Blood Pressure Control and Selected Care Practices among Patients with Hypertension Attending the Medical Clinic at Base Hospital Muthur, Sri Lanka: A Retrospective Record-Based Study
Rajiya Mohamed Muyees, Thayal Nathasha Vitiyala Vidanage
Abstract: Background: Hypertension is a major modifiable risk factor for cardiovascular, cerebrovascular and renal disease. Facility-level studys of blood pressure control and routine documentation can identify practical gaps in chronic disease care. Methods: A retrospective record-based study was conducted using 189 hypertension clinic records from Base Hospital Muthur, Sri Lanka, reviewed during August–September 2026. The latest documented systolic and diastolic blood pressure values and selected indicators of comorbidity assessment, investigations, lifestyle advice, follow-up and referral/complication status were extracted. Blood pressure was classified as controlled when systolic blood pressure was
Foreign Aid, Real Exchange Rate Dynamics and Dutch Disease in Rwanda: Evidence from a Cointegrated Time-Series Model, 1990–2023
Alan Tuyisenge
Abstract: This study examines the relationship between foreign aid and the real exchange rate in Rwanda using annual data for 1990–2023 and a five-variable Vector Error Correction Model (VECM). The principal system contains the real effective exchange rate (REER), aid relative to gross national income (AID/GNI), terms of trade (TOT), trade openness (OPEN), and government expenditure relative to GDP (GOV/GDP). The empirical strategy uses Johansen maximum-likelihood cointegration with one lag in first differences and a restricted constant in the cointegrating relation. The trace test identifies one cointegrating relationship. In the normalized long-run vector, AID/GNI is 0.895 (SE 0.069; p
Prevalence of Menstrual Migraine Among University students and its Impact on Quality of Life
Nisha Nambiar, Swapneela Jacob, Wong Jing Ni
Abstract: Background: Menstrual migraine associated with hormonal fluctuations and low pain threshold during the menstrual cycle is common but underrecognized condition. It significantly impairs daily functioning and quality of life yet research into their prevalence and impact remains limited. This study aims to address this gap by exploring the prevalence of menstrual migraine and to find its impact on quality of life as this pain occur along with menstrual pain. This highlights the importance of interventions to improve well-being during periods.
Method: A cross-sectional study with 384 participants was conducted. Data was collected via an online survey incorporating demographic questions, the Menstrual Migraine Assessment Tool (MMAT), and the 12-Item Short Form Survey (SF-12). Pearson’s correlation analysed the relationship between menstrual migraines and quality of life using IBM SPSS Statistics version 26.
Results: The study reported 30.2% females having menstrual migraines. Participants with menstrual migraines had lower SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores compared to those without, with mean PCS and MCS scores of 43.3±5.91 and 38.6±8.21, respectively and an overall SF-12 score of 77.3±6.66. Mental health decline was more pronounced. Pearson’s correlation analysis showed a fair negative correlation between menstrual migraines (MMAT) and quality of life (SF-12) (r= -0.347, p
Impact of Primary Dysmenorrhea on quality of life among female University Students
Nisha Nambiar, Swapneela Jacob, Jeffrey Ong Yeu Hern
Abstract: Background: Primary Dysmenorrhea is the pain and discomfort occurring every month during menstrual periods. Bleeding along with severe pain in low back and abdominal region plus fatigue, breast soreness, lack of energy, weakness, vomiting and even fainting is common. This causes constant discomfort, reduced physical activity, absenteeism from class and work and cause irritability and mood upsets. These effects are crucial among females for whom studies, social participation, and daily functioning are important components of quality of life. It is utmost important to investigate the impact of primary dysmenorrhea on quality of life in females to analyze how this pain affects their daily functioning and well-being.
Method: A cross sectional study design was conducted. Convenience sampling was used to recruit participants. A self-administered questionnaire that consists of four sections was distributed to participants. Google form was used and the participants filled a validated questionnaire with four subsections on menstrual pain and quality of life details. SPSS version 26.0 was used to analyze the collected data.
Result: 315 female responses were obtained. Most of the participants reported higher pain intensity. A statistically significant association was observed between the severity of dysmenorrhea and quality of life (p < 0.05). Menstrual pain was associated with difficulties in daily activities, low grades in exam and difficulty in sports participation.
Conclusion: Primary dysmenorrhea has a negative impact on the quality of life of females. It affects their physical functioning, studies daily activities with tiredness and fatigue. Greater severity of menstrual pain is associated with greater disruption to daily life and reduced quality of life. Appropriate management, and health education regarding primary dysmenorrhea are important to reduce its impact and improve the overall well-being and quality of life.
What Lebsir’s Prime Progressions Gave the MRB Problem
Marvin Ray Burns
Abstract: Habib Lebsir studied three-term arithmetic progressions in the square intervals [nZ,(n+1)Z) and focused on progressions whose arithmetic mean is nZ+n-1, nZ+n, or nZ+n+1. His paper reports this pattern for the first 100 intervals and presents its continuation as a conjecture. When this geometry is applied to the MRB constant, the middle quantity nZ+n=n(n+1) becomes the exact center of a natural square block of the defining alternating nth-root series. This observation yields a symmetric block decomposition, a curvature correction with faster decay, and an Euler-polynomial description of the block coefficients. The purpose of this note is to record that connection carefully and to explain why it may be useful in the continuing rationality problem for the MRB constant.
Exergy-Based Assessment and Annual Performance of Rotary Pressure Exchanger–Integrated Transcritical CO₂ Refrigeration in Extreme Hot Climates
Alyan Al-Harbi
Abstract: Transcritical CO₂ systems lose efficiency in extreme heat through high-pressure expansion and flash-gas recompression. A rotary pressure exchanger (PX) recovers part of the expansion work by using the dense gas-cooler outlet stream to compress receiver vapour inside rotating ducts. This study evaluates a supermarket booster with 100 kW medium-temperature and 25 kW low-temperature loads in four configurations: flash-gas bypass (FGB), parallel compression (PC), PX with flash-gas bypass (PX), and PX combined with parallel compression (PX + PC). A reduced-order model based on constant-pressure displacement of the driven vapour and the Span–Wagner equation of state is coupled to the booster model. High-side and receiver pressures are optimised from 0 to 52 °C. Component exergy destruction is evaluated for each layout, while 8784 hourly weather observations from 2024 at Kuwait International Airport and Ali Al Salem, Kuwait, provide the basis for annual performance. At 45 °C, PX + PC achieves a COP of 1.66, compared with 1.37 for PC and 1.14 for FGB, while total exergy destruction falls from 85.7 kW in FGB to 51.8 kW. Annual electricity use falls by 11.7% relative to PC and 24.0% relative to FGB. Peak power is reduced by up to 24.2% relative to PC, and hours of operation at the 120 bar high-side limit fall by 87–88%. Volumetric effectiveness has the greatest influence on annual savings: effectiveness of 0.7–1.0 gives savings of 9.2–13.0% relative to PC. The results support pairing a PX with parallel compression for efficient CO₂-only commercial refrigeration in extreme heat.
Post-Quantum Key Agreement for CANsec over CAN XL: A Worst-Case Time-to-Key Analysis with ML-KEM
Omar Al-Daihani
Abstract: CAN XL supports payloads of up to 2048 bytes per frame. CANsec adds a MACsec-like data plane but leaves key agreement unspecified. Pre-shared keys alone provide no forward secrecy, and classical elliptic-curve exchange is vulnerable to cryptographically relevant quantum computers, a concern for long-lived vehicles. This paper proposes PQ-CKA, a CANsec key agreement based on ML-KEM (FIPS 203): the server broadcasts an ephemeral encapsulation key, members return ciphertexts authenticated with pre-shared keys, and the secure association key is distributed under KEM-derived key-encryption keys. A compositional worst-case time-to-key (WC-TTK) bound accounts for CAN XL frame durations, arbitration with transmission errors, first-in-first-out server processing and execution times derived from measured Cortex-M4 cycle counts. Evaluation uses a real-vehicle message set with 106 identifiers and 2,392 frames/s at 50% bus load, with 10 000-run simulations checking the bound. For 16 ECUs, ML-KEM-768 gives a WC-TTK of 122.7 ms versus 119.4 ms for X25519; all members hold the new key after 94.1 ms. The same protocol requires 363.5 ms on CAN FD at 2 Mbit/s. Mutual ML-DSA authentication increases the bound to 337.3 ms and makes it probabilistic because signing has an unbounded geometric tail. Sequential protocol rounds and the server's decapsulation rate dominate time-to-key, rather than post-quantum message size.
The Extent of Participation of Rural Women in Agricultural Production: A means of Livelihood in Rajaf Payam, South Sudan
M.A. Oliwai, Harrison Henry Boying, Santo Lado
Abstract: Rural women play integral role in food production, development and stability of rural areas in South Sudan. However, the role of rural women in South Sudan’s economic sector has been neglected. This study aims to document the extent of involvement of rural women in agriculture in Rajaf Payam. Purposive and random sampling techniques were used to select 120 sample size. A structured questionnaire was used, followed by frequency and descriptive analysis of the results. The results showed that 87.5% of rural women were within 18 – 60 years age bracket, 41.6% mostly married, 87.5% had yearly extension contacts and 54.2% were members of social organization. More than half of the women 51.6% lacked formal education and 82.5% had 11-40 years of farming experience. A significant 62.5% had farm sizes less than one hectare, with 58.3% of the farmers borrowing informally. Their level of income was found to be low. Cowpea, jute mellow (Kudura), groundnut, cassava, maize, okra, egg plant, and sorghum constituted predominant crops grown by the farmers while they also reared goats and sheep and kept chickens. It was also found that the farmers participated in land clearing, sowing, weeding, harvesting, transportation of produce/products, processing, storage and marketing. High cost of agricultural inputs (improved seeds and fertilizers) and high cost of farm labor were the highest ranked constraints faced by the rural women. The research recommends the provision of rural women farmers with relevant agricultural technologies, appropriate resources and training to enhance their production. Access to gender-sensitive technologies can alleviate the burden of agricultural tasks, processing, and storage activities, thereby enabling individuals to engage in other income-generating activities.
Boey Score as a Predictor of Mortality in Patients with Perforated Peptic Ulcer After Laparotomy at a Private Regional Hospital: An Analytic Study at Efarina Etaham Hospital, Pematang Siantar, Indonesia, 2022–2026
Rinadi Andara
Abstract: Perforated peptic ulcer (PPU) remains a major surgical emergency with persistently high postoperative mortality, particularly in resource-limited private regional hospitals where simple, rapid risk-stratification tools are most needed. This retrospective analytic cohort study evaluated the Boey score (preoperative shock, major comorbidity, and delayed presentation >24 hours) as a predictor of postoperative mortality in 67 patients with PPU who underwent laparotomy at RS Efarina Etaham, Pematang Siantar, Indonesia, between November 2022 and June 2026, using total sampling. Overall mortality was 25.4%. Delayed presentation >24 hours was the most frequent component (94.0%), followed by major comorbidity (61.2%) and preoperative shock (28.4%). Mortality rose steeply with increasing Boey score, from 0% at scores 0–1 to 87.5% at score 3 (chi-square p
ChallengeShift-FL: Rotating Behavioral Fault Challenges for Detecting Stealthy Poisoning in Non-IID Federated Industrial Learning
Sayor Ajfar Aaron, Sajjat Hossain Abir, Ashif Newaz, Md. Mushfiqur Rahman, Md Monir Hossain
Abstract: We investigate whether rotating controlled fault challenges improves behavioral screening of poisoned client updates under non-IID federated learning. ChallengeShift-FL compares candidate models with the current global model on sensor-window interventions, applies a normal-data stability allowance, and maintains bounded temporal trust for soft aggregation. A reproducible synthetic experiment executes seven methods across seven scenarios and three paired seeds: 147 runs and 3,528 federated rounds. Comparisons include FedAvg, coordinatewise median, fixed and rotating behavioral weighting, the complete design, and two ablations. Rotation does not consistently reduce target-fault suppression. Under limited-knowledge adaptive poisoning, instantaneous rotation changes target-to-normal error from 54.22% to 53.78%, a paired difference of −0.44 percentage points; the complete design performs worse than its no-rotation counterpart. Under scaled replacement, the complete design yields 99.72% target-to-normal error, compared with 40.11% for instantaneous rotating weighting and 21.22% for coordinatewise median. Its stability allowance reduces honest suspicious flags but also admits damaging fault-suppression updates. All candidates retain positive aggregation weights, so zero hard rejection is structural rather than evidence of fairness. The findings expose failure modes of normal-only tolerance and trust inertia. They do not establish an industrial security guarantee or a general advantage of rotation. Challenge coverage and sample refresh remain confounded, and validation on public physical fault datasets is required.
Girls’ Education Policy Management and Retention Rate in Twelve Years Basic Education in Muhanga District, Rwanda
CYUZUZO RUKUNDO Elyse, Dr. Andala O. Hesbon
Abstract: This study examined the influence of girls’ education policy management on female students’ retention in Twelve Years Basic Education schools in Muhanga District, Rwanda. Specifically, it assessed the effects of policy development and planning, implementation practices and monitoring and evaluation on student retention. Guided by human capital theory, social learning theory, gender equity theory, the capability approach, and education production function models, the study employed a mixed-methods research design. A sample of 381 respondents was selected from a target population of 7,887, comprising 332 female students, 48 school staff members and 1 education leader at district level. Data were collected using questionnaires, interview guides, and five-year school retention records. Quantitative data were analyzed using SPSS version 26.0, while qualitative data were examined through thematic content analysis. The findings revealed that all three dimensions of girls’ education policy management positively influenced female students’ retention. Policy development and planning (B= 0.472, t= 4.0732, p < 0.001), implementation practices (B= 0.328, t = 4.556, p < 0.001), and monitoring and evaluation (B= 0.404, t = 6.098, p < 0.001) demonstrated positive associations with retention. Monitoring and evaluation emerged as a particularly important mechanism for tracking policy implementation, addressing absenteeism, and following up on school dropouts. The study recommends strengthening policy planning, stakeholder engagement, consistent implementation, and systematic monitoring to improve girls’ retention in basic education. These findings provide insights for police makers and education practioners seeking to promote gender equity and educational continuity in Rwanda.
Emerging Challenges in Healthcare Systems
Ahmed Hussain Daghreri, Yasser Zayd Ahmed Zyad, Hussam Hamad Mohmad Hakami, Mohsen Shami Alielemi, Ahmed Abdullah Alwadani, Basim Mohammed Dighrir, Ali Ahmed Halawi, Ali Awaji Mohammed Humedi, Ahmed Ali Tamah, Aisha Omar Ayashi, Ibrahim Mohammed Mashhour
Abstract: Healthcare systems are vital to the health and wellbeing of populations but are navigating an increasingly complex environment. Population aging, increasing chronic disease rates, technological advances and the need for more workers, higher health care expenses, and threats to global health are taking a toll on health care systems and professionals. Meanwhile, patients are also demanding access to health services which are safe, efficient, affordable, responsive and accessible. These expectations add further stresses on already constrained resources and growing workloads.
The changing pattern of disease is one of the big problems. Healthcare systems are grappling with chronic diseases (cardiovascular, diabetes, cancer, respiratory) and an increasing response to infectious diseases and other acute diseases and problems. The increased cost burden may also be caused by ageing populations, since elderly patients tend to be more complex and demanding of ongoing and more intensive care. These pressures occur in addition to limited and uneven distribution of health care providers, which may impact access, quality and continuity of care.
Current Trends in Healthcare and Public Health
Amal Fayez Al-Mutairi, Abdullah Mohammed Zabbani, Huda Mohammed Al Daghriri, Khadija Ghareeb Mathami, Manar Ibrahim Alhawsawi, Ohood Khaled Asiri, Suaad Hussain Almehmadi, Ghadah Makki Mohammed Zakri, Abdulrahman Yahya Yahya Qadri, Abdulaziz Ali Yuseif Alareshi, Ali Hassan Mahzari
Abstract: Healthcare and public health is an integral part of human development, social stability and economic growth. The prevention, diagnosis, treatment and management of specific health problems is the focus of healthcare while the focus of public health is prevention and improvement of the health of entire populations. While these fields have various main lines of inquiry, they have a shared purpose of affecting health outcomes and the prevention of unnecessary morbidity and mortality. Advances in technology, demographic shifts, new disease threats, environmental issues, and changing expectations of quality and availability of health services have led to dramatic change in both fields in recent years.
A key advance in modern health care is the shift from a predominantly facility-based care to more integrated, preventive and patient-centred care. Electronic health records, continuous monitoring of patients and remote consultations are now possible through digital technologies, which have broadened the scope of opportunities. AI and sophisticated diagnostic tools are also opening up new avenues for disease detection, clinical decision-making, and streamlining healthcare processes. Meanwhile, public health practice is more and more attuned to the social, economic, behavioral and environmental determinants that have an impact on health.
Research and Innovation in Clinical Practice
Esmail Hassan Dabbaj, Mohammed Abu Bakr Badidi, Bandar Hamoud Aljohani, Yahay Gassim Tohari, Hawthan Salman Aljabri, Mohammed Suda Hassan Sayram, Sara Salim Harisi, Mohammed Khalefi Basbren, Jaffai Hamad Ibrahim Hamad, Rana Mansuor Moharg, Hamoud Aedh Musri Alqahtan
Abstract: Research and innovation are key elements of contemporary clinical practice and have important role to play in enhancing the quality, safety and effectiveness of health care. Rapid progress in medical science, evolution of disease patterns, new technologies and changing attitudes of patients, and the growing complexity of health care delivery are all constantly influencing clinical practice. Research delivers objective knowledge to healthcare practitioners for the understanding of diseases, measuring treatment, determining risk and enhancing clinical choice. Innovation enables this knowledge to be transformed into new technology, process, models of care and methods of working that can enhance the provision of health care services.
The evidence-based practice is now an important method to link research to daily clinical practice. This includes applying the most up to date research findings alongside professional skill and patient-specific preferences and needs. But research can produce evidence that isn't translated into the regular practice. There can be a gap between research results and clinical practice that can be attributed to factors of limited resources, insufficient training, organizational considerations, lack of access to research, unwillingness to change, and variations in the healthcare setting. Therefore, better connections between researchers and clinical practitioners are essential for maximizing the likelihood of transfer of useful evidence to clinical practice. Recent evidence found that factors like education, access to guidelines, organizational support and positive attitudes are important factors affecting evidence-based practice.
Advances in Medical and Health Sciences
Jamilah Saleh Alghazwani, Saud Safar Mohammed Alshahrani, Mohammed Ali Ageeli, Ali Abdu Gharawi, Ali Muodiysh Abdullah Matri, Wejdan Hassan Hussein Hakami, Alanoud Ali Bin Ali Otayf, Reem Hamadi Mohsn Meashi, Jaber Abushamlah Mousa Maashi, Sara Hassan Alami Hakami, Nada Mohammed Mousa Ageeli
Abstract: The medical and health sciences have made tremendous advances over the past decades, altering the way diseases are prevented, diagnosed, treated and managed. Advances in science, technology and clinical practice have helped to extend lifespan, lower death rates from some causes and enhance the quality of life for many populations. The emerging technologies of medical imaging, molecular biology, pharmaceutical research, biotechnology, and digital healthcare have given healthcare providers the means to detect disease at an earlier stage, prescribe and administer correct treatments, and track patient outcomes more effectively.
Improvements in medical science go hand-in-hand with improvements in scientific research and inter-disciplinary collaboration. This new era of healthcare sees a blend of medical and other disciplines like genetics, engineering, computer science, pharmacology, bioinformatics and public health. The partnerships have resulted in new diagnostic devices, more precise therapies, less invasive surgeries and innovative disease prevention techniques. The use of digital technologies and Artificial Intelligence (AI) is also impacting clinical decision-making, medical research and the organisation of healthcare services.
Advanced Weld Failure Prediction in Crashworthiness CAE
Tushar Phule, Sunil Waghmare
Abstract: Weld separation can redirect load paths, accelerate structural collapse, and create large discrepancies between physical crash tests and finite-element predictions. The difficulty is not limited to assigning a single rupture force. Automotive joints experience mixed-mode normal, shear, bending, and torsional loading; sheet tearing may compete with nugget pull-out or interfacial fracture; local heat-affected-zone softening and geometric eccentricity alter the effective resistance; and mesh size, connector formulation, strain rate, manufacturing scatter, and model assembly quality all influence the numerical response. This paper presents a comprehensive methodology for advanced weld failure prediction in crashworthiness computer-aided engineering (CAE), with emphasis on resistance spot welds, gas metal arc and metal inert gas seam welds, laser welds, projection welds, and mixed-material joints represented in explicit finite-element solvers such as LS-DYNA. The framework separates joint behavior into elastic stiffness, plastic deformation, damage initiation, mixed-mode interaction, progressive degradation, final separation, and post-failure contact. It defines a hierarchical test pyramid, parameter-identification workflow, verification matrix, full-vehicle validation strategy, uncertainty treatment, and governance process. Particular attention is given to solid nugget, beam/connector, tied-contact, cohesive, and detailed heat-affected-zone approaches; force-based versus stress/strain-based criteria; mesh-objective regularization; and model transfer across gauges, grades, stack-ups, and loading rates. A staged implementation is proposed in which screening-level connectors are retained for non-critical joints while high-fidelity representations are deployed along dominant crash load paths. The resulting process improves physical realism without imposing uncontrolled model size or calibration complexity. The paper concludes that predictive weld modeling is best treated as
Influence of Climate Change Knowledge on Adoption of Agroforestry Practices in Machakos County, Kenya
Merveille Sanginga Arlette, Ezekiel Ndunda, Monicah Mucheru-Muna
Abstract: Climate change continues to threaten agricultural productivity and household livelihoods across semi-arid regions in Kenya. Small-scale farmers remain highly vulnerable to erratic rainfall patterns, prolonged droughts, declining soil fertility, and increasing food insecurity because agricultural production in these regions largely depends on rainfall. Agroforestry has increasingly been promoted as an important climate adaptation strategy because it improves soil conservation, enhances food security, strengthens environmental sustainability, and increases household resilience. Despite these benefits, adoption of agroforestry practices among farmers remains inconsistent. This study, guided by Rogers' Diffusion of Innovation Theory, examined how knowledge about climate change influences adoption of agroforestry practices among small-scale farmers in Machakos County, Kenya. The study adopted a cross-sectional descriptive research design targeting 245 small-scale farming households from selected sub-counties in Machakos County. Data were collected using structured questionnaires. Quantitative data were analyzed using descriptive and inferential statistics, including chi-square analysis and mean score analysis, while qualitative findings were analyzed thematically. The findings revealed that agroforestry adoption was generally high across respondents, with adoption rates ranging between 70% and 85% across most household categories. Home gardens emerged as the most common agroforestry practice, particularly among female respondents (53.5%). The study further established high levels of climate change awareness among farmers, with respondents strongly agreeing that climate change affects food production (M = 4.58), that farmers require climate change knowledge (M = 4.62), and that climate knowledge empowers women farmers (M = 4.79). Significant relationships were observed between farming experience (p = 0.015), land tenure system (p = 0.008), and the types of agroforestry pr
A Socio-Historical Analysis of Indigenous Knowledge Systems Reflected in Traditional Pan-Craft Industry in the North Central Province of Sri Lanka: A Qualitative Case Study
Prof. MKL. Irangani, Dr. MA. Prasad Kumara, Mr. BMC. Madhusankha Bandara, Ms. MAL. Madhushika
Abstract: Indigenous Knowledge Systems (IKS) are an important heritage that represents the long-standing experiences, traditional techniques and cultural values of human society of Sri Lanka. Sri Lankan rural communities have developed traditional production methods using natural resources to meet basic needs. The traditional pan craft industry reflects this indigenous knowledge and has a long history among rural communities in Sri Lanka’s North Central Province (NCP). The main objective of this research is to analyze the indigenous knowledge systems embedded in the traditional pan craft industry of Kunuragama village in the North Central Province from a social and historical perspective. This study employed a qualitative research approach. Primary data were collected through in-depth interviews and participatory observation involving artisans, elderly community members, and knowledge holders in the pan craft industry in Kunuragama village. Secondary data were gathered from literary sources, research books, and reports. The collected data were analyzed using thematic analysis. The findings of the research revealed that the pan craft industry is not only a simple economic activity, but also a complex local knowledge system linked to a good understanding of the environment, natural resource management, production skills and social relations. It was also revealed that there is knowledge based on experiences transmitted over many generations in the process of selecting, preparing, coloring and creating products. Accordingly, this research shows that the Kunuragama pan craft industry is a unique heritage linked to local cultural identity, rural lifestyle and environmental adaptation. Accordingly, it is confirmed that the traditional pan craft industry is an important field that reflects the indigenous knowledge systems, social history and cultural heritage of Sri Lanka.
