The article discusses mediation as one of the forms of restorative justice. Mediation is a modern way of responding to unlawful behavior without resorting to court. This approach promotes a balance of interests between society, the victim, and the offender. It is noted that mediation in criminal proceedings has a positive aspect associated with reducing the judicial workload, reducing the costs of maintaining convicted individuals. The main goal of using mediation during criminal proceedings is to facilitate dialogue between the victim and the suspect/accused, rehabilitation of the offender, awakening a sense of responsibility in the offender, and providing them with an opportunity to rectify the situation and compensate for the harm caused, with the possibility of further reintegration and rehabilitation. It is stated that in Ukraine, mediation has become increasingly popular and relevant as an alternative to judicial processes in resolving various conflicts. It is emphasized that the lack of proper understanding of the effectiveness and potential of mediation among law enforcement agencies, legal professionals, and the public can be a significant obstacle to the implementation of this conflict resolution method in criminal cases. In addition, special attention is given to the experience of foreign countries, and examples of successful implementation of mediation procedures in criminal cases in Norway, Italy, the United States, and Sweden are analyzed. This indicates that international mediation standards serve as an important tool for resolving legal disputes and conflicts outside the judicial system. The conclusion is drawn that mediation as an alternative method of conflict resolution in criminal cases is an effective and promising approach that takes into account the interests of all parties involved, promotes the restoration of harmony in society, and reduces the burden on the judicial system. The widespread implementation of mediation in different countries confirms its success and importance in modern justice. However, to achieve full success, it is necessary to actively promote this method, ensure compliance of legislation with the requirements of mediation, increase public awareness, and enhance the professionalism of mediators. Mediation can play a crucial role in building a just society where conflicts are resolved through dialogue, understanding, and cooperation.

Mid-term surgical success after transscleral ab interno glaucoma gel stent implantation.

To investigate the surgical success and efficacy of XEN45 implantation (XEN45 μm, AbbVie Inc., USA) with and without combined cataract surgery up to the first 5 years. In a prospective observational monocentric trial, 192 eyes of 157 patients with open-angle glaucoma received either XEN45 implants only (solo surgery group) or combined surgery/cataract surgeries (combined surgery group). Surgical success (qualified and full success; IOP-limit: ≤12, 15, 18, 21 mmHg), time to secondary IOP-lowering procedure, IOP and number of IOP-lowering medications were analysed for 1, 2, 3, 4 and 5 years. Compared to baseline, IOP (24.1 ± 8.1 to 12.6 ± 2.8 mmHg, -48%, p < 0.001) and the number of IOP-lowering medications (3.0 ± 1.0 to 1.5 ± 1.2, -50%, p < 0.001) decreased significantly at 5 years. Although no differences between IOP and the number of IOP-lowering medication courses between the groups were detected at 5 years (p > 0.11), the combined procedure (63%, 37%) showed better success rates compared to the solo procedure (36%, 13%) in the definition IOP ≤18 and ≤12 mmHg (p = 0.035, 0.028). Solo XEN45 procedures had a higher rate of secondary IOP-lowering procedures compared to combined XEN45 cataract procedures (hazard ratio: 2.02, 95%CI: 1.03-3.97, p = 0.04). Twenty per cent of the eyes, including both procedures, required a secondary IOP-lowering procedure within 5 years. The XEN45 implant is effective in lowering IOP and the number of IOP-lowering medications in patients with open-angle glaucoma in the mid-term. Comparing XEN45 implant results with the results of trabeculectomy available in current literature, we speculate that there might be a higher surgical success rate without medications in favour of trabeculectomy.

Enhancing Accessibility and Inclusion in Engineering Education

Students in higher education, particularly in STEM programs, face numerous barriers to their full participation and educational success. This paper describes the development of a program with the goal of eliminating barriers for students with disabilities in engineering; the Accessibility and Inclusion in Engineering Education project. The pilot project aimed to integrate inclusive and accessible teaching practices systemically throughout the faculty via workshops, seminars, a teaching strategies toolkit, and engineering course material about equity, diversity, inclusion, and accessibility. Successes and challenges of implementing this pilot project, as well as next steps, are explored.

Development and implementation of a smart home automation system in the context of the Ukrainian housing sector: Challenges and prospects

Due to the rapid development of technology and the growing interest in the concept of “smart home”, the relevance of the study is to identify obstacles and opportunities, contributing to the effective implementation of these technologies in modern life. The purpose of this study is to analyse the modern state and determine the possibilities of developing and implementing smart home automation systems in the Ukrainian residential sector to increase the level of comfort, safety, and energy efficiency. The methods used include the analytical method, classification, functional method, statistical method, synthesis, etc. The results of the study reveal the profound impact of technology on the efficiency and security of a smart home. The modern state of smart home automation systems in the Ukrainian residential sector was analysed. Modern cybersecurity methods for protecting against potential threats were considered. Electronic keys, including Face Identification, fingerprint and voice recognition technologies, are being implemented to provide access and increase security in the smart home. The study reveals various methods that are used in different countries to implement smart homes, presenting various examples of development and features of their implementation. As a result, key technical and financial challenges are identified that call into question the effectiveness of implementing such systems. In addition, the possibilities of optimising these systems were considered based on market features and infrastructure constraints. According to the analysis, specific recommendations were developed for creating affordable and effective solutions for Ukrainian consumers. Based on these recommendations, it can be concluded that, despite the existing difficulties, the introduction of smart home systems in Ukraine has potential and prospects. However, to achieve full success, it is important to overcome technological challenges and consider the financial capabilities of the population. The study made a significant contribution to understanding the factors influencing the successful implementation of modern technologies in the residential sector of Ukraine, contributing to the practical development of science and providing concrete conclusions for the possibilities of implementing smart home automation systems

Https://rsisinternational.org/journals/ijriss/articles/challenges-in-supporting-visually-impaired-students-with-additional-disabilities/

This abstract explores the key barriers—communicational, technological, and attitudinal—that special educator face in accommodating children with visual impairment and additional disabilities under Samagra Shiksha Abhiyan. Communicational barriers arise due to the multifaceted needs of these children, requiring specialized methods such as braille, tactile aids, and adaptive communication strategies. However, the lack of adequate training and resources often hinders educators’ ability to effectively engage these students. Technological barriers further exacerbate the challenge, with insufficient access to and knowledge of assistive technologies like screen readers and adaptive devices limiting the support that can be provided. The rapid evolution of technology, coupled with financial and infrastructural constraints, leaves many educators struggling to keep pace with the tools necessary for inclusive education. Attitudinal barriers, stemming from societal biases and low expectations, significantly impact the educational experience of these children. Negative perceptions among educators, peers, and the broader community can lead to marginalization and inadequate support, undermining the inclusive goals of the program. Addressing these barriers is crucial for achieving the equitable educational opportunities envisioned by Samagra Shiksha Abhiyan. A focused approach that enhances training, improves technological access, and shifts attitudes towards inclusivity is essential for the full participation and success of children with visual impairments and additional disabilities. The accommodation of children with visual impairment and additional disabilities under Samagra Shiksha Abhiyan is fraught with significant challenges, particularly in terms of communicational, technological, and attitudinal barriers. Communicational barriers emerge as special educators struggle to address the complex needs of these students, who require specialized communication methods such as braille, tactile learning tools, and adaptive communication strategies. These methods are often not adequately supported by the existing infrastructure, and educators frequently lack the necessary training to implement them effectively. Technological barriers further compound the issue, with limited access to advanced assistive technologies such as screen readers, braille displays, and other adaptive devices. Even when these technologies are available, the rapid pace of advancement and the lack of proper training leave many educators unable to fully utilize them to support student learning. Attitudinal barriers represent another significant obstacle, as societal biases and misconceptions about the capabilities of children with multiple disabilities can lead to their marginalization. These attitudes, often reflected in the lower expectations of educators and the broader educational community, undermine efforts to provide a truly inclusive education. Addressing these barriers is crucial for realizing the goals of Samagra Shiksha Abhiyan and ensuring that all children receive the support they need to succeed in an inclusive educational environment.

The ALICE Service Work system

The "A Large Ion Collider Experiment" (ALICE), one of the four large experiments at the European Organization for Nuclear Research (CERN), is responsible for studying the physics of strongly interacting matter and the quark-gluon plasma. In order to ensure the full success of ALICE operation and data taking during the Large Hadron Collider Runs 3 and 4, a list of tasks identified as Service Work is established and maintained. This concerns detector maintenance, operation, calibration, quality control, data processing and outreach, as well as coordination and managerial roles in ALICE. The ALICE Glance Service Work system is a tool developed by a cooperation between the ALICE Collaboration and several universities that serves as the link between the user interaction and thousands of database entries. This paper describes the development process of this system and its functionalities, which range from planning the entire year of work for hundreds of tasks to individually assigning these tasks to members of the collaboration.

KEMAMPUAN DASAR GURU YANG PROFESIONAL DALAM MENGIMPLEMANTSIKAN KURIKULUM MERDEKA BELAJAR

This research explores the key role of professional teachers in presenting the Independent Learning Curriculum in educational environments. The main focus involves teachers' in-depth understanding of the principles of the new curriculum, the ability to design appropriate learning, adaptability to student needs, application of educational technology, and effective collaboration and communication skills. The results of this paper provide insight into how professional teachers can be a driving force for success in implementing the Independent Learning Curriculum, creating a dynamic learning environment and meeting the demands of contemporary education. The implications of this paper can provide a basis for the development of better teacher training programs and educational policy strategies that support the full success of the Independent Learning Curriculum initiative.

Fault identification and classification algorithm for high voltage transmission lines based on a fuzzy-neuro-fuzzy approach

ABSTRACT Traditional techniques are used for fault location detection in high-voltage transmission lines that mostly depend on traveling waves and impedance-based techniques suffer from large errors owing to the intricacy of fault modeling for various types of faults. Although single-line to ground faults are dominant in high-voltage transmission lines, fault resistance as well as fault inception angle might distort the current fault detection techniques. In addition, other types of faults exist and that raises the need to develop an accurate fault detection technique to minimize the recovery time. The current paper introduces a fuzzy and neuro-fuzzy algorithm to detect, analyze, and locate different faults taking place in high-voltage transmission lines. A MATLAB Simulink Model is used for analyzing different fault cases; fault detection and classification are done by the Fuzzy Interface System (FIS), while fault location detection is done using the Adaptive Neuro-Fuzzy Interface System (ANFIS). The introduced algorithm is evaluated via the Mean Square Error (MSE) technique. The results showed full success in detecting and identifying different fault types, with a 0.0042 validity performance factor for fault location detection using ANFIS.

Breaking the conformational ensemble barrier: Ensemble structure modeling challenges in CASP15.

For the first time, the 2022 CASP (Critical Assessment of Structure Prediction) community experiment included a section on computing multiple conformations for protein and RNA structures. There was full or partial success in reproducing the ensembles for four of the nine targets, an encouraging result. For protein structures, enhanced sampling with variations of the AlphaFold2 deep learning method was by far the most effective approach. One substantial conformational change caused by a single mutation across a complex interface was accurately reproduced. In two other assembly modeling cases, methods succeeded in sampling conformations near to the experimental ones even though environmental factors were not included in the calculations. An experimentally derived flexibility ensemble allowed a single accurate RNA structure model to be identified. Difficulties included how to handle sparse or low-resolution experimental data and the current lack of effective methods for modeling RNA/protein complexes. However, these and other obstacles appear addressable.

Long-term outcomes of laser dacryoplasty combined with intubation using a new silicon tube in patients with lacrimal duct obstruction.

To determine the 15-year outcomes of laser dacryoplasty (LDP) in patients with lacrimal duct obstruction; and to evaluate LDP combined with intubation using a new silicone tube to treat complicated cases. Patients with lacrimal duct obstruction and treated with LDP between April 2000 and April 2005 were investigated retrospectively. Totally 116 eyes with completed 15-year follow-up records were included in this study. For complicated cases (52 eyes of 52 patients), both LDP and intubation using a self-made silicon tube were performed. For patients with uncomplicated obstruction (64 eyes of 61 patients), only LDP was performed. Outcomes were assessed based on results of lacrimal irrigation and degree of symptoms during follow-up. At the follow-up time of 15y, 81 eyes achieved full success (69.8%); 21 eyes got improved (18.1%); and 14 eyes were considered failure (12.1%). The success rate was 71.2% (37/52 eyes) for complicated cases; and 68.8% (44/64 eyes) for uncomplicated cases. No statistically significant difference between two groups was observed (P=0.961). No postoperative complication was observed. LDP is a well-tolerated, simple, and effective procedure with satisfactory long-term outcomes in selected patients, which make it a good alternative to conventional dacryocystorhinostomy. In addition, intubation with the self-made mono-canalicular silicone tube facilitates the management of complicated cases with few complications.

Public order: limit or value? Inequality and poverty in the relationship between credit concession, child support, manners, education and accomplishment of the human being

Inequality and poverty are frequent topics in the modern debate. Despite, in fact, global opulence is in constant increase, it is known to all that the contemporary world continues to deny basic freedoms to a high number of human beings. Such evidence, moreover, is set to stay that way, since civil society will continue to obstruct the access to one of the fundamental requirements for a full professional success, which is represented by the opportunity to achieve an adequate education. An opportunity that, in turn, is strongly linked to the family environment, in which one lives, as well as to the level of income that one possesses. The purpose of research is to show that in a finance which is proclaiming itself respectful of ethical values, the purpose of research is to show that in a finance which is proclaiming itself respectful of ethical values, possible requests for financial support, which are intended to allow the full accomplishment of the individual, must be always considered worthy, finding directly in the order's fundamental principles their right foundation., which are intended to allow the full accomplishment of the individual, must always be considered worthy, finding directly in the order's fundamental principles their right foundation.

DILEMMAS OF RE-NATIVIZATION OF INDIGENOUS LAW

The author in this study tests the applicability of basic categories of Leon Petrażycki’s (1865–1931) socio-psychological theory of law, pointing at ambiguity of the concept of ‘indigenous law’, ‘natives’ law’ and ‘customary law’. First, however, the right to one’s own law is followed through the history of colonization. It is essential for the plight of the indigenous people that already in 1537 Popes recognized that ‘original inhabitants’ had ‘rights’ and thus ‘legitimate claims’. If, on the one hand, there are ‘rights’ and ‘rightful claims’ then, on the other, there are duties that include not only the negative refraining from appropriation but also the positive duty to protect in exchange for the impairing the indigenous sovereignty. But whenever the nexus iuris is recognized, i.e. the link of correlative rights and duties, there is a law (Petrażycki) and ‘inherent – even if impaired, or as some say, abused – sovereignty of the indigenous people’ (Justice Marshall). The pluralist notion of ‘law’, the distinction between the ‘normative positive’ reference and the ‘normative intuition’ and the distinction between the ‘normative’ and the ‘factual’ should allow one to organize systematically the multiple issues that one encounters when approaching the area of ‘indigenous law’. From discussion of the official nonindigenous indigenous law exemplified by the federal Native American law of the United States the paper moves on to discuss the Navajo case of the official tribal law. It comes out that the native procedures and law are full of religious meaning so the ‘cultural’ sovereignty is much more fundamental and value-loaded than the secular philosophy of human rights incommensurable with the right to one’s own law. This is not considered when borrowing from native law into secular Western law (Greenland’s Criminal Code; mediation procedures in North America). The meaning of cultural sovereignty is the right to develop one’s law so that it fits one’s needs and aims. But the full success story is when the antithesis of the ‘indigenous’ and ‘dominant’ law is settled through the feedback from the former to the latter, like when the law – not only of a country but also on the global level – becomes syncretic and embraces deeper universalization of the human rights.

Iatrogenic oesophageal fistulas after neckregion surgery

&lt;b&gt;Introduction:&lt;/b&gt; Iatrogenic esophageal fistulas after neck surgery are a rarely discussed topic in the Polish literature. Due to the scarcity of publications on esophageal fistulas, esophageal perforation after neck surgery, the topic of this paper was undertaken. For this purpose, the literature was reviewed and a description of two cases was presented, comparing the diagnostic and therapeutic difficulties encountered to the world literature.&lt;/br&gt;&lt;/br&gt; &lt;b&gt;Case reports:&lt;/b&gt; In the cases presented, esophageal fistula formation occurred after operations in the neck. In the first case, the esophageal fistula was a complication after resection of Zenker’s diverticulum and in the second case, the fistula developed after removal of the thyroid gland. Esophageal fistulas in the described patients proved to be a major therapeutic challenge. Despite a number of repair procedures undertaken by surgeons, laryngologists and thoracic surgeons in both patients, full therapeutic success was not achieved. In the present study, the authors related the management modalities of the presented patients to the experience of other centers. Methods of treating esophageal fistulas, possible complications and ways of treating these complications are discussed.

World Hepatitis day 2021 –screening and vaccination against Hepatitis B virus in Accra, Ghana

BackgroundIn Ghana, Hepatitis B virus (HBV) infection remains a major public health threat as in many parts of the world. Even with an effective vaccine, there are shortfalls with low vaccine coverage among adults. To create awareness and encourage vaccination, community engagement and public-private partnerships are needed in endemic settings to help fund campaigns and offer screening and vaccinations at no cost to under privileged people.ObjectivesAn awareness and screening exercise was scheduled by University of Ghana-based Hepatitis-Malaria (HEPMAL) project team to coincide with the World Hepatitis Day (WHD) 2021. It was to engage the community in creating awareness of the menace and offer diagnostic services to ascertain prevalence levels and provide needed clinical support.MethodsParticipants from the University of Ghana community and its immediate environs were registered, taken through pre-counselling sessions where they were educated on hepatitis transmission and prevention before consenting. Eligible participants were screened for HBV markers (HBsAg, HBeAg, HBsAb, HBcAb,HbcAg) with a rapid test kit. All HBsAb-negative participants were recommended for initial vaccination at the event, whilst the subsequent shots were administered at the University Hospital Public Health Department. Hepatitis B surface Antigen-positive participants were counselled and referred for appropriate care.Results/ Outcomes: A total of 297 people, comprising of 126 (42%) males and 171 (58%) females aged between 17 and 67 years were screened during the exercise. Amongst these, 246 (82.8%) showed no detectable protective antibodies against HBV and all of them agreed to and were given the first dose HBV vaccine. Additionally, 19 (6.4%) individuals tested positive for HBsAg and were counselled and referred to specialists from the University Hospital for further assessment and management. We found that 59 (19.9%) of our participants had previously initiated HBV vaccination and had taken at least one dose of the vaccine more than 6 months prior to this screening, 3 of whom tested positive for HBsAg. For the three-dose HBV vaccines deployed, a little over 20% (50/246) and a further 17% (33/196) did not return for the second and the third doses respectively, resulting in an overall 66% (163/246) of persons who completed all three vaccinations.Conclusions/ Lessons learnt: Our medical campaign exercise established an active case prevalence rate of 6.4% and achieved a full vaccination success rate of 66% which is critical in the induction of long-term immunity in the participants. Aside these achievements, we would like to reiterate the importance of the use of different approaches including educational events and WHD activities to target groups and communities to raise awareness. Additionally, home and school vaccination programmes may be adopted to enhance vaccine uptake and adherence to the vaccination schedule. We plan to extend this screening exercise to deprived and/or rural communities where HBV incidence may be higher than in urban communities.