Background: Scapulohumeral periarthritis commonly afflicts individuals in their middle age. Its etiology is multifaceted, and treatment presents a challenge with a high risk of recurrence. The main symptoms include shoulder pain and limited joint mobility, seriously affect the quality of life of the patients. Recent research indicate that acupuncture combined with bloodletting cupping can significantly improve the function of activity of shoulder joint and the pain in individuals with scapulohumeral periarthritis. However, these studies have typically been limited in scope, therefore additional research to substantiate the efficacy and safety of these intervention. Methods: To evaluate the efficacy of acupuncture combined with bloodletting cupping for treating patients with scapulohumeral periarthritis. We conducted an online search of databases in both Chinese and English, including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wangfang Data, China Science and Technology Journal Database (VIP) and Chinese BioMedical Literature Database (CBM), to collect randomized controlled trials (RCTs) concerning the use of acupuncture combined with bloodletting cupping in scapulohumeral periarthritis patients. We also examined the references within the identified literature. Search utilised subject headings and free-text terms in both languages, without racial restrictions, for records up to April 3, 2024. Two researchers independently screened the literature, extracted data, and evaluated their qualities. RevMan 5.3 software was used for meta-analysis of the included studies. The protocol of this review was recorded in the International Platform of Registered Systematic Review and Meta-analysis Protocols (PROSPERO). Its registration number is CRD42023454614. Results: This review incorporated 22 RCTs involving a total of 1,774 patients. The results of meta-analysis showed that the clinical effective rate (RR=1.25, 95%CI [1.20, 1.30], P＜0.00001) of treating scapulohumeral periarthritis with acupuncture combined with bloodletting cupping was higher in the experimental group than in the control group. The all of Visual Analogue Scale (VAS) score (MD=-1.70, 95% CI [-2.17, -1.22], P＜0.00001). Melle score (SMD=-2.45, 95% CI [-2.55, -2.34], P=0.007]) and recurrence rate (RR=0.23, 95% CI [0.07, 0.77], P=0.02) were lower in the experimental group than in the control group with statistical significance (P<0.05). Conclusion: The acupuncture combined with bloodletting cupping for the treatment of shoulder impingement syndrome demonstrates definite efficacy and safety, with superior clinical effectiveness, pain relief, improvement in shoulder joint mobility, and reduction in recurrence compared to acupuncture alone. Therefore, it is worthy of being promoted and applied clinically.

English language has become a global language due to first, the results of British colonial expansion and, global commercial interests. It has become a lingua franca in many countries, including Ghana. Qualitatively, the study adopted case study research design. The purpose of the study was to find out the perception and the attitude of Ghanaian English teachers towards the Native Speakers’ accents. The population of study consists of all ten (10) tutors in the Department of Languages, Offinso College of Education. Purposive and convenient sampling techniques were used to select the college and the tutors for the study. The main tool used for the collection of data was the semi-structured interview. Most of the participants revealed positive attitudes towards their own English accents which were different from that of the native speaker. Ghanaians are often faced with the challenge of which accent to use when communicating with each other and with outsiders. Most of the tutors from Offinso College of Education who participated in this study expressed positive responses to their non-native speaker’s accents. Not only did the idea of having a native speaker’s accent hold no attraction for them but they also found it strange because it would not represent their L1 identity. The majority of participants in this study preferred to use their non-native accents to attempt to adopt those of the native speaker. To them, there is only one distinction between English accents -you are either a native or non-native.

This paper investigated the role of informal diglossia on the learning of languages in Seventh Day Adventist (S. D. A) College of Education in the Eastern Region of Ghana. Mixed research approach was adopted for the study. Population of the study comprised one hundred level 300 students in S. D. A. College of Education in Asokore-Koforidua. Purposive, convenient and simple random techniques were to select the college, level 300 students for the study. The main instruments used for data collection for study were questionnaire and interview. Data were analyzed in line with Speech Accommodation Theory, where convergence and divergence were identified. The findings of the study revealed that the S. D. A. College of Education has a multilingual speech community where languages are in contact; students select their language of communication, depending upon their speech partners based on High or Low variety. Predominantly, students code-switch between languages specifically Twi and English language. In the midst of the multilingual environment, students developed the speaking of some Ghanaian languages they could not speak before coming to the college. The study also concluded that there was adult language acquisition in colleges; besides, in a formal academic setting where students were expected to communicate in the formal language, they rather gave were much higher attention to Ghanaian languages.

The automation of IT Service Management (ITSM) workflows using explicit rules and data has been established for years. Domain-specific rule engines interpret rules written in declarative rule modelling languages and generate forwarding arrows to process event streams and support decision making. Such automation is augmented by rule-driven Quality Assurance for correctness, safety, and risk management. The service desk is the onshore base of an ITSM supply chain. An end-to-end incident response service resolves incidents using only onshore resources and employs back office teams to help with unresolvable incidents. The forward factories of rule-based automation for ticket processing service are identified. Several rule-based workflows in incident and change management have been published. Further glimpses of the future across all ITSM workflows are provided based on training in an online ITSM service with automated operations. Rule engines are specialised components that direct the processing of data flows according to pre-defined rules. Decision factories complement the more common event-driven rule engines. While event processing occurs below the polling frequency of the source, rules in decision factories are triggered based on the arrival of data. These factories are applied in ITSM for risk and safety evaluation and quality assurance. Rule-enriched architectures incorporate domain-specific modelling languages to ensure correctness with respect to qualitative quality attributes. Dedicated factories provide resilience, detect slack or over-utilisation, and offer point-in-time assurance and testing.