Articles

<b>Objective: </b>Kratom (Mitragyna speciosa) has emerged as a widely accessible nonprescription substance that is being utilized in the United States. Kratom is commonly used for self-management of pain, psychiatric symptoms, and opioid withdrawal. Veterans receiving care within the Veterans Health Administration (VHA) represent a high-risk population due to elevated rates of chronic pain, post-traumatic stress disorder (PTSD), and substance use disorders (SUDs). Despite increasing prevalence, kratom use remains underrecognized and is not routinely assessed in clinical practice. This narrative review studies the pharmacology, patterns of use, and clinical implications of kratom among Veterans and proposes a standardized screening framework for implementation within the VHA. This will help to align with the patient centered care delivered to our Veterans related to mental health conditions often concurrent with substance use, pain management, and opioid safety. <b>Methods:</b> A targeted narrative review of the literature was conducted using PubMed, Google Scholar, and relevant federal agency reports. Search terms included “kratom,” “Mitragyna speciosa,” “substance use disorder,” “opioid withdrawal,” and “Veterans.” Articles were selected based on relevance to pharmacology, epidemiology, adverse effects, and clinical implications. Findings were synthesized and interpreted using DSM-5-TR substance use disorder criteria. <b>Results:</b> Kratom exhibits partial agonist activity at μ-opioid receptors, producing dose-dependent stimulant and opioid-like effects. According to the National Institutes of Health's National Library of Medicine, mu-opioid receptors, found in the brain and spinal cord, are primarily responsible for pain relief and other opioid-like effects such as euphoria and respiratory depression. Veterans frequently use kratom to self-manage pain, mood symptoms, and opioid withdrawal (Garcia-Romeu et al., 2020; Grundmann, 2017). Kratom use is associated with dependence, withdrawal, and increased risk of polysubstance use (Post et al., 2019). Detection remains limited due to lack of standardized screening tools and the absence of detection in routine toxicology panels. <b>Conclusions:</b> Given the rising incidence of kratom use among Veterans and associated clinical risks, implementation of a standardized screening within the VHA is an appropriate intervention. Incorporating DSM-5-TR-informed criteria into structured assessments can help improve early identification, enhance patient safety, and support evidence-based treatment strategies.

<b>Background:</b> Sleep deprivation is increasingly prevalent among young adults due to academic, occupational, and social demands, making them susceptible to circadian disruption. Executive functioning—encompassing working memory, inhibitory control, and cognitive flexibility is essential for academic and professional success. This meta-analysis quantifies the effect of sleep deprivation on executive functioning in healthy young adults. Practical Implications: These findings highlight the need for evidence-based interventions such as university-level sleep education programs, flexible academic scheduling, and workplace policies promoting adequate sleep to optimize cognitive performance and productivity among young adults. <b>Methods: </b>Following PRISMA 2020 guidelines, PubMed, Scopus, PsycINFO, and Web of Science were searched (January 2000–March 2024) for studies assessing acute (<6 hours sleep or ≥24 hours total deprivation) or chronic (<6 hours/night over multiple days) sleep deprivation in young adults. Outcomes included validated executive function tests (e.g., Stroop, N-Back). Random-effects meta-analysis (Hedges’ g) was conducted using R (version 4.3.2) with metafor/meta packages. Heterogeneity (I², Q-test), sensitivity (leave-one-out), and publication bias (funnel plot, Egger’s test) were evaluated. <b>Results: </b>Out of 2,478 screened studies, 39 met inclusion criteria (n=4,578). Sleep deprivation had a moderate-to-large detrimental effect on executive functioning (Hedges’ g = -0.62, 95% CI [-0.78, -0.45], p<0.001). Subdomain analysis revealed greatest impairment in working memory (g = -0.71), followed by inhibitory control (g = -0.59) and cognitive flexibility (g = -0.49) (all p<0.001). Moderate heterogeneity was present (I² = 58%), with results robust to sensitivity analysis. Egger’s test indicated no significant publication bias (p=0.22). <b>Interpretation</b><b>: </b>Sleep deprivation significantly impairs executive functioning in young adults, especially working memory. Interventions improve sleep may enhance cognitive performance and should be integrated into public health strategies and educational policies. Future research should assess chronic restriction and individual vulnerability factors.

This review article provides a comprehensive anatomical analysis of soccer footwear, delving into the intricate structure and functional roles of its constituent components, including the upper, heel counter, tongue, toe box, outsole/sole plate, studs, and insole. Manufacturing processes influencing these structural elements are also discussed. Current market offerings and patented innovations in soccer cleat technology are examined through a biomechanical lens, highlighting their intended functions and limitations. A critical synthesis of existing knowledge underscores the anatomical and biomechanical distinctions between male and female athletes' feet, arguing for the necessity of sex-specific footwear design. This review culminates in emphasizing the imperative for specifically engineered soccer footwear for female athletes to optimize performance, enhance comfort, and mitigate the elevated risk of lower extremity injuries prevalent in the female game, thereby identifying crucial directions for future research in sports biomechanics and footwear engineering.

<b>Background: </b>Maternal nutrition plays a crucial role in fetal brain development, with vitamin B12 being essential for neuronal myelination and cognitive function. The paper by Hrezova et al. entitled “Vitamin B12 Intake During Pregnancy Linked to Child Speech Development and Intelligence Quotient”, examines the association between maternal B12 intake and early childhood neurodevelopment. <b>Methods: </b>Using data from 5,151 mother-child pairs in the ELSPAC-CZ cohort, maternal B12 intake was assessed through dietary questionnaires, and child cognitive outcomes were evaluated at 18 months, 3 years, and 8 years. Multivariate adjustments were applied to control for potential confounders. <b>Results: </b>The research reports that higher maternal B12 intake was positively associated with improved language comprehension at 18 months (B=0.20,95% CI 0.06,0.34) and increased verbal IQ at 8 years (B=1.08,95% CI 0.09,2.08). However, no significant relationship was observed between maternal B12 intake and speech intelligibility at age 3 (OR=1.03,95% CI 0.99,1.07). Findings suggest B12’s role in early cognitive development but highlight gaps in its long-term effects. <b>Conclusions: </b>Ensuring adequate maternal B12 intake is vital for optimizing early neurodevelopment. Public health initiatives should promote B12 supplementation, especially for pregnant women at risk of deficiency. Further research with objective biomarkers is needed to clarify long-term effects.

<b>Background:</b> Diabetes is a chronic global health issue that requires effective management to improve patient outcomes and quality of life. Nursing education plays a critical role in empowering diabetic patients with self-management skills. Aim This systematic review evaluates the impact of diabetes-focused nursing education on patient outcomes and quality of life. <b>Methods:</b> This study uses PRISMA guidelines and a systematic approach to identify and evaluate relevant literature. <b>Results and Discussion:</b> Among the 14 studies reviewed, eight emphasized self-management education, while four incorporated multidisciplinary approaches. Findings consistently demonstrated that structured nursing education programs significantly improved self-management behaviors, glycemic control, and patient knowledge. For instance, nurse-led self-management programs resulted in substantial enhancements in self-care skills and diabetes-related knowledge. Moreover, interventions that combined health education with psychological support were particularly effective, leading to better blood glucose control and increased adherence to treatment. Studies that examined quality of life reported reductions in anxiety, improved lifestyle habits, and better overall self-management. These findings highlight the multifaceted benefits of nursing education, suggesting that structured, supportive programs positively impact both clinical and psychological aspects of diabetes care. <b>Conclusion:</b> The review emphasizes the value of comprehensive nursing education that integrates both clinical guidance and psychological support for holistic diabetes management. <b>Implications</b>: Ongoing professional development and culturally sensitive education programs are recommended to address the diverse needs of diabetic patients. Future research should investigate the long-term effects of nursing education and explore innovative strategies to enhance diabetes management outcomes.

<b>Background</b>: In the landscape of education, the decision-making process that leads students to pursue or reject nursing as a career is a multifaceted phenomenon shaped by a plethora of influences ranging from personal experiences to societal norms. <b>Aim</b>: To explore non-nursing students' insights on nursing education, seeking to shed light on the considerations and challenges that influence their views on nursing education. <b>Materials &#x26; Methods</b>: A qualitative approach using thematic analysis were utilized. Lincoln and Guba's framework for rigor and trustworthiness directed the validation process. Semi-structured interviews based on vetted questionnaires yielded the data<b>. Results</b>: Analysis of interviews with ten (10) non-nursing college students revealed three key themes: 1) initial insights, 2) factors influencing their insights, and 3) difficulty of nursing education. Non-nursing students view nursing education as multifaceted and rigorous, recognizing the profession's complexity but have reservations about the heavy workload, intense clinical demands, and health risks, particularly highlighted by the pandemic, which contributes to their reluctance to choose nursing as a career path. <b>Implications</b>: Addressing perceptions, enhancing curricula, offering mentorship, and providing emotional support, nursing education can be improved, steering more students towards a career in nursing. <b>Conclusion</b>: Non-nursing students respect the complexity of the nursing profession but are deterred by its demands and risks, indicating a need for educational reforms to better convey the role, value, and opportunities within nursing to encourage more students into the field.

Ghana's Free Senior High School (SHS) policy has been touted as one of the most significant educational reforms in recent years, fueling the nation's achievement of <i>Goal 4</i> of the United Nations Sustainable Development Goals (SDGs). While many studies have been conducted on the policy’s impact on beneficiaries, little is known about its impact on tertiary institutions. The purpose of this study is to evaluate the socioeconomic effects of the Free SHS policy on tertiary institutions in Ghana's Western Region. We also provide suggestions on how to improve the policy's efficacy and lessen any obstacles to its incorporation into higher education. Methodologically, 103 employees of Takoradi Technical University and the University of Mines and Technology were sampled using a purposive sampling technique. According to the report, despite the lack of adequate facilities such as lecture halls, dorms, and residence halls on campus, the Free SHS policy has increased enrollment at the postsecondary level. This has resulted in a high student-to-lecturer ratio, increased utility bills, a high cost of living on campus, and a rise in the opening of businesses on campus. To address some of these socioeconomic impacts, respondents proposed that the government should improve infrastructure in the country's higher institutions, hire more lecturers, boost incentives for lecturers, and foster partnerships with private institutions to support infrastructure development.

The management of supply chains is increasingly complex. This study provides a comparative analysis of the cost-benefit analysis for managing various risks. It identifies the financial implications of leveraging artificial intelligence in supply chains to better address risk. Empirical results show a business case for managing some sources of risk more proactively facilitated through predictive modeling techniques offered by AI. Across investigation streams, the use of AI results in an average total cost saving ranging from 41,254 to 4,099,617. Findings from our research can be used to inform managers and theorists about the implications of integrating AI technologies to manage risks in the supply chain. Our work also highlights areas for future research. Given the growing interest in studying sub-second forecasting, our research could be a point of departure for future investigations aimed at considering the impact of forecasting horizons such as an intra-day basis. We formulate a conceptual framework that considers how and to what extent performance evaluation metrics vary according to differences in the fidelity of predictive models and factor importance for identifying risks. We also utilize a mixed-method approach to demonstrate the applicability of our ideas in practice. Our results illustrate the financial implications of integrating AI predictive tools with business processes. Results suggest that real-world companies can circumvent inefficiencies associated with trying to manage many classes of risk via the use of AI-enhanced predictive analytics. As managers need to justify investment to top management, our work supports decision-making by providing a means of conducting a trade-off analysis at the tactical level.

Background:</b> The COVID-19 pandemic disrupted routine osteoporosis care due to clinic closures and limited in-person consultations. Telehealth emerged as an alternative model enabling remote care delivery and monitoring. However, previous reviews on telehealth either did not include the pandemic period or had a limited focus in scope. Evidence synthesized specifically for osteoporosis care during the pandemic is needed but lacking. <b>Methods:</b> We systematically searched PubMed, MEDLINE, EMBASE, PsycINFO, Web of Science, and CINAHL for studies on telehealth for osteoporosis published between January 2021 and March 2023. Five studies met the inclusion criteria of: osteoporosis population, telehealth intervention, and COVID-19 pandemic timeframe. Data was extracted on study characteristics, COVID-19 outcomes, osteoporosis status, telehealth purpose, patient satisfaction, and clinical outcomes. <b>Result:</b> The five studies showed telehealth was used for monitoring data, delivering test results, adjusting medications, and assessments. Osteoporosis prevalence among telehealth users ranged 30-100%. High patient satisfaction was reported with telehealth versus in-person care. No major differences occurred in medication delays or fractures between telehealth and in-person groups. <b>Conclusion:</b> This review found telehealth enables effective osteoporosis care and monitoring during the pandemic, with high patient and provider satisfaction. However, more robust randomized controlled trials are needed to establish stronger evidence around telehealth's impacts on clinical osteoporosis outcomes. <b>Implications:</b> Though promising, further high-quality studies will help clarify telehealth's role in improving osteoporosis care and outcomes. Findings inform guidelines on integrating telehealth into routine management. Evidence on user perspectives optimizes telehealth implementation policies.

Oncology nurses are more likely to get compassion fatigue (CF) than nurses in other fields because of the emotional stress and poor outlook of cancer patients. Because of this, the care might not be very good, the job might not be very satisfying, and there is a good chance that the patient's pain won't be noticed. <b>Aim.</b> To synthesize empirical evidence on compassion fatigue in order to extract the common, central, and fundamental elements that may improve nursing care. Design. An integrative review <b>Results.</b> Fifteen (15) studies met the eligibility criteria wherein five themes emerged. These are the level of compassion fatigue among oncology nurses, the oncology nurses' perspectives on compassion fatigue, precipitating factors leading to CF with 2 subthemes (work environment and a feeling of lack of support), the influence of compassion fatigue on the personal lives and general well-being of cancer nurses, and the consequences on the quality of oncology nurses' professional lives at work. <b>Conclusion.</b> CF is a significant problem for nurses who work in specialized areas such as cancer units, demonstrated as a basic incapacity to nurture others. The integration of studies provides evidence of clinical practice application which can provide better outcomes and improve nursing care<b>. Implications for Practice.</b> The findings provide understanding into healthcare practice on how to avoid compassion fatigue. Clinical management approaches that can mitigate compassion fatigue and its negative repercussions are presented, as well as the formation of peer support groups that have the ability to ameliorate CF.

<b>Background:</b> Oncology nurse navigators (ONNs) are becoming even more vital as healthcare continues to develop into a more complicated, confusing maze for patients. When many specialists on the treatment team have divergent points of view due to the nature of their respective professions or other factors, the patient may experience feelings of confusion. In the end, this can cause delays in treatment, pose a threat to the established standard of care, and lead to a decrease in patient satisfaction. <b>Aim:</b> To enumerate various ways in which ONNs may help improve the quality of life of cancer patients. <b>Design:</b> An integrative review. <b>Results:</b> A total of 19 studies related to the topic are evaluated. Four main themes namely: provider of psychological support, facilitator of timely care, oncology nurse navigators perception of their role and patient’s perception of oncology nurse navigators and 3 sub themes which are: information giver, source of emotional support and coordinator, were identified to be the roles of the ONNs. The findings showed that oncology nurse navigators help reduce patients anxiety and distress, increase patient satisfaction, shorten the time from diagnosis to treatment, provide necessary information, support them emotionally and coordinate their care with the different members of the healthcare team and resources. <b>Conclusion:</b> The main function of the ONNs is to address any barrier that may hinder the patient’s cancer treatment, survivorship and even palliative care. ONNs make sure that each patient has individualized nursing care according to the patients and their families' needs. <b>Implications for Practice:</b> ONNs have the potential to significantly contribute not only to the quality of life of cancer patients but also to the process of achieving better service integration. The result of this integrative review contributes to the growth of the healthcare system by improving accessibility, fairness, efficiency, effectiveness, and the ability to maintain health services throughout time brought about by ONNs.

<b>Background</b>: By rediscovering the medical field spiritual foundation, clinicians sought to balance their care and realize that spirituality is frequently associated with healthcare, thus one’s spiritual beliefs influence patients' decisions between aggressive care and complementary therapies in oncology care. <b>Aim:</b> This study investigates clinicians’ experiences and perceptions of spirituality in oncology care that clinicians can utilize to improve cancer and spiritual care provision. <b>Methods:</b> A thematic, qualitative synthesis. <b>Results:</b> Four main themes emerged from the synthesis of the 11 included studies that can steer future framework and policies to make clinicians more inept in providing care to address spiritual well-being of the patients and their family from a clinician's point of view of spirituality: “Maintaining Hope and Spiritual Wellness, Clinician’s Sensitivity to Cancer Patients, Provision of Culturally Respectful Spiritual Care, and Education in Providing Spiritual Care”. <b>Conclusion:</b> Cancer patients, cancer survivors, and clinicians’ quality of life is correlated with measures of spirituality and spiritual well-being. Spirituality also fulfill these oncologic patients has been linked to improved emotional and spiritual adjustment. <b>Implications:</b> Clinicians with different proficiencies, novice or expert, develop a strong spiritual belief can also be a strength when it comes to caring for those terminally ill patients, to be able to aid them in their sufferings. Amidst the challenges of spiritual care, these clinicians provide a patient strategy approach that is holistic to the care.

<b>Background:</b> Sexuality is considered to be one of the most significant markers of quality of life. This is due to the fact that sexuality is linked to ideas, feelings, behaviors, social integration, and therefore, a person's physical and mental health and well-being but with patients who have gynecologic cancers, there are significant challenges when it comes to matters of sexuality and intimacy. <b>Aim:</b> To find out how gynecological cancer affects women's sexual experiences and how they express sexuality in the context of their sickness <b>Design:</b> A qualitative synthesis, thematic approach <b>Result:</b> Nineteen (19) eligible studies centered with gynecologic cancers on sexual functioning were included with two (2) main themes emerged: (1) Issues with Sexual Experiences and (2) Physical and Emotional Burden. Many individuals were found to have one or more sexual dysfunctions, which commonly caused distress. <b>Conclusion:</b> Changes in the women’s quality of life in the sexual aspect due to their disease takes a toll not just on the physical but in other facets as well. Better knowledge and patient-centered approaches would improve gynecologic cancer patients' capacity to cope in terms of sexual functioning. <b>Implications:</b> Healthcare professionals such as oncology nurses and doctors should better understand ways to address the sexual problems of their patients following the myriad of events following their diagnosis and treatment of their gynecologic cancers.

<b>Background</b>: There are currently numerous risk instruments available to aid in predicting the present or future chance of getting a cancer diagnosis. It aids in determining a person's likelihood of developing certain cancers by looking at various risk factors, including environmental, behavioral, and genetic. <b>Aim:</b> To analyze the effectiveness of cancer risk assessment techniques utilized in primary care settings. <b>Methods</b>: An integrative review of literature <b>Results</b>: Five (5) studies were met the criteria based on the inclusion and exclusion criteria. These tools demonstrated effectiveness in improving patient outcomes and serving as useful therapeutic tools in the primary care setting. <b>Conclusion:</b> Advantages that may aid clinicians in the primary care setting in validating the diagnosis and assisting patients in determining the early signs and symptoms in the diagnosis of cancer. The role of assessment tools can enhance the reliability and caliber of clinical judgment, which can enhance patient outcomes. <b>Implications</b>: The role of healthcare professionals, such as oncologists, nurses, and the healthcare team, on cancer risk assessment in the primary care setting across the lifespan is crucial to ensure a care plan tailored to each patient’s needs.

The purpose of this study was to assess the educational implications of children involved in small scale mining activities at Kyebi in the Abuakwa South District of Ghana. Qualitatively, case study research design was adopted for the study. The population for the study consisted of junior high school head teachers in the Abuakwa South District of Ghana. Purposive sampling technique was used to select all the thirty (30) junior high school head teachers who have taught in the district between 25 to 30 years. The main instrument for data collection was Semi-structured interview guide. Data collected by the researchers from participants was analysed through the use of the interpretive method based on the themes identified at in the data collection. The themes were related to the research question and interpreted based on the number of issues raised by participants. The study concluded that, students’ academic lives are being hampered as a result of their continuous engagement in small scale mining activities at the expense of their schooling. The study also revealed that students always score below pass grades during the Basic Education Certificate Examination (BECE) due to the menace caused by illegal mining activities, hence the poor academic performance. It is recommended that the Ghana Education Service, in collaboration with other stakeholders must institute strict measures to curb absenteeism in schools. This would go a long way to ensure that the pupils would attend school on a regular basis. It is also recommended that government intervention programmes such as School Feeding and Free School uniforms be made available to these children in order to keep them in school.

<b>Purpose:</b><b> </b>The aim of this study is to the analysis of the South African history of the culture of teaching and learning. This study was driven by the desire for effective teaching and learning within the South African context. <b>Design / Method / Approach: </b>The information in this research came from outside sources (secondary sources). Journal articles (after peer review), dissertations (both published and unpublished), internet sources, and textbooks were used as informational resources. <b>Findings: </b>Teachers believe they have no say in the development of the educational system but are expected to execute its policies and procedures. Fear of change can lead to inappropriate behaviour. For a country to have globally competent citizens it needs to review its curriculum. South Africa has undergone a substantial educational change since the mid-1990s, but its efforts to implement new curricula have been problematic. After the dawn of democracy, concerns were raised about the decline of a positive culture of teaching and learning, especially in disadvantaged township schools. <b>Theoretical implications: </b>there is a lack of theory on an analysis of the South African history of the culture of teaching and learning. Thus, this study seeks to expand the theory. <b>Practical implications: </b>Findings from this research will advance the science behind the culture of teaching and learning in South Africa. <b>Originality / Value: </b>This research will shed light on the development of South Africa's teaching and learning culture, provide suggestions gleaned from its findings, and point the way toward other avenues of inquiry. <b>Research Limitation &#x26; Implications: </b>This research was constrained by the quantity and quality of published secondary sources at the time of writing.

The purpose of this study was to investigate the practices of honesty and dishonesty and its implications on the academic life of Assin Manso Senior High School students (AMASS) in the Central Region of Ghana. A qualitative method was used in this study. A case study research design was adopted for the study. The population of the study comprised students from Assin Manso senior high school in the Central Region of Ghana. Purposive sampling technique was employed to select fifty-two-(52) respondents for this study. The forty (40) respondents consisted of all Students Representative Councils (SRC) members in the school. Each class has a representation in the study. Twelve (12) teachers selected for the study constitute the members of the disciplinary committee in the school. The main instrument for data collection were unstructured interview guide and observation checklist. Data analysed and interpreted based on the themes related to the research questions. The study indicated that honesty is not only about truthfulness rather it entails sincerity, discipline, trustworthiness, frankness, authenticity, integrity, candour, probity,<b> </b>rectitude, incorruptibility and scrupulousness just to mention a few. The study also revealed that, some students were found not to be honest (cheating in examination, leaving school without exeat, covering up for wrongdoing, not obeying schools’ rules and regulations and so on) even though teachers do their best to instil moral values in them and this is due to the fact that the students have little knowledge about the importance and benefits of honesty to them, society, family, school, community and the country at large. Moreover, the study indicated that some of the students were aware of the harmful effects that dishonesty could have on all aspects of their lives. It is recommended that, Students who leave school without exeat or permission should be punished in order to deter others from doing same or to be made as a day student. Students who condone and connive a wrongdoing in the school should be punished. It is also recommended that to prevent students from cheating in an examination closed-circuit television (CCTV) should be fixed in the entire examination hall. Students who cheat in an examination should be punished by the examination committee.

Factory owners and vehicle manufacturers increasingly opt for predictive analytics to inform their decisions. While predictive analytics have been proven to provide insights into the initiation of maintenance measures before a machine actually fails, the right models and features could have a significant impact on the budget spent and resources allocated. This means that financially oriented questions need to at least partially guide the decisions in the planning phase of data science projects. Data-driven approaches will play an increasingly important role, but only a few of the firms that were confident performed logistic regression models for predictive maintenance. Also, from the available knowledge, data-driven classification models connecting vehicle component failures and the occurrence of delays at the assembly line have not been published. This paper utilizes a real-world data-driven approach using classification models in predictive analytics by vehicle manufacturers and thereby links the financial implications of such data science projects to their results. We expand the existing literature on predictive maintenance and possess a unique dataset of newly launched series of vehicles, presented as-is. Our research context is of interest to researchers and practitioners in the automotive industry that manage and plan the final vehicle assembly with just-in-time principles, factoring the consequences of component failures on the assembly process. Key findings of this paper highlight that while minor tweaking of the models is possible, their potential input in decision-making processes for budget optimization is limited.

The deflection of the vertical is an important parameter that combines both physical (astronomic) and geometric (geodetic) quantities. It is critical in such areas as datum transformation, reduction of astronomic observation to the geodetic reference surface, geoid modelling and geophysical prospecting. Although the deflection of the vertical is a physical property of the gravitational field of the earth; which almost all terrestrial survey measurements, with the exception of spatial distances, made on the earth surface are with respect to the Earth’s gravity vector, because a spirit bubble is usually used to align survey instruments. It has been ignored in most geodetic computation and adjustment. This research work is therefore aimed at computing the component of the deflection of the vertical component for part of Rivers State using a geometric method. This method involves the integration of Global Positioning System (GPS) to obtain the geodetic coordinate of points, precisely levelling to obtain the orthometric height of this point located within the study area. By least square using MATLAB program, the estimated deflections of vertical component parameters for the test station SVG/GPS-002 were; -0.0473” and 0.0393” arc seconds for the north-south and east-west components respectively. The associated standard errors of the North-south and East-west components were ±0.0093” and ±0.0060” arc seconds, respectively. The deflection of the vertical was also computed independently from gravimetric models of the earth as: ξ = 0.0204” ±0.0008814”, η = -0.0345” ±0.0014”; ξ =0.0157” ±0.000755”, η = -0.0246” ±0.0012”; ξ = -0.0546±0.0006014, η = -0.0208±0.0006014 for EGM 2008, EGM 1996 and EGM 1984 respectively. The two-tailed hypothesis test reveals that the estimated deflection component is statistically correct at 95% confidence interval. It was observed that the effect of the deflection of the vertical is directly proportional to the distance of the geodetic baseline. Therefore, including the derived component of deflection of the vertical to the ellipsoidal model will yield high observational accuracy since an ellipsoidal model is not tenable due to its far observational error in the determination of high-quality job. It is important to include the determined deflection of the vertical component for Rivers State, Nigeria.

The growing complexity of the operating environment urges pharmaceutical innovation. This essay addresses the need for the integration of advanced technologies in the pharmaceutical supply chain. It justifies the value proposition and presents a concrete use case for the integration of deep learning insights to make data-driven decisions. The supply chain has always been a priority for the pharmaceutical industry; research and development recognizes companies' increasing investment in big data strategies, with plans for a CAGR in big data tool adoption. The work presented herein has a preliminary explorative character to recuperate and integrate evidence from partly overlooked practical experience and know-how. The practical relevance of the essay is directed toward practitioners in pharmaceutical production, supply chain management, logistics, and regulatory agencies. The literature has shown a long-term concern for enhanced performance in the pharmaceutical supply chain network. This essay demonstrates the application of deep learning-driven insights to reveal non-evident flow dependencies. The main aim is to present a comprehensive insight into deep learning-driven decision support. The supply chain is portrayed in a holistic manner, seeking end-to-end visibility. Implications for public policy are discussed, such as data equity: many countries are protecting their populations and economic growth by building resilience and efficiency to ensure the capacity to move goods across supply chains. The implementation strategy is covered. The combined reduction of variability, efficiency as matured richness, reliability (on stochastic flows and their understanding through deep learning and data), and system noise (increased dampening through the inclusiveness of all stakeholders) results in increased responsiveness of supply chains for pharmaceutical products. Future work involves the integration of external data, closing the loop between planning and its application in reality.