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Killexams : IBM Implementation test Questions - BingNews https://killexams.com/pass4sure/exam-detail/000-197 Search results Killexams : IBM Implementation test Questions - BingNews https://killexams.com/pass4sure/exam-detail/000-197 https://killexams.com/exam_list/IBM Killexams : Death Of The Turing Test In An Age Of Successful AIs

IBM has come up with an automatic debating system called Project Debater that researches a topic, presents an argument, listens to a human rebuttal and formulates its own rebuttal. But does it pass the Turing test? Or does the Turing test matter anymore?

The Turing test was first introduced in 1950, often cited as year-one for AI research. It asks, “Can machines think?”. Today we’re more interested in machines that can intelligently make restaurant recommendations, drive our car along the tedious highway to and from work, or identify the surprising looking flower we just stumbled upon. These all fit the definition of AI as a machine that can perform a task normally requiring the intelligence of a human. Though as you’ll see below, Turing’s test wasn’t even for intelligence or even for thinking, but rather to determine a test subject’s sex.

The Imitation Game

Turing test with machine
Turing test with machine

The Turing test as we know it today is to see if a machine can fool someone into thinking that it’s a human. It involves an interrogator and a machine with the machine hidden from the interrogator. The interrogator asks questions of the machine using only keyboard and screen. The purpose of the interrogator’s questions are to help him to decide if he’s talking to a machine or a human. If he can’t tell then the machine passes the Turing test.

Often the test is done with a number of interrogators and the measure of success is the percentage of interrogators who can’t tell. In one example, to deliver the machine an advantage, the test was to tell if it was a machine or a 13-year-old Ukrainian boy. The young age excused much of the strangeness in its conversation. It fooled 33% of the interrogators.

Imitation game with a machine and a man
Imitation game with a machine and a man

Naturally Turing didn’t call his test “the Turing test”. Instead he called it the imitation game, since the goal was to imitate a human. In Turing’s paper, he gives two versions of the test. The first involves three people, the interrogator, a man and a woman. The man and woman sit in a separate room from the interrogator and the communication at Turing’s time was ideally via teleprinter. The goal is for the interrogator to guess who is male and who is female. The man’s goal is to fool the interrogator into making the wrong decision and the woman’s is to help him make the right one.

The second test in Turing’s paper replaces the woman with a machine but the machine is now the deceiver and the man tries to help the interrogator make the right decision. The interrogator still tries to guess who is male and who is female.

But don’t let that goal fool you. The real purpose of the game was as a replacement for his question of “Can a machine think?”. If the game was successful then Turing figured that his question would have been answered. Today, we’re both more sophisticated about what constitutes “thinking” and “intelligence”, and we’re also content with the machine displaying intelligent behavior, whether or not it’s “thinking”.  To unpack all this, let’s take IBM’s latest Project Debater under the microscope.

The Great Debater

IBM’s Project Debater is an example of what we’d call a composite AI as opposed to a narrow AI. An example of narrow AI would be to present an image to a neural network and the neural network would label objects in that image, a narrowly defined task. A composite AI, however, performs a more complex task requiring a number of steps, much more akin to a human brain.

Debate format

Project Debater is first given the motion to be argued. You can read the paper on IBM’s webpage for the details of what it does next but basically it spends 15 minutes researching and formulating a 4-minute opening speech supporting one side of the motion. It also converts the speech to natural language and delivers it to an audience. During those initial 15 minutes, it also compiles leads for the opposing argument and formulates responses. This is in preparation for its later rebuttal. It then listens to its opponents rebuttal, converting it to text using IBM’s own Watson speech-to-text. It analyzes the text and, in combination with the responses it had previously formulated, comes up with its own 4-minute rebuttal. It converts that to speech and ends with a summary 2-minute speech.

All of those steps, some of them considered narrow AI, add up to a composite AI. The whole is done with neural networks along with conventional data mining, processing, and analysis.

The following video is of a live debate between Project Debater and Harish Natarajan, world record holder for the number of debate competitions won. Judge for yourself how well it works.

Does Project Debater pass the Turing test? It didn’t take the formal test, however, you can judge for yourself by imagining practicing a transcript of what Project Debater had to say. Could you tell whether it was produced by a machine or a human? If you could mistake it for a human then it may pass the Turing test. It also responds to the human debater’s argument, similar to answering questions in the Turing test.

Keep in mind though that Project Debater had 15 minutes to prepare for the opening speech and no numbers are given on how long it took to come up with the other speeches, so if time-to-answer is a factor then it may lose there. But does it matter?

Does The Turing Test Matter?

Does it matter if any of today’s AIs can pass the Turing test? That’s most often not the goal. Most AIs end up as marketed products, even the ones that don’t start out that way. After all, eventually someone has to pay for the research. As long as they do the job then it doesn’t matter.

IBM’s goal for Project Debater is to produce persuasive arguments and make well informed decisions free of personal bias, a useful tool to sell to businesses and governments. Tesla’s goal for its AI is to drive vehicles. Chatbots abound for handling specific phone and online requests. All of them do something normally requiring the intelligence of a human with varying degrees of success. The test that matters then is whether or not they do their tasks well enough for people to pay for them.

Maybe asking if a machine can think, or even if it can pass for a human, isn’t really relevant. The ways we’re using them require only that they can complete their tasks. Sometimes this can require “human-like” behavior, but most often not. If we’re not using AI to trick people anyway, is the Turing test still relevant?

Mon, 01 Aug 2022 12:00:00 -0500 Steven Dufresne en-US text/html https://hackaday.com/2021/04/06/death-of-the-turing-test-in-an-age-of-successful-ais/
Killexams : Managing Requirements Tracking, Implementation and Sign-off for Embedded Systems INTRODUCTION

This document describes the issues faced when building hardware and software systems where the success of the project is dependant on requirements being fully supported and tested. Where the cost of failure is high there is a greater necessity for a robust requirements sign‐off capability. This particularly applies to systems where the financial cost of recalling a failing product is prohibitive and/or there is a high safety factor which is typical of embedded systems.

The following represents an approach to achieving the above through a combination of a software solution, asureSign™ and associated best practice as defined by Test and Verification Solutions Ltd (TVS).


Currently best practice in requirements tracing stops at test definition. From that point the industry provides only a partially automated approach and most software developers settle for a manual one. There is no tool that will automatically track the results of tests as they apply to requirements. Quite often companies export tests from their requirements management tool into a spreadsheet (or similar) and then record test results in the spreadsheet. They do not hold the tests results for more than a few days and as changes are made the test results are soon out‐of‐date. What is really required is the ability to automatically record test results against the requirements they satisfy, to generate management reports from those results generate and to keep those results for future reference.

The hardware industry has developed numerous techniques to help verify design correctness, such as pseudo random testing, functional coverage, assertions, formal verification etc. But the usage of all these approaches also brings other problems. Quite often a particular requirement will be Verified by a collection of approaches, and with hundreds (or thousands) of tests, functional cover points, properties etc complicated by the fact that some tests or cover points could target more than one requirement, it quickly becomes non‐trivial to determine how well a particular requirement is progressing. Different tools also require different approaches to analyse their status, often having independent people in charge of them with independent flows. This makes it harder to see the full picture and to understand how an individual’s activity fits in relation to the project. Most companies address this by taking a number of days at the end of a project (when the pressure is greatest) to manually map all these approaches to project requirements. Inevitably this is time consuming and only provides valuable information at the end of a project. It also usually results in the identification of verification holes, leading to more work and another round of manual signoff. Finding late bugs often has the same effect.

The software world developed an array of tools for analysing source code and testing executable code associated with newly developed programmes and applications. Source control software provides a mechanism for defining versions of software and an associated history. Requirements management software enables the definition and tracing of user requirements. Bug tracking provides a simple process of listing and describing bugs and their status. However, these do not address the issue of ensuring that requirements had tests defined against them and that these tests were successfully completed.


The asureSign approach was identified during a UK]wide survey into verification carried out by TVS on behalf of the National Microelectronics Institute. The approach is equally relevant to both hardware and software development in solving the above challenges. It is derived from the needs expressed by Infineon Technologies AG and XMOS Ltd; both companies are designers and manufacturers of advanced semiconductor products and their associated software. XMOS undertook early development of a solution to problems stated above and used it to sign off both their hardware and software products. That solution was subsequently taken over by TVS (under agreement with XMOS) and Infineon has contracted with TVS for development of a software product, and have been a primary contributor in determining the functionality.

asureSign addresses the gap between the capture and tracing of functional requirements available in industry leading products (such as DOORS. from IBM and Reqtify. from Geensoft) and the testing capability provided by a whole host of solutions. The industry has to date not addressed the need to ensure that for every functional requirement there is, i) a test for each requirement, ii) what tests have been specified but not written and iii) what tests have been written but not run. There has also been no simple and cohesive method for tracking over time how a project is developing with respect to every feature and requirement, and how these features relate to the tests that are used to measure their progress

asureSign has been developed to address these industry shortcomings. It provides a solution that both supports management in delivering higher quality products and developers/testers in achieving more complete and robust development and testing procedures in support of their system development.

asureSign uses the flexibility of a relational database to track how a project is developing over time for every feature and requirement, and how these features relate to the tests that are used to measure their progress. The product tracks not only tests, but an array of information that can be used to measure progress: coverage, memory leaks, performance, etc. The asureSign database enables management to ask more complex questions, from very high to the very low level:

  • reports on a range of key criteria associated with the sign‐off of your functional requirements including who ran the various tests and on what servers.
  • reporting of incomplete test specification and the presence of the tests specified, written and run on a project wide basis
  • how are my requirements progressing over ti me, with visibility in to historical results and trends and how they relate to requirements
  • improved decision making due to the high quality, real-time information on the project status

The database also provides the ability to access real]time information on the progress of a test run, and the advantage of aggregated statistics about the tests: How long to they take to run?How much computing power do I need to run or verify a particular requirement ?

For developers and testing teams asureSign provides a structured and logical means to Improve control;

  • visibility on early stages of test and verification and the automatic tracking of test resulcoverage (structural and functional) for a wide variety of verification and testing functio
  • bug tracking. When a test fails your bug fixing system will be updated
  • plotting of historic results e.g. Was this passing before? If so, then what version of the source code was it using and what changed between those two runs of the tests?
  • automatically relate test results to the code that generated them

Figure 1: This shows the change over time for the correlation between requirements that have tests specified, written, run and passed

asureSign has a number of opportunities to provide automated links to products addressing key areas of support for other parts of the system development llifecycle.

  • Requirements Management: By linking to established products users can ensure that requirements are fully tested.
  • Configuration Management: By llinking to a source control system asureSign can provide a history of which versions were tested at what time.
  • Bug Fixing: By linking to bug fixing systems users can ensure that their bug fixing system will be updated with the latest test results.


asureSign provides embedded system developers and management with a controlled environment for managing the implementation, tracking and sign-off of requirements. Development teams can be certain that requirements have been implemented through the development and testing of associated programs.

Wed, 07 May 2014 11:01:00 -0500 en text/html https://www.design-reuse.com/articles/32123/managing-requirements-tracking-implementation-and-sign-off-for-embedded-systems.html
Killexams : IT Consulting Services Market May See a Big Move | Fujitsu, IBM, Gartner

AMA introduce new research on Global IT Consulting Services covering micro level of analysis by competitors and key business segments (2021-2027). The Global IT Consulting Services explores comprehensive study on various segments like opportunities, size, development, innovation, sales and overall growth of major players. The research is carried out on primary and secondary statistics sources and it consists both qualitative and quantitative detailing.

Ask demo Report PDF @ https://www.advancemarketanalytics.com/sample-report/6525-global-it-consulting-services—procurement-market

Some of the Major Key players profiled in the study are Fujitsu Limited (Japan), HCL Technologies Limited (India), Hexaware Tech Limited (India), Infosys Limited (India), Ernst &Young (U.K), KPMG (Europe), PricewaterhouseCoopers (U.K), Avante (United States), Cognizant Tech Corp. (United States), Gartner, Inc. (United States), Syntel Inc. (United States), IBM Corp (United States), McKinsey & Company (United States),.

IT consulting market is expected to face significantly higher demand due to factors like digitization, analytics, cloud, robotics, and the Internet of Things (IoT). IT consulting services involves professional business computer consultancy and advisory services which provide expertise, experience, industry intelligence to the enterprise. This industry deals with professional service firms, staffing firms, contractors, information security consultants. The IT consulting segment includes both advisory and implementation services but excludes transactional IT activities. The IT consulting services market consists of eight main divisions i.e. IT Strategy, IT Architecture, IT Implementation, ERP services, Systems Integration, Data Analytics, IT Security and Software Management.

Influencing Market Trend

  • IT consulting services are helping organizations to manage their investment and technology and business strategies.

Market Drivers

  • Current trend on Generalization of business and operating module
  • Requirement of IT investment monitoring
  • Change in traditional IT solutions to computing solution
  • Transition in IT infrastructure to cloud computing infrastructure.


  • Cloud Infrastructure prospective is projected to create market opportunities for the market manufacturers.


  • Changing and rigorous legislative and accreditation needs is the major challenge faced by this market.

For more data or any query mail at [email protected]

Which market aspects are illuminated in the report?

Executive Summary: It covers a summary of the most vital studies, the Global IT Consulting Services market increasing rate, modest circumstances, market trends, drivers and problems as well as macroscopic pointers.

Study Analysis: Covers major companies, vital market segments, the scope of the products offered in the Global IT Consulting Services market, the years measured and the study points.

Company Profile: Each Firm well-defined in this segment is screened based on a products, value, SWOT analysis, their ability and other significant features.

Manufacture by region: This Global IT Consulting Services report offers data on imports and exports, sales, production and key companies in all studied regional markets

Highlighted of Global IT Consulting Services Market Segments and Sub-Segment:

IT Consulting Services Market by Key Players: Fujitsu Limited (Japan), HCL Technologies Limited (India), Hexaware Tech Limited (India), Infosys Limited (India), Ernst &Young (U.K), KPMG (Europe), PricewaterhouseCoopers (U.K), Avante (United States), Cognizant Tech Corp. (United States), Gartner, Inc. (United States), Syntel Inc. (United States), IBM Corp (United States), McKinsey & Company (United States),

IT Consulting Services Market: by Application (Information protection (Data loss prevention, authentication and encryption), Threat protection (Data center and end point), Web and cloud based protection, Services (Advisory, Design, Implementation, Financial, Healthcare, IT telecom))

IT Consulting Services Market by Geographical Analysis: Americas, United States, Canada, Mexico, Brazil, APAC, China, Japan, Korea, Southeast Asia, India, Australia, Europe, Germany, France, UK, Italy, Russia, Middle East & Africa, Egypt, South Africa, Israel, Turkey & GCC Countries

For More Query about the IT Consulting Services Market Report? Get in touch with us at: https://www.advancemarketanalytics.com/enquiry-before-buy/6525-global-it-consulting-services—procurement-market

The study is a source of reliable data on: Market segments and sub-segments, Market trends and dynamics Supply and demand Market size Current trends/opportunities/challenges Competitive landscape Technological innovations Value chain and investor analysis.

Interpretative Tools in the Market: The report integrates the entirely examined and evaluated information of the prominent players and their position in the market by methods for various descriptive tools. The methodical tools including SWOT analysis, Porter’s five forces analysis, and investment return examination were used while breaking down the development of the key players performing in the market.

Key Growths in the Market: This section of the report incorporates the essential enhancements of the marker that contains assertions, coordinated efforts, R&D, new item dispatch, joint ventures, and associations of leading participants working in the market.

Key Points in the Market: The key features of this IT Consulting Services market report includes production, production rate, revenue, price, cost, market share, capacity, capacity utilization rate, import/export, supply/demand, and gross margin. Key market dynamics plus market segments and sub-segments are covered.

Basic Questions Answered
*who are the key market players in the IT Consulting Services Market?
*Which are the major regions for dissimilar trades that are expected to eyewitness astonishing growth for the
*What are the regional growth trends and the leading revenue-generating regions for the IT Consulting Services Market?
*What are the major Product Type of IT Consulting Services?
*What are the major applications of IT Consulting Services?
*Which IT Consulting Services technologies will top the market in next 5 years?

Examine Detailed Index of full Research Study [email protected]: https://www.advancemarketanalytics.com/reports/6525-global-it-consulting-services—procurement-market

Table of Content

Chapter One: Industry Overview

Chapter Two: Major Segmentation (Classification, Application and etc.) Analysis

Chapter Three: Production Market Analysis

Chapter Four: Sales Market Analysis

Chapter Five: Consumption Market Analysis

Chapter Six: Production, Sales and Consumption Market Comparison Analysis

Chapter Seven: Major Manufacturers Production and Sales Market Comparison Analysis

Chapter Eight: Competition Analysis by Players

Chapter Nine: Marketing Channel Analysis

Chapter Ten: New Project Investment Feasibility Analysis

Chapter Eleven: Manufacturing Cost Analysis

Chapter Twelve: Industrial Chain, Sourcing Strategy and Downstream Buyers

Buy the Full Research report of Global IT Consulting Services [email protected]: https://www.advancemarketanalytics.com/buy-now?format=1&report=6525

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Thu, 28 Jul 2022 20:22:00 -0500 Newsmantraa en-US text/html https://www.digitaljournal.com/pr/it-consulting-services-market-may-see-a-big-move-fujitsu-ibm-gartner
Killexams : Cut Through The Fog: Ten Tests For A Family Business’ Succession Plan

Bert & I” are stories of Down East Maine by Marshall Dodge and are best known for his dry sense of humor. In story is of how, when two lobstermen, the Captain and his mate, are out pulling pots, a dense fog rolled in. This being the days before radar, they could only rely on printed charts. The captain tells the mate to get the old chart book, but as the Captain open the book to the page they needed, a puff of wind came and blew that loose chart from the old book and into the water. 

           “Well now what do we do?” asked the Mate.

           “We get moving and get onto this here next chart, is what we do” replied the captain.

           So, at its most basic, strategy is a way of thinking that shapes what you are going to do in the future, which is how to get to safety when the fog rolls in. Estate planning is an integral part of that thinking, but too often the strategic implications of the estate plan on the family controlled business is overlooked. 

The Question

           How many know that your estate planning is the strategy to achieve your goals for growth, control, protection and succession? 

 An estate planning strategy of complexity for the sake of tax savings and starving the family for income to avoid debt will not achieve your goals in the future, since it has nothing to do with preserving the company as a going concern. Tactics used by professionals, such as the use of Family Limited Partnerships, are all about tax and debt avoidance. The estate plan will render your client’s strategies ineffective if your goal is to transfer control of the company intact in the future. Being able to test whether the estate plan works in your overall strategy both before and during implementation allows you to avoid much of the cost and delays of change after implementation. 

The question “Will my estate planning strategy achieve my goals in the future?” is so board that is not very useful. Here are seven further, clarifying questions to estate planner to generate answers that open your mind to new ways of thinking and get greater value from your professional services in achieving your Goals.

Question 1: Does your Strategy tap a true source of advantage?

Question 2: Is your strategy sufficiently granular about where to seek an     advantage?

Question 3: Does your strategy put you ahead of the trends?

Question 4: Does your strategy rest on privileged insights?

Question 5: Does your strategy embrace uncertainty?

Question 6: does your strategy balance commitment with flexibility?

Question 7: How contaminated is your strategy with biases?

Question 8: Based on the Answers to these Questions, does your Strategy Achieve your Goals in the Future?

The next two are really observations –

9: Strategies do not work if there is no conviction to act on your strategy, and

10: Strategies need to be translated into an action plan to be effective.

Question 1: Does your Strategy Embrace Uncertainty?

Of these questions, the most critical is “Does your strategy embrace uncertainty?” so I will discuss this question first. For example, in 2010 no one could have predicted that the unified credit would be raised to $5 Million, and no one can predicted exactly how much the unified credit would remain at $5 Million.   Further, no one can tell what the economic future may hold, and if the Dollar declines in value, the inventory of a business may be worth more than the business itself. Some analyst, consultant or other pundit is always making predictions about the future, but unless you are comfortable relying on their crystal ball, only by embracing some uncertainty can your strategy work.

There are three different ways professionals handle uncertainty: Traditionalist, New Realists, or Futurists. 

Traditionalists rely on mathematical projections of what has happened in the latest past, with any errors in the projections due to a lack of greater knowledge, information or expertise. Basically the same solutions that worked in the past will work in the future, so long as you “get a better hammer” of increased resources to drive it home. I find this most often in the basic financial planning models.

New Realists rely on close monitoring for signs of change and rapid response to risks or opportunities when changes occur. Since there “is not strategy, only tactics” it tells nothing about where you are going, what you need to get there or when you arrive. I see this often in the succession planning models for family wealth, both inside and outside of a family controlled business. It is not until the death of a family principle that tactic are decided upon. 

The Futurists, or Scenario Analysis, strategic model is the best way of embracing the uncertainty of the future in the long term (i.e. more than ten years). Scenario analysis is a challenge for you, your family and your business, but the result is your 1) learn from others mistakes, 2) marshal the resources you need to meet risks you can anticipate and 3) have the mental flexibility to cope with those risks and opportunities you cannot anticipate.

Question 2: Does your Strategy Tap a True Source of Advantage?

When considering business strategies, the advantage of a special position or capability is one of the first things that defined. The same is true, though often unrecognized, with families. Your company has a competitive advantage, and you control this scarce resource.   Your competitive advantage may not be recognized at first but things like positional advantage you and your family has because your relationships within the closed markets of suppliers and customers, your conduct inside and outside of the company, and your focus on the family’s involvement and performance in the “business” gives them a relative advantage to the non-family businesses in the marketplace.

These advantages can be fleeting so both the advantages of the business and the advantages of the family must be tested and analyzed to see what would happen if they no longer where a true source of advantage.

Question 3: Is Your Strategy Granular Enough about Where to Compete?

In Mehrdad Baghai’s book Granularity of Growth he shows that 80% of the differential of growth in companies is based on picking the right place to compete, and only 20% is based on how a company competes. The same is true in collecting and other “alternative” investments. Too often, however, the niche that a company or a family seeks to compete in is drawn too broadly; the result is that false data and conclusions are created. 

Chris Bradley, Martin Hirt, and Sven Smit note an example of this when a national retail bank makes a regional effort to grow its retail banking business through better customer satisfaction, and at the end of the initiative, the regional data shows that the retail banking did, indeed, grow so validating the strategy. When, however, the bank looked at the data on a city by city and product by product basis, they found that 90% of the regional growth for the bank was due to new business in one rapidly developing urban center, and that was only in one fast growing product area. The granular data proved that the customer satisfaction model was not the reason for growth, but rather the placement of the bank in a rapidly growing urban center.

Question 4: Does Your Strategy put you ahead of the Trends?

Many forecast the future by projecting out the immediate past performance into the near future. Strategies need to have a deliberate analysis of the trends within and outside of the family, company or other organization. The risk of the internally based predictions is illustrated by Daniel Kahneman’s latest book Think Fast and Slow.  Kahneman recalls a project to revise a textbook and curriculum where, based on the internal projections of the work already done, this group of experts predicted that the project would be a success, and that it would be done in two years. HE then queried a participant who had experience in such projects about his specific experience outside of the internal trends of this group. This expert had supported the conclusion of success and two years the group had come up with, but on consideration of his outside experience, he realized that projects he had experience with had a 40% chance of complete failure, and if it was successful, the average time to completion was seven to ten years. Kahneman then goes on to describe his project in fact took eight years to complete.

Question 5: Does Your Strategy Rest on Privileged Insight?

Gaining insights is always hard to do. I usually begin with a short list of questions that have major implications. These can be personal (what if someone dies suddenly?) to technological (what if there is a process breakthrough?) to macro (what if we enter into a deflationary cycle?). In each case, the question must include data collected from both inside and outside of the family, business and organization, and has to focus on simple but often profound conclusions that offer the insight into how the family, the market and the client will behave in specific situations.

Question 6: Does your strategy balance commitment and flexibility?

Families and businesses sustain their advantages by being able to commit to a strategy for the very long term. This commitment may be to back a strategy that is high risk, but also very high potential returns, as well as commitment to a very low risk strategy, even though there is a low yield on the investment. Strategies require flexibility also, since when you commit is often not a fixed date. To create real options, there needs to be a strategy that commits to opening opportunities for the family or business as well as the flexibility to take advantage of opportunities when they come your way.

Question 7: How contaminated is your strategy by biases?

We are all products of our past and experiences, so we all have inherent biases towards some things and away from others. Even though it is not possible to avoid biases all together, any strategy needs to recognize how contaminated they are by biases, and how it warps the strategy. Some of the most common biases Chris Bradley, Martin Hirt, and Sven Smit note in their article include:

Over Optimism – This in only looking at the inside data and forecast from there, the most common bias of the “number cruncher” programs and experts in estate planning.

Anchoring – Determining the value based on some arbitrary outside point. An example is when IBM IBM gave up the PC operating software since there was no value for the PC for businesses at that time.

Loss Aversion – Avoidance of risk at the expense of those that might lead to opportunities. A classic example is the French loss aversion in 1939 prevented them from taking the opportunity to take on Germany when there was an advantage.

Confirmation Bias – Seeing only what confirms your existing opinion. A latest example is the way that the various warnings on the subprime mortgage investments were ignored by both rating agencies and investors until it was too late.

Herding – This is finding comfort in the crowd, and is the root cause of nearly every financial bubble. This is also a grave issue in estate planning, often under the guise of “best practices” the result is needlessly complex and convoluted plans, documents and operations that do not relate to the goals of the client but rather what the consensus in the industry is at the moment about what “everyone should have/do this”. 

Champion Bias – This is when an idea is accepted or rejected based on who is proposing the idea and not on its own merits. For example, the ratings on wine often have more to do with who is making the call than on the genuine quality of the wine itself.

The Halo Effect – This is copying the actions of others on the assumption that what has worked in the past for others will work in the future for you. Obviously lawyers who are trained to rely on case law and statutes for their planning without reference to the goals of the client (or the unique qualities of the specific case) are very susceptible to Halo effect. 

Survivor Bias – Here you only take lessons from those that succeed, and ignore the lessons that can be learned from those who have failed. This ignores the impact that luck and outside events have on strategies.


The Planning for future succession at a family business is like navigating in a fog. Success is only certain after your succession, but testing your strategy helps you cut through the fog.

Sun, 06 Feb 2022 19:23:00 -0600 Matthew Erskine en text/html https://www.forbes.com/sites/matthewerskine/2020/11/20/cut-through-the-fog-ten-test-for-a-family-business-succession-plan/
Killexams : SAP Application Services Market Is Dazzling Worldwide with Major Giants Atos, Deloitte, PwC, Cognizant

An extensive elaboration of Global SAP Application Services Market covering micro level of analysis by competitors and key business segments (2022-2030). The Global SAP Application Services explores comprehensive study on various segments like opportunities, size, development, innovation, sales and overall growth of major players. The study is a perfect mix of qualitative and quantitative Market data collected and validated majorly through primary data and secondary sources. Some of the MajorKey players profiled in the study are SAP, NTT Data, Infosys, Atos, Deloitte, Accenture, Capgemini, Wipro, Tata Consultancy Services (TCS), IBM, Fujitsu, PwC, Cognizant, CGI, DXC Technology & EPAM

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On the off chance that you are engaged with the industry or expect to be, at that point this investigation will deliver you complete perspective. It’s crucial you stay up with the latest sectioned by Applications [BFSI, Manufacturing, Retail & CPG, Telecom & IT & Life Sciences & Healthcare], Product Types, [, Management Services, Implementation and Upgrades, Post-Implementation Services & SAP Hosting] and some significant parts in the business
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Which market aspects are illuminated in the report?

Executive Summary: It covers a summary of the most vital studies, the Global SAP Application Services market increasing rate, modest circumstances, market trends, drivers and problems as well as macroscopic pointers.

Study Analysis:Covers major companies, vital market segments, the scope of the products offered in the Global SAP Application Services market, the years measured and the study points.

Company Profile: Each Firm well-defined in this segment is screened based on a products, value, SWOT analysis, their ability and other significant features.

Manufacture by region: This Global SAP Application Services report offers data on imports and exports, sales, production and key companies in all studied regional markets

Highlighted of Global SAP Application Services Market Segments and Sub-Segment:

SAP Application Services Market by Key Players: SAP, NTT Data, Infosys, Atos, Deloitte, Accenture, Capgemini, Wipro, Tata Consultancy Services (TCS), IBM, Fujitsu, PwC, Cognizant, CGI, DXC Technology & EPAM

SAP Application Services Market by Types: Management Services, Implementation and Upgrades, Post-Implementation Services & SAP Hosting

SAP Application Services Market by End-User/Application: BFSI, Manufacturing, Retail & CPG, Telecom & IT & Life Sciences & Healthcare

SAP Application Services Market by Geographical Analysis: North America, Europe, Asia-Pacific etc

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The study is a source of reliable data on: Market segments and sub-segments, Market trends and dynamics Supply and demand Market size Current trends/opportunities/challenges Competitive landscape Technological innovations Value chain and investor analysis.

Interpretative Tools in the Market: The report integrates the entirely examined and evaluated information of the prominent players and their position in the market by methods for various descriptive tools. The methodical tools including SWOT analysis, Porter’s five forces analysis, and investment return examination were used while breaking down the development of the key players performing in the market.

Key Growths in the Market: This section of the report incorporates the essential enhancements of the marker that contains assertions, coordinated efforts, R&D, new item dispatch, joint ventures, and associations of leading participants working in the market.

Key Points in the Market: The key features of this SAP Application Services market report includes production, production rate, revenue, price, cost, market share, capacity, capacity utilization rate, import/export, supply/demand, and gross margin. Key market dynamics plus market segments and sub-segments are covered.

Basic Questions Answered

*who are the key market players in the SAP Application Services Market?
*Which are the major regions for dissimilar trades that are expected to eyewitness astonishing growth for the
*What are the regional growth trends and the leading revenue-generating regions for the SAP Application Services Market?
*What are the major Product Type of SAP Application Services?
*What are the major applications of SAP Application Services?
*Which SAP Application Services technologies will top the market in next 5 years?

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Table of Content
Chapter One: Industry Overview
Chapter Two: Major Segmentation (Classification, Application and etc.) Analysis
Chapter Three: Production Market Analysis
Chapter Four: Sales Market Analysis
Chapter Five: Consumption Market Analysis
Chapter Six: Production, Sales and Consumption Market Comparison Analysis
Chapter Seven: Major Manufacturers Production and Sales Market Comparison Analysis
Chapter Eight: Competition Analysis by Players
Chapter Nine: Marketing Channel Analysis
Chapter Ten: New Project Investment Feasibility Analysis
Chapter Eleven: Manufacturing Cost Analysis
Chapter Twelve: Industrial Chain, Sourcing Strategy and Downstream Buyers

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Mon, 11 Jul 2022 20:45:00 -0500 Newsmantraa en-US text/html https://www.digitaljournal.com/pr/sap-application-services-market-is-dazzling-worldwide-with-major-giants-atos-deloitte-pwc-cognizant
Killexams : Pyongyang's [un]H0lyGh0st. Devlopments in the criminal underworld. $10m for troll-farmer info. Hacktivism in a hybrid war.

Dateline Moscow and Kyiv: A shift in momentum during an operational pause.

Ukraine at D+155: A shift in momentum? (The CyberWire) Russia's difficulties filling its depleted ranks (down nearly 50%, the US Intelligence Community is said to have told Congress) and its inability to advance (during what looks more like exhaustion and neutralization than it does operational pause) appear to have given Ukraine an opportunity to take back the initiative in the North, East, and, especially, the South. A look at hacktivism in the Ukrainian interest.

Russia-Ukraine war: List of key events, day 156 (Al Jazeera) As the Russia-Ukraine war enters its 156th day, we take a look at the main developments.

Russia-Ukraine war latest: what we know on day 156 of the invasion (the Guardian) Ukraine steps up campaign to retake Russian-controlled regions in south; Kyiv accuses Russia of a war crime over the deaths of more than 40 prisoners of war

Ukraine steps up counteroffensive against Russian forces (Al Jazeera) Ukrainian officials say campaign to retake parts of Kherson, Zaporizhia oblasts has begun, urging civilians to leave.

Russia-Ukraine war: Zelenskiy says grain exports ready to start; Kyiv and Moscow both launch investigations into PoW deaths – live (the Guardian) Ukraine’s president says Black Sea ports ready to export grain; Kyiv calls on world leaders to condemn Russia over attack that led to death of 40 PoWs

Ukraine could be turning the tide of war again as Russian advances stall (Washington Post) Russian advances in Ukraine have slowed almost to a standstill as newly delivered Western weapons help Ukrainian forces reclaim much of the advantage they had lost in latest months, opening a window of opportunity to turn the tide of the war in their favor again.

Ukraine war: Russian Kalibr cruise missiles strike military base near Kyiv (The Telegraph) Russian forces have struck a military base north of the capital Kyiv, Ukraine has said in a rare admission of a successful attack by Moscow on its military infrastructure.

Northern Ukraine Comes Under Burst of Russian Attacks Far From Front Lines (Wall Street Journal) Missiles and rockets rained down on northern Ukraine, marking the first time in weeks that the Kyiv region, far from the fighting in the country’s east and south, has been hit.

Ukraine war: West's modern weapons halt Russia's advance in Donbas (BBC News) Ukrainian soldiers credit the arrival of modern Western weapons for a sharp fall in Russia's attacks.

‘Half of Russian troops’ sent into Ukraine have been killed or injured (The Telegraph) According to US intelligence, casualties have rocketed to more than 75,000 – a loss equivalent to almost the entire British Army

Russia, Ukraine trade blame for deadly attack on POW prison (AP NEWS) Russia and Ukraine accused each other Friday of shelling a prison in a separatist region of eastern Ukraine, an attack that reportedly killed dozens of Ukrainian prisoners of war who were captured after the fall of a key southern city in May.

The Kremlin’s Plans to Annex Southeastern Ukraine Go into Effect (Wilson Center) After five months of all-out war, the Kremlin appears to have refined its plans for the future of the temporarily occupied territories in southeastern Ukraine.

Climbing the escalation ladder in Ukraine: A menu of options for the West (Atlantic Council) Our experts have assembled a list of possible policy responses the West ought to consider if Russia escalates its war against Ukraine.

Cascading Impacts of the War in Ukraine: Mental, Maternal, and Newborn Health (New Security Beat) This article was originally published as part of the summer 2022 issue of the Wilson Quarterly: Ripples of War.Ukraine and its people will feel the effects of the Russian invasion for years to [...]

Long Read: Russian Youth against War (Wilson Center) Young Russians strongly oppose the war in Ukraine. It is increasingly clear to them that the war is stealing their future and was started only to keep Vladimir Putin, his friends, and their heirs in power for as long as possible.

WSJ News Exclusive | New Group to Promote Open-Source Intelligence, Seen as Vital in Ukraine War (Wall Street Journal) A group of ex-U.S. national security officials has formed a professional association to promote the tradecraft of ‘open-source’ intelligence, the analysis of publicly available data that has helped Western powers understand and track Russia’s war on Ukraine.

Why Russia’s War in Ukraine Is a Genocide (Foreign Affairs) It’s not just a land grab, but a bid to expunge a nation.

Putin believed his own propaganda and fatally underestimated Ukraine (Atlantic Council) Russian President Vladimir Putin likes to pose as an unrivalled expert on Ukrainian history and identity politics. However, it is now apparent that his understanding of Ukraine has been hopelessly distorted by the wishful thinking of his own propaganda. When the Russian dictator gave the order to invade Ukraine five months ago, he seems to have genuinely believed his army would be met with cakes and flowers by a grateful population. Instead, he has plunged Russia into a disastrous war and turned his country’s closest neighbour into an implacable enemy.

Long Read: Russian Youth against War (Wilson Center) Young Russians strongly oppose the war in Ukraine. It is increasingly clear to them that the war is stealing their future and was started only to keep Vladimir Putin, his friends, and their heirs in power for as long as possible.

The Paradoxes of Escalation in Ukraine (Foreign Affairs) Slowly but surely, Russia and the West are drawing their redlines.

Climbing the escalation ladder in Ukraine: A menu of options for the West (Atlantic Council) Our experts have assembled a list of possible policy responses the West ought to consider if Russia escalates its war against Ukraine.

Can Putin Survive? (Foreign Affairs) The lessons of the Soviet collapse.

Is Viktor Orban right about the Ukraine war? (The Telegraph) The Hungarian leader's call for peace may make sense for Hungary now - but long-term it would cripple his country and the West

Putin 'embarrassed' as hackers launch cyber war on Russian President over Ukraine invasion (Express.co.uk) HACKERS are targeting and "embarrassing" Vladimir Putin in a bid to crush the Russian cybersecurity regime as it continues to wage its illegal war on Ukraine.

Is Anonymous Rewriting the Rules of Cyberwarfare? Timeline of Their Attacks Against the Russian Government (Website Planet) Jeremiah Fowler, together with the Website Planet research team, took an in depth look at how the hacker collective has changed the landscape of what

Ukraine’s tech excellence is playing a vital role in the war against Russia (Atlantic Council) Russia’s invasion of Ukraine is now in its sixth month with no end in sight to what is already Europe’s largest conflict since WWII. In the months following the outbreak of hostilities on February 24, the courage of the Ukrainian nation has earned admiration around the world. Many international observers are encountering Ukraine for the first time and are learning that in addition to their remarkable resilience, Ukrainians are also extremely innovative with high levels of digital literacy.

Russia’s pulling the plug on space cooperation. Should the world be worried? (Atlantic Council) Our experts break down Moscow’s extraplanetary plans after it pulls out of the International Space Station.

Crops ‘Stored Everywhere’: Ukraine’s Harvest Piles Up (New York Times) Farmers who have lived under the risk of Russian missile attacks have their doubts about an international agreement to ease a blockade on grain shipments through the Black Sea.

Ukraine to double energy exports amid Russian gas cuts to Europe (Fox Business) Ukraine will double its energy exports to Europe as EU nations cope with an energy standoff with Russia amid an international gas crisis.

Russian economy ‘crippled at every level’ despite Putin’s propaganda (The Telegraph) Country in ‘dire straits’ as exodus of Western firms knocks out 40pc of GDP

Isolation complication? US finds it's hard to shun Russia (AP NEWS) The Biden administration likes to say Russia has become isolated internationally because of its invasion of Ukraine . Yet Moscow's top officials have hardly been cloistered in the Kremlin.

‘Merchant of Death’ offered up by US in exchange for jailed citizens held in Russia (The Telegraph) Viktor Bout has been in US custody for 10 years for running a major arms smuggling operation

Russia has slowed flows of gas to Europe to a trickle - and the energy crisis could drag on until 2025, Goldman Sachs says (Markets Insider) Natural gas prices finally eased Thursday but have soared 145% since the start of June - and the crisis could continue for years, strategists said.

If Putin is using gas prices to fight Europe, how can it fight back? (the Guardian) Analysis: in this massive hybrid war, Europe is preparing its defences before winter and hoping sanctions bite

Attacks, Threats, and Vulnerabilities

How Threat Actors Are Adapting to a Post-Macro World (Proofpoint) In response to Microsoft’s announcements that it would block macros by default in Microsoft Office applications, threat actors began adopting new tactics, techniques, and procedures (TTPs).

CISA Releases Log4Shell-Related MAR (CISA) From May through June 2022, CISA responded to an organization that was compromised by an exploitation of an unpatched and unmitigated Log4Shell vulnerability in a VMware Horizon server. CISA analyzed five malware samples obtained from the organization’s network and released a Malware Analysis Report of the findings. Users and administrators are encouraged to review MAR 10386789-1.v1 for more information. For more information on Log4Shell, see:

MAR-10386789-1.v1 – Log4Shell (CISA) Since December 2021, multiple threat actor groups have exploited Log4Shell on unpatched, public-facing VMware Horizon and Unified Access Gateway (UAG) servers. From May through June 2022, CISA provided remote incident support at an organization where CISA observed suspected Log4Shell PowerShell downloads. During remote support, CISA confirmed the organization was compromised by malicious cyber actors who exploited Log4Shell in a VMware Horizon server that did not have patches or workarounds applied. CISA analyzed five malware samples obtained from the organization’s network: two malicious PowerShell files, two Extensible Markup Language (XML) files, and a 64-bit compiled Python Portable Executable (PE) file.

Threat Advisory: Hackers Are Selling Access to MSPs (Huntress) We’re currently monitoring a situation that entails a hacker selling access to an MSP with access to 50+ customers, totaling 1,000+ servers.

Experts warn of hacker claiming access to 50 U.S. companies through breached MSP (The Record by Recorded Future) Experts have raised alarms about a post on a hacker forum by someone claiming to have access to 50 different U.S. companies through an unknown managed service provider.

Exploit of Log4Shell Vulnerability Leads to Compromise of Major South American Vaccine Distributor (SecurityScorecard) Exploit of Log4Shell Vulnerability Leads to Compromise of Major South American Vaccine Distributor

Exploitation of latest Confluence Vulnerability Underway (SecurityWeek) Security researchers are already seeing the latest Questions for Confluence hardcoded password vulnerability being exploited in attacks.

Moxa NPort Device Flaws Can Expose Critical Infrastructure to Disruptive Attacks (SecurityWeek) Vulnerabilities found in Moxa’s NPort devices could allow attackers to cause significant disruption, including in critical infrastructure organizations.

Nuki Smart Lock Vulnerabilities Allow Hackers to Open Doors (SecurityWeek) NCC Group security researchers have identified 11 vulnerabilities impacting Nuki smart lock products, including some that allow attackers to open doors.

Vulnerability in Dahua’s ONVIF Implementation Threatens IP Camera Security (Nozomi Networks) Nozomi Networks Labs publishes a vulnerability in Dahua's ONVIF standard implementation, which can be abused to take over IP cameras.

Protestware on the rise: Why developers are sabotaging their own code (TechCrunch) A wave of software developers have self-sabotaged their code to protest big corporations to Russia's war in Ukraine.

Italian Insurer's Data Breach Uncovered Sensitive Staff Documents (Website Planet) Italian Insurer's Data Breach Uncovered Sensitive Staff Documents Vittoria Assicurazioni's open buckets exposed hundreds of thousands of files contai

Security Patches, Mitigations, and Software Updates

Google announces new Play Store policies around intrusive ads, impersonation and more (TechCrunch) Google announced new Play Store policies for developers on Wednesday that aim to address issues with intrusive ads, alarms, VPNs and impersonation of brands and other apps. The company said these policies will go into effect during different timeframes so developers have ample time to make changes …

Mitsubishi Electric Factory Automation Engineering Software (Update B) (CISA) 1. EXECUTIVE SUMMARY CVSS v3 8.3 ATTENTION: Exploitable remotely Vendor: Mitsubishi Electric Equipment: Mitsubishi Electric, Multiple Factory Automation Engineering Software products Vulnerability: Permission Issues 2.

Mitsubishi Electric FA Engineering Software (CISA) 1. EXECUTIVE SUMMARY CVSS v3 5.5 ATTENTION: Low attack complexity Vendor: Mitsubishi Electric Equipment: FA Engineering Software Vulnerabilities: Out-of-bounds Read, Integer Underflow 2. RISK EVALUATION Successful exploitation of these vulnerabilities may cause a denial-of-service condition.

Rockwell Products Impacted by Chromium Type Confusion (CISA) 1. EXECUTIVE SUMMARY CVSS v3 4.0 ATTENTION: Low attack complexity/public exploits are available Vendor: Rockwell Automation Equipment: FactoryTalk Software, Enhanced HIM for PowerFlex, Connected Components Workbench Vulnerability: Type Confusion 2. RISK EVALUATION Successful exploitation of this vulnerability could cause a denial-of-service condition.

2022 ForgeRock Consumer Identity Breach Report (ForgeRock) ForgeRock’s Consumer Identity Breach Report found that unauthorized access was the leading cause of breaches, accounting for 50% of all records compromised during 2021. To learn about the current threat landscape, download the report.

The State of Vulnerability Intelligence: 2022 Midyear Edition (Flashpoint) The State of Vulnerability Intelligence report empowers organizations to focus on what matters most, helping them to keep workloads manageable.

Software Supply Chain Risk (Coalfire) Coalfire, in conjunction with survey partner Cyber Risk Alliance, has developed our latest report to advance the cybersecurity community by researching and analyzing the risks currently facing the software supply chain.

Cyberattacks on satellites may only be getting more worrisome (Washington Post) Space is a burgeoning battleground for cyberattacks

It’s Not Just Loot Boxes: Predatory Monetization Is Everywhere (Wired) The UK recently declined to regulate prize draws as a form of gambling, but does it matter? The industry has moved on to more problematic ways to make money.


Cyber insurance is on the rise, and organizational security postures must follow suit (VentureBeat) When it comes to cyber insurance, much like other types of insurance, organizations should know what to look for — as well as what is expected of them. 

Cyber Insurance Price Hike Hits Local Governments Hard (Pew Trusts) Some rates have more than doubled, and many insurers require new security protections.

Cybersecurity Growth Investment Flat, M&A Activity Strong for 2022 (SecurityWeek) While global markets have suffered, sales of cybersecurity software have remained strong. VC investment in cybersecurity has adapted to the world economy rather than stalled.

Decentralized data platform Space and Time raises $10 million in seed round (The Block) Funds raised in the Framework Ventures-led round will be used to expand Space and Time's engineering team and decentralized network.

ThreatX Recognized as a demo Vendor in the 2022 Gartner® Hype Cycle™ for Application Security (Business Wire) ThreatX today announced the company has been acknowledged twice as a demo Vendor in the Gartner Hype Cycle for Application Security, 2022 report.

Axis Named Most Innovative Security Services Company at 2022 Golden Bridge Business and Innovation Awards (PR Newswire) Axis announced today that it has been named Most Innovative Security Services Company at the 2022 Golden Bridge Business and Innovation Awards...

Gartner Magic Quadrant PAM | Delinea Positioned as a Leader (Delinea) Download a complimentary copy of Gartner’s 2020 report on the PAM market and vendors to see why Delinea is recognized as a leader.

Axonius Appoints Tom Kennedy as Vice President of Axonius Federal Systems (Axonius) Axonius today announced it has appointed Tom Kennedy as its Vice President of Axonius Federal Systems LLC, the company’s government-focused subsidiary.

Products, Services, and Solutions

Fastly Partners with HUMAN Security to Protect Customers from Bot Attacks and Fraud (Business Wire) Fastly Partners with HUMAN Security to Protect Customers from Bot Attacks and Fraud

Everything Blockchain Inc. Launches EB Control (Business Wire) Everything Blockchain Inc., (OTCMKTS: OBTX), a technology company that enables real-world use of blockchain to solve critical business issues, today a

Technologies, Techniques, and Standards

Cyber grades bring down agencies’ scores in FITARA 14 (Federal News Network) The 14th version of the FITARA scorecard shows one agency increased their score, while eight earned lower scores, mostly due to cybersecurity shortcomings.

Legislation, Policy, and Regulation

EU to Open San Francisco Office Focused on Tech Regulation (Wall Street Journal) The European Commission is opening a San Francisco office, an effort to Improve trans-Atlantic tech policy relations after years of tension between European regulators and U.S. tech firms.

Why Indonesia Has Embraced Huawei (Foreign Policy) If the U.S. wants to compete with China in developing countries, our research shows it needs to offer tangible assistance in response to real needs.

Victim of Private Spyware Warns It Can be Used Against US (SecurityWeek) Months after her father was lured back to Rwanda under false pretenses and jailed, Carine Kanimba discovered her own phone had been hacked using private spyware.

House Passes Cybersecurity Bills Focusing on Energy Sector, Information Sharing (SecurityWeek) The House has passed two cybersecurity bills: the Energy Cybersecurity University Leadership Act and the RANSOMWARE Act.

House Passes Chips Act to Boost U.S. Semiconductor Production (Wall Street Journal) The $280 billion bill passed despite a late push by Republican leaders to block the legislation over a separate Democratic spending proposal.

CHIPS Act clears Congress, ensuring $52 billion boost to US foundries (The Verge) The vote was the long-awaited bill’s final hurdle before Biden.

Congressional Democrats Introduce Net Neutrality Bill (CNET) Senate and House Democrats introduce a bill to reinstate Obama-era net neutrality rules and to deliver the FCC authority over broadband networks.

Top White House cyber official says Congress should push for digital security mandates (The Record by Recorded Future) A senior White House official on Thursday said Congress could do more to set basic cybersecurity standards for critical infrastructure sectors to better protect them against digital threats.

Litigation, Investigation, and Law Enforcement

Police to share coding of AN0M app used in Operation Ironside arrests (ABC) Experts for alleged criminals charged in one of Australia's biggest criminal sting operations will be given access to the coding of a messaging app built by the Australian Federal Police to catch those allegedly involved in organised crime.

Rewards for Justice – Reward Offer for Information on Russian Interference in U.S. Elections (United States Department of State) The U.S. Department of State’s Rewards for Justice (RFJ) program, administered by the Diplomatic Security Service, is offering a reward of up to $10 million for information on foreign interference in U.S. elections. The reward offer seeks information leading to the identification or location of any foreign person, including a foreign entity, who knowingly engaged […]

Crackdown on BEC Schemes: 100 Arrested in Europe, Man Charged in US (SecurityWeek) Authorities in Europe announce the arrests of 100 individuals for invoice fraud as the US indicts a Florida man for role in BEC scheme.

U.S. Justice Department probing cyber breach of federal court records system (Reuters) The U.S. Justice Department is investigating a cyber breach involving the federal court records management system, the department's top national security attorney told lawmakers on Thursday.

US DoJ probing 'incredibly significant' breach of federal records (Computing) The breach dates back to early 2020

Justice Department investigating data breach of federal court system (POLITICO) House Judiciary Committee Chair Jerrold Nadler described a "system security failure" of the U.S. Courts' document management system.

France Closes 'Cookies' Case Against Facebook (SecurityWeek) French privacy regulators on Thursday closed a case against Facebook after determining the US tech giant had changed the way it collected user data to comply with the law.

Fri, 29 Jul 2022 04:26:00 -0500 text/html https://thecyberwire.com/newsletters/daily-briefing/11/145
Killexams : IoT and industrial AI: Mining intelligence from industrial things
  • By Renee Bassett
  • Cover Story
IoT and industrial AI: Mining intelligence from industrial things
Here’s how to understand what industrial AI can do, how IoT feeds it, and how to start a pilot project of your own
By Renee Bassett

There is nothing "artificial" about the intelligence that can be gleaned from the detailed monitoring of machines, processes, and the people who interact with them. Ever since the time and motion studies of the efficiency experts of the early 1900s, industrial engineers have been turning real-time data into information and decisions that could Improve productivity, efficiency, and profits. With the fourth industrial revolution upon us now, artificial intelligence (AI) technology is ready to go to work in ways that are not always obvious.

According to a Gartner Group forecast, The Business Value of Artificial Intelligence Worldwide, 2017-2025, AI and Internet of Things (IoT) "already work together in our daily lives without us even noticing. Think Google Maps, Netflix, Siri, and Alexa, for example. Organizations across industries are waking up to the potential. By 2022, more than 80 percent of enterprise IoT projects will have an AI component-up from less than 10 percent today" (2018).

The takeaway is clear, says data analytics software provider SAS: "If you're deploying IoT, deploy AI with it. If you're developing AI, think about the gains you can make by combining it with IoT. Either one has value alone, but they offer their greatest power when combined. IoT provides the massive amount of data that AI needs for learning. AI transforms that data into meaningful, real-time insight on which IoT devices can act."

AI and machine learning

Artificial intelligence uses a variety of statistical and computational techniques and encompasses a number of terms. Machine learning (ML), a subset of AI, identifies patterns and anomalies in data from smart sensors and devices without being explicitly programmed where to look. Over time, ML algorithms "learn" how to deliver more accurate results.

Because of this learning, "ML outperforms traditional business intelligence tools and makes operational predictions many times faster and more accurately than systems based on rules, thresholds, or schedules," according to SAS. "AI separates signal from noise, giving rise to advanced IoT devices that can learn from their interactions with users, service providers, and other devices in the ecosystem."

"The challenge is that people have not developed the level of trust in artificial intelligence and machine learning that they have in other technologies that automate tasks," says Oliver Schabenberger, COO and CTO of SAS. "People sometimes confuse automation with autonomy, he adds. But have no fear: "AI does not eliminate the need for humans, it just enables them to do their work more effectively," he says.

AI, around since the 1950s, is becoming a mainstream application as a result of the explosion in IoT data volume, high-speed connectivity, and high-performance computing.
Source: SAS

Defining AI applications

Industrial AI can range from low-intelligence applications like automation to higher-end intelligence capable of decision making. It can also be controlled centrally or distributed across multiple machines. According to Gartner vice president and analyst Jorge Lopez, AI applications can be broken down into five levels of sophistication:

Reactors follow simple rules but can respond to changing circumstances within limits (such as basic drones).

  • Categorizers recognize types of things and can take simple actions to deal with them within a controlled environment (warehouse robots).
  • Responders serve the needs of others by figuring out questions and situations (driverless cars, personal assistants).
  • Learners gather information from multiple sources to solve complex problems (IBM Watson, wholly automated military drones).
  • Creators initiate a paradigm shift, such as inventing a new business model. They are not merely tools that people use; they have the potential to engineer actions harmful to humans. They will change humans' relationship to technology as well as people's roles within society and the economy, says Gartner. Therefore, "AI creator applications require profound thought before development."

These five artificial intelligence models have three types of organization, says Gartner: standalone, federation, or swarm. A standalone AI system is an individual entity that acts by itself to solve problems. The enterprise exercises centralized control over it by overseeing the entity as it performs.

In a federation structure, says Gartner, multiple versions of an entity work in the same way but on different problems (e.g., robo-advisors, personal assistants). The enterprise can exercise central control or deliver more autonomy to the entities. In a swarm structure, multiple entities work together on the same problem (e.g., Intel light show drones, Perdix drones). Control over execution is left to the machines entirely or requires only light human management.

Early AI adopters like retail and banking firms have reaped the benefits of AI, but it is not too late for fast followers, according to Petuum. AI has caught the attention of industrial innovators and naysayers alike.
Source: McKinsey & Company

More than automation

The most common place to start with AI is with automation, but experts say it is a mistake to stop there. The more powerful use of AI is to aid human decision making and interactions. Because AI can classify information and make predictions faster and at higher volumes than humans can accomplish on their own, those terabytes of data being produced by industrial IoT devices are being transformed into powerful tools today.

In a latest blog post for industrial AI startup Petuum, author Atif Aziz says, "Some industry leaders are zooming past the basics: digitization, cloud infrastructure, monitoring and dashboards. They are putting newly acquired data to good use through AI-driven advanced analytics (e.g., uncovering patterns through system of systems) and automating complex processes. Some early adopters are implementing as many as 100 digital transformation initiatives simultaneously or using AI to automate their core production processes across 30 or more plants," Aziz says.

On the other end of the spectrum, "some folks still need to understand how AI can provide real value and balance the ROI with their limited resources," says Aziz. "The breakneck speed of advancement in the Industrial AI/ML space over the last three years affords a unique advantage for these newcomers. They can skip many of the expensive intermediate steps (e.g., significant investments in data aggregation infrastructure, dashboards, and monitoring centers) and gain the same AI benefits as the savvier early adopters."

Aziz says most industrial AI initiatives fall into three categories. AI for assets includes equipment automation, equipment stabilization, and equipment health. AI for processes includes yield maximization through efficiency gains, automation and stabilization across multiple assets or spanning multiple flows, and quality improvement. AI for operational excellence and/or business agility includes energy cost optimization, predictive maintenance, logistics and scheduling, research and development, and more.

AI for assets

IBM Watson IoT helps organizations make smarter decisions about asset management by combining IoT data with cognitive insights driven by AI. IBM's Maximo enterprise asset management (EAM) system uses Watson IoT technology to make better decisions about critical physical assets in industrial plants-whether they are discrete machines, complex functional asset systems, or human assets.

One Maximo user, Ivan de Lorenzo, is outage planning manager for Cheniere Energy, a Houston-based liquefied natural gas producer. He says that, with the software, "we have better information on assets and maintenance activity, and more sophisticated tools and mechanisms for managing it all. The result is greater operational control and accountability, especially when it comes to planning and scheduling."

AI-based asset life-cycle and maintenance management solutions like Maximo use real-time data collection, diagnostic, and analysis tools to extend an asset's usable life cycle. Use of the software also improves overall maintenance best practices; meets increasingly complex health, safety, and environmental requirements; and controls operational risk by embedding risk management into everyday business processes.

IBM says EAM also helps "control the brain drain among employees facing retirement by [putting] into place proven workflows and enforced best practices that capture the knowledge and critical skills of long-time employees." Such a system also helps a reduced workforce to work more efficiently and cost effectively "by using the captured intellectual experience of skilled workers in a format easily dispersed in a wide range of languages."

AI for processes

AI systems are being used to Improve whole processes as well as industrial assets. In an MIT Technology Review Insights publication produced in conjunction with IBM, Raytheon senior principal systems engineer Chris Finlay describes the benefits of replacing document-based information exchange with an AI-compatible digital platform to support engineering and design. "Once you start to capture things digitally, you can start to exploit machine learning or AI algorithms," he says. "You can start to reduce development costs because you can automate tasks that you were doing by hand."

Joe Schmid, director of worldwide sales for IBM Watson Internet of Things, says, "In the engineering process, you define what you want to do, design it, build it, test it, and prove that you've done it. The key is integrating those steps. But integrating is hard."

Customers that Schmid has worked with are often good at one part of the process, such as design, but they do not integrate design into the life cycle. "When they need to change goals or specs, it's all in people's heads," he says. "That doesn't work anymore with the complex systems we have today. One engineer can't have an entire system in their head. That's when errors pop up."

The goal of AI for engineering processes is to create an integrated "system of systems," a closed loop that runs from the requirements phase of product development to real-time monitoring of how consumers are using the product, and then deploy AI systems to analyze the data and leverage that knowledge to Improve the product, says Dibbe Edwards, vice president of IBM Watson IoT connected products offerings.

In another example, global building materials company Cemex is on an industry 4.0 journey toward enhanced standardized operations using AI. The ultimate goals are increased efficiencies, reduced fuel and energy consumption, better quality, reduced costs, and improved decision making. The company announced in March that it had installed "AI-based autopilots" for its rotary kiln and clinker cooler systems that will "autosteer" its cement plants and enable autonomous, operator-supervised plant operations.

Cemex used OSIsoft PI systems to power Petuum Industrial AI Autopilot products. The two work with plant control systems to provide precise real-time forecasts for significant process variables, prescriptions for critical control variables, and a supervised autosteer function aligned with business objectives while staying within applicable static and dynamic constraints. The PI systems fuel real-time predictive and prescriptive recommendations.

Rodrigo Quintero, operations digital technologies manager for Cemex, says, "Petuum Industrial AI Autopilot helped us achieve something we didn't think was possible at this time: yield improvements and energy savings up to 7 percent, which is game changing for our industry. Additionally, this is a giant step in digital transformation toward safe, highly standardized operations, that will help us strengthen our high-quality products portfolio while also ensuring we meet our operational and sustainability goals, and minimize costs."

The Autopilot products can ingest data from a variety of sources, including unstructured, images, structured, time series, customer relationship management (CRM) data, enterprise resource planning (ERP) data, and others. The Petuum platform provides sophisticated data processing, data cleansing, and machine/deep learning pipelines to implement advanced AI that is sensitive to linear, temporal, long range, and nonlinear data patterns in a range of industrial use cases.

AI for operational excellence

Staying ahead of maintenance and production challenges to keep precision metals rolling out of its plants on time is a high priority for Ulbrich Stainless Steel & Specialty Metals. That is why the global company chose SAS Analytics for IoT to gain access to the latest suite of AI, machine learning, and streaming analytics available to analyze the data from plant sensors.

Jay Cei, COO at Ulbrich, says, "Collecting machine and sensor data from our factories and integrating that with ERP system data will help us understand the intricate relationships between equipment, people, suppliers, and customers.

Learning what their IoT data means is critical for understanding how the company can become more productive and efficient in the future, Cei says. DJ Penix, president of SAS implementation partner Pinnacle Solutions, says, "Streaming analytics will not only help Ulbrich understand what is happening now with their machines. It will also enable them to predict future events, such as when a machine needs maintenance before it breaks down."

The software provides a simplified way for any user to prepare stationary and streaming IoT data for analysis without specialized skills, says Penex. Whether a data scientist, business manager, or someone in between, they can use SAS Analytics for IoT to quickly select, launch, transform, and operationalize IoT data, he says.

Jason Mann, vice president of IoT at SAS, says companies can no longer afford to ignore the hidden signals in their IoT data. "To thrive, organizations need a solution that addresses data complexity and automates timely and accurate decision making," he adds.

Tips for AI pilot projects

According to a latest Gartner survey, 37 percent of organizations are still looking to define their AI strategies, while 35 percent are struggling to identify suitable use cases. Once you have developed a solid understanding of AI and its potential applications, it is time to make a case for a pilot. Here are some tips from Gartner for making the pilot project a success.

  1. Be realistic about a timeline. Once you have approval from executives, it can be tempting to think a pilot project will follow quickly. In fact, according to results from Gartner's 2017 Annual Enterprise Survey, 58 percent of respondents in companies currently piloting AI projects say it took two or more years to reach the piloting phase, and only 28 percent of respondents reported getting past the planning stage in the first year.
  2. Aim for fairly soft outcomes, such as improvements to processes, customer satisfaction, products, or financial benchmarking. Gartner Research Circle respondents urged others not to fall into the trap of seeking only immediate monetary gains. Aim initially for less-quantifiable benefits from which financial gains would eventually arise.
  3. Focus on worker augmentation, not worker replacement. AI's potential to reduce staff head count attracts the attention of senior business executives as a potential cost-saving initiative. A more informed expectation, however, is for applications that help and Improve human endeavors, as AI promises benefits far beyond automation. Organizations that embrace this perspective are more likely to find workers eager to embrace AI.
  4. Plan for the transfer of knowledge from external service providers and vendors to enterprise information technology and business workers. External service providers can play a key role in planning and delivering AI-powered software, and knowledge transfer is crucial. AI requires new skills and a new way of thinking about problems. These include technical knowledge in specific AI technologies, data science, maintaining quality data, problem domain expertise, and skills to monitor, maintain, and govern the environment.
  5. Choose AI solutions that offer tracking and revealing AI decisions, ideally using action audit trails and features that visualize or explain results. To that end, Gartner predicts that by 2022, enterprise AI projects with built-in transparency will be twice as likely to receive funding from CIOs.
  6. Start small; do not worry about immediate return on investment. Digital transformation should begin with small experiments that are purely for learning, says Gartner. Use the time to pilot projects that employ a variety of technologies to assess which make the most sense for the business.

Reader Feedback

We want to hear from you! Please send us your comments and questions about this course to InTechmagazine@isa.org.

Thu, 08 Aug 2019 06:38:00 -0500 en text/html https://www.isa.org/intech-home/2019/july-august/features/iot-and-industrial-ai-mining-intelligence-from-ind
Killexams : Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification


Muscle injuries represent one-third of all injuries in football and cause one-quarter of total injury absence.1 Over 50% of muscle injuries affect the thigh muscles, and hamstring muscle injuries are the most common injury subtype representing 12% of all injuries.1 A professional male football team with 25 players suffers about five hamstring injuries and three quadriceps injuries each season, resulting in 130 lost football days.1

The aim is to return the player to training and matches as soon as possible. Prognostic information is vital for the medical staff to address questions from players, coaches, managers, media and agents regarding return to play.

The fact that muscle injuries present a heterogeneous group of injury types, locations, severities and sizes, makes prognoses about healing times and rehabilitation difficult.1–5

A radiological classification system of muscle injuries introduced by Peetrons6 is frequently used for imaging; recently, Ekstrand et al2 showed that MRI can be helpful in verifying the diagnosis of hamstring injuries and that radiological grading is associated with lay-off times after injury.

However, a clinical classification system correlating clinical grading with absence is presently not available.

Recently, the ‘Munich muscle injury classification system was introduced as a new terminology and classification system of muscle injuries’.7 This clinical system classifies muscle injuries into functional and structural–mechanical injuries, where functional disorders are fatigue-induced or neurogenic injuries causing muscle dysfunction, while structural–mechanical injuries are tears of muscle fibres.7

The aim of the present study was to implement the Munich classification system in male elite-level football teams in Europe (teams from Union of European Football Associations (UEFA) Champions League and English Premier League) and to evaluate if the classification system is applied and received well by the teams’ medical staff. A further aim was to prospectively evaluate the classification system as a predictor of return to play. A third aim was to provide normative data for the frequency of muscle injuries in the different classification groups as well as to analyse if the classification system could be useful both for anterior and posterior thigh muscle injuries.

We hypothesised that the classification system is well received and readily applicable by football medical teams and that the distribution of lay-off days is different across categories of the classification.

Material and methods

Study population

A prospective cohort study of men's professional football in Europe has been carried out since 2001, the UEFA Champions League (UCL) study.8 For the purpose of this substudy, 31 European professional teams (1032 players) were followed over the 2011/2012 season between July 2011 and May 2012. All contracted players in the first teams were invited to participate in the study.

Study design and definitions

The full methodology and the validation of the UCL injury study design are reported elsewhere.9 The study design followed the consensus on definitions and data collection procedures in studies of football injuries.9 ,10 An overview of the general definitions is seen in table 1. Specifically for this study, a thigh muscle injury was defined as ‘a traumatic distraction or overuse injury to the anterior or posterior thigh muscle groups leading to a player being unable to fully participate in training or match play’. Contusions, haematomas, tendon ruptures and chronic tendinopathies were excluded.

Table 1

Operational definitions

Data collection

Player baseline data were collected at the start of the season. Individual player exposure in training and matches was registered by the clubs on a standard exposure form and sent to the study group on a monthly basis. Team medical staff recorded thigh muscle injuries on a standard injury form that was sent to the study group each month. The thigh injury form is an A4 page consisting of ticking boxes for type, location, mechanisms of injuries as well as diagnostic procedures (clinical examination, imaging by MRI or ultrasonography) and treatments. All injuries resulting in a player being unable to fully participate in training or match play (ie, time-loss injuries) were recorded, and the player was considered injured until the team medical staff allowed full participation in training and availability for match selection. All injuries were followed until the final day of rehabilitation. To ensure high reliability of data registration, all teams were provided with a study manual containing definitions and describing the procedures used to record data, including fictive examples. To avoid language problems, the manual and the study forms were translated from English into five other languages: French, Italian, Spanish, German and Russian. In addition, all reports were checked each month by the study group, and feedback was sent to the teams in order to correct any missing or unclear data. While each team received detailed instructions on how to standardise the process of data collection, potential limitations included the risk for observer bias from the lack of independent injury classification and the evaluation of return to play performed by the same team medical staff.

Magnetic resonance imaging

For the purpose of this study, the clubs were instructed to perform the initial MRI examination within 24–48 h of the injury event. The MRI machine should not be older than 5 years and should have a field strength of at least 1.5 T. The minimum MR sequences should include axial and coronal planes using T1, T2 with fat saturation and/or STIR sequences. A MRI Thigh Injury Report Form was created with information about date of imaging, the name of the radiologist evaluating the images, MR sequences used, muscles involved and severity of injury.

For severity classification, a modification of Peetrons radiological classification6 was utilised with the following grading system: grade 0—negative MRI without any visible pathology; grade 1—oedema, but no architectural distortion; grade 2—architectural disruption indicating partial tear; and grade 3—total muscle or tendon rupture. All radiologists used the same standard evaluation protocol.

Injury evaluation

Of the 393 injuries recorded during the study period, all (100%) underwent physical examination, 215 (55%) were examined by MRI and 75 (35%) of these also had concomitant initial ultrasound. One-hundred and seven injuries (27%) were examined exclusively by initial ultrasound without MRI, and 70 (18%) were examined clinically without the use of any imaging. Information about examination method was missing for one injury.

Implementation and validation of the Munich muscle injury classification

During the season 2011/2012, ticking boxes for injury classification according to the Munich system were added to the thigh injury card. The team medical staffs were asked to tick one of the following alternatives: Fatigue-induced muscle disorder, delayed onset muscle soreness, neuromuscular muscle disorder—spine related, neuromuscular disorder—muscle related, partial muscle injury—minor, partial muscle injury—moderate, subtotal/complete muscle injury/tendinous avulsion. The definitions of functional and structural muscle disorders and their subgroups (as they appeared in the study manual) are shown in table 1. Validity presents the extent to which a concept, conclusion or measurement is well-founded and corresponds accurately to reality. The validation process of the classification was therefore designed to evaluate whether the concept and grading of the classification corresponded to clinically relevant parameters such as the lay-off times of the injured players.

Statistical analyses

Lay-off days are presented with median (Md) and IQR. χ2 Test was used to analyse the association between categorical data. Kolmogorov-Smirnov test (D) was used to test for normality in lay-off days, and Levene's test (F) was used to test for homogeneity of variance in subgroups. Non-parametric methods, Mann-Whitney U-test (U) and Kruskal-Wallis test (H) were used in this study to analyse differences in lay-off days between independent subgroups. All tests were two-sided and the significance level was set at p<0.05. All statistical analyses were made in IBM SPSS Statistics V.19.0 (IBM Corp, Armonk, New York, USA). The study design underwent an ethical review and was approved by the UEFA Football Development Division and the Medical Committee.


Of the 393 thigh muscle injuries reported during the study period, all (100%) injury forms included injury classification according to the Munich system.

Overall, 263 (67%) of the thigh injuries were classified as structural and 130 (33%) as functional. Two-hundred and ninety-eight (76%) injuries affected the posterior thigh; 193 (65%) were classified as structural injuries and 105 (35%) as functional disorders. Ninety-five (24%) injuries affected the anterior thigh; 70 (74%) were classified as structural injuries and 35 (26%) as functional disorders. There was no significant association between classification (functional/structural) and location (anterior/posterior), χ2(1)=2.59, p=0.108.

The distribution of lay-off days, in both structural injuries and functional disorders, was significantly non-normal, D(263)=0.21, p<0.001 and D(130)=0.24, p<0.001, respectively. Levene's test also indicated a significant difference in variance in the subgroups, F(1, 391)=33.80, p<0.001.

The number of lay-off days was significantly higher in structural injuries (Md 16, IQR 16 days) compared to functional disorders (Md 6, IQR 6 days), U=6184.5, z=−10.31, r=−0.52, p<0.001. The difference in lay-off days between structural injuries and functional disorders, within both anterior (Md 14, IQR 16 days vs Md 7, IQR 9 days) and posterior (Md 16, IQR 15 days vs Md 6, IQR 5 days) thigh injuries, was also significant, U=446.5, z=−3.62, r=−0.37, p<0.001 and U=3229.5, z=−9.72, r=−0.56, p<0.001, respectively. However, there was no significant difference in lay-off days between anterior (Md 12, IQR 15 days) and posterior (Md 12, IQR 14 days) thigh injuries overall, U=14 004.0, z=−0.16, r=−0.01, p=0.88.

Detailed classification-specific normative data are presented in table 2 and figure 1.

Table 2

Lay-off days by thigh muscle location and Munich muscle classification system

Figure 1

Days of absence after different groups of muscle injuries.

There was a significant difference in lay-off days between the subgroups of structural injuries, H(2)=93.91, p<0.001 (Md 13, IQR 10 days for minor partial muscle tears (1), Md 32, IQR 24 days for moderate partial muscle tears (2) and Md 60, IQR 5 days for subtotal/complete muscle injury/tendinous avulsion (3)). Pairwise comparisons were conducted to follow-up the significant difference among the subgroups, controlling for type I error across tests by using Bonferroni approach. The results of these tests indicated that the number of lay-off days was significantly higher in both subgroups (2) and (3) compared to subgroup (1). However, lay-off days were not significantly affected by the subgroups of functional disorders, H(3)=4.49, p=0.21. Median lay-off for the subgroups was between 4.5 and 8 days.

Information about the performed examinations was available in all except one injury. MRIs were performed in 36/130 (28%) of functional disorders and in 179/262 (68%) of structural injuries. MRI forms for 52 of the 215 MRI examinations (24%) were received from 14 of the 31 clubs. All 12 injuries, clinically classified as functional disorders, were reported to be either of radiological grade 0 (no MRI pathology) (17%) or grade 1 (oedema without visible tears) (83%) and without signs of muscle ruptures on MRI.

Thirteen injuries were clinically classified as moderate partial muscle tears; 10 (77%) were reported as MRI grade 2; and 3 (23%) were reported as MRI grade 1.

The 27 injuries clinically classified as minor partial muscle tears showed mixed MRI gradings. The majority (81%) were classified as either grade 0 (n=1) or grade 1 (n=21) with muscle tears reported in only 5 (19%).

The radiological size of the tears was only reported in 9 (60%) cases: 4 (80%) in minor and 5 (50%) in moderate partial muscle tears. The mean extent in millimetres of the minor partial muscle tears in z, x and y direction was 26±11 (range 10–33), 14±4 (range 11–19) and 9±3 (range 5–12), respectively.

Primary injuries versus re-injuries

Forty-nine injuries (12%) were classified as re-injuries (injury of the same type and at the same site as an index injury occurring no more than 2 months after a player's return to full participation from the index injury). No significant association between injury classification and re-injury rate could be found, χ2(1)=0.005, p=0.95. The re-injury rate was 33/263 (13%) within structural injuries (13% in minor and 12% in moderate partial muscle tears, and 20% in subtotal/complete muscle injury/tendinous avulsion) and 16/130 (12%) within functional disorders (10% in fatigue-induced muscle disorders and 18% in both muscle-related and spine-related neuromuscular disorders). Only seven (5%) of the initial functional disorders developed into secondary structural injuries within 2 months of the primary injury.


Muscle injuries present one of the most frequent and most relevant injuries in professional football accounting for a majority of time lost from competition.1 Owing to complex and heterogeneous presentation of these injuries, the development of a comprehensive muscle injury classification has traditionally been challenging. A critical aspect of a useful muscle injury classification is that it not only provides valid and practically relevant information to the treating medical practitioner but also easily applicable and accepted by medical staff. A main finding of the current study is that the implementation of the Munich muscle injury classification was highly successful, with full medical staff acceptance, and excellent injury data collection.

Functional muscle disorders are clinically underestimated

The present study showed a discrepancy between clinical and radiological classification. Among injuries classified both clinically and radiographically, 77% were clinically classified as structural tears, but radiological grading on MRI showed evidence of muscle tears in only 29% of injuries. This finding is in accordance with a latest study by Ekstrand et al,2 who showed that 70% of hamstring injuries seen in professional football show no signs of muscle fibre disruption on MRI. Still, these injuries are responsible for more than half of the muscle injury-related lay-off.2 The understanding of these most frequent muscle injuries/disorders with the highest impact on lay-off time is still limited and warrants further scientific evaluation. The differentiation of functional and structural muscle injuries introduced by the Munich classification is an important first step towards a more differentiated evaluation of this relatively undefined area of athletic muscle injury. The current study shows that functional muscle disorders are common, but associated with relatively short lay-off times, thereby providing useful information to medical staffs and athletes. Furthermore, our data demonstrate a low risk for the development of subsequent more severe re-injury after functional muscle disorders. Prospective specific investigation of functional muscle disorders with appropriate power is needed. Further systematic study is also required for developing reliable clinical and radiographic tools for differential diagnosis of functional muscle disorders and minor structural injury. However, this study suggests that for the purpose of predicting return to sport, differentiation of functional muscle disorders may not be as clinically relevant. Our finding that clinical classification tends to overestimate structural tears and underestimates functional disorders could be explained by the limited awareness of the high incidence of functional disorders in elite-level football. Since the Munich classification relies on a careful clinical examination and history of the injury, the skill of the clinician and a detailed understanding of the different disorders, there may be a distinct learning curve, and education and experience may become an important factor.

Return to play is longer after structural injuries

The ability to predict lay-off is very important for the injured player as well as the coaching staff. The Munich classification clearly shows a difference in return to play between structural and functional muscle injuries. This seems logical since by definition, structural injuries show macroscopic evidence of muscle fibre damage, and functional disorders show no such damage. Our study indicates that severity of the muscle injury directly affects the duration of the lay-off. Similarly, increased muscle injury severity on MRI has been associated with longer times to return to professional American Football2 ,4 ,5 ,11–13

Clinical classification relates to lay-off

Another main finding of this study is that subgrouping of structural injuries into minor or moderate partial tears as well as total ruptures is clearly associated with lay-off time from football. By definition, validity is the extent to which a concept, conclusion or measurement is well-founded and corresponds accurately to the real world. Our finding that the concept and grading of the classification corresponded to the lay-off times of the injured players therefore validates the concept provided in the classification. Thus, our study validates the ability of the Munich muscle injury classification to differentiate between functionally relevant degrees of muscle injury and its usefulness for the prognosis of healing time. Similarly, the extent of muscle injury on MRI has been shown to have prognostic relevance as injuries involving >50% of the muscle diameter were associated with longer lay-off times.11 ,14 In our study, MRI was unable to detect the differences between moderate or minor structural injuries, suggesting that the Munich classification is more sensitive than MRI in detecting low-grade structural injury. Müller-Wohlfahrt et al7 postulated that secondary muscle bundles, with a diameter of 2–5 mm, can be palpated by the experienced examiner, as well as suggested further studies to determine the size threshold between a minor and a moderate partial muscle tear. In the present study, MRI was unable to detect such small injuries (<5 mm) in any of the 52 injuries in either x, y or z led. Previous studies15 ,16 also noted that some clinically detected athletic muscle injuries are negative on 1.5 Tesla MRI and that these MRI-negative injuries resulted in faster return to competition. This suggests that MRI at the current resolution has limited sensitivity for the detection of minor muscle injury. Similarly, detection limits exist on clinical examination. Our study does not allow any definite conclusions of the tactile limit for the detection of minor muscle tears. Further systematic studies should try to better define the threshold for clinical detection of minor muscle injury possibly by correlation with high resolution MRI (3T or higher).

The diagnosis and definition of the MRI-negative injuries are challenging

Our study demonstrates that a negative MRI does not rule out clinically relevant muscle injury and that clinical diagnosis and management should be based on a combination of clinical history, physical examination and possibly radiographic evaluation. MRI grades 0–1 injuries constitute the majority of muscle injuries in professional football athletes and include a spectrum of pathology such as minor structural injuries as well as functional muscle disorders. Differential diagnosis of these muscle disorders can be challenging and requires a thorough understanding of the Munich classification and strong clinical diagnostic skills. While grading of structural injuries in the Munich classification has prognostic relevance for return to play, subgrouping of functional disorders seems less relevant since lay-off times were similar between the different functional disorders. However, the differentiation of functional disorders may be important as it can impact the therapeutic approach. Interestingly, the average number of lay-off days is similar between minor structural and muscle-related neuromuscular functional disorders. Since the treatment approach is similar, it raises the question if the underlying pathologies could overlap. Could there be a neurological response to a minor tear such as a reciprocal inhibition or could a neurological inhibition facilitate the development of minor tears? This particular aspect of the Munich muscle injury classification requires further specific and powerful substudy and validation with detailed documentation of history, clinical exam, MRI, ultrasound and functional outcome parameters. An improved understanding of MRI grades 0–1 muscle injuries will help to further optimise the management of these injuries and will help to develop evidence-based strategies for expedited and safe return to competition after athletic muscle injury.14 ,15 ,17

What are the new findings?

  • In summary, the current study demonstrates the successful implementation of the Munich muscle injury classification in elite football players. In addition, it validates the following aspects:

  • Structural injuries and functional disorders differ significantly in their lay-off times.

  • Subgrouping of structural muscle injuries based on injury severity has positive prognostic relevance.

  • Subgrouping of functional muscle disorders has less prognostic value.

How might it impact on clinical practice?

Sun, 13 Sep 2020 16:37:00 -0500 en text/html https://bjsm.bmj.com/content/47/12/769
Killexams : Urban Poor Community Settings' Knowledge and Screening Practices for Cervical Cancer in Ibadan, Nigeria

Cancer of the uterine cervix has become a growing public health challenge with increasing mortality and morbidity among women in lower human development index countries.1 It is reported as the foremost and fourth most common cause of cancer deaths among women.2,3 Bray et al2 reported estimated global new cases of 569,847 (3.2%) and a mortality of 311,365 (3.3%) in 2018. Low- and middle-income countries account for one of the highest prevalence of cervical cancer, with an estimated 90% of global deaths occurring in this region. Cancer of the uterine cervix is the second leading female cancer among Nigerian women, after breast cancer,4 and accounts for more than 10,000 annual deaths.2,5


  • Key Objective

  • What are men and women's knowledge and screening practices of cervical cancer in urban slum community settings?

  • Knowledge Generated

  • The mean knowledge score of cervical cancer detection was 5.0 ± 2.6 on a 0- to 39-point scale. Cervical cancer prevention practices (screening and human papillomavirus vaccination) were very low.

  • Relevance

  • Low knowledge potentially translates to low practice, as shown in this study. These may result in late detection and presentation at health facilities with poor treatment outcomes. Prevention strategies, at primary and secondary levels, including educational interventions should be encouraged in clinical and other settings to prevent an overburdening of the health system.

The major cause of cervical cancer is the human papillomavirus (HPV), and the disease is sexually transmitted. Other risk factors include high parity, smoking, sexual initiation at an early age, multiple sexual partners, and prolonged use of oral contraceptives. The prevention rate for cervical cancer is high if detected and treated early.6 The WHO recommends regular screening every 3-5 years among women age 30-49 years, in addition to timely treatment of precancerous lesions.2 More recently, the World Health Assembly endorsed the WHO Global Strategy for elimination of cervical cancer. The global targets for 2030 emphasize primary prevention (90% coverage of HPV vaccination of girls by age 15 years) and secondary prevention (70% of women to be screened by age 35 and 45 years).7

Vaccination is reported as an important public health primary prevention approach to reduce the risk of HPV, whereas cervical cytology or Papanicolaou test (Pap smear) is documented as secondary form of prevention.8 In Nigeria, primary prevention through HPV vaccination is not yet part of the national routine immunization program; it is, however, accessible, at a high cost, through a limited number of private and public health care settings. Conventionally, secondary prevention through screening is carried out in Nigeria using Pap smear test.9 However, Pap smear test is not suitable as primary screening in low-resource settings although it has played a substantial role in reducing cervical cancer in developed countries over the past 70 years. Awareness and knowledge of cervical cancer are, however, necessary for improved involvement of women in prevention and screening practices. Several studies have been carried out among Nigerian women to assess the knowledge and screening practices for cervical cancer (including HPV vaccine and Pap smear test) and among HIV-infected women. Most studies have shown an appreciable high knowledge of cervical cancer in urban workplace settings, women attending health facilities, or health workers. Conversely, many studies have documented low knowledge and practice among women,1,10,11 especially at population levels. Incessant creation of awareness about cervical cancer has the potential to increase knowledge and utilization of cervical cancer screening practices.12 More research documenting both men's and women's knowledge of cervical cancer and screening practices among women in urban slum community settings is needed. Focus on men in addition to women on cervical cancer studies is very scanty in Nigeria. Thus, the inclusion of men, and not only women, is important because of the decision-making role of men in Nigerian families and in improving family health. This study therefore investigated the knowledge and screening practices for cervical cancer among male and female adults in urban poor settings in Ibadan, Nigeria. The findings from this study would inform baseline data for planning appropriate health promotion and education, prevention interventions, and policy formulation to prevent and control cervical cancer in poor community settings in Nigeria.

Study Design and Setting

This study used a cross-sectional design in two urban community-based settings in Ibadan, Oyo State, Nigeria. Data collection lasted for 3 weeks in both communities. Ibadan is the largest city in Africa situated in the western region of Nigeria. Ibadan has a population of 3 million and is a combination of both urban and semiurban community settings. Two underserved communities located in the urban slum areas of Ibadan North Local Government Areas (LGAs) were identified. The two communities selected for this study are at the heart of Ibadan city in an urban LGA but have a mixture of higher- and lower-educated people and subsequently a combination of high-, middle-, and low-income communities. The LGA has an estimated population of 308,119, and sanitary conditions in the slum areas are poor as the majority of houses do not have access to potable water and water-flushed toilets.

Study Population, Sampling, and demo Size

All consenting male and female adults in both communities age 18-65 years were eligible to participate in this study. Exclusion criteria included persons who did not deliver consent to participate in the study and physically or mentally ill men and women, who were unable to provide adequate information. A previous community-based study by Nnodu et al13 informed the calculation of the demo size of 500, using the Leslie Kish formula. The prevalence of knowledge about HPV was 33%, with calculations on the basis of 95% confidence level, a margin of error of 5%, and a design effect of 1.5. The final demo size calculated was 334, but to cater for attrition and to cover a larger demo area, the demo size was increased to 500. Community members age 18-65 years were randomly selected from the total community population. Simple random sampling technique was used to select participating households, whereas one respondent was selected in each household by ballot to avoid selection bias. A total of 147 males and 353 females completed the electronic data.

Data Collection Methods and Instruments

The research team had earlier visited and interacted with the communities' stakeholders including the heads of the landlord association, executives of the association, and religious leaders. The two communities had committed to support the study and paved the way for easy connection to the community members. In the two communities, 552 people were approached and only 52 declined to participate, mostly because they had to engage with other commitments at the time of the interview. Most of those who consented to participate were self-employed so could create time for the interview.

Data collection instrument was developed and converted into an electronic data capture tool (ODK Collect). Data collection was interviewer administered using the translated instrument into the local language Yoruba and back-translated to English for content validity. Data tool contained both open- and closed-ended questions (Data Supplement). Interviewers were trained before data collection process to ensure increased quality of data set, and all followed a homogenous procedure. Data were pretested in similar community settings before genuine data collection was undertaken. The ODK tool included questions on sociodemographic characteristics of respondents and cervical cancer questions on awareness and knowledge of cervical cancer risk factors, symptoms, and detection. Questions were also asked about screening practices with Pap smear, visual inspection with acetic acid, reasons for nonscreening, and HPV vaccination. Respondents were asked to identify their responses to knowledge questions with yes or no as appropriate. Open-ended question responses were recorded on the ODK tool by interviewers. Knowledge questions were scored (on a scale of 0-39) for respondents' knowledge of cervical cancer detection, symptoms, and risk factors. Total scores were added together, and a mean knowledge score for respondents was calculated.

Quality Assurance

Throughout the data collection process, research assistants were monitored and gave daily feedback on the research process. The electronic data collected were uploaded daily and checked for completeness and errors. In those cases where there were errors, research assistants were asked to collect additional data and the data previously collected were discarded. Quality assurance meetings were held weekly to review the data collected, weekly targets, and any challenges that research assistants encountered. This enabled immediate response to facilitate ease of data collection procedure.

Data Analysis

Electronic data collected using the ODK tool were checked before they were transferred into the Statistical Package for Social Sciences (IBM SPSS) version 21. Both descriptive and inferential statistics analyses were used to meet the criteria of the study objectives. Categorical variables were presented using frequencies and percentages, whereas continuous variables reported means and standard deviations. Inferential statistics was obtained using chi-square statistics to estimate the degree of association between the variables in the study. Multivariate regression analysis was not carried out because there was no statistical significance from the chi-square statistics.

Ethical Consideration

The study protocol was approved and informed (by signing an informed consent form), and voluntary consents were sought and obtained from community leaders, stakeholders, and all study respondents, before the commencement of data collection (Data Supplement). There were no physical risks to the respondents; data were collected in privacy, and respondents were assured that they would not be penalized in any way if they chose to stop the data collection at any stage. Respondents were assured of confidentiality of responses, and only identification codes were assigned to ODK files. Study findings were disseminated to participating communities after the completion of the study.

The study protocol was approved by the University of Ibadan/University College Hospital Nigeria Ethical Review Committee, Nigeria, with the reference number UI/EC/17/0410.

Awareness of Cervical Cancer

A majority of respondents were not aware of cervical cancer screening (91.2%) and Pap smear test (93.6%). Few (10%) had ever heard of HPV vaccine for the prevention of cervical cancer.

Knowledge of Cervical Cancer (detection, symptoms, and risk factors)

The knowledge of the risk factors for cervical cancer showed that majority (92.4%; 0.92 ± 0.27) reported that old age, low socioeconomic status (88%; 0.88 ± 0.33), unhealthy diet (75.8%; 0.76 ± 0.43), and high rate of abortion (73%; 0.73 ± 0.44) were risk factors for cervical cancer (Table 2).


TABLE 2 Knowledge of Cervical Cancer (Risk Factors, Symptoms, and Detection)

A majority of respondents (91.60%; 0.92 ± 0.28) reported that the absence of menstruation or irregular menstruation, itching at the vagina (91.00%; 0.91 ± 0.29), and painful menstruation (95.40%; 0.95 ± 0.21) constitute symptoms of cervical cancer (Table 2).

The results of knowledge on detection of cervical cancer showed less than half (41.4%; 0.41 ± 0.49) of the respondents reported that cervical cancer can be terminal. However, a majority of respondents (88.6%; 0.89 ± 0.32) reported that it is sufficient to only do cervical cancer test once to eliminate its risk, and 83.4% (0.83 ± 0.37) reported that cervical cancer is a genetic disease, whereas 92.6% (0.93 ± 0.26) reported that postmenopausal women still have the risk of getting cervical cancer.

The mean knowledge score of cervical cancer detection was 5.0 ± 2.6 with a minimum knowledge score of two and a maximum of 13, the mean knowledge score of cervical cancer symptoms was 3.3 ± 0.8 with a minimum knowledge score of one and a maximum of eight, and the mean knowledge score of risk factors for cervical cancer was 6.7 ± 1.6 with a minimum knowledge score of three and a maximum of 13. The overall knowledge of participants was pooled and assessed on a (0-39) point scale. This was further categorized into ranges with 0-18 points as poor knowledge, 19-23 points as fair knowledge, and 24-39 points as good knowledge of cervical cancer. Respondents' overall mean knowledge score was 15.0 ± 4.1. Majority (77.2%) had low knowledge score for cervical cancer.

There was a statistically significant association between knowledge of cervical cancer and employment status of respondents (χ2 = 10.35; P < .05). There was no statistically significant difference between knowledge and sex (Table 3).


TABLE 3 Knowledge of Cervical Cancer, Employment Status, and Sex

Cervical Screening Practices

Only women (n = 353) reported about cervical cancer practices. Very few women had been screened for cervical cancer with the Papanicolaou test (4%), and one woman with visual inspection with acetic acid (0.3%). Four women had taken HPV vaccine before (1.1%) (Table 4).


TABLE 4 Cervical Cancer Screening Practices

The overall results of this study indicated low knowledge of cervical cancer and screening practices. The study findings revealed a considerable proportion of the respondents to have had either secondary or tertiary education. Average to high level of education did not seem to translate to awareness or good knowledge of cervical cancer among the study respondents. This was in contrast to findings reported by Ezenwa et al10 among women in similar urban community settings in Nigeria. Importantly, findings highlighted low socioeconomic status on the basis of low income of respondents with majority living on 20,000 naira or less per month (equivalent of 51 dollars per month), and moreover, majority were self-employed with petting trading. This translates to less ability to afford the cost of screening or vaccination for the prevention of cervical cancer, coupled with lack of accessibility. This result was similar to the findings of Olanlesi-Aliu et al14 on the quality of services on cervical cancer being affected by inadequate resources. Subsequently, the employment status was a variable that could exert influence on knowledge of the respondents on cervical cancer.

Poor level of awareness was reported for cervical screening, Pap smear, and HPV vaccine from the results of this study. Previous research findings13,15 corroborated these outcomes. These findings consequently demonstrate a need for increased awareness on cervical cancer, HPV screening, and vaccination, as well as the need for health promotion and education strategies targeting cervical cancer screening and the benefits of vaccination among adults in poor urban community settings in Nigeria. Almost all the knowledge scores for questions on risk factors, symptoms, and detection for cervical cancer had responses below the average. This is suggestive of perceived low susceptibility to the disease, but strikingly, majority perceived postmenopausal women to still have the risk of getting cervical cancer, whereas mean score was high for testing is only needed once to eliminate the risk of cervical cancer. Knowledge gaps among study respondents highlight a crucial need for health education to increase knowledge about cervical cancer. Health education should include recommendations for screening, according to the ACOG. The ACOG highlighted that women age between 25 and 29 years are recommended for cervical cytology or Pap test only at 3-year intervals, whereas those who are 30 years to 65 years could have a combination or cotesting of Pap test and HPV test every 5 years. For women over 65 years, screening can be halted on the basis of acceptable previous negative screening within the past 5 years.16

This study highlights major gaps in prevention practices for cervical cancer and identifies an urgent need to upscale cervical cancer prevention and intervention strategies in urban poor community settings of Nigeria. Findings are similar to a latest study carried out among women,1 where only two women had gone through cervical cancer screening test, but none of them had taken HPV vaccination. These findings are reflective of the inadequate health programs and services regarding cervical cancer prevention in Nigeria.14

In conclusion, the findings of this study have underscored a necessity for increased awareness creation through health promotion interventions and strategies to alleviate low knowledge of cervical cancer, prevention, and screening practices in poor community settings in Nigeria. The provision of prevention services, which must be accessible and affordable to the populace irrespective of the geographical location, is also needed.

© 2021 by American Society of Clinical Oncology

Presented at the 7th Annual Symposium on Global Cancer Research: Translating and Implementation for Impact in Global Cancer Research, Chicago, IL, March 7, 2019. This study abstract has been published in J Global Oncol 2019:3. © 2019 by American Society of Clinical Oncology following international conference/symposium presentation and can be found here: DOI: 10.1200/JGO.19.10000.


Supported by a planning grant awarded by the US National Institutes of Health, Fogarty International Center, Addressing NCDs In Nigeria Through Enhanced International Partnership and Interdisciplinary Research Training, award number 1D71TW010876-01.

We acknowledge all the respondents and research assistants for their contributions to the conduct of the study. We are grateful to the ethical committee who provided approval for this study.

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