The maritime transport industry, often referred to as the backbone of global trade, plays a pivotal role in facilitating the movement of goods across international markets. Despite its importance, the industry is plagued by several persistent challenges that hinder its operational efficiency and sustainability. Among the most critical are the imbalance of empty containers, environmental degradation due to emissions and fuel consumption, and inefficiencies in port operations. These issues collectively pose serious implications for cost management, environmental impact, and service reliability. In an effort to address these concerns, this paper proposes a novel multi-objective mathematical model that seeks to optimize three primary goals in an integrated manner: maximizing economic profitability, minimizing the imbalance of empty containers, and enhancing environmental sustainability. The model is designed to reflect real-world shipping dynamics, incorporating the interactions between liner and feeder ships, multiple sea routes, and various types of ports, including hub, feeder, and satellite ports. To demonstrate the practical applicability and robustness of the model, a case study is conducted on a representative shipping network involving selected ports in the Middle East and East Asia. The model is implemented using the General Algebraic Modeling System (GAMS), and its outputs are analyzed across three distinct time periods. Results indicate a significant reduction in the number of empty containers, along with concurrent improvements in both cost-effectiveness and environmental performance indicators. Additionally, a comprehensive sensitivity analysis underscores the pivotal role of ship capacity in influencing system outcomes. However, it also reveals that improvements in a single dimension are insufficient for holistic system optimization. Effective and sustainable management of maritime transport requires a multidimensional strategy that balances economic, environmental, and operational factors. The proposed model offers valuable insights for decision-makers aiming to improve the resilience and sustainability of global shipping networks.

Introduction: Vertigo is a clinical symptom of many disorders of the balance system. Benign Paroxysmal Positional Vertigo (BPPV), which is told to be idiopathic, may be due to the collection of calcium elements in the gelatinous material of sensory end organs in semicircular canals of the inner ear in different age groups. Medical treatment is no more than a symptom therapy. In some references, physical maneuvers are discussed to be effective in a complete cure of the symptoms. In this study, the effects of physical exercise on the relief of signs and symptoms are evaluated.Materials and Methods: In 2008 and 2000, a total of 112 patients with clinical diagnosis of BPPV, without any other clinical or laboratory findings were divided in two equal groups. The first group was trained in one hour by an experienced physiotherapist to do special maneuvers for 15 minutes TDS. The second group was treated with betaserc mg daily. A third physician evaluated the clinical results at the end of the first, third and sixth months.Results: Age and sex distributions were the same. The disease was commoner in the fifth 10-day period in females and in the sixth 10-day period in males. Complete recovery appeared with rehabilitation in the first month in 62% of females and in 58% of males. The results in the third month were 78% and 82% respectively. In the sixth month, they were 90% and 92% respectively. No worsening or complication was detected in this group. The results in the second group were 32% and 38% for females and males in the first month, 46% and 52% in the third month and 42% and 48% in the sixth month, respectively. Nausea and GI upset were detected in 32% of females and 18% of males. Discussion: Comparison of results between the two groups shows a significant difference and lower effectiveness of medical therapy in these patients. Conclusion: In clinical diagnosis of BPPV by physicians and R/O of the other causes of vertigo, rehabilitation may be recommended as an effective, inexpensive and low complication route of treatment.

Background and Objective: The high prevalence of Unilateral Chronic Ankle Instability (UCAI) in human society and particularly in athletes, and possibility of its related side effects to become chronic led to decrease their ability to fulfill the expected roles in different aspects of life. So, in order to return them back to sport activities, a reliable functional test is needed. Hence, the purpose of this research program was decided to study the effect of Star Excursion balance Training (SEBT) on the distance reached by the uninvolved leg while standing on the involved leg, and its effect on dynamic balance of subjects with UCAI via agility hop test.Subjects and methods: Twenty four patients with UCAI, were randomly assigned to the study and were divided into two groups of 12 subjects. The control and test group participants underwent the conventional and modern physical therapy interventions respectively.Results: Comparison of results regarding the SEBT scores of the test group is witness of improvement of dynamic balance in these patient. These results suggest that despite the improvement that was shown with respect to increase in the reached distance by the unaffected leg, the significant difference between two treatment methods, was evident only in 4 out of 8 directions of anterior, anteromedial, posterior and posteromedial (P£0.05 respectively). Descriptive and analytic (independent t- test) was carried out by SPSS 15 software.Conclusion: Result of this present study revealed the fact that both PT intervention programs were effective in improvement of the dynamic balance of patients with UCAI. However, a significant difference between two intervention programs regarding the reached distance is evident from the session 10 to 12 in 4 directions. So, in order to consider a significant difference between these two intervention programs, it might be essential to increase the number of treatment sessions to more than 12.

Objective: Despite tilt-board exercises benefits and its role in ligamentus injury prevention, little research has been done in this case. The goal of this study is investigation of balance exercises effect for six weeks on balance tests and strength of lower extremity ligaments. Materials & Methods: In present Quasi experimental study, case group was consisted of two 17 subjects groups which did balance exercises for 6 weeks (one group on dominant limb and another on non-dominant limb). Control group did not do any exercise in this period. These groups were evaluated and re-evaluated before and after the exercise period by Biodex balance System. Results: Statistical analysis revealed significant differences between groups (P<0/05). Conclusion: According to our results it can be concluded that tilt-board exercises can be used.