Chronic pain is a serious health concern and potentially debilitating condition, leading to anxiety, depression, reduced productivity and functionality, and poor quality of life. This condition can be even more detrimental and incapacitating in the pediatric patient population. In low and middle income countries (LMICs), pain services are inadequate or unavailable, leaving most of the world's pediatric population with chronic pain untreated. Many of these children in LMICs are suffering without treatment, and often die in pain. Awareness and advocacy for this population must be prioritized. We reviewed the available literature on the chronic pediatric pain burden in LMICs, barriers to treatments, and current efforts to treat these patients.

Drowning is a serious public health concern. Low middle income countries are mostly affected, as they carry 90% of the global drowning burden. The purpose of this epidemiological study is to provide a comprehensive overview of fatal drownings in South Africa between 2016 and 2021. The data used for the study was obtained from the South African Police Service. Descriptive statistics were used to summarise data. Statistical analysis included a t-test and chi-square test. The results indicate that the average fatal drownings per annum is 1477 in South Africa, with a drowning rate of 2.54 per 100 000 population from 2016 - 2021. The KwaZulu-Natal province had the highest incidence of drowning. The 0 – 4-year category has a high prevalence of drowning amongst all the age categories. More males drowned in South Africa compared to females. The study highlights key areas of concern these include age, sex, race, province, type of water body and time of day. This information is crucial to inform drowning prevention initiatives in South Africa.

Pharmaceutical poisoning is a significant global public health concern, causing approximately 190,000 deaths yearly. This scoping review aims to comprehensively map the available literature on pharmaceutical poisoning and compare patterns between high-income countries (HICs) and low-middle-income countries (LMICs). A systematic search was performed across the following databases: Embase, PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL. Studies included were from 1st January 2011 to 31st December 2020, in English, with full text available. Seventy-nine articles were included in the study; 21 were from LMICs and 58 were from HICs. The toxic exposure was largely intentional (77%) in LMICs and accidental (68%) in HICs. Drugs acting on the nervous system were responsible for 95% of toxicities worldwide with analgesics accounting for the largest subtherapeutic group in both LMICs (40%) and HICs (58%). Notable statistics were that HICs accounted for 99% of opioid overdoses, and LMICs accounted for 19% of anti-epileptic-induced toxicities. Overall, the medical outcomes of poisonings were generally worse in LMICs. The review provides possible interventions to target specific geographic locations, based on the trends identified, to reduce the burden worldwide. Many gaps within the literature were recognised, calling for more robust analytical research.

During puberty and emerging sexuality, adolescents experience important physical, mental, and social transformations. In the process of dealing with these changes, adolescents can become potentially vulnerable to mental health problems.The aim was to identify and synthesize published research evidence on sexuality-related mental health stressors among adolescent girls and boys, identify gaps (if any) in current knowledge, and contribute to knowledge about the experiences of emerging sexuality and health among adolescents, to further inform research, practice, and policy initiatives in sexual health.A scoping literature review of peer-reviewed articles published between 1990 and 2018. MEDLINE, CINAHL, EMBASE, PsycINFO, Global health, ERIC, and Sociological Abstracts databases were searched for research studies that reported experiences of sexuality related mental health issues and symptomatology of adolescents. We targeted studies conducted with adolescent populations between ages 11-24 years living in LMICs.Data from 12 published research papers, including 8 qualitative studies, 3 quantitative studies, and 1 mixed method study, were systematically analyzed. Four major themes and 4 sub themes were identified regarding sexual health and mental health of adolescents: 1) Relationship of sexuality and mental health; 2) Social and cultural influences; 3) Challenges in seeking sexuality information and services among adolescents; and 4) Educational needs among adolescents related to sexuality; and 4) Educational needs among adolescents related to sexuality. Lack of social support, Unmet needs for accessible adolescent friendly sexual health services, counseling, and age-appropriate information may be associated with several mental health stressors and symptoms, such as sadness, depressive and anxiety symptomatology, regret, fear, embarrassment, low self-esteem, guilt, shame, and anger. Therefore, tackling sexuality-related stressors could play an important role in addressing the overall wellbeing of young people. Future studies need to generate a deeper understanding of the concept of sexual health and its relation to mental health in diverse contexts. Health care professionals need to be aware of sexuality-related experiences of adolescent girls and boys by offering effective youth-friendly sexual and reproductive health education to support overall mental health and improve the experiences of emerging sexuality in adolescents.

The transition to sustainable mobility is a recognized socio-economic and environmental challenge, particularly among young adults in low- and middle-income countries (LMICs). This paper addresses the lack of comprehensive research on mobility patterns for LMICs by examining the travel patterns of students, staff, and lecturers at the National Advanced School of Public Works, Yaoundé (NASPW) to understand transport mode choices and barriers to the use of public and active transport modes. Data was collected through online questionnaires from 425 participants. Findings revealed that most students (27.5%) used multiple modes of transport, with moto-taxis being the most common (21%). Lecturers primarily used private cars (50%), while staff relied on taxis or multiple modes (33%). Accessibility, vehicle speed, and flexibility appeared as the most important reasons for the preferred modes of transport. Barriers included long waiting times and traffic congestion for public transport, and distance and inadequate infrastructure for active mobility. The usage of public transportation was encouraged by its affordability and reduced travel time, whilst active options were preferred due to their cost savings and health benefits. To promote sustainable mobility for campus travel, it is crucial to encourage active modes, develop mass transport systems, and raise awareness through symposiums and conferences among students and staff.

Children five years or younger in low- and middle-income countries (LMICs) are severely affected by diarrhoea disease, especially in the sub-Saharan region. Hence, the study aimed at determining the prevalence and determinants of diarrhea disease among children under 5 years in Epworth Township, Zimbabwe. A descriptive cross-sectional study was conducted at a local clinic in Epworth Township, Harare. A convenience sampling strategy was used to recruit study participants for participation and 386 children were enrolled in the study. The majority were male children (n=229; 59.3%), while there were more female caregivers (n=370; 95.9%) than male caregivers (n=16; 4.1%). The prevalence of diarrhea disease in the study was 25.1%. The determinants associated with diarrhea were being partially vaccinated (OR 2.38, CI 95% 2.80–8.22), collecting water more than 1 kilometre from a household (OR 4.55; CI 95% 2.10–9.85) and using untreated water (OR 6.22; CI 95% 2.13–18.20). The age of the caregiver and using a clean water container (OR 0.05; p=0.020) were protective factors. Provision of primary health care, especially prevention of disease through immunization and rendering environmental health services could reduce the prevalence of diarrhea in disadvantaged townships.

Objectives: Low and Middle Income Countries (LMICs) are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases (NCDs) such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity (MMD). However, preventing MMD has received little attention in LMICs, especially in Sub-Saharan African Countries. Design: Narrative review which scoped the most recent evidence in LMICs about MMD determinants and appropriated them for potential MMD prevention strategies. Methods: MMD in LMICs is affected by several determinants including increased age, female gender, environment, lower socio-economic status, obesity, and lifestyle behavious, especially poor nutrition and physical inactivity. Results: MMD public health interventions in LMICs, especially Sub-Saharan are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent MMD clusters, especially hypertension, diabetes and cardiovascular disease, can provide an early prevention of MMD, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing MMD in LMICs.

In Low and Lower-Middle-Income countries, the prevalence of anemia in infancy remains high. In early childhood anemia cause irreversible cognitive deficits and represents a higher risk of child mortality. The consequences of anemia in infancy are a major barrier to overcome poverty traps. The aim of this study was to analyze based on a multi-level approach, different factors associated with anemia in children 6–23 m old based on recent available Standard Demographic Health Surveys (S-DHS). We identified 52 S-DHS that had complete information in all covariates of interest in our analysis between 2005 and 2015. We performed traditional logistic regressions and multilevel logistic regression analyses to study the association between hemoglobin concentrations and household, child, maternal, socio-demographic variables. In our sample, 70 % of the 6–23 m old children were anemic. Child anemia was strongly associated with maternal anemia, household wealth, maternal education and low birth weight. Children fed with fortified foods, potatoes and other tubers had significantly lower rates of anemia. Improving overall household living conditions, increasing maternal education, delaying childbearing and introducing iron rich foods at six months of age may reduce the likelihood of anemia at in toddlerhood.

This study aimed to assess the prevalence and identify risk factors for schistosomiasis among school-aged children in low- and middle-income communities. A retrospective cross-sectional study was conducted, involving the examination of 24 034 children for Schistosoma haematobium ova. Data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 27. Logistic regression was employed to determine the factors associated with schistosomiasis. The overall prevalence of schistosomiasis in the study population was 75%, with higher rates observed in rural-dominated areas, particularly Bushbuckridge (73%) and Nkomazi (51%). Age, a history of bilharzia, and the presence of blood in urine were significantly associated with schistosomiasis, while being a female child was found to be a protective factor. This study underscores the importance of implementing robust screening procedures and the necessity for health education to mitigate the high prevalence of schistosomiasis and prevent its further spread.

Transitioning to clean cooking fuels is not only part of achieving SDG7, but also makes a significant contribution to mitigating climate change by reducing carbon emissions. The paper contradicts the conventional wisdom that electricity is too expensive to cook with. The paper explores the energy required to cook dishes using different technologies and fuels by analysing data from Cooking Diaries and Controlled Cooking tests conducted under the MECS programme. Electric pressure cookers (EPCs) use least energy when compared with electric hotplates, and a detailed description of how the EPC works explains why this should be. The paper draws out distinctions between African and Asian dishes, notably the impact of energy intensive dishes prepared mostly in Africa. Standard efficiency based approaches to comparing the performance of stoves are not appropriate to modern electric cooking devices so an alternative approach based on specific energy consumptions is proposed e.g. charcoal stoves use 15 times as much energy as EPCs to cook African dishes. Energy ratios provide a basis for estimating carbon emission reductions associated with transitioning to modern cooking fuels. Historical costs show that the cost of cooking with an EPC can be only 20% of the cost of cooking with charcoal, which highlights the potential for modern, energy efficient electric cooking devices to defy the conventional wisdom of the energy ladder.

Introduction. Self-sampling has the potential to increase cervical cancer screening (CCS) among women living with HIV (WLWH) in low and middle-income countries (LMICs). However, our understanding of how HPV self-collection studies have been conducted in WLWH is limited. The purpose of this scoping review was to examine the extent to which the HPV self-sampling has been applied among WLWH in LMICs. Method: We conducted multiple searches in several databases for articles published between 2000 and January 2022. With the combination of keywords relating to HPV self-sampling, LMICs, and WLWH, we retrieved over 9,000 articles. We used pre-defined inclusion and exclusion criteria to select relevant studies for this review. Once a study met the inclusion criteria, we created a table to extract each study’s characteristics and classified them under common themes. We used a qualitative descriptive approach to summarize the scoping results. Results: A total of 12 articles were included in the final review. Overall, 3,178 women were enrolled in those studies and 2,105 (66%) of them were WLWH. The self-sampling participation rate was 92.6%. The findings of our study show that 43% of the WLWH in 8 of the studies reviewed tested positive for high-risk HPV (hr-HPV) genotypes, indicating 4 out of 10 WLWH in the studies are at risk of cervical cancer. The prevalence of the hr-HPV in WLWH was 18% higher than that of HIV-negative women. Most women in the study found the self-sampling experience acceptable, easy to use, convenient, and comfortable. Self-sampling performance in detecting hr HPV genotypes is comparable to clinician-performed sampling. However, limited access (i.e., affordability, availability, transportation), limited knowledge about self-screening, doubts about the credibility of self-sampling results, and stigma remain barriers to wide acceptance and implementation of self-sampling. In conclusion, the findings of this review highlight that (a) cervical cancer is a threat to every sexually active woman but for WLWH the threat increases, (b) self-sampling laboratory performance is similar to clinician performed sampling, (c) self-sampling is associated with an increase in cervical cancer screening uptake and (d) WLWH reported a positive experience with self-sampling. However, personal, environmental, and structural barriers challenge the application of self-sampling in LMICs, and these need to be addressed. Keywords: keyword 1; keyword 2; keyword 3 (List three to ten pertinent keywords specific to the article yet reasonably common within the subject discipline.)

In this paper, we draw on recent experiences from the Young Lives study to discuss some of the ethical and practical challenges facing longitudinal cohort studies in low- and middle-income countries in the time of coronavirus. We argue that COVID-19 has instigated an ‘ethics of disruption’ for social researchers across the world, and for longitudinal cohort studies like Young Lives, this requires navigating three core considerations: first, managing research relationships and reciprocity within an observational study design; second, maintaining methodological continuity and consistency across time; and third, balancing an immediate short-term response to COVID-19 against the longer-term perspective. We refer to the study’s plan to implement a new COVID-19 phone survey to illustrate how the team are navigating this altered ethical terrain.

Worldwide, 200 million children experience disability, with the vast majority living in low and middle-income countries. The United Nations Convention on the Rights of the Child (CRC) places great importance on the rights of all children for the opportunities for survival, growth, health, and development. A subsequent document, the UN Convention on the Rights of Persons with Disabilities (CRPD) identifies children with disabilities as rights bearers, who should be considered in all policies and programming worldwide. Nigeria, in 1991 and 2010 ratified the CRC and the CRPD respectively. Nonetheless, knowledge of the extent to which their disability and child-directed policies are considered by these two key conventions remains limited. This study examined the extent to which Nigeria’s current disability and childhood policies have integrated the two normative frameworks from the UN. Using a structured search of databases and Nigerian federal and state government websites, we conducted a policy review to identify their disability and child-related disability policies. We also included the CRC and CRPD reports submitted by the Nigerian government to the United Nations Office of the High Commissioner for Human Rights (OHCHR) (2008 & 2010 cyclical year). A thematic analysis, based on the CRC and CRPD report, identified the following six themes: participation, support systems, awareness-raising, factors associated with adherence to the CRC, laws & rights, and services. The review showed that the available Nigerian disability policies were federal, with some state policies which aligned with the CRC and CRPD. Also identified was the lack of disability policies specific to children and their families. We concluded that, to ensure proper inclusion of the rights of all children, including those with disabilities, in Nigeria there is a need for a more optimal uptake of recommendations of the CRC and CRPD as laid out by the UN.

Delayed diagnosis and a lack of adequate care for people with autism spectrum disorder (ASD) are related to worse outcomes and quality of life. This study aimed to identify the profile of service use, barriers to access care, and factors related to those barriers in Brazilian families with children with ASD. A total of 927 families with ASD children (3-17 years) from five Brazilian regions completed an online version of the Caregivers Needs Survey. Results showed that the most used services were behavioral interventions and pharmacotherapy, while the most used professionals were neurologists, nutritionists, speech therapists, psychiatrists, psychologists, and pediatricians. The main barriers included waiting lists, costs, and the absence of services or treatment. Service use varied according to age, the region of residence, the type of health care system used, and the parents/caregivers' education. Access to behavioral interventions was more frequent among users of the private system/health insurance and families whose caregivers had higher education. The absence of specialized services/treatments was less frequent among residents of state capitals and families whose caregivers had higher levels of education. This study highlights how families with children/adolescents with ASD in Brazil face significant barriers to access care related to sociodemographic factors.

We performed a global analysis with data from 149 countries to test whether temperature can explain the spatial variability of the spread rate and mortality of COVID-19 at the global scale. We performed partial correlation analysis and linear mixed effect modelling to evaluate the association of the spread rate and motility of COVID-19 with maximum, minimum, average temperatures and temperature extreme (difference between maximum and minimum temperature) and other environmental and socioeconomic parameters. After controlling the effect of the duration after the first positive case, partial correlation analysis revealed that temperature was not related with the spatial variability of the spread rate of COVID-19. Mortality was negatively related with temperature in the countries with high-income economies. In contrast, temperature extreme was significantly and positively correlated with mortality in the low-and middle-income countries. Taking the country heterogeneity into account, mixed effect modelling revealed that inclusion of temperature as a fixed effect in the model significantly improved model skill predicting mortality in the low-and middle-income countries. Our analysis suggest that warm climate may reduce the mortality rate in high-income economies but in low and middle-income countries temperature extreme may increase the mortality risk.

Background: The ongoing COVID-19 pandemic and subsequent lockdown have adversely affected global health care services to varying extent. Emergency Services were also affected along with elective surgeries, which were deferred to accommodate the added burden of COVID 19 affected patients, on the healthcare systems. We aimed to assess the change in delivery of essential and emergency surgeries due to the pandemic. Methodology: A research consortium led by WHO Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in Low- and Middle-Income countries (LMIC), India, conducted this retrospective cross-sectional study with 12 recruited centers. All surgeries performed during the months of April 2020 were compared with those performed in April 2019. These surgeries were stratified into emergency and elective, and further categorized based on NHS surgery prioritization documents. Results: A total of 4396 surgeries were performed at these centers in April 2019 and 1216 surgeries were performed in same month during 2020, yielding a fall of 72.3% (1216 /4396).We found a 54% reduction in emergency surgeries and a 91% reduction in the elective surgeries. Number of cesarean sections reduced by 29.7% and fracture surgeries declined by 85.3% Laparotomies and surgeries for local soft tissue infections with necrotic tissue reduced by 71.7% and 69.5% respectively. Conclusion: Our study quantifies the effects of COVID 19 pandemic on surgical care delivery in India and documents that the overall surgical volume reduced by three fourths in the pandemic period. Emergency surgeries reduced to half when compared with pre-pandemic period. Cesarean section surgeries were affected the least by pandemic, whereas the fracture surgeries and laparotomies were affected the most.

Advanced Hepatocellular carcinoma (HCC) is no longer a terminal illness. This change was mainly attributed to the development of new treatments including tyrosine-kinase inhibitors (TKIs), vascular endothelial growth factor (VEGF) inhibitors and immune checkpoint inhibitors (ICPIs) but the financial toxicity of treating advanced HCC is of a major concern specially in low middle-income countries (LMICs) where the patients are still battling for their most basic rights. Most of advanced HCC patients in LMICs have very limited accessibility to the new treatments including ICPIs. Searching for out of the box solutions to improve access to treatments -mainly ICPIs- is an utmost necessity for LMICs advanced HCC patients.

Speeding is a significant global issue, with disparities in speed outcome and speed research between low- and middle-income countries (LMICs) and high-income countries (HICs). This study aims to address speed research gaps by examining the prevalence of self-reported speeding and factors influencing drivers' speeding behavior (SB) using the Theory of Planned Behavior (TPB). An online survey involving 387 anonymous drivers was conducted in Yaoundé. Results showed that all drivers reported exceeding speed limits, with 81% exceeding by 5km/h, 12% by 10km/h, and 7% by more than 10km/h in urban areas. On highways, 54% reported exceeded the limit by more than 10km/h. Age, driver's license, and gender showed significant associations with speed limits non-compliance. The study results suggests that the TPB can be useful in assessing speeding behavior, as the inclusion of TPB variables led to a more than 50% proportionate increase in SB variance. Structural equation modeling revealed attitude towards speeding as the strongest predictor of speeding intention (SI), along with certain demographics indirectly influencing SB through SI. Perceived behavioral control (PBC) and SI directly influenced SB. These findings emphasize the potential of interventions targeting attitude, intentions, and perceived behavioral control to modify speeding behavior and improve road safety.

Methicillin-resistant Staphylococcus aureus (MRSA) constitutes a serious public health concern with a considerable impact on patients' health and substantial healthcare costs. In this study, patients, and healthcare workers (HCWs)from six public hospitals in Benin were screened for MRSA. Strains were identified as MRSA using conventional microbiological methods in Benin and confirmed using Matrix-Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) mass spectrometry in Belgium. Whole genome sequencing (WGS) was used on confirmed MRSA isolates to characterize their genomic content and study their relatedness. In total,304 and 61 samples were collected from patients and HCWs, respectively. The mecA gene was detected in all isolates. The isolates were assigned to five sequence types (STs), with ST8 (55.6%, n=15), ST152 (18.52%, n=5), and ST121 (18.52%, n=5) being the most common. All isolates carried multiple virulence genes, including genes encoding the Panton-Valentine leukocidin toxin (48.15%, n=13) and the test gene (29.63%, n=8) associated with toxic shock syndrome. The presence of strains carrying numerous genomic features associated with antibiotic resistance and virulence in HCWs is a major public health concern. This study highlights the need to implement a multimodal strategy for reducing the risk of cross-transmission of MRSA in hospitals.

Vitamin C is an essential nutrient that must be obtained through the diet in adequate amounts to prevent hypovitaminosis C and the potentially fatal deficiency disease scurvy. Global vitamin C status and prevalence of deficiency has not previously been reported, despite vitamin C’s pleiotropic roles in both non-communicable and communicable disease. This review highlights the global literature on vitamin C status and the prevalence of hypovitaminosis C and deficiency. Related dietary intake is reported if assessed in the studies. We also explore if global vitamin C status has changed over time. Overall, the review illustrates the shortage of high quality epidemiological studies of vitamin C status in many countries, particularly low- and middle-income countries. The available evidence indicates that vitamin C deficiency is common in low- and middle-income countries and not uncommon in high income settings. Further high quality studies are required to confirm these findings, including in the countries not yet represented, and to fully understand associations with a range of disease processes. Our findings suggest a need for interventions to prevent deficiency in a range of at risk groups and regions of the world.

Disseminated or military tuberculosis (TB) is defined as the presence of at least two non-contiguous sites of Mycobacterium tuberculosis, occurring as a result of progressive primary infection, reactivation and spread of a latent focus or due to iatrogenic origin. Disseminated TB represents a life-threatening condition, especially in at-risk children and when the diagnosis and treatment are delayed. We report on a case of a 3-year old boy who presented with long-lasting unrecognised disseminated TB that was successfully managed in a low-resource setting.

There is a systematic exclusion of gender-based violence, safe abortion, reproductive cancers, infertility services, comprehensive sexuality education, sexuality services, and STI’s other than HIV in essential health packages in LMICs. To accelerate progress on sexual reproductive health (SRH), the Guttmacher–Lancet Commission proposed the adoption of these interventions into an essential health package of SRH services that should be universally available. In this commentary, we use a healthcare priority-setting processes lens to review the importance of these services for universal health coverage. We isolate inherent challenges in social value judgments for terminal, process and content evidence for their healthcare priority-setting. We then advance promising emerging practical examples from low to middle-income countries on evidence-informed decision-making processes. We recommend capacity development through regional support, generating equity and efficiency evidence and strengthening political and publicly acceptable processes to institutionalise and operationalise evidence-informed decision-making.

Studies at the juncture of development economics and public health host considerable responsibility in addressing inequality and related mental health distress. Mental health care in economically marginalized populations requires depicting the linkages between socioeconomic status and psychological distress. In the present work, a sequential mixed-methods design was used to study 190 people in such communities in India. Gender-dependent psychological distress was found according to Kessler Psychological Distress Scale (K-10) with moderate distress in women (M= 26.30, SD= 9.15) and mild distress in men (M= 21.04, SD= 8.35). Regression analysis indicated that gender significantly predicted psychological distress, followed by age, marital status, and education of the head of the family. The Interpretative Phenomenological Analysis of semi-structured interviews to six women who scored the highest on the distress scale unveiled three master themes: (1) Manifestation of Psychological Distress, (2) Contextual Challenges, and (3) Sources of Strength and Resilience. Overall, participants reported lack of resources, community violence, gender discrimination, and widespread substance use as major contributors to the ongoing distress. These findings can pave the way for future studies to expand beyond independent economic indicators and curate clinical interventions for culturally competent mental health care.

The purpose of this study was to present the challenges faced when implementing a diet and exercise intervention for low-income older Hispanics with type 2 diabetes with an observational study of recruitment, attendance, and characteristics of Hispanic adults with type 2 diabetes in a community congregate meal site pre and post administration of a diet and exercise intervention. This report evaluates retentions and diabetes self-management beliefs Hispanic adults ≥60 years with type 2 diabetes (n=17) at baseline, and completion of the six-month intervention in terms of the Health Belief Model. There was limited interest in controlling diabetes with diet and exercise. Major barriers included lack of perceived vulnerability to diabetes complications and a belief that medication alone is sufficient to stabilize blood glucose. Environmental barriers included lack of transportation, access to exercise groups, access grocery stores, and limited ability to pay for healthy foods. A lesson learned from this intervention was that the diet and exercise intervention given was insufficient as a cue to action for this population interventions to engage low-income, older Hispanics with diabetes in diet and exercise need to consider strategies to overcome barriers such as health beliefs, transportation issues, lack of access to nutritious food and group exercise classes.

The COVID-19 pandemic halted progress in global vaccine coverage and disrupted routine childhood vaccination practices worldwide. While there is ample evidence of vaccination declines experienced during the pandemic, it is less clear how low-income countries were affected. We executed a systematic review to synthesize the current literature on impacts to routine childhood vaccinations in low-income countries from January 1, 2020 to February 8, 2023. We collected data using an extraction form on Covidence and assessed the quality of studies included in the review using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Effect estimates for changes in vaccination during the pandemic were reported and summarized. Factors that influenced changes were grouped into descriptive themes. Thirteen studies, encompassing 18 low-income countries and evaluating 15 vaccines at varying doses, were included in the final review. We found that routine childhood vaccinations during the COVID-19 pandemic varied considerably by vaccine type, location, and phase of the pandemic. Nine different themes were identified as factors that influenced changes in vaccination. Documenting past experiences and lessons learned is crucial for informing preparedness efforts in anticipation of future public health emergencies. Failure to effectively address these things in the next public health emergency could result in a recurrence of declining routine childhood vaccinations.

Through long-term Rayleigh lidar observations during 2010-2022, atmospheric gravity wave (AGW) activities in the middle atmosphere (30–65 km) are statistically investigated at Haikou (110.3°E, 19.9°N) in China. In total, 827 quasi-monochromatic AGW events are identified from the lidar dataset, and the vertical wavelength, observed wave period, and vertical propagation direction of dominant waves are extracted for each AGW event by analyzing the power spectra of wave-induced temperature perturbations. It is revealed that 81.7% of all AGW events were associated with upward-propagating waves, and the proportion of upward-propagating AGWs reached a maximum in autumn and a minimum in winter. The most common vertical wavelengths and wave periods were 6–11 km and 4–10 hours, respectively. In particular, 68 AGW events associated with simultaneous upward and downward propagating waves were observed by lidar, corresponding to 8.2% of the events. The occurrence of such special AGW phenomena is qualitatively discussed, and multiple formation mechanisms may exist. Comparisons are made with previously reported lidar observation results, and the statistical features of AGW activity in the low-latitude middle atmosphere may vary over a relatively wide range depending on the location and altitude. However, a majority of AGWs propagate upward in the middle atmosphere.

The rising prevalence of autism internationally has been accompanied with an increased appreciation of the poorer mental health experienced by people with this condition and also of their family care-givers. In particular higher incidences of anxiety and depression are reported in high income nations and these conditions are likely to be under-recognised and under-reported in lower resourced regions or countries. Mainstream mental health services seem to be ill-equipped to respond adequately to the needs of autistic persons and their care-givers. This scoping review of 30 recently published literature reviews covering over 1,000 journal articles, summarises the insights and strategies that have been shown to promote the mental health and emotional wellbeing of autistic persons. In particular, a focus on family-centred, community-based supports is needed that aim to enhance social communication, extend social connections and promote an individual’s self-esteem, self-determination and social motivation. These low-cost interventions are especially pertinent in low resourced settings but they can be used internationally to prevent mental illness and assist in the treatment of anxiety and depression in autistic persons and their family carers. The priority is to focus on primary care responses with cross-sectoral working rather than investing in high-cost psychiatric provision.

In response to new developments of work and employment in high-income countries (HICs), psychosocial aspects of work and health received increased attention. In contrast, middle-income countries (MICs) are mainly concerned with severe challenges of noxious and dangerous material work environments, poor employment conditions, and deficient social policies, leaving psychosocial aspects in a marginal role at best. More recently, differences between these two worlds were even aggravated by the COVID-19 pandemic. Yet, with economic globalisation and growing worldwide interconnectivity, the world of work in MICs is being rapidly transformed, sharing several concerns with modern Western societies. In this process, psychosocial occupational health will become an increasingly pressing issue. This contribution explores to what extent psychosocial aspects of work and health are already addressed in research originating from MICs. A selective focus on recent findings from two regions, Asia Pacific and Latin America, reveals a high degree of awareness of, and inquiry into, work-stress related problems within these countries. Importantly, in addition to incorporating research progress from HICs, these analyses identify new aspects within specific cultural and socio-economic environments, thus enriching the international state of art.

Chronic pain is a source of major alterations in quality of life. It represents significant costs for health systems, and reduces the competitiveness of the working population. Vulnerability can drive the incidence of chronic pain, through its influence on modifiable risk factors, and reduced utilization of health care systems. But vulnerability can also be the consequence of a chronic pain: illness can push people into precariousness. We analysed the factors associated with pain intensity among vulnerable persons with a chronic condition, in five European countries (N=1,364). Pain was, among the whole set of variables, the main predictor of sleep problems, fatigue, depression, self-perceived health, physical and mental quality of life. This is in line with other studies showing the major impact of pain on an individual’s health and life. Multivariable analyses, adjusting for the whole set of variables, showed that women had more intense pain, as well as participants with a lower education level. These results confirm the social component in the complex etiology of pain and clearly plaid in favor of integrated care, taking into account individual characteristics and environment.

Continued high rates of both under- and over-nutrition in low- and low-middle-income countries highlight the importance of understanding dietary practices such as early and exclusive breastfeeding, and dietary patterns such as timely, appropriate complementary feeding—these behaviors that are rooted in complex cultural ecologies. A systematic review and synthesis of available qualitative research related to infant and young child dietary patterns and practices from the perspective of parents and families in low income settings is presented, with a focus on barriers and facilitators to achieving international recommendations. Data from both published and grey literature from 2006-2016 was included in the review. Quality assessment consisted of two phases (CASP guidelines and assessment using GRADE-CERQual), followed by synthesis of the studies identified, and subsequent thematic analysis and interpretation. The findings indicated several categories of both barriers and facilitators, spanning individual and system level factors. The review informs efforts aimed at improving child health and nutrition, and represents the first such comprehensive review of the qualitative literature, uniquely suited to understanding complex behaviors leading to infant and young child dietary patterns.

Preschoolers with disabilities and their caregivers have been neglected in health and social service provision in most low-income countries and arguably too in low resourced areas of more affluent nations. Yet as this rapid review of published literature identifies, there are low-cost, evidence-based strategies to address their needs that can be implemented in communities by local people. Five key features of the necessary supports are examined. First the leadership functions required to create and implement the support services. Second, the family-centred, home-based support provided to caregivers and the personnel undertaking this form of support. Third, providing opportunities for peer support to flourish and encouraging the formation of advocacy groups across families. Fourth, mobilizing the support of significant groups within the community; notably traditional healers and leaders; health services and poverty alleviation initiatives. Fifth, devising ways in which preschool educational opportunities can be offered to children as a prelude to their inclusion in primary schools. The review serves a further purpose. It provides an example of how public health researchers and academics could achieve more rapid implementation of evidence-based knowledge into existing and new support services through dissemination to community practitioners.

The Süttő 21 site is a fissure fill of the freshwater limestone of the Gazda quarry in Süttő. The material was collected between 2017 and 2019, the results are summarised in this article, with a special focus on the small vertebrate fauna of the site and its stratigraphic and paleoecological significance. The fissure fill can be placed around the early/middle Pleistocene boundary (ca. 1.1 and 0.77 Ma). The paleoecological analysis of the herpeto- and mammal fauna of the sequence indicates the proximity of a permanent water body. The lower part of the sequence is dominated by open habitat indicator taxa indicating a cool, dry climate. Towards the upper part of the sequence, the climate remained cool but became wetter, and the vegetation gradually changed to forest-steppe/open forest. The fauna of the Süttő 21 site can be compared with the material of sites, which are of similar age, thus revealing taxonomic and paleoecological differences between different areas of the country. While a warm, dry climate and open vegetation can be reconstructed in the Villány Hills around the early/middle Pleistocene boundary, the northern Hungarian areas had a cooler, wetter climate, and slightly more closed (grove, forest-steppe) vegetation during this period.

This article is an anthropology study on how western-style coffee culture influences Indonesian coffee culture and eventually develops a new localized coffee culture. Immense development of such worldwide coffee franchise as Starbucks affects local community's coffee culture, particularly the middle class. This new wave is considered as an alternative lifestyle for those who are consumptive and seeking for leisure, dynamics, and identity. Broader than just the process of domestication or creolization, Indonesian new coffee culture has an element of “soft countering to” western coffee culture even though it still embraces some parts of the western styles. This phenomenon is referred to by the writer as the cultural encapsulation process or the process of substantial cultural resistance by drawing a line between the two coffee cultures with the intention of taking merely compatible elements.

This paper provides an overview of current literature on community-led development initiatives in urban contexts, their role in addressing urban inequality, and the challenges they face. This study examines effective strategies of community-led initiatives, such as empowering communities, building partnerships, mobilizing resources, focusing on local needs, and participatory design methods. Case studies from around the world demonstrate how successful community-led development initiatives have been able to overcome obstacles to create more inclusive and equitable urban environments. Institutional support, including technical assistance, capacity building, and regulatory frameworks, are crucial for promoting the success and sustainability of these initiatives. Challenges to community-led initiatives include limited resources, capacity building needs, inadequate infrastructure, lack of institutional support, and lack of trust among community members. Therefore, the paper suggests that it is essential to address these challenges to enable the success of community-led development initiatives. Furthermore, this study recommends that future research should explore how emerging technologies and innovative approaches can effectively support community-led development initiatives and advance more just and sustainable urban development.

(1) Background: This paper details the development process of two assistive technology products (ATs) implemented in the PAID project, aiming to promote the social, educational, and labor inclusion of people with disabilities across 10 municipalities of Antioquia, Colombia. (2) Methods: Applying Design Thinking (DT) methodology, including stages of empathizing, defining, ideating, prototyping, and testing, alongside a demographic study where specific needs of people with disabilities (PwDs) were identified. (3) Results: As a result, the construction process of two specific cases of assistive technology products (ATs) is detailed, including finite element simulation, mechanical testing, and delivery to end-users. Additionally, workshops for assistive product fabrication conducted in select municipalities of the project are highlighted. (4) Conclusions: the information gathered guided the development of the ATs, focusing on their features on accessibility and ease of replication. The primary objective is to facilitate the participation of PwDs in educational environments, thus promoting inclusion and accessibility. This article describes the results of two of these ATs; however, it is worth noting that this process was performed for 112 ATs delivered through the duration of the project.

Improving the effectiveness of health interventions is a major challenge in public health research and program development. A large body of literature has found low or no impact of health education and promotional interventions. We aim to develop a conceptual framework in support of intervention designs for preventive health behavior improvement programs and outcomes. The proposed approach is based on a narrative review of empirical literature assessing the limitations of less effective or ineffective field experiments regarding preventive health education and promotion interventions. We found three major limitations regarding the mental model’s balance of treatment and comparison groups, treatment groups’ willingness to adopt suggested behaviors, and the type, length, frequency, intensity, and sequence of treatments. To minimize the influence of these concerns, we propose a mental model-based repeated multifaceted (MRM) intervention design framework to provide an intervention design for improving health education and promotional programs.

Based on data from the Yunnan Province farm household survey, we examine the effect of rural land rights policy on farmers’ income. The regression results show that right significantly raises the total income of farmers, with farm income serving as the primary source of total income. After performing numerous robustness tests, using instrumental variables to handle endogeneity and arriving at the same conclusion, the result is still valid. According to the heterogeneity analysis, in the sample of households with long-term migrant workers, the confirmation of rural land rights significantly increases total and nonfarm income while decreasing farm income. Furthermore, total income includes nonfarm income, which reflects the effect of different farmers' optimal labor allocation based on the external market environment. According to the impact mechanism anal-ysis, right can increase farmers' total income by promoting land transfer, and farmers in less developed areas are more willing to increase their income by land transfer out.

This study aims to identify the factors determining the income of forestry household in South Korea. We examine an empirical analysis using 3-year panel data conducted by the Korea Forest Service charged with maintaining South Korea's forest lands. The hypothesized factors determining the income of forestry household are classified into four types of assets and three types of livelihood strategies. We divided the income of forestry household (IFH) into three elements: forestry income (FI), non-forestry income (NFI), and transfer income (TI). We assessed the influences of household assets and livelihood strategies on each income. A random effect model was used as a statistical analysis with valid 979 of forestry household for three years. We found that household head's age, labor hours, savings, business category, cultivated land size, and region are significantly associated with IFH. Also, FI is influenced by labor capacity, cultivated size, business category, forestry business portfolio, and region while NFI is determined by household head's age, household head's gender, forestry business portfolio, and savings. TI is affected by household head's age, household head's education level, forestry business portfolios, savings, and region. The effect sizes and directions vary across different types of income (IFH, FI, NFI, and TI). The findings show that forestry in South Korea is highly dependent on sustainable assets and strategies. It is therefore expected that the effectiveness of forest policies to increase the income of forestry household would be differed by the source of each income. The results of this study draw attention to the need for an income support policy that should consider the characteristics of household assets and livelihood strategies in order to enhance IFH in South Korea.

The regions with the best economy have a greater capacity to develop low-income or social impact housing, thus contributing to the reduction of poverty, and therefore, to the fulfillment of the Sustainable Development Goals. This is observed in fewer people living in extreme poverty and with fewer unmet basic needs. The present article analyzes the correlation between development by the main economic sectors in the different regions (departments) of Colombia, and the offer of low-income housing. The valid relationship found is between the economic condition of the regions (GDP) and non-social housing (more expensive commercial value) (Spearman´s Rho: 0.9). That means that there is an imbalance between regional economic capacity and the low-income housing offer because their economic potential allows them to have less of a demanding population, that is, living in poverty. This correlation is higher with activities that are mostly developed in an urban environment, such as manufacturing, construction, real estate, and finance and insurance. On the contrary, the correlation is lower with industries such as mining and agriculture, which mostly operate in rural areas. The analysis for low-income housing and economic sectors GDP yields low correlations, but are especially dismissible for more rural industries, such as mining and agriculture. The analysis shows the change of trend in the correlations for the year 2021, the beginning of the post-pandemic economic recovery.

Globally, 2.2 billion urban residents are living without safely-managed sanitation, the majority of whom are slum residents. To improve the situation, Dhaka Water Supply and Sewerage Authority (DWASA) is implementing the Dhaka Sanitation Improvement Project (DSIP), mostly funded by the World Bank. This study assessed the feasibility of connecting low-income communities (LICs) within the proposed sewerage network by 2025. We conducted nine key-informant interviews from DWASA and City Corporation, and 23 focus-group discussions with landlords, tenants and Community Based Organisations (CBOs) from 16 LICs near the proposed catchment area. To achieve connections, LICs would require improved toilet infrastructures and have to be connected to main roads. Construction of large communal septic tanks is also required where individual toilet connections are difficult. To encourage connection in LICs, income-based or area-based subsidies were recommended. For financing maintenance, respondents suggested monthly fee collection for management of the infrastructure by dividing bill equally among sharing households, or by users per household. Participants also suggested the government's cooperation with development-partners/NGOs to ensure sewerage connection construction, operation and maintenance and prerequisite policy changes such as assuring land tenure.

Taking four of the United Nations Development Goals as reference, this overview describes the need to see from a systemic perspective, the food certifications programs along the food chain in Mexico as today food certifications are voluntary. Using secondary data, the main objectives were: a) there is a fall short in food safety policies and those federal agencies responsible for food safety, to guarantee safe food along the whole domestic food chain, especially in that for low income players; b) the amount of the Mexican Federal Budget Expenses devoted to safety food issues is really low, considering the health, well- being, and food security consequences; and c) due the structural heterogeneity of the Mexican food market, there is a lack of coordination in food regulations along all agents of the food supply chain, bringing to alternate informal markets that put at risk peoples´ health, increasing poverty and inequalities. According to this exercise, only 0.7- 8.7% of producers, 12.5% of supermarkets as well as 42.8% of restaurants would have some type of certifications. Public policies must attend this issue in order to improve food safety and security for the whole population, reducing inequalities, poverty and ensuring them a healthy live.

Older adults in low-and middle-income countries experience a disproportionate burden of non-communicable diseases (NCDs). Unintentional injuries are among the major NCDs, and falls are the second leading cause of these injuries and deaths worldwide, including in Thailand. We aimed to culturally adapt the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) for Thai older adults and explore the feasibility, appropriateness, and acceptability of using STEADI in primary care via trained community health workers (CHWs) and care managers (CMs). STEADI takes a coordinated care approach that consists of three steps: screening, assessing, and intervening. In Step a, CHWs screened fall risk in 20 community-dwelling older adults using three key questions and found that all of them had fall risk, then CHWs screened with a Stay Independent questionnaire (range 0-14) and found that 100% have high fall risk (total scores 9.7± 2.4). In Step b, CMs assessed balance, vision, footwear, postural hypotension, medications, and CHWs assessed home hazards. They found that 50% had poor balance, 70% took 4+ medications,75% fell on the walkway, and 70% had no bathroom modifications. In Step c, individual participants received fall prevention interventions to mitigate their specific fall risk factors. CHWs and CMs indicated high acceptability (19.20±.1.31 of 20 total), appropriateness (18.80± 1.79 of 20 total), and feasibility (18.60±1.67 of 20 total) of the Thai-STEADI intervention. Our study showed that the community-based multifactorial Thai-STEADI delivered by CHWs and CMs is feasible and acceptable to prevent falls in older adults with limited access to health care.

Investigating the potential impact of composting and recycling waste on income distribution are crucial to promote a fairer and more sustainable fresh tomato supply chain (FTSC). Therefore, this study aims to explore the potential of gaining extra income from recycling tomatoes waste generated along the FTSC and to calculate the contribution of extra income from recycling tomato waste to reduce income inequality along the FTSC. Data were collected from 136 greenhouse tomato producers, 60 wholesalers, 18 exporters, 120 domestic retailers, 22 overseas retailers, and 3 recycling facilities in Türkiye. Marketing cost, absolute marketing margin, relative marketing margin and net profit margin were used when economically analyzing the FTSCs. Research results showed that the net profit share of the producer decreased associated with the increasing number of intermediaries. Research results also showed that revenue gained from composting and recycling of product loss and waste increased the welfare of greenhouse producer more than other supply chain actors. When taking into account the revenue from composting and recycling of wastes, producers increased their net profit by 9.85% at first FTSC, while that of second and third FTSCs were 8.29% and 9.21%, respectively comparing to the prevailing conditions. The contribution of extra revenue from composting and recycling of wastes to retailers was more comparing wholesaler and exporter. Retailers and wholesalers gaining from recycling in domestic FTSCs was more comparing to overseas one. Close cooperation between producers, wholesalers, exporters, retailers, and recycling facilities is essential for the effective implementation of waste recycling initiatives. Organizing the training and education programs focused on waste management can increase the extra income of producers and active intermediaries in FTSC from composting and recycling tomato wastes. Offering financial incentives, grants, or subsidies can encourage producers and other actors within the supply chain to adopt waste recycling practices. Continuous research and innovation are crucial in identifying and developing new technologies, processes, and strategies to minimize food loss and waste. Dominating fair-trade practices to ensure that all FTSC actors may balance the income distribution among FTSC actors.

Recent clinical SARS-CoV-2 studies link diabetes, cardiovascular disease, and hypertension to increased disease severity. In the US, racial and ethnic minorities and low socioeconomic status (SES) individuals are more likely to have increased rates of these comorbidities, lower baseline health, limited access to care, increased perceived discrimination, and limited resources, all of which increase their vulnerability to severe disease and poor health outcomes from SARS-CoV-2. Previous studies demonstrated the disproportionate impact of pandemic and seasonal influenza on these populations, due to these risk factors. This paper reviews increased health risks and documented health disparities of racial and ethnic minorities and low SES individuals in the US. Pandemic response must prioritize these marginalized communities to minimize the negative, disproportionate impacts of SARS-CoV-2 on them and manage spread throughout the entire population. This paper concludes with recommendations applicable to healthcare facilities and public officials at various government levels.

Diagnostics is believed to drive about 70% of medical interventions, but this may not be true for all demographics. With more than 30% of the African population living in extreme poverty ($1.9 per day - 2022); and healthcare costs competing unfavorably against unbridled access to antibiotics and herbal concoctions, especially in Sub-Saharan Africa, how do you convince such a people to choose diagnostics first? More importantly, how do you design a medical device targeted at meeting the diagnostic needs of this demographic? In developing diagnostic devices for such a market, what is worth sacrificing? How dire is the need for advanced technologies in devices developed for such a demographic? These are questions that remain unaddressed by the technological breakthroughs and current research in medical device development, especially for infectious disease diagnostics. The objective of this paper is to underscore critical concerns which must be considered in the bid to successfully design medical diagnostic devices for Africa and perhaps, other limited-resource settings. It is also written as a suggestive guidance document for researchers whose interest is in the development of infectious disease diagnostic platforms for rural Africa and similar limited-resource environments.

This paper empirically analyzes the relationship between digital inclusive finance and rural income, and demonstrates that digital inclusive finance plays a significant role in promoting rural income, based on the 2012-2018 panel data of 17 cities in Henan Province of China. Further dimensional research unveils that all of its breadth of coverage, depth of use and degree of digitization present significant positive correlation with rural income, and a robustness test was conducted through the sub-sample method. In addition, according to regression analysis on the influencing factors of digital inclusive finance through the Tobit model, the level of economic development, the Internet popularity rate and the urbanization rate have a positive effect on the development of digital inclusive finance in Henan, while the income gap between urban and rural areas and the degree of opening up have a negative effect. Finally, predicated on the analysis of the restrictive factors of Henan’s digital inclusive finance in increasing rural income, the paper puts forward specific policy proposals based on the native state quo.

Primary and middle school teachers are a critical part of China’s foundational education; teacher turnover heavily affects the stable development of foundational education. In this study, interviews with 20 teachers found that relatively low income, high work pressure, unfair distribution, and difficulty in achieving promotion to higher professional titles are the main reasons for teacher turnover intention. This study investigates 485 primary and middle school teachers from Zhejiang and Jiangsu provinces. We found that primary and middle school teachers reported intense feelings of unfairness about their distribution of income. Their salary satisfaction was low, and the ratio of turnover intention was high. The main reasons for teachers’ high turnover intentions were low income, high pressure from work, unfair distribution, and the difficulty of achieving professional title promotion. To lower teachers’ turnover intentions, China should raise teachers’ income appropriately and increase the number of teachers with high professional titles. Schools should improve procedural, distributive, and interactive justice. Teachers should adjust their income references and perceptions of fairness. This situation can be effectively resolved only if all parties work hard to make positive changes.

The paper draws attention and opens the debate on major societal issues that concern not only Muslims but human societies, at large, because of their profound implications, afflictions, and their present and future transitive dimensions. The paper discusses two major issues that have attracted a great deal of attention in the recent past: wealth and income disparities, and global indebtedness. Four remedies have stressed upon and/or proposed to eradicate and/or lessen some of the burdens of these problems have been thoroughly examined. These are: - Stripping commercial banks of their power to create money out of thin air (i.e., Ex Nihilo). Thus, reviving financial reform in line with the spirit of the call for the “Establishment of a National Bank [in England]” in the 1820s by the renowned British economist David Ricardo (1772-1823). The Bank of England was a private commercial entity at that time. - Prohibiting of ‘harmful’ speculation activities in financial and economic transactions and/or imposing hefty taxes on transactions relating to such activities. The implementation of such a policy requires and clear-cut distinction between the ‘harmful’ and ‘non-harmful’ speculative activities in financial and non-financial markets. - Levying adequate and fair taxes on the wealthiest upper class at the global scene. Calls for such a policy is on rise in the past few years. For instance, “Speakers at the European Development Days summit in Brussels, [in 2017], said that a just tax system should be “at the heart” of the development debate, and that more transparency is needed to ensure that companies pay their fair share. Tax avoidance schemes used by multinational companies, such as moving profits to tax havens, result in global losses of around $650 billion a year in tax receipts — with developing countries losing $200 billion, according to a study from the International Monetary Fund”, (Edwards, 2017; Crivello et al., 2015, p. 21) - Establishing a neutral legislative and tax regimes for different modes of financing. Thus, providing ‘a level playing field’ for equity and debt modes of financing due to the current biasness of the tax regimes to debt-based financing instruments as it has been documented in various studies carried out by the IMF, the European Commission, and other international prominent bodies.

This study aligns with the 2030 United Nations Sustainable Development Goals- 3 which aim to “ensure healthy lives and promote well-being for all at all ages”. It contributes to the nascent literature stream on energy-health dynamics by introducing a holistic theoretical model to empirically examine the mediation effect of carbon emissions on the relationship between nonrenewable energy and infant mortality rates. Using an unbalanced panel data on 42 Asia and the Pacific countries from 2005 to 2015 and deploying the structural equation modeling approach, the empirical results are surmised as follows: (i) in regard to the full sample of countries, nonrenewable energy indirectly increases infant mortality rates through increasing carbon emissions. In other words, carbon emissions play a partial mediation role between nonrenewable energy and infant mortality rates; and (ii) for the different income groups, carbon emissions show varying mediation effects. For example, the mediation effects of carbon emissions in lower-middle and upper-middle income countries are found to be similar to those of the full sample of countries. Therefore, based on these findings, we conclude that nonrenewable energy is an essential determinant of infant mortality rates. Policy recommendations are put forward.

Chondrosarcoma, represents approximately 0.1% of all neoplasms of the head and neck, being considered a rare disease, but with a relatively good prognosis. The 5-year overall survival (OS) rate is estimated at 70-80%, being considered a disease with a low growth rate. About 13% of all cases of chondrosarcoma, are located in the region of the head and neck. We present the case of a young patient treated multimodally, lost from the oncological records less than two years after the diagnosis, without evidence of disease progression. The early loss from the oncological follow-up programs of patients with a lower risk of early repalpse, without evidence of a recurrence or metastasis could be the consequence of a major complication among which we could assume an aspiration pneumonia secondary to a dysphagia, associated with an aggressive multidisciplinary treatment. Large tumor size and positive resection margins (R1 resection) are risk factors that support an intensive adjuvant approach in order to reduce the risk of recurrence, but the low grade of tumor, associating a lower risk of recurrence as well as the adverse events (AE) of adjuvant radiotherapy and chemotherapy justifies a more reserved therapeutic approach. Taking into account the longer life expectancy of these patients, it is recommended to use a more conformal irradiation technique in order to reduce doses to radiosensitive structures as well as to omit elective neck irradiation, taking into account the lower risk of lymph node involvement. The lack of guidelines that include very rare tumors including low grade chondrosarcoma of head and neck make a unified approach difficult, but the data presented even in case reports could contribute to choosing the regimen that offers the best therapeutic ratio.

A hydrothermal pretreatment of the microalga Nannochloropsis gaditana at mild temperatures has been studied in order to reduce N and O content in the biocrude obtained by hydrothermal liquefaction (HTL). The work is focused on the evaluation of temperature, reactor loading and time (factors) to maximize the yield of the pretreated biomass and the heteroatom contents transferred from the microalga biomass to the aqueous phase (responses). The study followed the factorial design and response surface methodology. An equation for every response has been obtained, which leads to the accurate calculation of the operating conditions required to obtain a given value of these responses. Temperature and time are critical factors with a negative effect on the pretreated biomass yield, but a positive one on the N and O recovery in the aqueous phase. The slurry concentration has to be low to increase heteroatom recovery and high to maximize the pretreated microalga yields

In post mortem analyses, SARS-CoV-2 was found in the middle ear of some, but not all patients with COVID-19 disease. It is not clear whether SARS-CoV-2 penetrated the ear passively post mortem, or existed in the middle ear of living patients during, and perhaps also after infection. This study investigates whether SARS-CoV-2 can be found in the middle ear of living patients during ear surgery. Swabs from the nasopharynx, the filter connected to the tracheal tube and secretion from the middle ear were collected during middle ear surgery. All samples were tested for the presence of SARS-CoV-2 with PCR. History of vaccination, COVID-19 and contact with SARS-CoV-2-positive individuals were recorded preoperatively. Postoperative SARS-CoV-2 infection was noted at the follow-up visit. Overall 63 participants (62%) were children and 39 (38%) were adults. SARS-CoV-2 was found in the middle ear and in the nasopharynx of two and four CovEar Study participants, respectively. The filter connected to the tracheal tube was sterile in all cases. Cycle threshold (ct) values of the PCR test were between 25.94 and 37.06. SARS-CoV-2 penetrates into the middle ear of living patients and can be found in asymptomatic patients. The presence of SARS-CoV-2 in the middle ear may have implications for ear surgery and can pose a risk of infection for operating room staff. It may also directly affect the audio-vestibular system.

This article introduces the design and analysis of a slope detection circuit tailored for on-chip sensing of the load current in DC-DC converters. The novel indirect sensing approach is grounded in measuring the output voltage slope across the filtering capacitor during discharge phases. Consequently, this slope data can be effectively harnessed to control the converter switches. The slope detector circuit was designed in standard 65 nm CMOS technology using the nominal supply voltage of 1.2 V and can be used for current sensing within the range from one to hundreds of mA. Since the proposed circuit has mainly digital character, the robustness to process, temperature and supply voltage variations can be ensured rather conveniently.

The object of study is a transversely bent triangular plate made of orthotropic material fixed along the edges of the plate under the action of a uniformly distributed load. Fourth-order differential equilibrium equations with variable orthotropy parameters were used. The equations were approximated by finite differences for a grid of scalene triangles. This type of mesh accurately describes the boundary contour of the triangular-shaped plates. The boundary conditions for the mesh consider the orthotropy of the plate material. Seven standard finite-difference equations have been developed considering the boundary conditions along the three edges of the plate and the presence of three angles of an irregularly shaped triangle. A finite difference matrix is obtained. The matrix structure makes calculating a triangular plate at different base angles possible. The boundary conditions were varied in the form of rigid or hinged support of triangular plates. The calculation method considers the orthotropic parameters of the material in two mutually perpendicular planes. The adaptation of the numerical method to the calculation of orthotropic plates of arbitrary shape is described. Relationships are given for determining the rigidity characteristics of orthotropic materials. An algorithm for simple engineering calculation of triangular orthotropic plates is proposed, which makes it possible to perform accurate calculations in variant design.

Purpose: This study aimed to describe the molecular epidemiology and seasonality of human rhinovirus (HRV) in chronic obstructive pulmonary disease (COPD) and its association with COPD exacerbations in Abu Dhabi, the United Arab Emirates (UAE). Methods: Sputum specimens were collected for analysis from all COPD patients who visited a medical center from November 2021 to October 2022. The real-time quantitative polymerase chain reaction (qPCR) test was used to detect HRV. Results: Of the 78 COPD patients included in the study, 58 (74%) pa-tients presented with one or more exacerbation episodes. The incidence of COPD exacerbation peaked over the winter and substantially decreased during the summer. HRV positivity in pa-tients during exacerbation (E1) was 11/58 (19%) and 15/58 (26%) two weeks after the exacerbation episode (E2). There was no significant difference in the HRV load in these patients. No statistically significant difference was observed in the detection of HRV during exacerbation compared to patients with stable COPD. Conclusion: This is the first study to assess the association between HRV detection by qPCR and COPD exacerbations in the UAE. The high sensitivity of the detec-tion technology helped collect reliable epidemiologic data. Few studies have provided similar Middle East data. This study's pattern of COPD exacerbations and HRV detection parallels that of temperate countries. This information can help with future, more extensive surveillance of res-piratory viruses in the UAE and the Middle East and their association with COPD exacerbations.

An ionospheric response at middle latitudes to geomagnetic storms is not yet very well understood. Total electron content (TEC) variations associated with eight strong geomagnetic storms between 2015 and 2022 obtained from GNSS receivers in the western area of the North Atlantic (Portuguese continental and insular territory) are studied in an attempt to fill this gap. It was found that for most of the studied geomagnetic storms TEC variations are synchronous for the longitudinal ranges from 27ºW and 9ºW. In the southern part of the studied region (around 32ºN) the amplitude of TEC variations is, in general, significantly higher than in the northern part (around 39ºN). Some of the studied geomagnetic storms were associated with TEC variations that we interpret as effects of post-sunset equatorial plasma bubbles that travelled well north from their habitual region. Also, while most of the studied storms were accompanied by reports on different kind of malfunction of GNSS systems (GPS; GALILEO and other), there is no clear pattern in their appearance in dependence on the geomagnetic/ionospheric storms’ strength, commencement time, and its characteristics, in general.

The owners of forests with water protection functions in Bulgaria do not receive compensation for their limited right to use wood and non-wood forest products from the forest areas they own. At the same time, the contribution derived from forests with water protection functions is received by water users and water consumers, whereas the costs of managing the forests are borne by their owners. The problem thus defined is not a forestry one, but an economic one, and the purpose of this paper ensues therefrom, namely to propose and test a methodology for valuating the produc-tion function of forest areas with water protection function in Bulgaria, allowing a fair distribu-tion of income between the forest owner and the user of forest ecosystem services. The methodol-ogy is based on the form of forest management and the analytical expression of the economic rela-tionship between a forest owner and a user of forest ecosystem services, constructed using Schen-rock’s formula. It has been tested with actual data on forest areas with water protection functions falling within the administrative and territorial scope of Velingrad municipality and based on the obtained results proposals have been made for the distribution of the contributions generated by forest ecosystems between the forest owner and the user of the forest ecosystem services.

We have studied the relative positions of the frontier levels determine the main electronic properties and reaction ability, there is important necessity to compare the MO of the purine and рyrimidine bases: adenine (A), guanine (G), cytosine (C), thymine (T) and uracil (U). The donor and acceptor properties are the fundamental characteristic of the conjugated molecules and can be quantitatively estimated by relative positions of the frontier molecular orbitals. The MO’s energies can be estimated experimentally or quantum-chemically. Analysis of the relative position of the frontier levels (calibrated by the energy gap) enables the investigation of the donor/acceptor properties of the RNA/DNA bases more detailed. The index φ0 is proposed for the quantitative quantum-chemical estimation of the donor ability of the conjugated molecules: it points on the shifting of the energy gap relative to the reference electron balanced system. The RNA/DNA bases divided strictly by two groups: predominantly donors (φ0 > 0.5) and predominantly acceptors (φ0 > 0.5). Each representative base of the first group forms the stable base pair the representative base of the second group the difference of indices Δφ0 should be optimal to enables the DNA replication.

The present study examined and compared the effects of high- and low-molecular weight (MW) chitosan, a nutraceutical, on intestinal and liver lipid metabolism in rats fed with high-fat diet. Both high- and low-MW chitosan decreased liver weight, elongated small intestine, improved the dysregulation of blood lipids and liver fat accumulation, and increased fecal lipid excretion in high-fat diet-fed rats. Supplementation of both high- and low-MW chitosan significantly inhibited the decreased phosphorylated AMP-activated protein kinase (AMPK)α and peroxisome proliferator-activated receptor (PPAR)α protein expressions and the increased lipogenesis/cholesterogenesis-associated protein expressions (sterol regulatory element binding protein (SREBP)1c, SREBP2, and PPARγ) and the decreased apolipoprotein (Apo)E and microsomal triglyceride transfer protein (MTTP) protein expressions in the livers of high-fat diet-fed rats. Both high and low-MW chitosan supplementation could also suppress the increased MTTP protein expression and the decreased angiopoietin-like protein (Angptl)4 protein expression in the intestines of high-fat diet-fed rats. Comparison between high and low-MW chitosan, high-MW chitosan has a higher efficiency than low-MW chitosan on the inhibition of intestinal lipid absorption and the increase of hepatic fatty acid oxidation, which can improve liver lipid biosynthesis and accumulation.

The creep behaviors of TA2 and R60702 at low and intermediate temperature were presented and discussed in this paper. Experimental results indicated that an apparent threshold stress exhibited in the creep deformation of R60702. Meanwhile, the primary creep phase was found as the main pattern in the room temperature creep behavior of TA2. Compared with exponential law, the power law has been proved to be a proper constitutive model in the description of primary creep phase. It also showed that θ projection method had its significant advantage in the evaluation of accelerated creep stage. Thus, a composite model which combined power law with θ projection method was applied in the creep curves evaluation at low and intermediate temperature. Based on the multiaxial creep deformation results, the model was modified and discussed. A linear relationship existed between composite model parameters and applied load. Finally, the creep life could be accurately predicted and the composite model method is suitable for application in low and intermediate temperature creep life analysis.

Appeals to governments for implementing basic income are contemporary. The theoretical backgrounds of the basic income notion, only prescribe transferring equal amounts to individuals irrespective of their specific attributes. However, the most recent basic income initiatives all around the world are attached to certain rules with regard to the attributes of the households. This approach is facing significant challenges to appropriately recognize the vulnerable groups. A possible alternative for setting rules with regard to the welfare attributes of the households is to employ artificial intelligent algorithms that can process unprecedented amounts of data. Can integrating machine learning change the future of basic income by perdition of vulnerable to future poverty households? In this paper, we utilize a multidimensional and longitudinal welfare data comprising one and a half million individual data and a Bayesian beliefs network approach to examine the feasibility of predicting households’ vulnerability to future poverty based on the existing households’ welfare attributes.

The issue of polarization, as opposed to inequality, has been little explored for European countries. in this paper, using harmonized data produced by Luxembourg Income Study Database, observes income trends for 12 European countries, showing an increase in polarization in many of the countries considered. the drivers that led to this concentration of income are also analyzed, noting heterogeneous factors within countries.

Mangrove ecosystems play an important role in local livelihoods in coastal regions of tropical and subtropical countries. However, in recent years urbanisation has changed the income structure of residents near mangroves. Different landscapes provide different job opportunities; thus, analysis of regional landscape patterns is important for understanding income structures. In this study, surveys on the income structure and landscape patterns of the surrounding areas of three mangrove sites were conducted in the Hau and Hoang Mai River estuaries in Nghe An Province, North-Central Vietnam. The results revealed that both natural and socio-economic landscape components affected income structure. The major occupations in the study area were agriculture, including husbandry, sea fishing, and trading. Land morphology and river type were the major factors influencing the income from agriculture, while coastline morphology primarily affected income from sea fishing. Community-based trading was carried out in the study area; thus, the population inside each administrative unit was a significant factor increasing income, while the retail market size in an area had significant negative effects, potentially due to the increasing number of competitors. Our study aimed to evaluate mangrove ecosystem importance for local livelihoods in relation to landscape patterns, and the results contribute to urban planning based on the conservation and sustainable use of mangrove ecosystems.

Previous studies have shown that agricultural works bear a disproportionately higher burden of HIV, which is the highest HIV prevalence ever reported in any working population in South Africa. This study aimed to assess HIV knowledge, attitudes and practices of agricultural workers, as a precarious and vulnerable workforce. A cross-sectional study design was employed. A pre-piloted paper-based questionnaire was administered to a consenting sample of agricultural workers. Descriptive and inferential statistics were performed using stata version 16.1 software, 0.05 level was used as a measure of significance. The majority of agricultural workers had adequate knowledge level (72.1%) regarding HIV/AIDS. Knowledge was significantly associated with having some level of education,) secondary education (AOR: 1.46, 95% CI:1.01-2.12), and post-matric qualification (AOR: 3.07, 95% CI: 1.61-5.83). The attitudes level of workers towards HIV was good (88.1%). Attitude was negatively associated with residing in informal settlements (AOR: 0.64, 95% CI 0.43-0.97). Majority of participants exhibited poor prevention practices regarding HIV (60.9%). Half of participants reported low condom usage (50.9%) and multiple sexual partners (50.6%). The portrayed risky sexual behavior establishes agricultural workers as an HIV high-risk population. Strategizing non-conventional approaches to HIV prevention and behavior change communication targeting agricultural workers is recommended.

This review provides a comprehensive overview of two major advancements in hearing loss treatment: the middle ear implant (MEI) and bone conduction implants (BCIs). MEI, surgically inserted in the middle ear, directly stimulate the ossicles, and are primarily employed to treat sensorineural, conductive, or mixed hearing losses. BCIs work via bone conduction, bypassing the outer and middle ear to deliver sound vibrations to the inner ear, beneficial especially for conductive or mixed hearing losses and single-sided deafness. The decision to opt for these devices is a multifaceted process, considering audiological criteria, surgical feasibility, and patient expectations. The review also details the portfolio of available devices, their functioning, and audiological usage indications. While both MEI and BCIs prove beneficial for patients, the review emphasizes the need for careful preoperative planning and counselling, considering factors such as potential complications, surgical challenges, and patient suitability. Overall, the two types of implants, despite their individual complexities, provide an effective alternative to traditional hearing aids, offering a path to improved sound clarity and quality for patients with various types of hearing loss.

The composition and pattern of ecosystems are important factors determining the overall status and spatial differences of ecosystem service functions. However, under the background of differential land policies and ecological protection policies, research on the trend of ecological system pattern changes in the Fenhe River Basin is insufficient. Taking the upper and middle reaches of the Fenhe River Basin as the study area, based on long-term NDVI index and multi-period LUCC remote sensing images, this study used spatial statistics and time trend analysis methods to analyze the spatio-temporal dynamic changes of vegetation, land use, landscape pattern, and explored the impact of major driving factors on ecosystem changes. The results show that: (1) From 2010 to 2020, the vegetation cover in the upper and middle reaches of the Fenhe River Basin increased, with an annual NDVI increment of 0.003 (P<0.001). NDVI showed an increasing trend spatially, with significant statistics (P<0.001) and significant changes (P<0.05) in vegetation in high-altitude mountain areas, and the vegetation cover was mostly forests or grasslands. There was no significant change in vegetation cover in the low-lying urban agglomeration area. (2) From 2010 to 2020, the area of water bodies or wetlands in the study area significantly decreased, with 51.3% converted to arable land and 33.9% transferred to construction land, while only 2.2% remained as water bodies or wetlands. From 2015 to 2020, the trend of water body changes slowed down, with the proportions of conversion to arable land and construction land being 44.0% and 18.4% respectively, while the area of wetlands or water bodies remained at 16.3%. During the period of 2015-2020, the area of water bodies or wetlands converted to other land types increased by more than 14% compared to 2010-2015. This proportion reached more than 30% compared to the 13th Five-year Plan Period. (3) From 2010 to 2020, the spatial changes of landscape diversity (SHDI) and evenness (SHEI) of LUCC showed heterogeneous characteristics. In the high-altitude areas near the river basin boundary, the values of SHDI and SHEI were below 1.0. While in the low-altitude plain areas and urban areas with relatively frequent human activities, the values of SHDI and SHEI were above 1.0, and the values in urban areas could reach above 1.5. The evolution of ecosystem patterns in the upper and middle reaches of the Fenhe River Basin in the past decade has been clarified, providing a scientific basis for the construction and management of ecological environment governance and restoration projects in the Fenhe River Basin, and providing practical references for ecological protection and high-quality development practice in the Yellow River Basin.

Although numerous articles have been published to address drivers or barriers of corporate social responsibility (CSR), some parts of the world have received less attention. In this study, I reviewed the literature, from 2010 to 2021, to identify drivers and barriers of CSR in the the Middle East and North Africa (MENA) region and compare them with the findings in western countries. (2) Methods: For this study, I used a structured literature review method. By setting the inclusion and exclusion criteria, only 28 articles remained from selected database; (3) Results: The findings revealed some CSR drivers, such as leadership styles, profitability, reputation, moral commitment, and environmental conservation are common in both regions. There are also some differences between CSR drivers, for example religious beliefs, low concentration of ownership, and company characteristics are some of the drivers in the MENA region. Maintaining social license to operate, avoiding the risks of community opposition, pressure from the government, and consumer demand tend to be more important in western countries. Common barriers in both regions are lack of financial resources, cost, lack of CSR knowledge and awareness, and ownership concentration. This review also highlighted that lack of law enforcement, lack of stakeholder communication, lack of management commitment, lack of interests, corruption, and financial debts are some of the addressed barriers of CSR in the MENA region, while cost/benefit ratio, lack of customer interest, and lack of scientific frameworks are the special barriers in western countries. (4) Conclusions: While researchers in western countries have more focus on energy sector, there is a lack of research about drivers and barriers of CSR in the MENA region in several industries, including oil and gas.

The VLSI industry is facing parasitic effects that trouble development in the nanoscale domain. However, instead of replacing the traditional MOSFET design, it would be more advantageous to apply different doping profiles and discerning which deal with specific parasitic effects the best. With a review of Gaussian doping, Uniform doping, and Delta doping profiles and analysis of the FET technology characteristics that use these doping profiles, a comparison can be made among them for integrated circuit design engineers. These doping profiles are compared based on how well they perform against non-ideal and ideal environments. Also, both digital and analog performance are measured to ensure the uniqueness of each doping profile that is present. After getting a list of benefits from each doping profile, it is derived to determine which doping profile works best against a host of parasitic effects and what type of application do these doping profiles have

This study aims to determine the impact of the type of ICT usage on household income from main vegetables, agriculture (including main vegetables), and total income. This study is based on surveys and interviews with vegetable farmers using structured questionnaires conducted in three villages in Indonesia, including Cianjur, Sleman, and Malang in West Java, Yogyakarta, and East Java, respectively. The data were collected from 375 respondents selected in each region from November 2021 to March 2022. An econometric model called the multivariate linear regression (MLR) model is used to assess heterogeneous factors that influence the possibility of increasing the income of vegetable farmers. The study found that variables that use ICT as a primary variable, household, marketing, geographical characteristics, and immediate source information in agriculture have a significant impact on household income (P < 0.01) from primary vegetables, agriculture, and total income, with multiple R squares of 70.5, 72.0, 73.7% and F statistics of 28.48, 30.66, and 33.34, respectively. In summary, this novel study shows that the five categories of information technology used in farming and selling of harvest have a positive impact on household incomes

The purpose of this study was to determine the income, costs and revenue of the Gontor Putri 3 bakery. Want to know the efficiency of the bakery business in Karangbanyu Regency. The method used in this research is analytical descriptive by conducting a survey. The data used in this research is primary data. Data collection techniques use observation, interviews and documentation, while the process of analysis is quantitative descriptive. Using the R/C ratio, a value of 1.72 per month is obtained. This value indicates that the bakery factory in Karangbanyu is efficient because the value is more than one.

The study examined key socio-economic characteristics of smallholder farmers identified for their contribution to market participation. These variables include gender, age, marital status, level of education, household size, additional income, membership of cooperative, herd size and use of ICTs. Using a structured questionnaire, primary data was collected from a total of 129 respondents which was analysed with the Statistical Package for the Social Sciences, and presented using cross-tabulations, percentages and count data. The result indicates that age, additional income, cooperative membership and use of ICTs were important variables which contributed to market participation among respondents. The study also made applicable recommendations as the findings may have relevance for future research, policy and practice for commercializing smallholder farmers.

In the field of agricultural food production, the transition between organic and inorganic farming methods has been an issue of much debate. The debate, on one hand, stresses the urgency for the transition in order to preserve environment and health; and, on the other hand, emphasizes the pressure of maintaining food production for a large growing population. Thus, the dilemma is how to find an agricultural system that would balance between obtaining food security and ensuring a safe sustainably environment-friendly food production system. This article focuses on the debate, in the context of Bangladesh, and questions whether it is the proper time, and stage in the development process, to attempt the transition from inorganic conventional food production methods to organic food production methods. This article contemplates why the organic rice market is not expanding in Bangladesh, and attempts to explain the slow growth of the market through the two main factors of income constraint and lack of awareness among people about the environmental and health detriments of inorganic farming methods. The study is exploratory in nature, and finds that it is not mainly the lack of awareness but the income constraint that can be principally attributed to the slow expansion of the organic rice market in Bangladesh. Through exploring consumers’ awareness about organic farming methods and their demand for organic products, this study shows how income as the major constraint, besides price, affects consumers demand for organic and inorganic rice in Bangladesh. Income being identified as the major barrier reveals the potential of the organic rice market to grow in the future, as Bangladesh continues its journey towards becoming a middle-income country.

Sports are framed within the context of the Olympic spirit and are, therefore, within the vision and mission of the Olympic Committee, aimed at “building a better world”. This is identified as a fundamental value and sustainability is therefore explicitly considered to be a “working principle” of this. In this research an analysis of the performance of professional European football teams publicly listed on stock markets, restating the income statements according to the Value-Added perspective is carried out. This takes into account the effective sustainable contribution in the distribution of added value with reference to the human, structural, debt, infrastructural, and risk capitals of these organisations. The Value-Added Statement is considered as a part of the broader CSR Reporting and can be traced back to the late 1970s. However, it is in widespread contemporary use and is regarded as being both a credible and a tested measure. In this paper, the authors apply a slightly modified and simplified version of this tool to these publicly listed European football clubs as a proxy for wider professional sport. This research demonstrates that, although professional sports clubs are profit-oriented, the distribution of wealth generated by the added value is unbalanced. In most cases, at least in financial terms, shareholders are the most disadvantaged and athletes are the most rewarded.

Doppler findings of persistent reverse end-diastolic flow (PREDF) in a fetal middle cerebral artery (MCA) are a very rare sonographic finding and are a marker of poor fetal condition. This finding often leads to intrauterine fetal death or early neonatal death. The reverse end-diastolic flow in the middle cerebral artery is the terminal hemodynamic event. Fetal cerebral circulation normally has a high impedance; in the event of fetal hypoxemia, impedance decreases, resulting in the central redistribution of blood flow to vital organs, which maintains the oxygen delivery to the brain. Reverse flow in the middle cerebral arteries describes the loss of this autoregulatory process. PREDF is a sequence happening due to increased extracranial or intracranial pressure. Previous case reports mentioned intracranial hemorrhage, intrauterine growth restriction (IUGR), fetal anemia, and fetal hepatic abnormalities as leading problems to PREDF. This condition presumably arises due to cerebral edema associated with severe hypoxemia. We reported Doppler findings of PREDF MCA in a 33-year-old female at 30 weeks gestation who was referred to the hospital with severe preeclampsia accompanied by IUGR and oligohydramnios. A cesarean section was performed due to severe preeclampsia and a low bishop score. Hypotheses on various etiologies and their association with intrauterine/neonatal death as well as the best management still require further investigation.

Research on climacteric syndrome among middle-aged men remains scant than the research among women. Research is also scant on climacteric syndrome among older adults living alone, particularly men, who are more vulnerable than such females. This cross-sectional study investigated whether the prevalence of climacteric syndrome is associated with the type of household middle-aged men live in and identified the determinants of climacteric syndrome based on the household type. Six hundred middle-aged men living in multi-person households and 600 living alone were surveyed about general characteristics, diet-related factors, and climacteric syndrome. Data were analyzed using Pearson’s chi-squared test, Fisher’s exact test, and logistic regression. The risk of climacteric syndrome in single-person households was found to be 1.6 times higher than that among in multi-person households (p = 0.006). In multi-person households, income and breakfast frequency predicted climacteric syndrome (p < 0.05), while age, breakfast frequency, dinner frequency, and weekly eating out frequency predicted climacteric syndrome in single-person households (p < 0.05). Thus, dietary factors are more closely linked to the prevalence of climacteric syndrome in single-person households than in multi-person households. This highlights the need for climacteric syndrome interventions for middle-aged men whose health concerns may persist into older adulthood.

Based on the 2014-2015 China Education Panel Survey (CEPS) and using the propensity score matching method, we studied the causal relationship between physical exercise and prosocial behavior of junior middle school students in China. Ordinary least squares regression and propensity score matching estimation results showed that participation in physical exercise significantly increases students’ prosocial behavior by more than 0.2 standard points. The results of this study were tested and found to be robust.

Background: Our knowledge of prostate cancer (PCa) genomics mainly reflects European (EUR) and Asian (ASN) populations. Our understanding of the influence of Middle Eastern (ME) and African (AFR) ancestry on the mutational profiles of prostate cancer is limited. Design, setting and participants: To characterize genomic differences between ME, EUR, ASN and AFR ancestry, fluorescent in situ hybridization (FISH) studies for NKX3-1 deletions and MYC amplification was carried out on 42 tumors arising in individuals of ME ancestry. These were supplemented by analysis of copy number profiles of 401 tumors of all ancestries. Outcome measurement and statistical analysis: FISH results of NKX3-1 and MYC were assessed in the ME cohort and compared to other ancestries. Gene level copy number aberrations (CNAs) for each sample were statistically compared between ancestry groups. Results and Limitation: NKX3-1 deletions by FISH were observed in 17/42 (17.5%) prostate tumors arising in men of ME ancestry, while MYC amplifications were only observed in 1/42 (0.23%). Using CNAs called from arrays, the incidence of NKX3-1 deletions was significantly lower in ME vs. other ancestries (20% vs. 52%; p = 2.3 x 10-3). No differences in MYC amplifications was noted between the two cohorts using array-based CNAs. Across the genome, tumors arising in men of ME ancestry had fewer CNAs than those of other ancestries (p = 0.014). Additionally, the somatic amplification of 21 specific genes was more frequent in tumors arising in men of ME vs. EUR ancestry (Proportions test; Q < 0.05). Those included amplifications in the glutathione S-transferase family on chromosome 1 (GSTM1, GSTM2, GSTM5) and the IQ Motif Containing family on chromosome 3 (IQCF1, IQCF2, IQCF13, IQCF4, IQCF5, IQCF6). Conclusion: Significant differences in genetic background exists between different ancestries. The lower number of somatic CNAs observed in prostate cancer arising in men of ME ancestry may explain the relatively good prognosis in this population. Larger studies are warranted.

Available water resources in the Middle East, as one of the most water-scarce regions of the world, have undergone extra pressure due to climatic change, population growth, and economic development during the past decades. The objective of this study is to detect the trends and quantify the changes in aridity with respect to precipitation and potential evapotranspiration in 20 countries of the Middle East and the adjacent area. A Pixel-wised trend analysis was conducted on precipitation, potential evapotranspiration, and aridity index for 71 years from 1948 to 2018. A nonparametric Mann-Kendall test was used over 14106 points in the study area to detect the trends at monthly and annual time scales. Results showed statistically significant (|Z| >1.96) upward trends in aridity (a downward trend in aridity index) up to 96 percent from December through September in most parts of the region. Aridity in October and November had a downward tendency in most parts of the study area. At the annual time scale, 62.5 percent of the statistically significant trends in aridity were found to be upward (up to 96 percent increase in aridity) due to the combined effects of the decrease in precipitation and the increase in potential evapotranspiration and 37.5 percent of the detected trends were downward (up to 61 percent decrease in aridity). The highest and the lowest trends in aridity were found in the north of Sudan (96 percent increase in aridity) and Eastern Arabia (61 percent decrease in aridity), respectively.

The Middle East spans the transition between temperate Mediterranean climate in the Levant to hyper-arid sub-tropical deserts in the southern part of the Arabian Peninsula, with the complex alpine topography in the northeast feeding the Euphrates and Tigris rivers which support life in the southeastern Fertile Crescent (FC). Climate projections predict severe drying in major parts much of the ME in response to global warming, making it important to understand the controls of hydro-climate perturbations in the region. Here we discuss 23 ME speleothem stable oxygen isotope (δ¹⁸Occ) records from 16 sites from the SISAL_v1 database, which provide a record of past hydro-climatic variability. Sub-millennial changes in ME speleothem δ¹⁸Occ values primarily indicate changes in past precipitation amounts superimposed on variations of the main synoptic pattern in the region, specifically Mediterranean cyclones. The coherency (or lack thereof) between regional records is reviewed from Pleistocene to present, covering the Last Glacial Maximum (LGM), prominent events during deglaciation, and transition into the Holocene. The available speleothem δ¹⁸Occ time-series are investigated by binning and normalizing at 25-year and 200-year time windows over the Holocene. Important Holocene climatic oscillations are discussed, such as the 8.2 ka, 4.2 ka and 0.7 ka (the Little Ice Age) Before Present events. Common trends in the standardized anomalies are tested against different climate archives. Finally, recommendations for future speleothem-based research in the region are given along with comments on the utility and completeness of the SISAL database.

Currently the bimatoprost implant (DURYSTA) is approved for a single administration secondary to concern for progressive corneal endothelial cell (CEC) loss with intracameral administration. In order to better understand the cause of CEC loss and other adverse events (AEs) with intracameral administration, multimodal imaging of the implant utilizing optical coherence topography (OCT), robotic ultrasound and bio microscopy video recording was utilized. Inherently the anterior chamber is a non-confined space. In certain examples the implant assumed a round and spotted structure as it picked up iris pigment as it migrated around the anterior chamber. Accordingly, we explored delivery of the implant in the middle segment behind the iris and in front of the pseudophakic lens. We then evaluated the suitability of various imaging modalities to assess the implant in this location. For middle segment administration, the ArcScan Insight 100 robotic ultrasound provided resolution and repeatability sufficient to monitor the implant behind the iris. This preliminary study hypothesizes that DURYSTA migration in the anterior chamber is the main source of AEs. Through use of a confined location, the middle segment, the implant is unlikely to migrate and cause CEC loss while also delivering drug closer to its site of action, the ciliary body. Further efforts are underway to understand the suitability of the middle segment for serial DURYSTA administration to maximize intraocular pressure lowering while minimizing AEs.

Earth Observation (EO) techniques have significantly evolved over time, covering a wide range of applications in different domains. The scope of this study is to review the research conducted on EO in the Eastern Mediterranean, Middle East, and North Africa (EMMENA) region and to identify the main knowledge gaps. We searched through the Web of Science database for papers published between 2018 and 2022 for EO studies in the EMMENA. We categorized the papers in the following thematic areas: Atmosphere, Water, Agriculture, Land, Disaster Risk Reduction (DRR), Cultural Heritage, Energy, Marine Safety and Security (MSS) and Big Earth Data (BED); 6647 papers were found with the highest number of publications in the thematic areas of BED (27%) and Land (22%). Most of the EMMENA countries are surrounded by sea, yet there was a very small number of studies on MSS (0.9% of total number of papers). This study detected a gap in fundamental research in the BED thematic area. Other future needs identified by this study are the limited availability of very high resolution and near real time remote sensing data, the lack of harmonized methodologies and the need for further development of models, algorithms, early warning systems and services.

Amylose content (AC) stands as a pivotal determinant of rice grain quality, primarily governed by the Waxy gene (Wx), with its allelic diversity significantly influencing AC variation. In the current culinary landscape, soft rice varieties, known for their low AC and superior palatability, are particularly sought after by consumers. Notably, many soft japonica rice varieties cultivated in southern China, including the Nangeng series, are characterized by the presence of the Wxmp allele, derived from the ancestral Wxmq allele. While both alleles are associated with reduced AC, there remains a paucity of detailed understanding regarding the interplay between specific functional single nucleotide polymorphisms (SNPs) within these alleles and the overarching rice grain quality. Employing site-directed mutagenesis, we engineered three distinct transgenic rice lines, each harboring either the Wxmp, Wxmq, or Wxb-5c alleles, against the background of the glutinous rice cultivar Nip(wx). This suite of transgenic rice showcased a gradation ingrain transparency inversely correlated to AC, delineating a sequence from Wxmq, signifying the lowest, through Wxmp, to Wxb-5c, indicating the highest. Consequently, this gradation in AC precipitated variations in other rice grain physicochemical attributes, such as the taste value of cooked rice, gel consistency (GC), and starch pasting properties. Furthermore, analyses of gene expression and enzyme activity revealed that the functional SNPs, Ex4-53G/A and Ex5-53T/C, lead to a decline in the GBSSI enzyme activity without affecting expression levels. These findings underscore the potential of harnessing these SNPs in breeding programs aimed at developing soft rice varieties endowed with enhanced culinary qualities.

With technological transformations such as big data, blockchain, artificial intelligence, and cloud computing, digital techniques are penetrating the field of finance. Digital finance is a resource-saving and environmentally friendly innovative financial service. It shows great green attributes and can drive the flow of financial resources towards environmentally friendly enterprises, thereby promoting green and low-carbon development. This paper investigates the effects of digital finance on green and low-carbon cyclic development and the mechanism. First, the level of green and low carbon cyclic development in China is estimated from multiple aspects based on the panel data of 31 provinces by using the spatio-temporal range entropy weight method. Then, the working mechanism of digital finance on green and low carbon cyclic development is revealed by performing empirical tests based on panel regression models, mediating effect models, and threshold models. Finally, the effects of digital finance and conventional variables on green and low-carbon cyclic development are investigated by using a random forest model and a CatBoost model in based on the machine learning. The results show that digital finance has significant positive effects on green and low-carbon cyclic development, and technological innovation plays a key role in the effects of digital finance on green and low-carbon cyclic development; meanwhile, the driving effect of digital finance on green and low carbon cyclic development shows nonlinear features with increasing “marginal effect”; besides, both digital finance and conventional factors have significant impacts on green and low carbon cyclic development. This study provides an empirical basis and path reference for digital finance to achieve “carbon peak, carbon neutralization” in China.

Background: Chronic non-specific low back pain (CNSLBP) is defined as back pain that lasts longer than 12 weeks. Objectives: To investigate the efficacy of manual therapy (MT) program combined with Capacitive and Resistive Electric Transfer (TECAR) therapy in individuals with CNSLBP. Method: Sixty adults with CNSLBP were randomly equally divided into three groups. The first group followed an MT protocol in the lumbar region (MT group), the second group followed the same MT protocol combined with TECAR therapy (MT + TECAR group) using a conventional capacitive electrode as well as a special resistive electrode bracelet and the third group (Control group) received no treatment. Both intervention programs included six treatments over two weeks. Pain in the last 24 hours with the Numeric Pain Rating Scale (NPRS), functional ability with the Roland-Morris Disability Questionnaire (RMDQ), Pressure Pain Threshold (PPT) in the lumbar region with pressure algometry, and mobility of the lumbo-pelvic region through fingertip-to-floor distance (FFD) test were evaluated before and after the intervention period with a one-month follow-up. Analysis of variance with repeated measures was applied. Results: In the NPRS score, both intervention groups showed statistically significant differences compared to the control group both in the second week as well as in the one-month follow-up (p < .001). Between-groups differences were also noticed between the two intervention groups in the second week (p < .05). Differences in the RMDQ score in the second week and on the one-month follow-up were detected between the intervention groups and the control group (p < .001), while differences between the two intervention groups were only detected in the one-month follow-up (p < .001). Regarding the PPT values, differences were found mainly between the MT + TECAR and the control group and between the MT + TECAR and the MT group (p < .05), with the MT + TECAR group in most cases showing the greatest improvement compared to the other two groups, which remained statistically significant in the one-month follow-up (p < .05). Finally, both intervention groups improved the mobility of the lumbo-pelvic region in both time points compared to the control group without, however, statistically significant differences between them (p> .05). Conclusion: The application of an MT protocol with TECAR therapy appeared more effective than conventional MT as well as compared to the control group in reducing pain and disability and improving PPT in individuals with CNSLBP. No further improvement was noted in mobility of the lumbo-pelvic region by adding TECAR to the MT intervention.

We report the negative effective mass metamaterials based on the electro-mechanical coupling exploiting plasma oscillations of a free electron gas. The negative mass appears as a result of vibration of a metallic particle with a frequency of ω which is close to the frequency of the plasma oscillations of the electron gas m_2 relatively to the ionic lattice m_1. The plasma oscillations are represented with the elastic spring k_2=ω_p^2 m_2, where ω_p is the plasma frequency. Thus, the metallic particle vibrated with the external frequency ω is described by the effective mass m_eff=m_1+(m_2 ω_p^2)/(ω_p^2-ω^2 ) , which is negative when the frequency ω approaches ω_p from above. The idea is exemplified with two conducting metals, namely Au and Li embedded into various matrices. The one-dimensional lattice built of the identical metallic micro-elements m_eff connected by ideal springs k_1 representing various media such as polydimethylsiloxane and soda-lime glass is treated. The optical and acoustical branches of longitudinal modes propagating through the lattice are elucidated for various ratios ω_1/ω_p . The 1D lattice built of the thin metallic wires giving rise to the low frequency plasmons is treated. The possibility of the anti-resonant propagation, strengthening the effect of the negative mass occurring under  = p = 1 is addressed.

Background: Young adults, particularly university students might be at greater risk of developing psychological distress, and exhibiting symptoms of anxiety and depression during the COVID-19 pandemic. Objective: The primary objective of this study was to explore and compare the determinants and predictors of mental health (anxiety and depression) during and after COVID-19 lockdown among university students. Methods: This was an observational, cross-sectional study with a sample size of 417 students. An online survey utilizing International Physical Activity Questionnaire–Short Form (IPAQ-SF), General Anxiety Disorder–7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) was distributed to Universiti Tunku Abdul Rahman students via Google forms. Results: During lockdown, family income [χ² (1, n=124) = 5.155, p=0.023], and physical activity [χ² (1, n=134) = 6.366, p=0.012] were associated with anxiety, while depression was associated with gender [χ² (1, n=75) = 4.655, p=0.031]. After lockdown, family income was found to be associated with both anxiety [χ2 (1, n=111) = 8.089, p=0.004], and depression [χ2 (1, n=115) =9.305, p=0.002]. During lockdown, family income (OR=1.60, p=0.018), and physical activity (OR=0.59, p=0.011) were predictors for anxiety, and gender (OR=0.65, p=0.046) being the only predictor for depression. After lockdown, family income was a predictor for both anxiety (OR=1.67, p=0.011), and depression (OR=1.70, p=0.009). Conclusion: Significant negative effects attributed to the COVID-19 lockdown, and certain factors predisposed to the worsening of mental health status in university students. Family income, physical activity level, and gender were some of the major determinants that influenced the anxiety and depression.

Based on 2010, 2013 and 2015 CGSS data, the impact of Internet use and social capital on the income gap among farmers in the past five years is assessed at three time points using the OLS method and a quantile regression method. The study finds that (1) the income gap among farmers increases continuously in the five-year period, while Internet use plays a positive impact on farmers’ income growth in all five quartiles; the coefficient differences are all significantly negative, indicating that Internet use plays a positive role in alleviating the income gap between high-income and low-income farmer subgroups, and (2) social capital plays a positive role in moderating the income gap among farmers and that Internet use by farmers expands the boundary of social capital, which in turn increases the income level of and alleviates the income gap among farmers.

Rural households across developing countries rely on diversified sources of income and forest resource play important role in this regard. This study is designed with the objectives of assessing the contribution of forests to annual income of rural households and identifying its determinants with the case of Essera woreda forest in western Ethiopia. It also examined the gender dimensions of forest income and how this income varies with the wealth status of households key informants interview focus group discussion and household based questionnaire survey were used to collect data. On average income from crop production accounted for (40.7%) of the total annual household income. Forest income is second in importance contributing (32.6%), income from livestock off and non-farm activities and woodlots accounted for (13.6%), (11.4%) and (1.7%) of the total household income respectively. Firewood is the most used forest product and constituted the largest proportion (79%) of the total forest income. Forest income is more important for poor households (47.3%) than for medium (30.5%) or rich (20.2%) households. It is also more important for female headed households (58.2%) than for male headed households (29%). The gender dimension of forest income is also important within the household. Female members generated about four times more forest income (77% of the household forest income) than male members (23%). Policy to promote new forest management arrangement such as participatory forest management (PFM) needs to take in to account the major forest users and the types of products they depend on and be accompanied with other poverty reduction measures so that improved forest conservation outcome will not have negative consequences on local livelihoods particularly on poor and women who depend most on the forest.

1) Background: The environmental, financial and social questions in Africa remain unanswered up-to-date, with the rapid increase in human population and the demand for fuel energy, trigger the need to generate data on the socio-economic factors influencing the knowledge of use and adoption of family-sized bio-digesters. The increasing prices of fossil fuels and taxes on energy sources require finding the alternative, clean and economical sources of energy for households in developing countries. Moreover, in Africa, the consumption of firewood and charcoal continues to increase, with wood fuel consumption predicted to increase by 2030 to over 140%. The study objectives were 1) to determine the socio-economic characteristics of the people in Ngoma district, 2) to assess socio-economic factors influencing people to use and adopt family-sized bio-digesters. 2) Methods: Quantitative data collected with semi-structured questionnaires and interviews were analyzed using descriptive statistics. 3) Results: The results show that many households had not realized the potential benefits of biogas use and adoption in Rwanda. The study further found that a number of factors such as household income levels, socio-economic, technological, and institutional influence the household use and adoption of biogas energy. 4) Conclusions: At the end, the study suggests the need for all players such as Government, Non-Governmental Organizations (NGO's) and local communities to work together to provide incentives and favorable environment that can attract individual households to invest in biogas energy production and utilization.

Widespread poverty is the most serious threat and social problem that Bangladesh faces. Regional vulnerability to climate change threatens to escalate the magnitude of this poverty. It is essential that projections of poverty be made while bearing in mind the effects of climate change. The main purpose of this paper is to investigate the agrarian sub-national regional analysis of climate change vulnerability in Bangladesh under various climate change scenarios and its potential impact on poverty. This study is relevant to socio-economic research on climate change vulnerability and agriculture risk management and has the potential to contribute new insights to the complex interactions in household income and climate change risks to agricultural communities in Bangladesh and South Asia. The current study uses analysis of variance, cluster analysis, decomposition of variance and log-normal distribution to estimate the parameters of income variability that ascertain vulnerability levels and help us to understand the poverty levels that climate change could potentially incur. It is found that the income share in income sources revealed that income category shares across the various regions of Bangladesh are far from uniform. The variance decomposition of income showed that agricultural income in Mymensingh and Rangpur is the main cause of income difference. Moreover, large variance of agricultural income in the regions is induced by gross income from rice production. Additionally, constant reduction of rice yield due to climate change in Bangladesh is not such a severe problem for farmers, however, the extreme events like flood, flash flood, drought, sea level rise, and greenhouse gas emission based on RCPs could increase the poverty rates in Mymensingh, Rajshahi, Barisal, and Khulna regions that would be highly affected by unexpected yield loss due to extreme climatic events. Therefore, research and development of adaptation measures to climate change for regions where farmers are largely dependent on agricultural income is important.

The German government's ambitious goal of achieving CO2-neutrality by 2045 has prompted a focus on improving building insulation as a vital step toward energy efficiency. However, in this process, existing radiators and boilers are often left unchanged, leading to inefficiencies due to oversized heating systems. This paper presents various approaches to reduce the required radiator inlet temperature, drawing on data from 100 multifamily buildings. The approaches include heat reserve reduction, heat power shifting, uniform radiator usage, and heat requirement analysis. These approaches collectively aim to lower flow temperatures and decrease peak heat loads, reducing energy consumption, and minimizing waste in compliance with the user comfort temperature. The findings reveal that the application of these methods can lead to substantial temperature reductions, with an average decrease of 20.82 K and 7.28 K for the highest necessary flow temperature in the provided example. Furthermore, peak load reductions of 21.07% and 13.65% were achieved, demonstrating the potential to enhance energy efficiency. While each approach can be applied individually, their synergistic implementation can highly increase the efficiency of water to x heat pumps, due to the lower required flow temperatures.

Office workers often experience occupational musculoskeletal disorders. The aim of the current systematic review was to investigate the effectiveness of workplace exercise intervention on the oldest age group of office workers who have been reported in the literature so far, in terms of workability and well-being. Randomized Controlled Trials were used and the methodological guidelines of PRISMA were followed. The keywords used were: office workers, older, exercise intervention, workplace, microbreaks, workability and well-being. The databases searched were: PubMed, PEDro, ResearchGate, CINAHL, PsychINFO and Science Direct. PROSPERO ID: CRD42022329656. Five studies (total number of participants: 1190, mean age: 46,4) met the inclu-sion criteria. Their quality was deemed to be moderate to high, according to PEDro and MPSER scales. Workplace interventions of gradually increased strengthening and moderate stretching exercises, isometric positioning and postural reminders, either with or without supervision, result in decreasing musculoskeletal pain, disability, sick-leave from work and in the improvement of quality of life and physical activity of the middle-aged office workers, without negative impact on their workability. Despite the worldwide aging workforce, there is a knowledge gap due to research absence in the field of microbreak exercise interventions in the group of older office workers.

The increasing cancer burden is a major health concern in Arab countries with variations in cancer profiles. Given the limited oncology research output and scarce data on cancer trial participation in the Arab region, this study explored the therapeutic cancer trial landscape in Arab countries over the past 20 years. A bibliometric analysis of the PubMed database was conducted on primary publications of therapeutic trials with a participating Arab center. Arab countries participated in 320 published cancer-related therapeutic trials (2000‒2021). There was a consistent increase in the number of trials, sample size, multiregional site participation, and number of randomized trials. However, most trials were small, did not receive external funding, and included a single Arab site. Compared with Arab-only trials, trials with joint non-Arab sites were larger (p = .003) and more likely to be externally funded (p < .001). Citation numbers and journal impact factors were higher in trial publications with joint non-Arab authorship than those without (p < .001, for both). Despite improving conduct and publication records of oncology trials with Arab centers, cancer trial participation remains limited in Arab countries. Concerted efforts are required to encourage sponsorship and international collaboration in this region.

The increasing prevalence of obesity and sedentary lifestyles has led to an increased incidence of metabolic syndrome (MetS) worldwide. In Taiwan, middle-aged women are at a greater risk of MetS, type 2 diabetes, and cardiovascular disease than men are because they have more subcutaneous fat and larger waist circumferences compared to men with equal visceral fat levels. This study investigated the effects of calorie restriction supplemented with fish oil (CRF) in middle-aged women with MetS. For 12 weeks, 75 eligible participants were randomly assigned either calorie restriction (CR) or CRF. Both dietary intervention groups were further divided into two age groups: ≤45 and >45 years. The changes in MetS severity, inflammatory status, iron status, and red blood cell fatty acid profile were evaluated. Seventy-one participants completed the trial. Both dietary interventions significantly ameliorated MetS and improved the participants’ inflammatory status. CR significantly increased total iron binding capacity, whereas CRF increased hepcidin levels. Furthermore, CRF significantly increased the n-6/n-3 and arachidonic acid/docosahexaenoic acid ratios. In conclusion, CR and CRF improved the anthropometric and MetS characteristics of early-middle aged women, including body weight, blood glucose levels, triglyceride levels, as well as the scores for the homeostasis model assessment of insulin resistance and quantitative insulin sensitivity cheque index. Dietary intervention was more effective in >45-year-old women than ≤45-year-old women.

Climate change is increasing air temperatures and altering the precipitation and hydrological re-gime on a global scale. Challenges arise when assessing the impacts of climate change on the local scale for water resources management proposes, especially for low mountain headwater catch-ments that not only serve as important water towers for local communities, but also have distinct hydrological characteristics. Until now, no low flow or hydrological drought studies have been carried out on the Lauter River. This study is unique in that it compares the Lauter River, a transboundary Rhine tributary with a nearby station on the River Rhine just below its confluence at the French-German border. The Lauter catchment is a mostly natural, forested catchment, however, its water course has been influenced by past and present cultural activities. Climate change disturbances cascade through the hydrologic regime right down to the local scale. As we are expecting more low flow events, the decrease in water availability could cause conflicts be-tween different water user groups in the Lauter catchment. However, the choice of different methods for identifying low flow periods may cause confusion for local water resources manag-ers. Using flow rate time series of the Lauter River between 1956 and 2022 we compare for the first time three low flow identification methods: the variable threshold method (VT), the fixed threshold method (FT), and the Standardized Streamflow Index (SSI). Similar analyses are applied and compared to the adjacent Maxau station on the Rhine River for the same time period. This study aims at 1) interpreting the differences amongst the various low flow identification methods and 2) revealing the differences in low flow characteristics of the Lauter catchment compared to the Rhine River. It appears that the FT reacts faster to direct climate or anthropogenic impacts whereas VT is more sensitive to indirect factors such as decreasing subsurface flow which is typical for small headwater catchments, such as the Lauter where flow dynamics react faster to flow disturbances. Abnormally low flow during the early Spring in tributaries such as the Lauter can help predict low flow conditions of the Rhine River during the following half year and espe-cially for the summer. The results could facilitate Early Warning of hydrological droughts and drought management for water users in the Lauter catchment and further downstream along some of the Rhine.

As the PCIe 6.0 specification places higher requirements on signal integrity and transmission la-tency, it becomes especially important to improve signal transmission performance at the physical layer of the transceiver interface. Retimer circuit as a key component of high-speed serial interface, its delay and jitter size directly affect the overall performance of PCIe. For the conventional Retimer circuit with large latency and low jitter performance, this paper proposes a low latency and low jitter Retimer circuit based on CDR+PLL architecture for PCIe 6.0, using a jitter canceling filter circuit to eliminate the frequency difference between the retiming clock and data, reduce the retiming clock jitter, and improve the quality of Retimer output data; The data is sampled using the retiming clock and then output, avoiding the problem of large penetration latency of con-ventional Retimer circuits. The circuit is designed using CMOS 28nm process. Simulation results show that when 112Gbps PAM4 data is input to the Retimer circuit, the Retimer penetration la-tency is 27.3 ps, which is 83.5% lower than the conventional Retimer structure; the output data jitter is 741 fs, a 31.4% reduction compared to the conventional Retimer structure.

We show that an exponential income distribution will emerge spontaneously in a peer-to-peer economic network that shares the publicly available technology. Based on this finding, we identify the exponential income distribution as the benchmark structure of the well-functioning market economy. However, a real market economy may deviate from the well-functioning market economy. We show that the deviation is partly reflected as the invalidity of exponential distribution in describing the super-low income class that involves unemployment. In this regard, we find, theoretically, that the lower-bound u of exponential income distribution has a linear relationship with (per capita) unemployment compensation. In this paper, we test this relationship for the United Kingdom from 2001 to 2015. Our empirical investigation confirms that the income structure of low and middle classes (about 90% of populations) in the United Kingdom exactly obeys exponential distribution, in which the lower-bound u is exactly in line with the evolution of unemployment compensation.

Kei-apple (Dovyalis caffra L) is an indigenous fruit tree of southern Africa. It is currently found in the dry, wooded grassland and forest edges of the arid and semi-arid regions of the world. Existing literature have mainly focused on the medicinal and nutritional as well as phytochemical characterization of Kei-apple. Thus, this review highlights beneficial economic prospects of Dovyalis caffra and its contribution to the economic prosperity. It is a drought tolerant plant with diverse uses such as income from the sale of the fruit, cultivated as a fence or to form an impenetrable hedge while the leaves are used for nutrient leaching prevention, fodder and compost making. The trunk of Dovyalis caffra serves as a good source of hard wood for fuel, house building and furniture making. It is also a good apicultural fruit tree and an excellent habitat and fertilizer derivation agent for farming activities. Considering the multidimensional effect of poverty and the food insecurity on many rural communities globally, there is a need to explore the potentials by encouraging the cultivation of Dovyalis caffra to assist with reducing unemployment, food insecurity and income-poverty problems in the arid and semi-arid areas of the world.

There are many uncertainties and risks in residential electricity consumption during the economic development. Knowledge of the relationship between residential electricity consumption and its key determinant—income—are important to the sustainable development of electric power industry. Using panel data from 30 provinces for the 1995-2012 period, this study investigates how residential electricity consumption changes as incomes increase in China. Previous studies typically used linear or quadratic double-logarithmic models imposing ex ante restrictions on the indistinct relationship between residential electricity consumption and income. Contrary to those models, we employed a reduced piecewise linear model that is self-adaptive and highly flexible and circumvents the problem of “prior restrictions.” Robust tests of different segment specifications and regression methods are performed to ensure the conservatism of the research. The results provide strong evidence that the income elasticity was approximately one, and it remained stable throughout the estimation period. The income threshold at which residential electricity consumption automatically remains stable or slows has not been reached. To ensure the sustainable development of the electric power industry, introducing higher energy efficiency standards for electrical appliances and improving income levels are vital. And government should emphasize electricity conservation in industrial sector rather than in residential sector.

Computation of Common Middle Point seismic sections and their subsequent time migration and diffraction imaging provides very important knowledge about the internal structure of 3D heterogeneous geological media and are key elements for successive geological interpretation. Full-scale numerical simulation, that computes all single shot seismograms, provides a full understanding of how the features of the image reflect the properties of the subsurface prototype. Unfortunately, this kind of simulations of 3D seismic surveys for realistic geological media needs huge computer resources, especially for simulation of seismic waves’ propagation through multiscale media like cavernous fractured reservoirs. In order to significantly reduce the query of computer resources we propose to model these 3D seismic cubes directly rather than the shot-by-shot simulation with subsequent CMP stacking. To do that we modify the well known "exploding reflectors principle" for 3D heterogeneous multiscale media by use of the finite-difference technique on the base of grids locally refined in time and space. To be able to simulate realistic models and acquisition we develop scalable parallel software, which needs reasonable computational costs. Numerical results for simulation of Common Middle Points sections and their time migration are presented and discussed.