Search results for: regional anesthesia

Authors: Xi Zhang, Yong Geng

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It is crucial to decouple economic growth from environmental pollution in China. This study aims to evaluate the decoupling degree between PM₂.₅ emissions and economic growth in China from a regional investment perspective. Using the panel data of 30 Chinese provinces for the period of 1998-2016, this study combines decomposition analysis with decoupling analysis to identify the roles of conventional factors and three novel investment factors in the mitigation and decoupling of PM₂.₅ emissions in China and its four sub-regions. The results show that China’s PM₂.₅ emissions were weakly decoupled to economic growth during the period of 1998-2016, as well as in China’s four sub-regions. At the national level, investment scale played the dominant role while investment structure had a marginal effect. In contrast, emission intensity was the largest driver in promoting the decoupling effect, followed by investment efficiency and energy intensity. The investment scale effect in the western region far exceeded those in other three sub-regions. At the provincial level, the investment structure of Inner Mongolia and investment scales of Xinjiang and Inner Mongolia had the greatest impacts on PM₂.₅ emission growth. Finally, several policy recommendations are raised for China to mitigate its PM₂.₅ emissions.

Keywords: decoupling, economic growth, investment, PM₂.₅ emissions

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Authors: Si Jack Chong, Chew Theng Yap, Wan Loong James Mok

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Introduction: Regional burn centres face the spectra of introduced multi-drug resistant organisms (MDRO) from transfer patients resident in MDRO endemic countries. MDRO can cause severe nosocomial infection, which in massive burn patients, will lead to greater morbidity and mortality and strain the institution financially. We aim to highlight 4 key measures that have effectively prevented transmission of imported MDRO. Methods: A case of Candida auris (C. auris) from a massive burn patient transferred from an MDRO endemic country is used to illustrate the measures. C. auris is a globally emerging multi-drug resistant fungal pathogen causing nosocomial transmission. Results: Infection control measures used to mitigate the risk of outbreak from transfer cases are: (1) Multidisciplinary team approach involving Infection Control and Infectious Disease specialists early to ensure appropriate antibiotics use and implementation of barrier measures, (2) aseptic procedures for dressing change with strict isolation and donning of personal protective equipment in the ward, (3) early screening of massive burn patient from MDRO endemic region, (4) hydrogen peroxide vaporization terminal cleaning for operating theatres and rooms. Conclusion: The prevalence of air travel and international transfer to regional burn centres will need effective infection control measures to reduce the risk of transmission from imported massive burn patients. In our centre, we have effectively implemented 4 measures which have reduced the risks of local contamination. We share a recent case report to illustrate successful management of a potential MDRO outbreak resulting from transfer of massive burn patient resident in an MDRO endemic area.

Keywords: burns, burn unit, cross infection, infection control

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Authors: Chatkaew Tansakul, Saovajit Nanruksa, Surasak Chonchirdsin

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Heavy metals in the environment can be occurred by both natural weathering process and human activity, which may present significant risks to human health and the wider environment. A number of heavy metals, i.e. Arsenic (As) and Manganese (Mn), are found with a relatively high concentration in the northern part of Thailand that was assumptively from natural parent rocks and materials. However, scarce literature is challenging to identify the accurate root cause and best available explanation. This study is, therefore, aim to gather heavy metals data in 5 provinces of the North of Thailand where PTT Exploration and Production (PTTEP) public company limited has operated for more than 20 years. A thousand heavy metal analysis is collected and interpreted in term of Enrichment Factor (EF). The trend and distribution of heavy metals in soil and sediment are analyzed by considering altogether the geochemistry of the regional soil and rock. . In addition, the relationship between land use and heavy metals distribution is investigated. In the first conclusion, heavy metal concentrations of (As) and (Mn) in the studied areas are equal to 7.0 and 588.6 ppm, respectively, which are comparable to those in regional parent materials (1 – 12 and 850 – 1,000 ppm for As and Mn respectively). Moreover, there is an insignificant escalation of the heavy metals in these studied areas over two decades.

Keywords: contaminated soil, enrichment factor, heavy metals, parent materials in North of Thailand

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Authors: Anu S. Krishna

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The paper tries to analyse the UN involvement/intervention in the case of intra-state armed conflict of El Salvador and Nepal comparatively. The peace mission in El Salvador is considered to be the most successful missions of UN ever since it started involving in the peace-building activities. Meanwhile, in the armed conflict of South Asian country, Nepal, the result seemed to be disappointing in comparison with its counterpart. The study on this paper takes three variables as the success or failure of international mediation, i.e., a) signing of the peace agreement, b) disarmament/demobilization and c) constitutional mechanism. A significant amount of scholarship looks at the case of ONUSAL (United Nations Mission in El Salvador). Meanwhile, the armed conflict of Nepal and the role of UNMIN (United Nations Mediation in Nepal) are under researched so far. The paper thus tries to throw light on these cross-regional contexts that share certain similarities and dissimilarities in the nature of conflict. In addition, the international third-party involvement and their way of approaching both the cases differ, which again affected the mediation outcome. The paper tries to argue that, since the approach of the UN led international mediation in theses peace missions were contextual and varied from case to case, thus, finally affected the mediation outcome too.

Keywords: Nepal, UNMIN, El Salvador, ONUSAL, international mediation, armed conflict

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Authors: Md. Shahriar Sabuz

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Bangladesh, a South Asian developing country, has experienced an increasing rate of contraceptive use in the last few decades. But one-third of the pregnancies are still unintended, and the fertility rate surpasses the desired rate of children. It may be because of the discontinuation of the use of contraceptive methods. So, it is necessary to find out the reasons for the discontinuation of the use of contraceptives. Moreover, the rate of contraception discontinuation varies from rural to urban, region to region. In this study, our objectives are to find out the reasons behind the discontinuation of the use of the contraceptive method, and the regional variations of the rate of those reasons. We are using the dataset of Bangladesh Demographic and Health Surveys (BDHS) 2014 for this study and the ever-married women of Bangladesh who have discontinued the use of contraceptive methods aged 15-49. The data was collected from the seven districts of the country. The finding shows that currently there are 23% of women have stopped using their contraception. The most common reasons for stopping using the method are that either they are pregnant or want to be pregnant. A significant number of people are not using the contraceptive method because of the fear of side effects. Though the rate of non-user is higher in rural areas than in urban areas, reasons for method discontinuation are not significantly different between urban and rural areas. However, reasons for discontinuing contraceptive methods significantly vary from region to region.

Keywords: discontinuation of contraceptive, health, pregnant, fertility

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Authors: Dimas Tri Anantyo, Zsa-Zsa Ayu Laksmi, Adhie Nur Radityo, Arsita Eka Rini, Gatot Irawan Sarosa

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A six-point-two-magnitude earthquake rocked Mamuju District, West Sulawesi Province, Indonesia, on 15 January 2021, causing significant health issues for the affected community, particularly among vulnerable populations such as neonates and children. The aim of this study is to examine and describe the diseases diagnosed in the pediatric population in Mamuju 14 days after the earthquake. This study uses a prospective observational study of the pediatric population presenting at West Sulawesi Regional Hospital, Mamuju Regional Public Hospital, and Bhayangkara Hospital for the period of 14 days after the earthquake. Demographic and clinical information were recorded. One hundred and fifty-three children were admitted to the health center. Children younger than six years old were the highest proportion (78%). Out of 153 children, 82 of them were male (54%). The most frequently diagnosed disease during the first and second weeks after the earthquake was respiratory problems, followed by gastrointestinal problems that showed an increase in incidence in the second week. This study found that age has a correlation with frequent disease in children after an earthquake. Respiratory and gastrointestinal problems were found to be the most common diseases among the pediatric population in Mamuju after the earthquake.

Keywords: health outcomes, pediatric population, earthquake, Mamuju

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Authors: P. T. Collett, M. Kershaw

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Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol.

Keywords: anaesthesia, orthopaedics, intensive care, patient centered decision making, treatment escalation

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Authors: E. Machinyise

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The main purpose of this study was to investigate the attitudes of parents and teachers towards multilingual medium of instruction in lower primary schools of Zambia. In 2013, the Government of Zambia formulated a language policy which stipulates that regional familiar languages should be used as the medium of instruction (MOI) from grade one to four in all public primary schools, while English is introduced as a subject in the second grade. This study investigated the views of parents and teachers on the use of multilingual medium of instruction in lower primary schools in order to accommodate learners who are not native speakers of regional familiar languages as well as the second languages which are official languages used in class. The study revealed that most parents suggested that teachers who teach lower primary school classes should be conversant with at least the four major local languages of Zambia (Bemba, Nyanja, Tonga and Lozi). In the same vain other parents felt that teachers teaching lower grades should not only be familiar with the regional official language but should be able to speak other dialects found in the region. Teachers teaching in lower primary grade felt that although it is difficult to speak all languages of learners in class, it is important for a teacher of lower grade class to try to accommodate children who are not speakers of the familiar languages by addressing them in the language they understand. Both teachers and parents highlighted a number of advantages of teaching children in their mother tongues. Both qualitative and quantitative methods were used for the collection of data for this study. 30 teachers from selected public primary schools and 20 parents of Kapiri district and five lecturers of teacher training colleges in Central province were selected for this study. The researcher also observed class lessons in lower primary schools of Kapiri district. This study revealed that both parents and teachers are of the views that teachers teaching lower primary classes should use multilingual medium of instruction in lower primary classes so as to accommodated children of different linguistic backgrounds.

Keywords: familiar languages, medium of instruction, multilingual medium of instruction, native speakers

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Authors: Emmanuel Olamijuwon

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Despite laws against child marriage - a violation against child rights, the practice remains widespread in sub-Saharan Africa and globally partly because of persistent poverty, gender inequality, protection and the need to reinforce family ties. Using pooled data from the recent demographic and health surveys of 20-sub-Saharan African countries with a regional representative sample of 36,943 girls under 18 years, this study explores the prevalence, pattern and infant mortality implications of this marriage type while also examining its regional variations. Indications from the study are that child marriage is still very high in the region with variations above one-tenth in West, Central and Southern Africa regions except in the East African region where only about 7% of children under 18 were already married. Preliminary findings also suggest that about one-in-ten infant deaths were to child brides many of whom were residing in poor households, rural residence, unemployed and have less than secondary education. Based on these findings, it is, therefore, important that government of African countries addresses critical issues through increased policies towards increasing enrollment of girl children in schools as many of these girls are not likely to have any economic benefit to the region if the observed pattern continues.

Keywords: child marriage, infant mortality, Africa, child brides

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Authors: Stephanie Watson, Fabrice Stephenson, Conrad Pilditch, Carolyn Lundquist

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Spatial data detailing both the distribution and density of functionally important marine species are needed to inform management decisions. Species distribution models (SDMs) have proven helpful in this regard; however, models often focus only on species occurrences derived from spatially expansive datasets and lack the resolution and detail required to inform regional management decisions. Boosted regression trees (BRT) were used to produce high-resolution SDMs (250 m) at two spatial scales predicting probability of occurrence, abundance (count per sample unit), density (count per km2) and uncertainty for seven coastal seafloor taxa that vary in habitat usage and distribution to examine prediction differences and implications for coastal management. We investigated if small scale regionally focussed models (82,000 km2) can provide improved predictions compared to data-rich national scale models (4.2 million km2). We explored the variability in predictions across model type (occurrence vs abundance) and model scale to determine if specific taxa models or model types are more robust to geographical variability. National scale occurrence models correlated well with broad-scale environmental predictors, resulting in higher AUC (Area under the receiver operating curve) and deviance explained scores; however, they tended to overpredict in the coastal environment and lacked spatially differentiated detail for some taxa. Regional models had lower overall performance, but for some taxa, spatial predictions were more differentiated at a localised ecological scale. National density models were often spatially refined and highlighted areas of ecological relevance producing more useful outputs than regional-scale models. The utility of a two-scale approach aids the selection of the most optimal combination of models to create a spatially informative density model, as results contrasted for specific taxa between model type and scale. However, it is vital that robust predictions of occurrence and abundance are generated as inputs for the combined density model as areas that do not spatially align between models can be discarded. This study demonstrates the variability in SDM outputs created over different geographical scales and highlights implications and opportunities for managers utilising these tools for regional conservation, particularly in data-limited environments.

Keywords: Benthic ecology, spatial modelling, multi-scalar modelling, marine conservation.

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Authors: Farzad Hosseini Hossein Abadi, Cristina Prieto Sierra, Cesar Álvarez Díaz

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Predicting streamflow accurately in flashy catchments prone to floods is a major research and operational challenge in hydrological modeling. Recent advancements in deep learning, particularly Long Short-Term Memory (LSTM) networks, have shown to be promising in achieving accurate hydrological predictions at daily and hourly time scales. In this work, a multi-timescale LSTM (MTS-LSTM) network was applied to the context of regional hydrological predictions at an hourly time scale in flashy catchments. The case study includes 40 catchments allocated in the Basque Country, north of Spain. We explore the impact of hyperparameters on the performance of streamflow predictions given by regional deep learning models through systematic hyperparameter tuning - where optimal regional values for different catchments are identified. The results show that predictions are highly accurate, with Nash-Sutcliffe (NSE) and Kling-Gupta (KGE) metrics values as high as 0.98 and 0.97, respectively. A principal component analysis reveals that a hyperparameter related to the length of the input sequence contributes most significantly to the prediction performance. The findings suggest that input sequence lengths have a crucial impact on the model prediction performance. Moreover, employing catchment-scale analysis reveals distinct sequence lengths for individual basins, highlighting the necessity of customizing this hyperparameter based on each catchment’s characteristics. This aligns with well known “uniqueness of the place” paradigm. In prior research, tuning the length of the input sequence of LSTMs has received limited focus in the field of streamflow prediction. Initially it was set to 365 days to capture a full annual water cycle. Later, performing limited systematic hyper-tuning using grid search, revealed a modification to 270 days. However, despite the significance of this hyperparameter in hydrological predictions, usually studies have overlooked its tuning and fixed it to 365 days. This study, employing a simultaneous systematic hyperparameter tuning approach, emphasizes the critical role of input sequence length as an influential hyperparameter in configuring LSTMs for regional streamflow prediction. Proper tuning of this hyperparameter is essential for achieving accurate hourly predictions using deep learning models.

Keywords: LSTMs, streamflow, hyperparameters, hydrology

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Authors: Marisol Warthon-Medina, Jenny Plumb, Ayoub Aljawaldeh, Mark Roe, Ailsa Welch, Maria Glibetic, Paul M. Finglas

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Similar to Western Countries, the Eastern Mediterranean Region (EMR) also presents major public health issues associated with the increased consumption of sugar, fat, and salt. Therefore, one of the policies of the World Health Organization’s (WHO) EMR is to reduce the intake of salt, sugar, and fat (Saturated fatty acids, trans fatty acids) to address the risk of non-communicable diseases (i.e. diabetes, cardiovascular disease, cancer) and obesity. The project objective is to assess status and provide training and capacity development in the use of improved standardized methodologies for updated food composition data, dietary intake methods, use of suitable biomarkers of nutritional value and determine health outcomes in low and middle-income countries (LMIC). Training exchanges have been developed with clusters of countries created resulting from regional needs including Sudan, Egypt and Jordan; Tunisia, Morocco, and Mauritania; and other Middle Eastern countries. This capacity building will lead to the development and sustainability of up-to-date national and regional food composition databases in LMIC for use in dietary monitoring assessment in food and nutrient intakes. Workshops were organized to provide training and capacity development in the use of improved standardized methodologies for food composition and food intake. Training needs identified and short-term scientific missions organized for LMIC researchers including (1) training and knowledge exchange workshops, (2) short-term exchange of researchers, (3) development and application of protocols and (4) development of strategies to reduce sugar and fat intake. An initial training workshop, Morocco 2018 was attended by 25 participants from 10 EMR countries to review status and support development of regional food composition. 4 training exchanges are in progress. The use of improved standardized methodologies for food composition and dietary intake will produce robust measurements that will reinforce dietary monitoring and policy in LMIC. The capacity building from this project will lead to the development and sustainability of up-to-date national and regional food composition databases in EMR countries. Supported by the UK Medical Research Council, Global Challenges Research Fund, (MR/R019576/1), and the World Health Organization’s Eastern Mediterranean Region.

Keywords: dietary intake, food composition, low and middle-income countries, status.

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Authors: Kenneth Christie

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Syria and Iraq are Arabian nightmares at the local, the regional and global levels in terms of human security and the protection of the vulnerable. Wracked by civil war, ethnic and political violence in the last 5 years in the case of Syria and 13 years in the case of Iraq, the body count now is staggering; the humanitarian crisis continues and there appears no end to this. A crisis that has claimed the lives of 200,000 people so far in Syria, sparked a humanitarian catastrophe fuelled violent Islamic extremism and exposed serious splits in the international community who appear to have no consensus. The international community’s failure to act is simply another sign of the desperate situation which has developed over conflicts that appears unsolvable in the immediate future and may be intractable in the long range. Three things are really at stake I’m going to argue in these continuing crises and how it will affect the human security dimensions of the conflict. Firstly, the protection of vulnerable individuals and civilians in the war, 2ndly, the dire consequences for regional instability as a result and thirdly the risks for minority and ethnic identities who are caught up in this, within and across these volatile borders. This paper will examine these elements and the consequences of the conflict in terms of human security, migration and development.

Keywords: human security, migration, Syria and Iraq, conflict and development

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Authors: T. Garlan, I. Gabelotaud, S. Lucas, E. Marchès

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Production of a global sedimentological seabed map has been initiated in 1995 to provide the necessary tool for searches of aircraft and boats lost at sea, to give sedimentary information for nautical charts, and to provide input data for acoustic propagation modelling. This original approach had already been initiated one century ago when the French hydrographic service and the University of Nancy had produced maps of the distribution of marine sediments of the French coasts and then sediment maps of the continental shelves of Europe and North America. The current map of the sediment of oceans presented was initiated with a UNESCO's general map of the deep ocean floor. This map was adapted using a unique sediment classification to present all types of sediments: from beaches to the deep seabed and from glacial deposits to tropical sediments. In order to allow good visualization and to be adapted to the different applications, only the granularity of sediments is represented. The published seabed maps are studied, if they present an interest, the nature of the seabed is extracted from them, the sediment classification is transcribed and the resulted map is integrated in the world map. Data come also from interpretations of Multibeam Echo Sounder (MES) imagery of large hydrographic surveys of deep-ocean. These allow a very high-quality mapping of areas that until then were represented as homogeneous. The third and principal source of data comes from the integration of regional maps produced specifically for this project. These regional maps are carried out using all the bathymetric and sedimentary data of a region. This step makes it possible to produce a regional synthesis map, with the realization of generalizations in the case of over-precise data. 86 regional maps of the Atlantic Ocean, the Mediterranean Sea, and the Indian Ocean have been produced and integrated into the world sedimentary map. This work is permanent and permits a digital version every two years, with the integration of some new maps. This article describes the choices made in terms of sediment classification, the scale of source data and the zonation of the variability of the quality. This map is the final step in a system comprising the Shom Sedimentary Database, enriched by more than one million punctual and surface items of data, and four series of coastal seabed maps at 1:10,000, 1:50,000, 1:200,000 and 1:1,000,000. This step by step approach makes it possible to take into account the progresses in knowledge made in the field of seabed characterization during the last decades. Thus, the arrival of new classification systems for seafloor has improved the recent seabed maps, and the compilation of these new maps with those previously published allows a gradual enrichment of the world sedimentary map. But there is still a lot of work to enhance some regions, which are still based on data acquired more than half a century ago.

Keywords: marine sedimentology, seabed map, sediment classification, world ocean

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Authors: Jonathan Palatz Cedeño

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The paper will seek to examine the scope and limitations of the process of construction of ordinary and extraordinary migration regulatory tools of the countries of Latin America, due to the Venezuelan diaspora in Ibero-America (2015-2018). The analysis methodology will be based on a systematic presentation of the existing advances in the subject under a qualitative approach, in which the results are detailed. We hold that an important part of the Latin American countries that used to be the emitters of migrants have had to generate, with greater or lesser success both nationally and regionally, ordinary and extraordinary migration regulatory tools to respond to the rapid intensification of the current Venezuelan migratory flows. This fact beyond implementing policies for the reception and integration of this population marks a new moment that represents a huge challenge both for the receiving States and for the young Ibero-American institutional migration system. Therefore, we can say that measures to adopt reception and solidarity policies, despite being supported by organs of the multilateral system such as UNHCR and IOM, are not found as guidelines for national and regional action, at the expense of the reactions of the respective public opinions and the influence of what to do of the neighboring countries in the face of the problem.

Keywords: Venezuela, migration, migration policies and governance, Venezuelan diaspora

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Authors: A. Zeynolabedin, M. A. Olyaei, B. Ghiasi

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Drought is an inevitable part of the earth’s climate. It occurs regularly with no clear warning and without recognizing borders. In addition, its impact is cumulative and not immediately discernible. Iran is located in a semi-arid region where droughts occur periodically as natural hazard. Standardized Precipitation Index (SPI), Surface Water Supply Index (SWSI), and Palmer Drought Severity Index (PDSI) are three well-known indices which describe drought severity; each has its own advantages and disadvantages and can be used for specific types of drought. These indices take into account some factors such as precipitation, reservoir storage and discharge, temperature, and potential evapotranspiration in determining drought severity. In this paper, first all three indices are calculated in Aharchay river watershed located in northwestern part of Iran in East Azarbaijan province. Next, based on two other important parameters which are groundwater level and solar radiation, two new indices are defined. Finally, considering all five aforementioned indices, a combined drought index (CDI) is presented and calculated for the region. This combined index is based on all the meteorological, hydrological, and agricultural features of the region. The results show that the most severe drought condition in Aharchay watershed happened in Jun, 2004. The result of this study can be used for monitoring drought and prepare for the drought mitigation planning.

Keywords: drought, GIS, intensity index, regional assessment, variation maps

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Authors: Dona Primasari

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This study examines the antecedent variables of Government Financial Acccounting System (SAKD) implementation and its consequence. The antecedent variables are: decentralization of decision making, adaptation, and the manager support. The consequences are satisfaction and performance officer. This research represents the empirical test which used convenience sampling technics in data collection. The data were collected from 167 officers of local government in the Regional Coordinating Agency for Development of Cross County/City Region III Central Java Province. Data analysis used Structural Equation Model (SEM) with the AMOS 18.0 program. The result of hypothesis examination indicates that six raised hypothesis are accepted and two hypothesis are rejected.

Keywords: decentralization of decision making, adaptation officer, manager support, implementation of Government Accounting Financial System (SAKD), satisfaction and performance officer

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Authors: Cristina Chaminade, Mandar Kulkarni, Balaji Parthasarathy, Monica Plechero

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The characteristics of a regional innovation system (RIS) and the specificity of the knowledge base of an industry may contribute to create peculiar paths for innovation and development of firms’ geographic extended innovation networks. However, the relative empirical evidence in emerging economies remains underexplored. The paper aims to fill the research gap by means of some recent qualitative research conducted in 2016 in Beijing (China) and Bangalore (India). It analyzes cases studies of firms in the new media industry, a sector that merges different IT competences with competences from other knowledge domains and that is emerging in those RIS. The results show that while in Beijing the new media sector results to be more in line with the existing institutional setting and governmental goals aimed at targeting specific social aspects and social problems of the population, in Bangalore it remains a more spontaneous firms-led process. In Beijing what matters for the development of innovation networks is the governmental setting and the national and regional strategies to promote science and technology in this sector, internet and mass innovation. The peculiarities of recent governmental policies aligned to the domestic goals may provide good possibilities for start-ups to develop innovation networks. However, due to the specificities of those policies targeting the Chinese market, networking outside the domestic market are not so promoted. Moreover, while some institutional peculiarities, such as a culture of collaboration in the region, may be favorable for local networking, regulations related to Internet censorship may limit the use of global networks particularly when based on virtual spaces. Mainly firms with already some foreign experiences and contact take advantage of global networks. In Bangalore, the role of government in pushing networking for the new media industry at the present stage is quite absent at all geographical levels. Indeed there is no particular strategic planning or prioritizing in the region toward the new media industry, albeit one industrial organization has emerged to represent the animation industry interests. This results in a lack of initiatives for sustaining the integration of complementary knowledge into the local portfolio of IT specialization. Firms actually involved in the new media industry face institutional constrains related to a poor level of local trust and cooperation, something that does not allow for full exploitation of local linkages. Moreover, knowledge-provider organizations in Bangalore remain still a solid base for the IT domain, but not for other domains. Initiatives to link to international networks seem therefore more the result of individual entrepreneurial actions aimed at acquiring complementary knowledge and competencies from different domains and exploiting potentiality in different markets. From those cases, it emerges that role of government, soft institutions and organizations in the two RIS differ substantially in the creation of barriers and opportunities for the development of innovation networks and their specific aim.

Keywords: regional innovation system, emerging economies, innovation network, institutions, organizations, Bangalore, Beijing

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Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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Authors: Ting-Yu Hsu, Shyu-Yu Wu, Shieh-Kung Huang, Hung-Wei Chiang, Kung-Chun Lu, Pei-Yang Lin, Kuo-Liang Wen

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Regional earthquake early warning (EEW) systems are not suitable for Taiwan, as most destructive seismic hazards arise due to in-land earthquakes. These likely cause the lead-time provided by regional EEW systems before a destructive earthquake wave arrives to become null. On the other hand, an on-site EEW system can provide more lead-time at a region closer to an epicenter, since only seismic information of the target site is required. Instead of leveraging the information of several stations, the on-site system extracts some P-wave features from the first few seconds of vertical ground acceleration of a single station and performs a prediction of the oncoming earthquake intensity at the same station according to these features. Since seismometers could be triggered by non-earthquake events such as a passing of a truck or other human activities, to reduce the likelihood of false alarms, a seismometer was installed at three different locations on the same site and the performance of the EEW system for these three sensor locations were discussed. The results show that the location on the ground of the first floor of a school building maybe a good choice, since the false alarms could be reduced and the cost for installation and maintenance is the lowest.

Keywords: earthquake early warning, on-site, seismometer location, support vector machine

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Authors: Adegboyega Adeolapo Ola, Gerelene Jagganath

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One of the greatest challenges of human right in the world, especially African states is the use of child soldiers in armed conflict, constituting a major source of destruction of lives and properties. Mostly, they are in developing countries with the situation in Sub-Saharan Africa, the abduction and employment of children as soldiers is a form of exploitative labour that is tantamount to slavery. Since the end of cold war, Child soldier has increased in Africa countries like Angola, Liberia, Sierra Leone and Uganda. This study examines the main cause of the recruitment and use of child soldiers and its challenges to human right. It further assesses the role of international regional bodies and various governments in curbing child soldiers with a view to proffer suggestions on how to address some of the resultant threat of human right. The study posits that the control of small arms and light weapons is essential in curtailing the spread of child soldier and abuse of human right. This hopefully should result in the sustainability of human/child right in African continent. It is a recommendation of this study that, in order to sustain human right in the region, all Africa leaders, government and regional bodies; such as African Union, Economic Community of West African States, South African Development Community among others, should cooperate and work together to address the issue of illicit small arms, which could eventually lead to child soldier.

Keywords: arms control, child soldier, human right, small arms

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Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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Authors: Vladimir Korovkin, Albert Park, Evgeny Kaganer

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The paper studies the second-level digital divide (the one defined by the way how digital technology is used in everyday life) between regions of the Russian Federation. The paper offers a systemic review of literature on the measurement of the digital divide; based upon this it suggests a composite Digital Life Index, that captures the complex multi-dimensional character of the phenomenon. The model of the index studies separately the digital supply and demand across seven independent dimensions providing for 14 subindices. The Index is based on Internet-borne data, a distinction from traditional research approaches that rely on official statistics or surveys. Regression analysis is used to determine the relative importance of factors like income, human capital, and policy in determining the digital divide. The result of the analysis suggests that the digital divide is driven more by the differences in demand (defined by consumer competencies) than in supply; the role of income is insignificant, and the quality of human capital is the key determinant of the divide. The paper advances the existing methodological literature on the issue and can also inform practical decision-making regarding the strategies of national and regional digital development.

Keywords: digital transformation, second-level digital divide, composite index, digital policy, regional development, Russia

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Authors: Jacob Dangerfield, Jacob Pollard, Jennifer DeCou

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Introduction: Burnout, anxiety, and depression are three conditions that are prevalent in medical providers. This is especially the case in the field of anesthesia, which has a high number of providers suffering from burnout and burnout syndrome. A major contributor to this issue is isolation in the workplace, with a perceived lack of peer support as a major risk factor for burnout. Two organizational interventions that can be done to help improve this issue are small group sessions and providing affordable mental health services. Per American College of Graduate Medical Education (ACGME) Guidelines, these affordable mental health services are a requirement of all residency programs, but for a variety of reasons, many residents do not access them. As physicians, we are often not good at asking for help. With this in mind, we hypothesized that carrying out small group resiliency sessions facilitated by Graduate Medical Education (GME) Wellness Counselors would improve both resident peer support as well as the likelihood that a resident will reach out to GME Wellness in a time of need. Methods: We held small group resiliency sessions with the GME Wellness Mental Health Professionals during protected didactic time. These sessions were small groups, including the members of one’s class (i.e., first-year residents on their own), and were facilitated by 1-2 mental health professionals. After these sessions, we surveyed residents who attended using a short Google Forms survey and using a 5-point Likert Scale, asked residents about some outcomes from the session. A “strongly agree” or “agree” was considered a positive response. Results: Results from our survey showed that the resident sessions had multiple positive outcomes. This survey was sent to 29 residents, and we had a 62% response rate. We found out through this survey that these small group sessions had a perceived positive impact on resident personal well-being, increased perceived peer support from classmates, and made residents more likely to reach out to GME Wellness in the future. Perceived positive impact on well-being was found in 83% of resident respondents, improved perceived peer support in 83% of respondents, and 78% of resident respondents stated that this session increased their likelihood of reaching out to mental health professionals. Conclusions: Through this study, we can conclude that our hypothesis was correct in that Small Group Resiliency Sessions that are facilitated by GME Wellness Counselors improve both resident peer support as well as the likelihood a resident reaches out to these mental health professionals in time of need. We believe these findings are very important as they address two important factors that can aid in decreasing a provider’s risk of experiencing burnout. Through this simple means, we believe other residency programs can help the well-being of their residents, and together, we can decrease the number of cases of burnout in anesthesia.

Keywords: anesthesiology, burnout, wellness, depression, residents, trainees, mental health

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Authors: Lakmali Anthony, Madeline Gillies

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Background: Colorectal cancer (CRC) is usually managed with surgical resection. Many of the outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO), such as Health-Related Quality of life (HRQoL), provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. HRQoL has previously been shown to be impacted by psychosocial, behavioral and disease-specific characteristics. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods: Consecutive patients who had resection of colorectal cancer in a single regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey instrument designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Demographic and disease-specific data were also collected via medical record review. Results: Forty-six patients completed the survey. Clinically significant levels of fear of recurrence as well as emotional distress, were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for CRC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL; however, the operative approach (laparoscopic vs. open) was associated with HRQoL for these patients. All psychosocial factors measured were associated with HRQoL, including cancer worry, emotional distress, body image and dispositional optimism. Conclusion: HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative colorectal cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: surgery, colorectal, cancer, PRO, HRQoL

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Authors: Renzo Munoz-Najar, Cristina Wong, Daniel De La Torre Ugarte

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The literature on price transmission usually deals with asymmetries related to different commodities and/or the short and long term. The role of domestic regional differences and the relationship with asymmetries within a country are usually left out. This paper looks at the asymmetry in the transmission of rice prices from the international price to the farm gate prices in four northern regions of Peru for the last period 2001-2016. These regions are San Martín, Piura, Lambayeque and La Libertad. The relevance of the study lies in its ability to assess the need for policies aimed at improving the competitiveness of the market and ensuring the benefit of producers. There are differences in planting and harvesting dates, as well as in geographic location that justify the hypothesis of the existence of differences in the price transition asymmetries between these regions. Those differences are due to at least three factors geography, infrastructure development, and distribution systems. For this, the Threshold Vector Error Correction Model and the Autoregressive Vector Model with Threshold are used. Both models, collect asymmetric effects in the price adjustments. In this way, it is sought to verify that farm prices react more to falls than increases in international prices due to the high bargaining power of intermediaries. The results of the investigation suggest that the transmission of prices is significant only for Lambayeque and La Libertad. Likewise, the asymmetry in the transmission of prices for these regions is checked. However, these results are not met for San Martin and Piura, the main rice producers nationwide. A significant price transmission is verified only in the Lambayeque and La Libertad regions. San Martin and Piura, in spite of being the main rice producing regions of Peru, do not present a significant transmission of international prices; a high degree of self-sufficient supply might be at the center of the logic for this result. An additional finding is the short-term adjustment with respect to international prices, it is higher in La Libertad compared to Lambayeque, which could be explained by the greater bargaining power of intermediaries in the last-mentioned region due to the greater technological development in the mills.

Keywords: asymmetric price transmission, rice prices, price transmission, regional economics

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Authors: Muhammad Yaqub Olatunde

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Arabic linguistic science is redirecting its focus towards the analysis and description of social, regional, and temporal varieties of social, regional, and temporal varieties in order to show how they vary in pronunciation, vocabulary, and grammar. This is not to say that the traditional Arabic linguists did not mention scores of dialectical variations but such works focused on the geographical boundaries of the Arabic speaking countries. There is need for a comprehensive survey of various Arabic dialects within the boundary of Arabic speaking countries and outside showing both the similarities and differences of linguistic and extra linguistic elements. This study therefore examines the syllable structure and process in noun and verb in the shuwa Arabic dialect speaking in North East Nigeria [mainly in Borno state]. The work seeks to establish the facts about this phenomenon, using auto- segmental analysis. These facts are compared, where necessary; using possible alternative analysis, with what operate in other related dialects within and outside Arabic speaking countries. The interaction between epenthesis and germination in the language also generate an interesting issue. The paper then conclude that syllable structure and process in the language need to recognize the existence of complex onset and a complex rhyme producing a consonant cluster in the former and a closed syllable in the letter. This emerges as result of resyllabification, which is motivated by these processes.

Keywords: Arabic, dialect, linguistics, processes, resyllabification

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Authors: Akinnubi Rufus Temidayo

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Coastal West Africa is highly sensitive to climate variability, driven by complex ocean-atmosphere interactions that shape temperature, precipitation, and extreme weather. Radiative feedback mechanisms—such as water vapor feedback, cloud-radiation interactions, and surface albedo—play a critical role in modulating these patterns. Yet, limited research addresses these feedbacks in climate models specific to West Africa’s coastal zones, creating challenges for accurate climate projections and adaptive planning. This study aims to evaluate the influence of radiative feedbacks on the coastal climate of West Africa by quantifying the effects of water vapor, cloud cover, and sea surface temperature (SST) on the region’s radiative balance. The study uses a regional climate model (RCM) to simulate feedbacks over a 20-year period (2005-2025) with high-resolution data from CORDEX and satellite observations. Key mechanisms investigated include (1) Water Vapor Feedback—the amplifying effect of humidity on warming, (2) Cloud-Radiation Interactions—the impact of cloud cover on radiation balance, especially during the West African Monsoon, and (3) Surface Albedo and Land-Use Changes—effects of urbanization and vegetation on the radiation budget. Preliminary results indicate that radiative feedbacks strongly influence seasonal climate variability in coastal West Africa. Water vapor feedback amplifies dry-season warming, cloud-radiation interactions moderate surface temperatures during monsoon seasons, and SST variations in the Atlantic affect the frequency and intensity of extreme rainfall events. The findings suggest that incorporating these feedbacks into climate planning can strengthen resilience to climate impacts in West African coastal communities. Further research should refine regional models to capture anthropogenic influences like greenhouse gas emissions, guiding sustainable urban and resource planning to mitigate climate risks.

Keywords: west africa, radiative, climate, resilence, anthropogenic

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Authors: Wasse Uddin Ahmed Saleh, Nawreenbinte Anwar

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A well-written operating note is crucial as a teaching tool for providing patients with high-quality medical care and fending off medico-legal claims. In this review article, some adjustments have been advised to the operative note guidelines by the Royal College of Surgeons (RCS) for different methods of ocular anesthesia and ophthalmic procedures like cataract surgeries, kerato-refractive surgeries, glaucoma surgeries, oculoplastic surgeries, etc. Some modifications of the WHO Surgical Safety Checklist have also been mentioned, including pre-operative responsibilities of the nurses, operative assistants and operating ophthalmologists. It has become essential to assemble globally accepted structured operative note guidelines modified for each ocular surgery.

Keywords: ocular surgeries, operation notes, cataract surgery, kerato-refractive surgery, Oculoplastic surgeries, guidelines

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Authors: J. Jarolímek, P. Urban, P. Pavlínek, D. Dzúrová

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The industry constitutes a dominant economic sector in Czechia. The automotive industry represents the most important industrial sector in terms of gross value added and the number of employees. The objective of this study was to analyse the occurrence of occupational diseases (OD) in the automotive industry in Czechia during the 2001-2014 period. Whereas the occurrence of OD in other sectors has generally been decreasing, it has been increasing in the automotive industry, including growing spatial discrepancies. Data on OD cases were retrieved from the National Registry of Occupational Diseases. Further, we conducted a survey in automotive companies with a focus on occupational health services and positions of the companies in global production networks (GPNs). An analysis of OD distribution in the automotive industry was performed (age, gender, company size and its role in GPNs, regional distribution of studied companies, and regional unemployment rate), and was accompanied by an assessment of the quality and range of occupational health services. The employees older than 40 years had nearly 2.5 times higher probability of OD occurrence compared with employees younger than 40 years (OR 2.41; 95% CI: 2.05-2.85). The OD occurrence probability was 3 times higher for women than for men (OR 3.01; 95 % CI: 2.55-3.55). The OD incidence rate was increasing with the size of the company. An association between the OD incidence and the unemployment rate was not confirmed.

Keywords: occupational diseases, automotive industry, health geography, unemployment

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