Search results for: neurocognitive decline

Authors: Mingke Ma

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The recent discovery of the High-Income Trap phenomena and the established Middle-Income Trap literature have identified the similarity of the structural challenges that both Mainland China and Taiwan have been facing since the simultaneous growth slowdown from the 2000s. Mainland China and Taiwan’s ineffectiveness in productivity growth weakened their overall competitiveness in Global Value Chains. With the subsequent decline of industrial profitability, social compression from late development persists and jeopardises the social cohesion. From Ma Ying-jeou’s ‘633’ promise and Tsai Ing-wen’s ‘5+2’ industrial framework to Mainland China’s 11th to 14th Five-Year Plans, leaderships across the Strait have been striving to constitute new models for inclusive and sustainable development through policy responses. This study argues that social consensuses that have been constructed by the domestic political processes define the feasibility of the reform strategies, which further construct the conditions for Cross-Strait interactions. Based on the existing literature of New Institutional Economics, Middle/High Income Trap, and Compressed Development, this study adopts a Historical Institutionalist analytical framework to identify how the historical path-dependency contributes to the contemporary growth constraints in both economies and the political difficulty on navigating the institutional and Organisational change. It continues by tracing the political process of economic reform to examine the sustainability and resilience of the manifested social consensus that had empowered the proposed policy frameworks. Afterwards, it examines how the political outcomes in such a simultaneous process shared by both Mainland China and Taiwan construct the social, economic, institutional, and political foundations of contemporary Cross-Strait engagement.

Keywords: historical institutionalism, political economy, cross-strait relations, high/middle income trap

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Authors: Pebri Nurhayati, Rozanah Ahlam Fadiyah

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In the development of the city often use rural areas that can not be separated from the change in land use that lead to the degradation of urban green space in the city fringe. In the long run, the degradation of green open space this can impact on the decline of ecological, psychological and public health. Therefore, this research aims to (1) determine the relationship between the parameters of the degradation rate of urban development with green space, (2) develop a spatial model of the impact of urban development on the degradation of green open space with remote sensing techniques and Geographical Information Systems in an integrated manner. This research is a descriptive research with data collection techniques of observation and secondary data . In the data analysis, to interpret the direction of urban development and degradation of green open space is required in 2005-2010 ASTER image with NDVI. Of interpretation will generate two maps, namely maps and map development built land degradation green open space. Secondary data related to the rate of population growth, the level of accessibility, and the main activities of each city map is processed into a population growth rate, the level of accessibility maps, and map the main activities of the town. Each map is used as a parameter to map the degradation of green space and analyzed by non-parametric statistical analysis using Crosstab thus obtained value of C (coefficient contingency). C values were then compared with the Cmaximum to determine the relationship. From this research will be obtained in the form of modeling spatial map of the City Development Impact Degradation Green Space in Urban Fringe eastern city of Yogyakarta 2005-2010. In addition, this research also generate statistical analysis of the test results of each parameter to the degradation of green open space in the Urban Fringe eastern city of Yogyakarta 2005-2010.

Keywords: spatial analysis, urban development, degradation of green space, urban fringe

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Authors: Raheleh Farzanmanesh, Christopher J. Weston

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Mangroves are forest ecosystems located in the inter-tidal regions of tropical and subtropical coastlines that provide many valuable economic and ecological benefits for millions of people, such as preventing coastal erosion, providing breeding, and feeding grounds, improving water quality, and supporting the well-being of local communities. In addition, mangroves capture and store high amounts of carbon in biomass and soils that play an important role in combating climate change. The decline in mangrove area has prompted government and private sector interest in mangrove conservation and restoration projects to achieve multiple Sustainable Development Goals, from reducing poverty to improving life on land. Mangrove aboveground biomass plays an essential role in the global carbon cycle, climate change mitigation and adaptation by reducing CO2 emissions. However, little information is available about the effectiveness of mangrove sustainable management on mangrove change area and aboveground biomass (AGB). Here, we proposed a method for mapping, modeling, and assessing mangrove area and AGB in two Global Environment Facility (GEF) blue forests projects based on Sentinel-2 Level 1C imagery during their conservation lifetime. The SVR regression model was used to estimate AGB in Tahiry Honko project in Madagascar and the Abu Dhabi Blue Carbon Demonstration Project (Abu Dhabi Emirates. The results showed that mangrove forests and AGB declined in the Tahiry Honko project, while in the Abu Dhabi project increased after the conservation initiative was established. The results provide important information on the impact of mangrove conservation activities and contribute to the development of remote sensing applications for mapping and assessing mangrove forests in blue carbon initiatives.

Keywords: blue carbon, mangrove forest, REDD+, aboveground biomass, Sentinel-2

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Authors: Bisi Olawoyin

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The idea of knowledge sharing facilitated by the internet and complemented by a collaborative offline process in form of shared workshops called Makerspaces has become an attractive economic development agenda worldwide. Towards this end, Nigeria has established a number of Technology Incubation Centers (TICs) across the country with a view to using them as institutional mechanisms for commercializing Research and Development results; thus helping to promote venture creation and economic development. This study thus examines the impact of the nurturing by the TICs, on the performance of selected incubated enterprises that have grown into medium scale businesses in different sectors of the economy. The objective is to determine the extent to which the process of incubation has contributed to their growth in relation to similar businesses that developed outside the TICs. Six enterprises nurtured by TICs and six others outside, these were selected for the study. Data were collected in respect of the twelve enterprises covering their first five years of operation. Performances in terms of annual turnover, market share, and product range were analysed by scatter diagram plotted to show these variables against time and on comparative basis between TIC and non-TIC enterprises. Results showed an initial decline in performance for most of the incubatees in the first two years due to sluggish adjustment to withdrawal of subsidies enjoyed at the TICs. However, four of them were able to catch up with improved performance and surpass their non–TIC counterparts consistently from the third year. Analysis of year on year performance also showed average growth rate of 7% and 5 % respectively for TIC and non–TIC enterprises. The study, therefore, concludes that TICs have great role to play in nurturing new, innovative businesses but sees the need for government to address the provision of critical facilities especially electricity and utilities that constitute critical cost components for businesses. It must also address the issue of investment grants, loans including the development of technology/industrial parks that will serve to boost business survival.

Keywords: entrepreneurship, incubation, innovation, makerspaces

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Authors: Danielle C. B. Honorato, Rafael H. Carvalho, Adriana L. Soares, Ana Paula F. R. L. Bracarense, Paulo D. Guarnieri, Massami Shimokomaki, Elza I. Ida

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Over the past decade, the Brazilian production of turkey meat increased by more than 50%, indicating that the turkey meat is considered a great potential for the Brazilian economy contributing to the growth of agribusiness at the marketing international scenario. However, significant color changes may occur during its processing leading to the pale, soft and exudative (PSE) appearance on the surface of breast meat due to the low water holding capacity (WHC). Changes in PSE meat functional properties occur due to the myofibrils proteins denaturation caused by a rapid postmortem glycolysis resulting in a rapid pH decline while the carcass temperature is still warm. The aim of this study was to analyze the physical, chemical and histological characteristics of PSE turkey meat obtained from a Brazilian commercial processing plant. The turkey breasts samples were collected (n=64) at the processing line and classified as PSE at L* ≥ 53 value. The pH was also analyzed after L* measurement. In sequence, PSE meat samples were evaluated for WHC, cooking loss (CL), shear force (SF), myofibril fragmentation index (MFI), protein denaturation (PD) and histological evaluation. The abnormal color samples presented lower pH values, 16% lower fiber diameter, 11% lower SF and 2% lower WHC than those classified as normal. The CL, PD and MFI were, respectively, 9%, 18% and 4% higher in PSE samples. The Pearson correlation between the L* values and CL, PD and MFI was positive, while that SF and pH values presented negative correlation. Under light microscopy, a shrinking of PSE muscle cell diameter was approximately 16% shorter in relation to normal samples and an extracellular enlargement of endomysium and perimysium sheaths as the consequence of higher water contents lost as observed previously by lower WHC values. Thus, the results showed that PSE turkey breast meat presented significant changes in their physical, chemical and histological characteristics that may impair its functional properties.

Keywords: functional properties, histological evaluation, meat quality, PSE

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Authors: Avijit Mahala

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Present study is primarily concerned with the physical processes and status of land degradation in a tropical plateau fringe. Chotanagpur plateau is one of the most water erosion related degraded areas of India. The granite gneiss geological formation, low to medium developed soil cover, undulating lateritic uplands, high drainage density, low to medium rainfall (100-140cm), dry tropical deciduous forest cover makes the Silabati River basin a truly representative of the tropical environment. The different physical factors have been taken for land degradation study includes- physiographic formations, hydrologic characteristics, and vegetation cover. Water erosion, vegetal degradation, soil quality decline are the major processes of land degradation in study area. Granite-gneiss geological formation is responsible for developing undulating landforms. Less developed soil profile, low organic matter, poor structure of soil causes high soil erosion. High relief and sloppy areas cause unstable environment. The dissected highland causes topographic hindrance in productivity. High drainage density and frequency in rugged upland and intense erosion in sloppy areas causes high soil erosion of the basin. Decreasing rainfall and increasing aridity (low P/PET) threats water stress condition. Green biomass cover area is also continuously declining. Through overlaying the different physical factors (geological formation, soil characteristics, geomorphological characteristics, etc.) of considerable importance in GIS environment the varying intensities of land degradation areas has been identified. Middle reaches of Silabati basin with highly eroded laterite soil cover areas are more prone to land degradation.

Keywords: land degradation, tropical environment, lateritic upland, undulating landform, aridity, GIS environment

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Authors: Ayman A. Al Hayek, Asirvatham A. Robert, Mohamed A. Al Dawish, Rim B. Braham, Hanouf S. Goudeh, Fahad S. Al Sabaan

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Introduction: The aim of this study was to explore the impact of insulin pump therapy on diabetes treatment satisfaction and glycemic control among patients with type 1 diabetes mellitus (T1DM) in Saudi Arabia. Methods: A 6-month, prospective study was conducted among 47 patients (aged17–24 years) with T1DM who attended the Insulin Pump Clinic at Prince Sultan Military Medical City, Riyadh, Saudi Arabia, between April 2014 and November 2014. The respondents were purposively and conveniently selected and were interviewed using the Arabic version of the Diabetes Treatment Satisfaction Questionnaire at baseline, 3, and 6 months. Demographics and clinical variables including hemoglobin A1c (HbA1c) were also collected. Results: The mean (±standard deviation) age of the study cohort was 19.1 ± 1.93 years. Seventeen patients were male (36.2%) and 30 were female (63.8%). Compared to baseline, significant positive differences were found in treatment satisfaction among female patients and patients with long-standing T1DM at 6 months. Frequency of hyperglycemia and hypoglycemia declined significantly in female patient’s at 6 months and in patients who had a shorter duration of T1DM. Furthermore, significant positive differences were found in HbA1c levels among female patients and among those who had a shorter duration of T1DM compared to baseline. Both female and male patients and those with a shorter duration of T1DM showed significant decline in insulin necessity at6months when compared to baseline. Conclusion: Although multiple daily injections is a feasible preference for insulin supply, insulin pumps should also be considered for patients with T1DM as it appears to increase patients’ treatment satisfaction, decrease the frequency of hypoglycemia, hyperglycemia, and reduce HbA1c levels.

Keywords: type 1 diabetes, insulin pump, Saudi Arabia, T1DM

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Authors: Ayo Osisanya, Promise Ebuka Okonkwo

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Reduced hearing sensitivity among the elderly has been attributed to some risk factors and influence of age-related degenerative conditions such as diabetes, cardiovascular disease, Alzheimer’s disease, bipolar disorder, and hypertension. Hearing loss; especially the age-related type (presbycusis), has been reported as one of the global burden affecting the general well-being and quality of life of the elderly with hypertension. Thus, hearing loss has been observed to be associated with hypertension and functional decline in elderly, as this condition makes them experience poor communication, fatigue, reduced social functions, mood-swing, and withdrawal syndrome. Emerging research outcomes indicate a strong relationship between hypertension and reduced auditory performance among the elderly. Therefore, this study determined the prevalence, types, and patterns of hearing loss associated with hypertension, with a bid to suggesting comprehensive management strategies and a model of creating awareness towards promoting good healthy living among the elderly in Nigeria. One hundred and seventy-two elderly, aged 65–85 with hypertension were purposively selected from patients undergoing treatment for hypertension in some tertiary hospitals in southwest Nigeria for the study. Participants were suggested to Pure-Tone Audiometry (PTA) through the use of Maico 53 Diagnostic Audiometer to determine the degree, types ad patterns of hearing loss among the elderly with hypertension. Results showed that 148 (86.05%) elderly with hypertension presented with different degrees, types, and patterns of hearing loss. Out of this number, 123 (83.11%) presented with bilateral hearing loss, while 25 (16.89%) had unilateral hearing loss. Degree of hearing loss, 74 moderate hearing loss, 118 moderately severe and 50 severe hearing loss. 36% of the hearing loss appeared as flat audiometric configuration, 24% were slopping, 19% were rising, while 21% were tough-shaped audiometric configurations. The findings showed high prevalence of hearing loss among the elderly with hypertension in Southwest, Nigeria. Based on the findings, management of elderly with hypertension should include regular audiological rehabilitation and total adherence to hearing conservation principles, otological management, regulation of blood pressure and adequate counselling / follow-up services.

Keywords: auditory performance, elderly, hearing loss, hypertension

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Authors: Hande Aladağ, Gökçe Aydın

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The world’s population is increasing continuously and rapidly. Moreover, there are other problems such as the decline of natural energy resources, global warming, and environmental pollution. These facts have made sustainability an important and primary topic from future planning perspective. From this perspective, constituting sustainable cities and communities can be considered as one of the key issues in terms of sustainable development goals. The concept of sustainable cities can be evaluated under three headings such as green/sustainable buildings, self – contained cities and sustainable transportation. This study only concentrates on how to form and support a sustainable urban transportation system to contribute to the sustainable urbanization. Urban transportation system inevitably requires many engineering projects with various sizes. Engineering projects generally have four phases, in the following order: Planning, design, construction, operation. The order is valid but there are feedbacks from every phase to every phase in its upstream. In this regard, engineering projects are iterative processes. Sustainability is an integrated and comprehensive concept thus it should be among the primary concerns in every phase of transportation projects. In the study, a meta-analysis will be performed on the related studies in the literature. It is targeted and planned that, as a result of the findings of this meta-analysis, a framework for the list of principles and actions for sustainable transport will be formed. The meta-analysis will be performed to point out and clarify sustainability approaches in every phase of the related engineering projects, with also paying attention to the iterative nature of the process and relative contribution of the action for the outcomes of the sustainable transportation system. However, the analysis will not be limited to the engineering projects, non-engineering solutions will also be included in the meta-analysis. The most important contribution of this study is a determination of the outcomes of a sustainable urban transportation system in terms of energy efficiency, resource preservation and related social, environmental and economic factors. The study is also important because it will give light to the engineering and management approaches to achieve these outcomes.

Keywords: meta-analysis, sustainability, sustainable cities, sustainable urban transportation, urban transportation

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Authors: Anshar Ajatasatru

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The decline of coal prices over past years have been significantly increasing the awareness of effective mining operation. A viable step must be undertaken in becoming more cost competitive while striving for best mining practice especially at Melak Coal Mine in East Kalimantan, Indonesia. This paper aims to show how effective dozer push measurement method can be implemented as it is controlled by contract rate on the unit basis of USD ($) per bcm. The method emerges from an idea of daily dozer push activity that continually shifts the overburden until final target design by mine planning. Volume calculation is then performed by calculating volume of each time overburden is removed within determined distance using cut and fill method from a high precision GNSS system which is applied into dozer as a guidance to ensure the optimum result of overburden removal. Accumulation of daily to weekly dozer push volume is found 95 bcm which is multiplied by average sell rate of $ 0,95, thus the amount monthly revenue is $ 90,25. Furthermore, the payment mechanism is then based on push distance and push grade. The push distance interval will determine the rates that vary from $ 0,9 - $ 2,69 per bcm and are influenced by certain push slope grade from -25% until +25%. The amount payable rates for dozer push operation shall be specifically following currency adjustment and is to be added to the monthly overburden volume claim, therefore, the sell rate of overburden volume per bcm may fluctuate depends on the real time exchange rate of Jakarta Interbank Spot Dollar Rate (JISDOR). The result indicates that dozer push measurement can be one of the surface mining alternative since it has enabled to refine method of work, operating cost and productivity improvement apart from exposing risk of low rented equipment performance. In addition, payment mechanism of contract rate by dozer push operation scheduling will ultimately deliver clients by almost 45% cost reduction in the form of low and consistent cost.

Keywords: contract rate, cut-fill method, dozer push, overburden volume

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Authors: Baishali Deb, Hari Om Pandey, Shrilla Elangbam, Mukesh Singh, Ayon Tarafdar, A. K. S. Tomar, A. K. Pandey, Triveni Dutt

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The goal of the present investigation was to determine the impact of social stress on behavioural characteristics, physiological responses, and haemato-biochemical indicators under various social environments in Tharparkar cattle. Serum cortisol and faecal cortisol metabolites analysis were used to determine the stress level of Tharparkar cattle. Social isolation and social mixing were the two different social circumstances used to evaluate the animals. In both the experiments i.e., social isolation and social mixing, the lying period of animals decreased significantly (p<0.05) while standing period significantly (p<0.05) increased. Frequency and duration of activities like idling, walking, exploration, oral manipulation, and elimination increased significantly (p<0.05) in Tharparkar cattle after being subjected to social isolation and social mixing. Time spent in grooming (self-grooming and allo-grooming) in respect to social isolation significantly increased during isolation and post-reunion, whereas there was a significant (p<0.05) decline in the grooming behaviour especially allo-grooming during mixing of the animals. Feeding and rumination time also decreased significantly (p<0.05) in animals during both the experiments. Physiological parameters such as respiration rate, heart rate and pulse rate increased during the treatment periods. There was no significant difference in the haematological parameters for both the experiments. There was significant (p<0.05) increase in serum cortisol and faecal cortisol metabolites (FCM) concentration in animals subjected to social stress. Therefore, it can be concluded that social stress strongly impacts the behaviour and physiological parameters of the animals, causing stress and nervousness, proving that social stress is a valid psychological stress in animals. The higher concentration of FCM in Tharparkar cattle subjected to social stress, further supported by higher serum cortisol and behaviour manifestations, suggest that FCM could be used to assess stress response as a non-invasive method.

Keywords: social stress, fecal cortisol metabolites, non-invasive, animal welfare, behaviour

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Authors: Shri Dubey, Jamal Ghorieshi

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Instability of the lumbar spine is caused by various factors that include degenerative disc, herniated disc, traumatic injuries, and other disorders. Pedicle screws are widely used as a main fixation device to construct rigid linkages of vertebrae to provide a fully functional and stable spine. Various technologies and methods have been used to restore the stabilization. However, loosening of pedicle screws is the main cause of concerns for neurosurgeons. This could happen due to poor bone quality with osteoporosis as well as types of pedicle screw used. Compatibilities and stabilities of pedicle screws with bone depend on design (thread design, length, and diameter) and material. Grip length and pullout strength affect the motion and stability of the spine when it goes through different phases such as extension, flexion, and rotation. Pullout strength of augmented pedicle screws is increased in both primary and salvage procedures by 119% (p = 0.001) and 162% (p = 0.01), respectively. Self-centering pedicle screws at different trajectories (0°, 10°, 20°, and 30°) show the same pullout strength as insertion in a straight-ahead trajectory. The outer cylindrical and inner conical shape of pedicle screws show the highest pullout strength in Grades 5 and 15 foams (synthetic bone). An outer cylindrical and inner conical shape with a V-shape thread exhibit the highest pullout strength in all foam grades. The maximum observed pullout strength is at axial pullout configuration at 0°. For Grade 15 (240 kg/m³) foam, there is a decline in pull out strength. The largest decrease in pullout strength is reported for Grade 10 (160 kg/m³) foam. The maximum pullout strength of 2176 N (0.32-g/cm³ Sawbones) on all densities. Type 1 Pedicle screw shows the best fixation due to smaller conical core diameter and smaller thread pitch (Screw 2 with 2 mm; Screws 1 and 3 with 3 mm).

Keywords: polymethylmethacrylate, PMMA, classical pedicle screws, CPS, expandable poly-ether-ether-ketone shell, EPEEKS, includes translaminar facet screw, TLFS, poly-ether-ether-ketone, PEEK, transfacetopedicular screw, TFPS

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Authors: Zimu Li, Zheng Wan

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The Suez Canal plays an important role in global shipping networks and is one of the most frequently used waterways in the world. The 2021 canal obstruction by ship Ever Given in March 2021, however, completed blocked the Suez Canal for a week and caused significant disruption to world trade. Therefore, it is very important to quantitatively analyze the impact of the accident on the robustness of the global shipping network. However, the current research on maritime transportation networks is usually limited to local or small-scale networks in a certain region. Based on the complex network theory, this study establishes a global shipping complex network covering 2713 nodes and 137830 edges by using the real trajectory data of the global marine transport ship automatic identification system in 2018. At the same time, two attack modes, deliberate (Suez Canal Blocking) and random, are defined to calculate the changes in network node degree, eccentricity, clustering coefficient, network density, network isolated nodes, betweenness centrality, and closeness centrality under the two attack modes, and quantitatively analyze the actual impact of Suez Canal Blocking on the robustness of global shipping network. The results of the network robustness analysis show that Suez Canal blocking was more destructive to the shipping network than random attacks of the same scale. The network connectivity and accessibility decreased significantly, and the decline decreased with the distance between the port and the canal, showing the phenomenon of distance attenuation. This study further analyzes the impact of the blocking of the Suez Canal on Chinese ports and finds that the blocking of the Suez Canal significantly interferes withChina's shipping network and seriously affects China's normal trade activities. Finally, the impact of the global supply chain is analyzed, and it is found that blocking the canal will seriously damage the normal operation of the global supply chain.

Keywords: global shipping networks, ship AIS trajectory data, main channel, complex network, eigenvalue change

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Authors: Hala Alioua, Alberic Tellier

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This paper is designed to spotlight the research on corporate strategic planning, by emphasizing the role of middle manager of SBU’s and related issues such as the context of vision change. Previous research on strategic vision has been focused principally at the SME, with relatively limited consideration given to the role of middle managers SBU’s in the context of change. This project of research has been done by using a single case study. We formulated through our immersion for 2.5 years on the ground and by a qualitative method and abduction approach. This entity that we analyze is a subsidiary of multinational companies headquartered in Germany, specialized in manufacturing automotive equipment. The "Delta Company" is a French manufacturing plant that has undergone numerous changes over the past three years. The two major strategic changes that have a significant impact on the Delta plant are the strengths of its core business through « lead plant strategy» in 2011 and the implementation of a new strategic vision in 2014. These consecutive changes impact the purpose of the mission of the middle managers. The plant managers ask the following questions: How the middle managers make sense of the corporate strategic planning imposed by the parent company? How they appropriate the new vision and decline it into actions on the ground? We chose the individual interview technique through open-ended questions as the source of data collection. We first of all carried out an exploratory approach by interviewing 8 members of the Management committee’s decision and 19 heads of services. The first findings and results show that exist a divergence of opinion and interpretations of the corporate strategic planning among organization members and there are difficulties to make sense and interpretations of the signals of the environment. The lead plant strategy enables new projects which insure the workload of Delta Company. Nevertheless, it creates a tension and stress among the middle managers because its provoke lack of resources to the detriment of their main jobs as manufacturer plant. The middle managers does not have a clear vision and they are wondering if the new strategic vision means more autonomy and less support from the group.

Keywords: change, middle managers, vision, sensemaking

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Authors: Bianca W. O. Silva, Adriana C. M. Andrade, Gustavo C. M. Lucena, Virna M. S. Lima

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Introduction: Basic life support (BLS) involves the immediate recognition of cardiopulmonary arrest. Each year, 359.400 and 275.000 individuals with cardiac arrest are attended in emergency departments in USA and Europe. Brazilian data shows that 200.000 cardiac arrests occur every year, and half of them out of the hospital. Medical schools around the world teach BLS in the first years of the course, but studies show that there is a decline of the knowledge as the years go by, affecting the chain of survival. The objective was to analyze the knowledge of medical students about BLS and the retention of this learning throughout the course. Methods: This study included 150 students who were at the second and third year of a medical school in Salvador, Bahia, Brazil. The instrument of data collection was a structured questionnaire composed of 20 questions based on the 2015 American Heart Association guideline. The Pearson Chi-square test was used in order to study the association between previous training, sex and semester with the degree of knowledge of the students. The Kruskal-Wallis test was used to evaluate the different yields obtained between the various semesters. The number of correct answers was described by average and quartiles. Results: Regarding the degree of knowledge, 19.6% of the female students reached the optimal classification, a better outcome than the achieved by the male participants. Of those with previous training, 33.33% were classified as good and optimal, none of the students reached the optimal classification and only 2.2% of them were classified as bad (those who did not have 52.6% of correct answers). The analysis of the degree of knowledge related to each semester revealed that the 5th semester had the highest outcome: 30.5%. However, the acquaintance presented by the semesters was generally unsatisfactory, since 50% of the students, or more, demonstrated knowledge levels classified as bad or regular. When confronting the different semesters and the achieved scores, the value of p was 0.831. Conclusion: It is important to focus on the training of medical professionals that are capable of facing emergency situations, improving the systematization of care, and thereby increasing the victims' possibility of survival.

Keywords: basic life support, cardiopulmonary ressucitacion, education, medical students

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Authors: Marjeta Misigoj Durakovic, Maroje Soric, Lovro Stefan

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Background and aim: Physical inactivity has been linked with increased morbidity and premature mortality and adolescence has been recognised as the critical period for a decline in physical activity (PA) level. In order to properly direct interventions aimed at increasing PA, high-risk groups of individuals should be identified. Therefore, the aim of this study is to describe gender differences in: a) PA level; b) weekly PA patterns. Methods: This investigation is a part of the CRO-PALS study which is an on-going longitudinal study conducted in a representative sample of urban youth in Zagreb (Croatia). CRO-PALS involves 903 adolescents and for the purpose of this study data from a subgroup of 190 participants with information on objective PA level were analysed (116 girls; mean age [SD]=15.6[0.3] years). Duration of moderate and vigorous PA was measured during 5 consecutive by a multiple-sensor physical activity monitor (SenseWear Armband, BodyMedia inc., Pittsburgh, USA). Gender differences in PA level were evaluated using independent samples t-test. Differences in school week and weekend levels of activity were assessed using mixed ANOVA with gender as between-subjects factor. The amount of vigorous PA had to be log-transformed to achieve normality in the distribution. Results: Boys were more active than girls. Duration of moderate-to-vigorous PA averaged 111±44 min/day in boys and 80±38 min/day in girls (mean difference=31 min/day, 95%CI=20-43 min/day). Vigorous PA was 2.5 times higher in boys compared to girls (95%CI=1.9-3.5). Participants were more active during school days than on weekends. The magnitude of the difference in moderate-to-vigorous PA was similar in both gender (p value for time*gender interaction = 0.79) and averaged 19 min/day (95%CI=11-27 min/day). Similarly, vigorous PA was 36% lower on weekends compared with school days (95%CI=22-46%) with no gender difference (p value for time*gender interaction = 0.52). Conclusion: PA level was higher in boys than in girls throughout the week. Still, in both boys and girls, the amount of PA reduced markedly on weekends compared with school days.

Keywords: adolescence, multiple-sensor physical activity monitor, physical activity level, weekly physical activity pattern

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Authors: Rajesh Kumar Suman, Ipseeta Ray Mohanty, Manjusha K. Borde, Ujjawala maheswari, Y. A. Deshmukh

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Background: Metabolic syndrome encompasses cluster of risk factors for cardiovascular disease which includes abdominal obesity, dyslipidemia, hypertension, and hyperglycemia. The incidence of metabolic syndrome is on the rise globally. Objective: The present study was designed to develop a unique animal model that will mimic the pathological features seen in a large pool of individuals with diabetes and metabolic syndrome; suitable for pharmacological screening of drugs beneficial in this condition. Material and Methods: A combination of high fat diet (HFD) and low dose of streptozotocin (STZ) at 30, 35 and 40 mg/kg was used to induce metabolic syndrome co-existing with diabetes mellitus in Wistar rats. Results: The 40 mg/kg STZ produced sustained hyperglycemia and the dose was thus selected for our study to induce diabetes mellitus. Rat fed HFD (HF-DC) group showed significant (p < 0.001) increase in body weight on 4th and 7th week as compared with NC (Normal Control) group rats. However, the increase in body weight of HF-DC group rats was not sustained at the end of 10th weeks. Various components of metabolic syndrome such as dyslipidemia {(Increased Triglyceride, total Cholesterol, LDL Cholesterol and decreased HDL Cholesterol)}, diabetes mellitus (Blood Glucose, HbA1c, Serum Insulin, C-peptide), hypertension {Systolic Blood pressure (p < 0.001)} were mimicked in the developed model of metabolic syndrome co existing with diabetes mellitus. In addition significant cardiac injury as indicated by CPK-MB levels, artherogenic index, hs-CRP. The decline in hepatic function {(p < 0.01) increase in the level of SGPT (U/L)} and renal function {(increase in creatinine levels (p < 0.01)} when compared to NC group rats. The histopathological assessment confirmed presence of edema, necrosis and inflammation in Heart, Pancreas, Liver and Kidney of HFD-DC group as compared to NC. Conclusion: The present study has developed a unique rodent model of metabolic syndrome; with diabetes as an essential component.

Keywords: diabetes, metabolic syndrome, high fat diet, streptozotocin, rats

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Authors: Kathryn Rooney, Kaitlyn Eddy, Evan Landers, Weihui Li

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The international mortality rate for neonates and infants has been declining at a disproportionally low rate when compared to the overall decline in child mortality in recent decades. A significant portion of infant deaths could be prevented with the implementation of low-cost and easy to use physiological monitoring devices, by enabling early identification of symptoms before they progress into life-threatening illnesses. The oral diagnostic device discussed in this paper serves to continuously monitor the key vital signs of body temperature, respiratory rate, heart rate, and oxygen saturation. The device mimics an infant pacifier, designed to be easily tolerated by infants as well as orthodontically inert. The fundamental measurements are gathered via thermistors and a pulse oximeter, each encapsulated in medical-grade silicone and wired internally to a microcontroller chip. The chip then translates the raw measurements into physiological values via an internal algorithm, before outputting the data to a liquid crystal display screen and an Android application. Additionally, a biological sample collection chamber is incorporated into the internal portion of the device. The movement within the oral chamber created by sucking on the pacifier-like device pushes saliva through a small check valve in the distal end, where it is accumulated and stored. The collection chamber can be easily removed, making the sample readily available to be tested for various diseases and analytes. With the vital sign monitoring and sample collection offered by this device, abnormal fluctuations in physiological parameters can be identified and appropriate medical care can be sought. This device enables preventative diagnosis for infants who may otherwise have gone undiagnosed, due to the inaccessibility of healthcare that plagues vast numbers of underprivileged populations.

Keywords: neonate mortality, infant mortality, low-cost diagnostics, vital signs, saliva testing, preventative care

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Authors: O. Elkana, O Heyman, S. Hamdan, M. Franko, J. Vatine

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Objective: To investigate whether a direct link exists between perceived pain (PP) and executive functions (EF), above and beyond the influence of depression symptoms, in the context of medical rehabilitation. Design: Cross-sectional study. Setting: Rehabilitation Hospital. Participants: 125 medical records of hospitalized patients were screened for matching to our inclusion criteria. Only 60 patients were found fit and were asked to participate. 19 decline to participate on personal basis. The 41 neurologically intact patients (mean age 46, SD 14.96) that participated in this study were in their sub-acute stage of recovery, with fluent Hebrew, with intact upper limb (to neutralize influence on psychomotor performances) and without an organic brain damage. Main Outcome Measures: EF were assessed using the Wisconsin Card Sorting Test (WCST) and the Stop-Signal Test (SST). PP was measured using 3 well-known pain questionnaires: Pain Disability Index (PDI), The Short-Form McGill Questionnaire (SF-MPQ) and the Pain Catastrophizing Scale (PCS). Perceived pain index (PPI) was calculated by the mean score composite from the 3 pain questionnaires. Depression symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Results: The results indicate that irrespective of the presence of depression symptoms, PP is directly correlated with response inhibition (SST partial correlation: r=0.5; p=0.001) and mental flexibility (WSCT partial correlation: r=-0.37; p=0.021), suggesting decreased performance in EF as PP severity increases. High correlations were found between the 3 pain measurements: SF-MPQ with PDI (r=0.62, p<0.001), SF-MPQ with PCS (r=0.58, p<0.001) and PDI with PCS (r=0.38, p=0.016) and each questionnaire alone was also significantly associated with EF; thus, no specific questionnaires ‘pulled’ the results obtained by the general index (PPI). Conclusion: Examining the direct association between PP and EF, beyond the contribution of depression symptoms, provides further clinical evidence suggesting that EF and PP share underlying mediating neuronal mechanisms. Clinically, the importance of assessing patients' EF abilities as well as PP severity during rehabilitation is underscored.

Keywords: depression, executive functions, mental-flexibility, neuropsychology, pain perception, perceived pain, response inhibition

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Authors: Daly M. J, Condron C, Mulhall C, Eppich W, O'Neill J.

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Introduction: In contemporary clinical cardiology, comprehensive and holistic bedside evaluation including accurate cardiac auscultation is in decline despite having positive effects on patients and their outcomes. Methods: Scripted histories and scoring checklists for three clinical scenarios in cardiology were co-created and refined through iterative consensus by a panel of clinical experts; these were then paired with recordings of auscultatory findings from three actual patients with known valvular heart disease. A wearable vest with embedded pressure-sensitive panel speakers was developed to transmit these recordings when examined at the standard auscultation points. RCSI medical students volunteered for a series of three formative long case examinations in cardiology (LC1 – LC3) using this hybrid simulation. Participants were randomised into two groups: Group 1 received individual teaching from an expert trainer between LC1 and LC2; Group 2 received the same intervention between LC2 and LC3. Each participant’s long case examination performance was recorded and blindly scored by two peer participants and two RCSI examiners. Results: Sixty-eight participants were included in the study (age 27.6 ± 0.1 years; 74% female) and randomised into two groups; there were no significant differences in baseline characteristics between groups. Overall, the median total faculty examiner score was 39.8% (35.8 – 44.6%) in LC1 and increased to 63.3% (56.9 – 66.4%) in LC3, with those in Group 1 showing a greater improvement in LC2 total score than that observed in Group 2 (p < .001). Using the novel checklist, intraclass correlation coefficients (ICC) were excellent between examiners in all cases: ICC .994 – .997 (p < .001); correlation between peers and examiners improved in LC2 following peer grading of LC1 performances: ICC .857 – .867 (p < .001). Conclusion: Hybrid simulation and quantitative grading improve learning, standardisation of assessment, and direct comparisons of both performance and acumen in clinical cardiology.

Keywords: cardiology, clinical skills, long case examination, hybrid simulation, checklist

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Authors: Elisabeth Louise Ndjengue Mindang, Charline Florence Awounfack, Derek Tantoh Ndinteh, Rui W. M. Krause, Dieudonne Njamen

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The evolution of human fertility over the last 50 years has shown considerable problems due to a growing number of couples that find it difficult to procreate without medical assistance. In Africa, this inability to conceive affect 30 to 40% of couples. A number of contaminants in the environment are thought to contribute significantly to the observed infertility epidemic. Methods: On this basis, the impact of 40-days unique oral administration (between 9 and 10 am) of potassium sorbate (at of 12.5, 45, and 78 mg/kg BW doses) was evaluated on sexual maturation and hematologic parameters on immature Wistar rats (21-22 days of age). At the end of the treatment, animals were sacrificed. Vaginal opening was evaluated before the sacrifice. After the sacrifice, relative weight of reproductive organs, pituitary gonadotrophin level (LH and FSH), and sexuals steroids (estrogen and progesterone), cholesterol level in ovaries, folliculogenesis, and some hematological parameters were evaluated. Results: Compared to the control group, no significant variation was observed in the body weight of the animals treated with patassium sorbate. On the other hand, potassium sorbate, a significantly lower percentage (25%) of vaginal-opening in these rats, was observed from day 46 of age (p <0.01); likewise, a significant decrease was observed on the relative weight of the ovaries (p <0.01), number of primary follicles (p <0.01), and a significant increase of follicle number (p <0.001) at 78 mg/kg BW have been obseved. Potassium sorbate always decreased the number of white blood cells (p <0.05). Taken together, these results confirm the disturbing effects on the endocrine system, causing a decrease in fertility by increasing the number of follicles in atresia. A deleterious effect on the immune system was also observed. Overall, these results validate at least in part the global observations on the growing decline in fertility in populationsfeeding increasingly on industrial processed foods.

Keywords: potassium sorbate, early puberty, folliculogenesis, endocrine disruptor, immatur wistar rat

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Authors: Hanieh Mohammadi, Sarah Fraser, Anil Nigam, Frederic Lesage, Louis Bherer

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A chronically higher cerebral pulsatility is thought to damage cerebral microcirculation, leading to cognitive decline in older adults. Although it is widely known that regular physical activity is linked to improvement in some cognitive domains, including executive functions, the mediating role of cerebral pulsatility on this link remains to be elucidated. This study assessed the impact of 6 months of regular physical activity upon changes in an optical index of cerebral pulsatility and the role of physical activity for the improvement of executive functions. 27 older adults (aged 57-79, 66.7% women) with cardiovascular risk factors (CVRF) were enrolled in the study. The participants completed the behavioral Stroop test, which was extracted from the Delis-Kaplan executive functions system battery at baseline (T0) and after 6 months (T6) of physical activity. Near-infrared spectroscopy (NIRS) was applied for an innovative approach to indexing cerebral pulsatility in the brain microcirculation at T0 and T6. The participants were at standing rest while a NIRS device recorded hemodynamics data from frontal and motor cortex subregions at T0 and T6. The cerebral pulsatility index of interest was cerebral pulse amplitude, which was extracted from the pulsatile component of NIRS data. Our data indicated that 6 months of physical activity was associated with a reduction in the response time for the executive functions, including inhibition (T0: 56.33± 18.2 to T6: 53.33± 15.7,p= 0.038)and Switching(T0: 63.05± 5.68 to T6: 57.96 ±7.19,p< 0.001) conditions of the Stroop test. Also, physical activity was associated with a reduction in cerebral pulse amplitude (T0: 0.62± 0.05 to T6: 0.55± 0.08, p < 0.001). Notably, cerebral pulse amplitude was a significant mediator of the link between physical activity and response to the Stroop test for both inhibition (β=0.33 (0.61,0.23),p< 0.05)and switching (β=0.42 (0.69,0.11),p <0.01) conditions. This study suggests that regular physical activity may support cognitive functions through the improvement of cerebral pulsatility in older adults with CVRF.

Keywords: near-infrared spectroscopy, cerebral pulsatility, physical activity, cardiovascular risk factors, executive functions

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Authors: James Patrick A. Diaz, Raul E. Ramboyong

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Background: Hypertensive response during maximal exercise test provides important information on the level of blood pressure control and evaluation of treatment. Method: A single center retrospective descriptive study was conducted among 117 young (aged 20 to 40) and middle age (aged 40 to 65) hypertensive patients, who underwent treadmill stress test. Currently on maintenance frontline medication either monotherapy (Angiotensin-converting enzyme inhibitor/Angiotensin receptor blocker [ACEi/ARB], Calcium channel blocker [CCB], Diuretic - Hydrochlorthiazide [HCTZ]) or combination therapy (ARB+CCB, ARB+HCTZ), who attained a maximal exercise on treadmill stress test (TMST) with hypertensive response (systolic blood pressure: male >210 mm Hg, female >190 mm Hg, diastolic blood pressure >100 mmHg, or increase of >10 mm Hg at any time during the test), on Bruce and Modified Bruce protocol. Exaggerated blood pressure response during exercise (systolic [SBP] and diastolic [DBP]), peak exercise blood pressure (SBP and DBP), recovery period (SBP and DBP) and test for ischemia and their antihypertensive medication/s were investigated. Analysis of variance and chi-square test were used for statistical analysis. Results: Hypertensive responses on maximal exercise test were seen mostly among female population (P < 0.000) and middle age (P < 0.000) patients. Exaggerated diastolic blood pressure responses were significantly lower in patients who were taking CCB (P < 0.004). A longer recovery period that showed a delayed decline in SBP was observed in patients taking ARB+HCTZ (P < 0.036). There were no significant differences in the level of exaggerated systolic blood pressure response and during peak exercise (both systolic and diastolic) in patients using either monotherapy or combination antihypertensives. Conclusion: Calcium channel blockers provided lower exaggerated diastolic BP response during maximal exercise test in hypertensive middle age patients. Patients on combination therapy using ARB+HCTZ exhibited a longer recovery period of systolic blood pressure.

Keywords: antihypertensive, exercise test, hypertension, hyperytensive response

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Authors: Adekemi Adebowale

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The duty of disclosure in Nigerian insurance law is in need of reform. The materiality of an undisclosed fact (notwithstanding that it was an honest and innocent non-disclosure) currently entitles insurers to avoid insurance policies, leaving an insured with an uncovered loss. While the test of materiality requires an insured to voluntarily disclose facts that will influence an insurer's decision without proper guidelines from the insurer, the insurer is only expected to prove that the undisclosed fact had influenced its judgment in fixing the premium or determining whether to accept the risk. This problem places an onerous duty on the assured to volunteer to the insurer every material fact even though the insured only has a slight idea about the mind of a hypothetical prudent insurer. This paper explores the modern approach to revisiting the problem of an insured’s pre-contractual obligation to determine material facts in Nigerian insurance law. The aim is to build upon the change in the structure of insurance contract obligations in other common law jurisdictions such as the United Kingdom. The doctrinal and comparative methodology captures the burden imposed on the insured under the existing Nigerian insurance law. It finds that the continued application of the law leaves the insured in the weakest position, and he stands to lose in a contract supposedly created for his benefit. It is apparent that if this problem remains unresolved, the over-all consequence will contribute to a significant decline in the insurance contract, which may affect the Nigerian economy. The paper aims to evaluate the risks of the continuous application of the traditional law, which does not keep with the pace of modern insurance practice. It will ultimately produce a legally compliant reform, along with a significant deviation from the archaic structure that exists in the Nigerian insurance law. This paper forms part of an on-going PhD research on "The insured’s pre-contractual duty of utmost of utmost good faith". The outcome from the research to date finds that the insured bears the burden of the obligation to act in utmost good faith where it concerns disclosure of material facts.

Keywords: disclosure, materiality, Nigeria, United Kingdom, utmost good faith

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Authors: Sohaib Raza, Parvez Mantry

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Frailty is a multi-system impairment associated with stressors such as age, disease, and invasive surgical procedures. This multi-system impairment can lead to increased post-transplant mortality and functional decline. Additionally, the prevalence and/or severity of frailty increases when patient pre-habilitation is unsatisfactory or lacking. We conducted a retrospective study to examine whether the COVID-19 Pandemic, and subsequent lack of patient access to pre-habilitation and physical therapy resources, led to an increase in the prevalence and severity of frailty, sarcopenia, and other comorbidities including diabetes, hypertension, and COPD. Secondarily, we examined the correlation between patient survival rate and liver frailty index as well as muscle wasting/sarcopenia. Data were analyzed in order to correlate variables associated with these parameters. Three hundred sixty-nine liver transplant candidates at Methodist Dallas Medical Center were administered pre-transplant frailty assessments, which consisted of chair stands, grip strength, and position balance time. A frailty score less than 3.2 indicated a robust condition, a score from 3.3 to 4.4 indicated a pre-frail condition, and a score greater than 4.5 indicated a frail condition. Greater than 50 percent of patients were found to have muscle wasting in the COVID-19 period (March 13, 2020 to February 28, 2022), an increase of 16.5 percent from the pre-COVID period (April 1st, 2018 to March 12, 2020). Additionally, sarcopenia was associated with a two-fold increase in patient mortality rate. Furthermore, high liver frailty index scores were associated with increased patient mortality. However, there was no significant difference in liver frailty index or number of comorbidities between patients in the two cohorts. Conclusion: The COVID-19 Pandemic exacerbated sarcopenia-related muscle wasting in liver transplant candidates, and patient survival rate was directly correlated with liver frailty index score and the presence of sarcopenia.

Keywords: frailty, sarcopenia, covid-19, patient mortality, pre-habilitation, liver transplant candidates

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Authors: Mythri G., Manjunath ML, Girish Babu M., Shireen Swaliha Quadri

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Background: The increase in diabetes among the elderly is of concern because in addition to the wide range of traditional diabetes complications, evidence has been growing that diabetes is associated with increased risk of cognitive decline. Aims and Objectives: To find out if there is any association between blood sugar levels and short-term and working memory status in patients of type 2 diabetes. Materials and Methods: The study was carried out in 200 individuals aged between 40-65 years consisting of 100 diagnosed cases of Type 2 Diabetes Mellitus and 100 non-diabetics from OPD of Mc Gann Hospital, Shivamogga. Rye’s Auditory Verbal Learning Test, Verbal Fluency Test and Visual Reproduction Test, Working Digit Span Test and Validation Span Test were used to assess short-term and working memory. Fasting and Post Prandial blood sugar levels were estimated. Statistical analysis was done using SPSS 21. Results: Memory test scores of type 2 diabetics were significantly reduced (p < 0.001) when compared to the memory scores of age and gender matched non-diabetics. Fasting blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.837), VFT (r=-0.888), VRT(r=-0.787), WDST (r=-0.795) and VST (r=-0.943). Post- Prandial blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.922), VFT (r=-0.848), VRT(r=-0.707),WDST (r=-0.729) and VST (r=-0.880) Memory scores in all 5 tests were found to be negatively correlated with the FBS and PPBS levels in diabetic patients (p < 0.001). Conclusion: The decreased memory status in diabetic patients may be due to many factors like hyperglycemia, vascular disease, insulin resistance, amyloid deposition and also some of the factor combine to produce additive effects like, type of diabetes, co-morbidities, age of onset, duration of the disease and type of therapy. These observed effects of blood sugar levels of diabetics on memory status are of potential clinical importance because even mild cognitive impairment could interfere with todays’ activities.

Keywords: diabetes, cognition, diabetes, HRV, respiratory medicine

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Authors: Abidemi C. Adegboye, Samuel Iweriebor

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The primary link between financial institutions and economic performance is the provision of resources by these institutions to businesses in order to drive enterprise expansion, sustainability, and development. In this study, the role of access to finance in driving innovations and productivity in Nigerian SMEs is investigated using the World Bank Enterprise Survey (ES) dataset. Innovation is defined based on the ES analysis using five compositions including product, method, organisational, use of foreign-licensed technology, and spending on R&D. The study considers finance in terms of source in meeting investment needs and in terms of access. Moreover, finance access is categorized as external and internal to a firm with each having different implications. The research methodology adopted a survey analysis based on the 2014 World Bank Enterprise Survey of 19 states in Nigeria. The survey comprised over 10,000 manufacturing and services firms, both at the small scale and medium scale levels. The logit estimation technique is used to estimate the relationships in the study. The results from the empirical analysis show that in general, access to finance drives SME innovation in Nigeria. In particular, ease of accessing bank loans and credit is shown to be the strongest positive force in driving all types of innovation among SMEs in Nigeria. In the same vein, the type of finance source for investment matters in terms of how it affects innovation: it is shown that both internal and external sources improve investment in product, process, and organisational innovation, but only external financing has effect on R&D spending and use of foreign licensed technology. Overall spending on R&D is only driven by access to external finance by the SMEs. For productivity, the results show that while structure of financing investment improves productivity, increased access to finance may actually lead to productivity decline among SMEs in Nigeria. There is a need for the financial system to evolve structures to increase fund availability to SMEs in Nigeria, especially for the purpose of innovation investment.

Keywords: access to finance, financing investment, innovation, productivity, SMEs

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Authors: Annika Kjallman Alm, Ove Hellzen, Malin Rising-Homlstrom

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The concept of dementia‐friendly communities focuses on the lived experience of people who have dementia and is most relevant to addressing their needs and the needs of those people who live with and provide support for them. The goal of communities becoming dementia‐friendly is for dementia to be normalized and recognized as a disabling condition. People with dementia find being connected to self, to others, and to the environment by meaningful activities as important. According to the concept underlying dementia-friendly communities, people with dementia or cognitive decline can continue to live in the community if their residential community has sufficiently strong social capital. The aim of this study is to explore staff and leaders’ experiences in implementing interventions to enhance a more inclusive dementia-friendly community. A municipality in northern Sweden with a population of approx. 100 000 inhabitants decided to create a dementia friendly municipality. As part of the initiative, a Centre for support was established. The Centre offered support for both individuals and groups, did home visits, and provided information about Dementia. Interviews were conducted with staff who had undergone training in a structured form of multidimensional support, the PER-model®, and worked at the Centre for support. The staff consisted of registered nurses, occupational therapists, and specialized nurses who had worked there for more than five years, and all had training in dementia. All interviews were audio-recorded and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results suggest that implementing the PER-model® of support for persons in the early stages of dementia and their next of kin added a much-needed form of support and perceived possibilities to enhance daily life in the early stages of dementia. The staff appreciated that the structure of PER-model® was evidenced based. They also realized that they never even considered that the person with dementia also needed support in the early stages but that they now had tools for that as well. Creating a dementia friendly municipality offering different kinds of support for all stages of dementia is a challenge. However, evidence-based tools and a broad spectrum of different types of support, whether individual or group, are needed to tailor to everyone’s needs. A conviction that all citizens are equal and should all be involved in the community is a strong motivator.

Keywords: dementia, dementia-friendly, municipality, support

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Authors: Chew Zhao Hong

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Since the transition of power in 2018, the Malaysian political landscape has experienced substantial shifts and complexities. The decline of the longstanding ruling party, United Malays National Organization (UMNO), following the party rotation, has given rise to splinter parties such as the Indigenous Unity Party (Bersatu), along with the enduring presence of the Pan-Malaysian Islamic Party (PAS) in the northern region of the Malay Peninsula. However, the "Sheraton Move" in 2020 led to the fall of the Pakatan Harapan government and the emergence of Perikatan Nasional, signifying the ascent of a third political force. The 2022 general elections marked Malaysia's entry into a hung parliament, culminating in an intricate negotiation that resulted in a coalition government formed by Pakatan Harapan, Barisan Nasional, and the Sarawak parties alliance (GPS), collectively governing the Malaysian federal administration. During the 2023 state elections, Pakatan Harapan and Barisan Nasional formed an unprecedented alliance, yet the media framing benefited Perikatan Nasional, even securing substantial support from UMNO's traditional constituencies. In the era of converging new media, Malaysia’s democratization faces new challenges: first, political leaders leveraging media to cultivate unfiltered personas risk inducing populism; second, under the influence of agenda-setting and two-step flow theories, media contributes to polarization; lastly, Malaysia's multi-party system is no longer effectively moderate extreme ideologies into the political center. This study examines the role of media framing and its impact on the democratization process within Malaysia's consociational democracy under a multi-party system and analyzes media discourse before and after the 2023 Malaysian state elections to explore how different parties shape public opinion and political discourse, and how political messages may be amplified or distorted in the process.

Keywords: multi-party system, democratization, elections, political polarization, Malaysia, media framing

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Authors: S. K. Thind, Aparjot Kaur

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Heat stress is one of the major environmental factors drastically reducing wheat production. Crop heat tolerance can be enhanced by preconditioning of plants by exogenous application of osmoprotectants. Presently, the effect of trehalose pretreatment (at 1 mM, and 1.5 nM) under heat stress of 35±2˚C (moderate) and 40±2˚ (severe) for four and eight hour was conducted in wheat (Tricticum aestivum L.) genotypes viz. HD2967, PBW 175, PBW 343, PBW 621, and PBW 590. Heat stress affects wide spectrum of physiological processes within plants that are irreversibly damaged by stress. Membrane thermal stability (MTS) and cell viability was significantly decreased under heat stress for eight hours. Pretreatment with trehalose improved MTS and cell viability under stress and this effect was more promotory with higher concentration. Thermal stability of photosynthetic apparatus differed markedly between genotypes and Hill reaction activity was recorded more in PBW621 followed by C306 as compared with others. In all genotypes photolysis of water showed decline with increase in temperature stress. Trehalose pretreatment helped in sustaining Hill reaction activity probably by stabilizing the photosynthetic apparatus against heat-induced photo inhibition. Both plant growth and development were affected by temperature in both shoot and root under heat stress. The reduction was compensated partially by trehalose (1.5 mM) application. Adaption to heat stress is associated with the metabolic adjustment which led to accumulation of soluble sugars including non-reducing and reducing for their role in adaptive mechanism. Higher acid invertase activity in shoot of tolerant genotypes appeared to be a characteristic for stress tolerance. As sucrose synthase play central role in sink strength and in studied wheat genotype was positively related to dry matter accumulation. The duration of heat stress for eight hours had more severe effect on these parameters and trehalose application at 1.5 mM ameliorated it to certain extent.

Keywords: heat stress, Triticum aestivum, trehalose, membrane thermal stability, triphenyl tetrazolium chloride, reduction test, growth, sugar metabolism

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