Search results for: levels of care

Authors: Madiha El Awamie, Catherine Rees

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Natural preservatives have been used as alternatives to traditional chemical preservatives; however, a limited number have been commercially developed and many remain to be investigated as sources of safer and effective antimicrobials. In this study, we have been investigating the antimicrobial activity of an extract of Glycyrrhiza glabra (liquorice) that was provided as a waste material from the production of liquorice flavourings for the food industry, and to investigate if this retained the expected antimicrobial activity so it could be used as a natural preservative. Antibacterial activity of liquorice extract was screened for evidence of growth inhibition against eight species of Gram-negative and Gram-positive bacteria, including Listeria monocytogenes, Listeria innocua, Staphylococcus aureus, Enterococcus faecalis and Bacillus subtilis. The Gram-negative bacteria tested include Pseudomonas aeruginosa, Escherichia coli and Salmonella typhimurium but none of these were affected by the extract. In contrast, for all of the Gram-positive bacteria tested, growth was inhibited as monitored using optical density. However parallel studies using viable count indicated that the cells were not killed meaning that the extract was bacteriostatic rather than bacteriocidal. The Minimum Inhibitory Concentration [MIC] and Minimum Bactericidal Concentration [MBC] of the extract was also determined and a concentration of 50 µg ml^-1 was found to have a strong bacteriostatic effect on Gram-positive bacteria. Microscopic analysis indicated that there were changes in cell shape suggesting the cell wall was affected. In addition, the use of a reporter strain of Listeria transformed with the bioluminescence genes luxABCDE indicated that cell energy levels were reduced when treated with either 12.5 or 50 µg ml^-1 of the extract, with the reduction in light output being proportional to the concentration of the extract used. Together these results suggest that the extract is inhibiting the growth of Gram-positive bacteria only by damaging the cell wall and/or membrane.

Keywords: antibacterial activity, bioluminescence, Glycyrrhiza glabra, natural preservative

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Authors: D. W. M. S. Samarathunga, Isuru Dharmarathne

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In aphasia, various levels of symbolic language processing (semantics) are affected. It is shown that Persons with Aphasia (PWA) often experience more problems comprehending some categories of words than others. The study aimed to determine lexical semantic deficits seen in Auditory Comprehension (AC) and to describe lexical-semantic deficits across six selected word categories. Thirteen (n =13) persons diagnosed with post-stroke aphasia (PSA) were recruited to perform an AC task. Foods, objects, clothes, vehicles, body parts and animals were selected as the six categories. As the test stimuli, black and white line drawings were adapted from a picture set developed for semantic studies by Snodgrass and Vanderwart. A pilot study was conducted with five (n=5) healthy nonbrain damaged Sinhala speaking adults to decide familiarity and applicability of the test material. In the main study, participants were scored based on the accuracy and number of errors shown. The results indicate similar trends of lexical semantic deficits identified in the literature confirming ‘animals’ to be the easiest category to comprehend. Mann-Whitney U test was performed to determine the association between the selected variables and the participants’ performance on AC task. No statistical significance was found between the errors and the type of aphasia reflecting similar patterns described in aphasia literature in other languages. The current study indicates the presence of selectivity of lexical semantic deficits in AC and a hierarchy was developed based on the complexity of the categories to comprehend by Sinhala speaking PWA, which might be clinically beneficial when improving language skills of Sinhala speaking persons with post-stroke aphasia. However, further studies on aphasia should be conducted with larger samples for a longer period to study deficits in Sinhala and other Sri Lankan languages (Tamil and Malay).

Keywords: aphasia, auditory comprehension, selective lexical-semantic deficits, semantic categories

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Authors: Amna Imtiaz

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Aims: To correlate serum ferritin with left ventricular function in beta thalassemia major patients with increased transfusion dependence and to find out whether echocardiography can be used to assess pre clinical cardiac disease in these patients. Methods: The cross sectional study was conducted at Department of Pathology, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad. 60 patients of beta thalassemia major with increased transfusion dependence were enrolled in this study. Serum ferritin levels of all patients were measured by using indirect enzyme linked immunosorbent assay (ELISA). Echocardiography was performed on all patients by a consultant cardiologist by linking conventional echocardiography with tissue Doppler imaging. Ejection fraction and E/A ratio were measured in all patients to assess left ventricular systolic and diastolic function. Results: On the basis of serum ferritin level, patients were divided into three groups. Group I consisted of patients having serum ferritin level equal to or less than 2500 ng/ml. A total of 25 patients were placed in this group. Group II included patients having serum ferritin level between 2500 to 5000 ng/ml. A total of 22 patients were placed in this group. Group III included patients having serum ferritin level more than 5000 ng/ml. This group consisted of 13 patients. All patients having serum ferritin below 2500ng/ml had normal systolic function, and only 16% of the patients in this group had diastolic dysfunction as reflected by abnormal E/A ratio. In group II, 27% of the patients had systolic dysfunction reflected by subnormal ejection fraction while 40% of the patients had diastolic dysfunction. In group III, 62% of the patients had abnormal systolic and diastolic function. Pearson correlation was used to find a correlation between serum ferritin and left ventricular function. A strong negative correlation was found which is reflected by a p value of less than 0.05 which is significant. Chi square test is used to correlate serum ferritin with E/A ratio. P value came out to be less than 0.05 which is significant.

Keywords: beta thalassemia major, left ventricular function, serum ferritin, transfusion dependence

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Authors: Afsaneh Soltani, Zahra Mohajer

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Migraine is one of the most common chronic neurological diseases. Migraines affect different aspects of life. Severe migraine headaches lead to dysfunction, a reduced presence at work, and decreased ability to think and make decisions. Non-pharmacological treatments play a very important role in controlling and preventing migraine headaches. A healthy lifestyle helps control migraine headaches. Migraine headaches can be reduced by following these steps: Avoiding stress, eating regularly and avoiding hunger and thirst, avoiding stimulants such as chocolate, caffeine, and cigarettes, following a regular bedtime routine, or avoiding sleep deprivation. Exercise a lot, and do regular exercise (and prevent obesity). Non-pharmacological treatment is especially important in pregnant women and children because in these cases, medical treatments are not preferred due to the many side effects. Exercise is one of the most effective and uncomplicated non-pharmacological alternatives in the treatment of migraine headaches. Exercising for episodic migraines is a safe, effective, and promising complementary treatment option. Numerous studies have shown that aerobic exercise reduces the severity and duration of migraine headaches. Effective aerobic exercise includes cycling and brisk walking. Exercise improves the quality of life and reduces the use of medication in people with migraines. Patients who exercise have fewer migraine days, resulting in better personal, social, and occupational performance. Several studies have shown that pain intensity and frequency in patients who exercise regularly decreased significantly after exercise compared to controls who did not exercise. According to a study, regular exercise reduces the levels of interleukins, especially IL-12P70, which reduces anxiety and reduces the number of days of migraine in patients. An article has shown that endurance exercise reduces the number of migraine days and also increases cerebrovascular health in migraine patients. According to studies, the minimum duration of exercise to achieve a positive effect of exercise in patients with migraine is 3 months (12 weeks) and 40 minutes three times a week.

Keywords: exercise, headache, migraine, physical activity

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Authors: Chu-Tzu Chen, Angela S. Huang, Yu-Min Chou, Chin-Hui Yang

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Dengue is a major public health concern throughout tropical and sub-tropical regions. Taiwan is located in the Pacific Ocean and overlying the tropical and subtropical zones. The island remains humid throughout the year and receives abundant rainfall, and the temperature is very hot in summer at southern Taiwan. It is ideal for the growth of dengue vectors and would be increasing the risk on dengue outbreaks. During the first half of the 20th century, there were three island-wide dengue outbreaks (1915, 1931, and 1942). After almost forty years of dormancy, a DEN-2 outbreak occurred in Liuchiu Township, Pingtung County in 1981. Thereafter, more dengue outbreaks occurred with different scales in southern Taiwan. However, there were more than ten thousands of dengue cases in 2014 and in 2015. It did not only affect human health, but also caused widespread social disruption and economic losses. The study would like to reveal the epidemiology of dengue on Taiwan, especially the severe outbreak in 2015, and try to find the effective interventions in dengue control including dengue vaccine development for the elderly. Methods: The study applied the Notifiable Diseases Surveillance System database of the Taiwan Centers for Disease Control as data source. All cases were reported with the uniform case definition and confirmed by NS1 rapid diagnosis/laboratory diagnosis. Results: In 2014, Taiwan experienced a serious DEN-1 outbreak with 15,492 locally-acquired cases, including 136 cases of dengue hemorrhagic fever (DHF) which caused 21 deaths. However, a more serious DEN-2 outbreak occurred with 43,419 locally-acquired cases in 2015. The epidemic occurred mainly at Tainan City (22,760 cases) and Kaohsiung City (19,723 cases) in southern Taiwan. The age distribution for the cases were mainly adults. There were 228 deaths due to dengue infection, and the case fatality rate was 5.25 ‰. The average age of them was 73.66 years (range 29-96) and 86.84% of them were older than 60 years. Most of them were comorbidities. To review the clinical manifestations of the 228 death cases, 38.16% (N=87) of them were reported with warning signs, while 51.75% (N=118) were reported without warning signs. Among the 87 death cases reported to dengue with warning signs, 89.53% were diagnosed sever dengue and 84% needed the intensive care. Conclusion: The year 2015 was characterized by large dengue outbreaks worldwide. The risk of serious dengue outbreak may increase significantly in the future, and the elderly is the vulnerable group in Taiwan. However, a dengue vaccine has been licensed for use in people 9-45 years of age living in endemic settings at the end of 2015. In addition to carry out the research to find out new interventions in dengue control, developing the dengue vaccine for the elderly is very important to prevent severe dengue and deaths.

Keywords: case fatality rate, dengue, dengue vaccine, the elderly

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Authors: Rani Fernandez

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As global concerns regarding environmental degradation and climate change intensify, the imperative for sustainable living has never been more critical. This research delves into the role of eco-products in everyday life as a pivotal strategy for achieving sustainability. The study investigates the awareness, adoption, and impact of eco-friendly products on individual and community levels. The research employs a mixed-methods approach, combining surveys, interviews, and case studies to explore consumer perceptions, behaviours, and motivations surrounding the use of eco-products. Additionally, life cycle assessments are conducted to evaluate the environmental footprint of selected eco-products, shedding light on their tangible contributions to sustainability. The findings reveal the diverse range of eco-products available in the market, from biodegradable packaging to energy-efficient appliances, and the extent to which consumers integrate these products into their daily routines. Moreover, the research examines the challenges and opportunities associated with widespread adoption, considering factors such as cost, accessibility, and efficacy. In addition to individual consumption patterns, the study investigates the broader societal impact of eco-product integration. It explores the potential for eco-products to drive systemic change by influencing supply chains, corporate practices, and government policies. The research highlights successful case studies of communities or businesses that have effectively incorporated eco-products, providing valuable insights into scalable models for sustainability. Ultimately, this research contributes to the discourse on sustainable living by elucidating the pivotal role of eco-products in shaping environmentally conscious behaviours. By understanding the dynamics of eco-product adoption, policymakers, businesses, and individuals can collaboratively work towards a more sustainable future. The implications of this study extend beyond academia, informing practical strategies for fostering a global shift towards sustainable consumption and production.

Keywords: eco-friendly, sustainablity, environment, climate change

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Authors: Ranjit Kumar Sahu, Ramakar Jha

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Urban Water Management is the practice of managing freshwater, waste water, and storm water as components of a basin-wide management plan. It builds on existing water supply and sanitation considerations within an urban settlement by incorporating urban water management within the scope of the entire river basin. The pervasive problems generated by urban development have prompted, in the present work, to study the spatial extent of urbanization in Golden Triangle of Odisha connecting the cities Bhubaneswar (20.2700° N, 85.8400° E), Puri (19.8106° N, 85.8314° E) and Konark (19.9000° N, 86.1200° E)., and patterns of periodic changes in urban development (systematic/random) in order to develop future plans for (i) urbanization promotion areas, and (ii) urbanization control areas. Remote Sensing, using USGS (U.S. Geological Survey) Landsat8 maps, supervised classification of the Urban Sprawl has been done for during 1980 - 2014, specifically after 2000. This Work presents the following: (i) Time series analysis of Hydrological data (ground water and rainfall), (ii) Application of SWMM (Storm Water Management Model) and other soft computing techniques for Urban Water Management, and (iii) Uncertainty analysis of model parameters (Urban Sprawl and correlation analysis). The outcome of the study shows drastic growth results in urbanization and depletion of ground water levels in the area that has been discussed briefly. Other relative outcomes like declining trend of rainfall and rise of sand mining in local vicinity has been also discussed. Research on this kind of work will (i) improve water supply and consumption efficiency (ii) Upgrade drinking water quality and waste water treatment (iii) Increase economic efficiency of services to sustain operations and investments for water, waste water, and storm water management, and (iv) engage communities to reflect their needs and knowledge for water management.

Keywords: Storm Water Management Model (SWMM), uncertainty analysis, urban sprawl, land use change

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Authors: Emmanuel Nkemakolam Okwuduba, Fransica Chinelo Offiah

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The technique of teaching chemistry to students is one of the determining factors towards their achievement. Thus, the study investigated the relationship between classroom interaction patterns and students’ achievement in Chemistry. The purpose of this study was to identify patterns of interaction in an observed chemistry classroom, determine the amount of teacher talk, student talk and period of silence and to find out the relationship between them and the mean achievement scores of students. Five research questions and three hypotheses guided the study. The study was a correlational survey. The sample consisted of 450 (212males and 238 females) senior secondary one students and 12 (5males and 7 females) chemistry teachers drawn from 12 selected secondary schools in Awka Education Zone of Anambra state. In each of the 12 selected schools, an intact class was used. Science Interaction Category (SIC) and Chemistry Achievement Test (CAT) were developed, validated and used for data collection. Each teacher was observed three times and the interaction patterns coded using a coding sheet containing the Science Interaction Category. At the end of the observational period, the Chemistry Achievement Test (for collection of data on students’ achievement in chemistry) was administered on the students. Frequencies, percentage, mean, standard deviation and Pearson product moment correlation were used for data analysis. The result showed that the percentages of teacher talk, student talk and silence were 59.6%, 37.6% and 2.8% respectively. The Pearson correlation coefficient(r) for teacher talk, student talk and silence were -0.61, 0.76 and-0.18 respectively. The result showed negative and significant relationship between teacher talk and mean achievement scores of students; positive and significant relationship between student talk and mean achievement scores of students but there is no relationship between period of silence and mean achievement scores of students at 0.05 significant levels. The following recommendations were made based on the findings: teachers should establish high level of student talk through initiation and response as it promotes involvement and enhances achievement.

Keywords: academic achievement, chemistry, classroom, interactions patterns

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Authors: Emmanuel Olasope Bamigboye, Ismail Oladeji Oladosu

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Local people of south-western Nigeria like in other climes, continue to be confronted with the vagaries of changing environments. Through the modification of existing practice and shifting resource base, their strategies for coping with change have enabled them to successfully negotiate the shifts in climate change and the environment. This article analyses indigenous adaptation strategies for climate change with a view to enhancing sustainable crop farming in south –western Nigeria. Multi-stage sampling procedure was used to select 340 respondents from the two major ecological zones (Forest and Derived Savannah) for good geographical spread. The article draws on mixed methods of qualitative research, literature review, field observations, informal interview and multinomial logit regression to capture choice probabilities across the various options of climate change adaptation options among arable crop farmers. The study revealed that most 85.0% of the arable crop farmers were males. It also showed that the use of local climate change adaptation strategies had no relationship with the educational level of the respondents as 77.3% had educational experiences at varying levels. Furthermore, the findings showed that seven local adaptation strategies were commonly utilized by arable crop farmers. Nonetheless, crop diversification, consultation with rainmakers and involvement in non-agricultural ventures were prioritized in the order of 1-3, respectively. Also, multinomial logit analysis result showed that at p ≤ 0.05 level of significance, household size (P<0.08), sex (p<0.06), access to loan(p<0.16), age(p<0.07), educational level (P<0.17) and functional extension contact (P<0.28) were all important in explaining the indigenous climate change adaptation utilized by the arable crops farmers in south-western Nigeria. The study concluded that all the identified local adaptation strategies need to be integrated into the development process for sustainable climate change adaptation.

Keywords: crop diversification, climate change, adaptation option, sustainable, small farmers

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Authors: Mervat Kassem, Nourhan Fanaki, F. Dabbous, Hamida Abou-Shleib, Y. R. Abdel-Fattah

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With increasing environmental awareness and emphasis on a sustainable society in harmony with the global environment, biosurfactants are gaining prominence and have already taken over for a number of important industrial uses. They are produced by living organisms, for examples Pseudomonas aeruginosa which produces rhamnolipids, Candida (formerly Torulopsis) bombicola, which produces high yields of sophorolipids from vegetable oils and sugars and Bacillus subtilis which produces a lipopeptide called surfactin. The main goal of this work was to optimize biosurfactants production by an environmental Gram positive isolate for large scale production with maximum yield and low cost. After molecular characterization, phylogenetic tree was constructed where it was found to be B. subtilis, which close matches to B. subtilis subsp. subtilis strain CICC 10260. For optimizing its biosurfactants production, sequential statistical design using Plackett-Burman and response surface methodology, was applied where 11 variables were screened. When analyzing the regression coefficients for the 11 variables, pH, glucose, glycerol, yeast extract, ammonium chloride and ammonium nitrate were found to have a positive effect on the biosurfactants production. Ammonium nitrate, pH and glucose were further studied as significant independent variables for Box-Behnken design and their optimal levels were estimated and were found to be 7.328 pH value, 3 g% glucose and 0.21g % ammonium nitrate yielding high biosurfactants concentration that reduced the surface tension of the culture medium from 72 to 18.16 mN/m. Next, kinetics of cell growth and biosurfactants production by the tested B. subtilis isolate, in bioreactor was compared with that of shake flask where the maximum growth and specific growth (µ) in the bioreactor was higher by about 25 and 53%, respectively, than in shake flask experiment, while the biosurfactants production kinetics was almost the same in both shake flask and bioreactor experiments.

Keywords: biosurfactants, B. subtilis, molecular identification, phylogenetic trees, Plackett-Burman design, Box-Behnken design, 16S rRNA

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Authors: Michaels Aibangbee, Sowbhagya Micheal, Pranee Liamputtong, Elias Mpofu, Tinashe Dune

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Background: The challenges migrants and refugee youth (MRY) experience in maintaining their sexual and reproductive health and rights (SRHR) continues to be a global public health issue. Consequently, MRY is more likely to encounter adverse SRH experiences due to limited access to and knowledge of SRH services. Using a socio-ecological framework, this study examined the MRY’s SRHR micro-level experiences to macro-levels analyses of SRH-related social systems and constructions. Methods: Eighteen focus groups were conducted using participatory action research (PAR) methodology to understand the phenomena. The focus groups included MRY participants (ages 16-26) living in Greater Western Sydney and facilitated by youth project liaisons (YPL). The data was afterward synthesised and analysed using the thematic-synthesis method. Results: In total, 86 MRY (male n= 25, female n= 61) MRY (across 20 different cultural backgrounds) participated in the focus groups. The findings identified socio-ecological factors characterising MRY SRHR, highlighting facilitators such as social media and significant barriers such as lack of access to services and socio-cultural dissonance, and the under-implementation of SRHR support and services by MRY. Key themes from the data included traditional and institutional stigma, lack of SRH education, high reliance on social media for SRH information, anonymity, and privacy concerns. Conclusion: The data shows a limited extent to which MRY SRHR is considered and the intergenerational understanding and stigma affecting the rights of MRY. Therefore, these findings suggest a need for policies and practices to empower MRY’s agency through a collaborative SRHR strategy and policy design to maintain relevance in multicultural contexts.

Keywords: migrant and refugee youth, sexual health, reproductive health, sexual and reproductive health and rights, culture, agency

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Authors: Davaakhuu Vandannyam, Amarsaikhan Dashtseren, Oyungoo Badamdorj

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Background: Shift work and extended working hours are increasing in many industries and organization's in the world. Over a 24 hour period, the circadian clock regulates sleep/wake patterns, body temperature, hormone levels, digestion and many other functions. Depending on the time of day or night, the human body is programmed for periods of wakefulness and sleep, high and low body temperature, high and low digestive activity and so on. Shift work is highly prevalent in industrialized societies (>20%) but, when it includes night work, it has pronounced negative effects on sleep, subjective and physiological sleepiness, performance, accident risk, as well as on health outcomes such as cardiovascular disease and certain forms of cancer. Method: In this cross-sectional field study, 634 shift work and day work nurses from a plant were involved, with participation rate of 100% (634 nurses). The general health questionnaire (GHQ-28) and RLS, ESS, ISI, FSS were used to evaluate the level of insomnia, sleepiness, fatigue and restless legs syndrome, respectively. Results: As a result of research on some indicators of health risks caused from work shift, it was proven that prevalence of restless legs syndrome was at 5.5% and 25.9% are in risk of becoming sick, 42.3% are in fatigue, 3.5% in high stage of insomnia and 27.4% are sleepy on duty. Insomnia of nurses mainly affected from long-hour shift, dissatisfaction, workload, lose of focus and use of coffee. There is sleepiness lies in the workplace due to number of shifts, unsatisfactory performance and emergency calls between shifts. It has been determined that risk of sickness influenced by number of shifts in a month and long hour shift, dissatisfaction and use of coffee and divisions are causing restless legs syndrome. Conclusions: Among the nurses, it was found that the prevalence of insomnia is 31.6%, sleepiness 27.4%, fatigue 42.3%, restless legs syndrome 35% and stress 25.9%. These factors of shift work affecting health tend to go up as working hours increase and more common among shift work nurses.

Keywords: shiftwork, insomnia, sleepiness, restless

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Authors: Zhang Cong, Cai Runlin, Jia Fengjiao

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The evolution of the urban agglomeration spatial structure requires strong support of the inter-city traffic system. And the inter-city traffic system can not only meet the demand of the urban agglomeration transportation but also guide the economic development. To correctly understand the relationship between inter-city traffic planning and urban agglomeration can help the urban agglomeration coordinated developing with the inter-city traffic system. The Yangtze River Delta is one of the most representative urban agglomerations in China with strong economic vitality, high city levels, diversified urban space form, and improved transport infrastructure. With the promotion of industrial division in the Yangtze River Delta and the regional travel facilitation brought by inter-city traffic, the urban agglomeration is characterized by highly increasing of inter-city transportation demand, the urbanization of regional traffic, adjacent regional transportation links breaking administrative boundaries, the networked channels and so on. Therefore, the development of inter-city traffic system presents new trends and challenges. This paper studies the interactions between inter-city traffic system and regional economic growth, regional factor flow, and regional spatial structure evolution in the Yangtze River Delta from two dimensions of time and space. On this basis, the adaptability of inter-city traffic development mode and urban agglomeration space structure is analyzed. First of all, the coordination between urban agglomeration planning and inter-city traffic planning is judged from the planning level. Secondly, the coordination between inter-city traffic elements and industries and population distributions is judged from the perspective of space. Finally, the coordination of the cross-regional planning and construction of inter-city traffic system is judged. The conclusions can provide an empirical reference for intercity traffic planning in Yangtze River Delta region and other urban agglomerations, and it is also of great significance to optimize the allocation of urban agglomerations and the overall operational efficiency.

Keywords: evolution, interaction, inter-city traffic system, spatial structure

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Authors: A. Abdulkadir, A. A. Okhimamhe, Y. M. Bello, H. Ibrahim, D. H. Makun, M. T. Usman

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Household waste form a larger proportion of waste generated across the state, accumulation of organic waste is an apparent problem and the existing dump sites could be overstressed. Niger state has abundant arable land and water resources thus should be one of the highest producers of agricultural crops in the country. However, the major challenge to agricultural sector today is the loss of soil nutrient coupled with high cost of fertilizer. These have continued to increase the use of fertilizer and decomposed solid waste for enhancing agricultural yield, which have varying effects on the soil as well a threat to human livelihood. Consequently, vegetable yield samples from poultry droppings decomposed household waste manure, NPK treatments and control from each replication were subjected to proximate analysis to determine the nutritional and anti-nutritional component as well as heavy metal concentration. Data collected was analyzed using SPSS software and Randomized complete Block Design means were compared. The result shows that the treatments do not devoid the concentrations of any nutritional components while the anti-nutritional analysis proved that NPK had higher oxalate content than control and organic treats. The concentration of lead and cadmium are within safe permissible level while the mercury level exceeded the FAO/WHO maximum permissible limit for the entire treatments depicts the need for urgent intervention to minimize mercury levels in soil and manure in order to mitigate its toxic effect. Thus, eco-agriculture should be widely accepted and promoted by the stakeholders for soil amendment, higher yield, strategies for sustainable environmental protection, food security, poverty eradication, attainment of sustainable development and healthy livelihood.

Keywords: anti-nutritional, healthy livelihood, nutritional waste, organic waste

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Authors: Lee A. Browne, K. Rumbold

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The first fluorinating enzyme, 5'-fluoro-5'-deoxyadenosine synthase (fluorinase) was isolated from the soil bacterium Streptomyces cattleya. Such an enzyme, with the ability to catalyze a C-F bond, presents great potential as a biocatalyst. Naturally fluorinated compounds are extremely rare in nature. As a result, the number of fluorinases identified remains relatively few. The field of fluorination is almost completely synthetic. However, with the increasing demand for fluorinated organic compounds of commercial value in the agrochemical, pharmaceutical and materials industries, it has become necessary to utilize biologically based methods such as biocatalysts. A key step in this crucial process is the large-scale production of the fluorinase enzyme in considerable quantities for industrial applications. Thus, this study aimed to optimize expression of the fluorinase enzyme in both prokaryotic and eukaryotic expression systems in order to obtain high protein yields. The fluorinase gene was cloned into the pET 41b(+) and pPinkα-HC vectors and used to transform the expression hosts, E.coli BL21(DE3) and Pichia pastoris (PichiaPink™ strains) respectively. Expression trials were conducted to select optimal conditions for expression in both expression systems. Fluorinase catalyses a reaction between S-adenosyl-L-Methionine (SAM) and fluoride ion to produce 5'-fluorodeoxyadenosine (5'FDA) and L-Methionine. The activity of the enzyme was determined using HPLC by measuring the product of the reaction 5'FDA. A gradient mobile phase of 95:5 v/v 50mM potassium phosphate buffer to a final mobile phase containing 80:20 v/v 50mM potassium phosphate buffer and acetonitrile were used. This resulted in the complete separation of SAM and 5’-FDA which eluted at 1.3 minutes and 3.4 minutes respectively. This proved that the fluorinase enzyme was active. Optimising expression of the fluorinase enzyme was successful in both E.coli and PichiaPink™ where high expression levels in both expression systems were achieved. Protein production will be scaled up in PichiaPink™ using fermentation to achieve large-scale protein production. High level expression of protein is essential in biocatalysis for the availability of enzymes for industrial applications.

Keywords: biocatalyst, expression, fluorinase, PichiaPink™

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Authors: Jean Paul Hategekimana, Dukuzumuremyi Yvonne, Mukeshimana Marthe, Alexandre Niyonshima

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Sweet potato (Ipomoea batatas) is a very important staple food crop in Rwanda due to its high growth and consumption in all parts of the country. The effect of seven different storage conditions on the quality and nutritional composition of the three most grown and consumed varieties of orange-fleshed sweet potato (OFSP), namely Kabode, Terimbere, and Vita, were studied over a period of six weeks at Postharvest Service and Training Center of University Rwanda, Busogo Campus. The potato stored under the following conditions (zero energy cooling chamber, ground washed sweet potato, ground unwashed sweet potato, perforated washed sweet potato, perforated unwashed sweet potato, non-perforated washed sweet potato, and non-perforated unwashed sweet potato) were assessed in this study. These storage conditions are the modifications of existing methods currently used in Rwanda for suitable local climatic conditions. Hence, 30kgs of freshly harvested OFSP for each variety were bought from farmers of Gakenke and Rulindo districts and then transported to the postharvest training and service center UR-CAVM, Busogo Campus. 2.5kg of each potato sample was selected and stored under the above-mentioned storage conditions after pretreatment. Data were collected for six weeks on percent weight loss, shrinkability and the general appearance at interval of three days. The stored samples were also analyzed for moisture, crude ash, crude fiber, and reduced sugar levels during the entire storage period. Results showed the difference among the various storage conditions. It was shown that ZECC and non-perforated sacs (in the open air) storage techniques had good potential for storage of orange flesh sweet potato for up to six weeks without considerable change in physical and nutritional parameters compared to other considered conditions and, therefore, can be recommended as more useful for OSFP at farm level and during transport and market storage.

Keywords: ZECC, orange fleshed sweet potato, perforated sacs, storage conditions

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Authors: Patrick Oehler, Nicholas Folger

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Following a new public management approach, Germany has widely reformed its higher education system around the turn of the millennium. Aimed at preparing the country’s publicly funded universities and applied science colleges for a century of glory, the reforms led to the introduction of rigid performance measurement and management practices, which disrupted the inert system on all levels. Yet, many of the new policies met significant resistance, and some of them had to be reversed over time. Ever since Germany has struggled to find a balance between its pre- and its post-millennial approach to performance measurement and management. This contribution combines insights of a joint research project, which was created and funded by the German Federal Ministry of Education and Research with the aim to better understand the effects of its performance measurement and management policies, including those the ministry had implemented over the previous decades. The research project combines researchers from 17 German research institutions who employed a wide range of theories from various disciplines and very diverse research methods to explain performance measurement and management and their consequences on the behavior of various stakeholders in higher education systems. In these projects, performance measurement and management have been researched from three angles—education, research, and third mission. The collaborative project differentiated functional and dysfunctional elements of common performance measurement and management practices, and identified key problems with these practices, such as (1) oversimplification of performance indicators, (2) ‘overmeasurement’ of performance in general, (3) excessive use of quantitative indicators, and (4), a myopic focus on research-focused indicators and a negligence of measures targeting education and third mission. To address these issues, the collaborative project developed alternative approaches to performance measurement and management, including suggestions for qualitative performance measures, improved supervision, review, and evaluations methods, and recommendations how to better balance education, research, and third mission. The authors would like to share the rich findings of the joint research project with an international audience and discuss their implications for alternative higher education systems.

Keywords: performance measurement, performance management, new public management, performance evaluation

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Authors: Patrick Ebong Ebewo

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The trend of high unemployment levels globally is a growing concern, which suggests that university students especially those studying the creative industries are most likely to face unemployment upon completion of their studies. Therefore the effort of university in fostering entrepreneurial knowledge is equally important to the development of student’s soft skill. The purpose of this paper is to assess the significance of perceived university environment and perceived educational support that influencing University students’ intention in starting their own business in the future. Thus, attempting to answer the question 'How does perceived university environment affect students’ attitude towards entrepreneurship as a career option, perceived entrepreneurial abilities, subjective norm and entrepreneurial intentions?' The study is based on the Theory of Planned Behaviour model adapted from previous studies and empirically tested on graduates at the Tshwane University of Technology. A sample of 150 graduates from the Arts and Design graduates took part in the study and data collected were analysed using structural equation modelling (SEM). Our findings seem to suggest the indirect impact of perceived university environment on entrepreneurial intention through perceived environment support and perceived entrepreneurial abilities. Thus, any increase in perceived university environment might influence students to become entrepreneurs. Based on these results, it is recommended that: (a) Tshwane University of Technology and other universities of technology should establish an ‘Entrepreneurship Internship Programme’ as a tool for stimulated work integrated learning. Post-graduation intervention could be implemented by the development of a ‘Graduate Entrepreneurship Program’ which should be embedded in the Bachelor of Technology (B-Tech now Advance Diploma) and Postgraduate courses; (b) Policymakers should consider the development of a coherent national policy framework that addresses entrepreneurship for the Arts/creative industries sector. This would create the enabling environment for the evolution of Higher Education Institutions from merely Teaching, Learning & Research to becoming drivers for creative entrepreneurship.

Keywords: business venture, entrepreneurship education, entrepreneurial intent, university environment

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Authors: Celeste E. van Rinsum, Sanne M. P. L. Gerards, Geert M. Rutten, Ien A. M. van de Goor, Stef P. J. Kremers

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Combined lifestyle interventions have shown to be effective in changing and maintaining behavioral lifestyle changes and reducing overweight and obesity. A lifestyle coach is expected to promote lifestyle changes in adults related to physical activity and diet. The present Coaching on Lifestyle (CooL) study examined participants’ physical activity level, dietary behavioral, and motivational changes immediately after the intervention and at 1.5 years after baseline. In CooL intervention a lifestyle coach coaches individuals from eighteen years and older with (a high risk of) obesity in group and individual sessions. In addition a process evaluation was conducted in order to examine the implementation process and to be able to interpret the changes within the participants. This action-oriented research has a pre-post design. Participants of the CooL intervention (N = 200) completed three questionnaires: at baseline, immediately after the intervention (on average after 44 weeks), and at 1.5 years after baseline. T-tests and linear regressions were conducted to test self-reported changes in physical activity (IPAQ), dietary behaviors, their quality of motivation for physical activity (BREQ-3) and for diet (REBS), body mass index (BMI), and quality of life (EQ-5D-3L). For the process evaluation, we used individual and group interviews, observations and document analyses to gain insight in the implementation process (e.g. the recruitment) and how the intervention was valued by the participants, lifestyle coaches, and referrers. The study is currently ongoing and therefore the results presented here are preliminary. On average, the participants that finished the intervention and those that have completed the long-term measurement improved their level of vigorous-intense physical activity, sedentary behavior, sugar-sweetened beverage consumption and BMI. Mixed results were observed in motivational regulation for physical activity and nutrition. Moreover, an improvement on the quality of life dimension anxiety/depression was found, also in the long-term. All the other constructs did not show significant change over time. The results of the process evaluation have shown that recruitment of clients was difficult. Participants evaluated the intervention positively and the lifestyle coaches have continuously adapted the structure and contents of the intervention throughout the study period, based on their experiences and feedback from research. Preliminary results indicate that the CooL-intervention may have beneficial effects on overweight and obese participants in terms of energy balance-related behaviors, weight reduction, and quality of life. Recruitment of participants and embedding the position of the lifestyle coach in traditional care structures is challenging.

Keywords: combined lifestyle intervention, effect evaluation, lifestyle coaching, process evaluation, overweight, the Netherlands

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Authors: Jorn Fricke, Frans Melissen

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Citizens in urban areas are prone to increased levels of stress due to urbanization, inadequate and overburdened infrastructure and services, and environmental degradation. Moreover, communities are fragile and subject to shocks and stresses through various social and political processes. A loss of (a sense of) community is often seen as related to increasing political and civic disintegration. Feelings of community can manifest themselves in various ways but underlying all these manifestations is the need for trust between people. One of the main drivers of trust between individuals is (shared) experiences. It is these shared experiences that may play an important role in building resilience, i.e., the ability of a community and its members to adapt to and deal with stresses, as well as ensure the ongoing development of a community. So far, experience design, as a discipline and academic field, has mainly focused on designing products or services. However, people-to-people experiences are the ones that play a pivotal role in building inclusiveness, safety, and resilience in communities. These experiences represent challenging objects of design as they develop in an interactive space of spontaneity, serendipity, and uniqueness that is based on intuition, freedom of expression, and interaction. Therefore, there is a need for research to identify which elements are required in designing the social and physical environment (or ‘experience scape’) to increase the chance for people-to-people experiences to be successful and what elements are required for these experiences to help in building resilience in urban communities that can resist shocks and stresses. By means of a comparative case study approach in urban areas in Germany and the Netherlands, using a range of qualitative research methods such as in-depth interviews, focus groups, participant observation, storytelling techniques, and life stories, this research identifies relevant actors and their roles in creating building blocks of optimal experience scrapes for building resilience in communities.

Keywords: community development, experiences, experience scapes, resilience

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Authors: Kwasi Sarfo, Bernard Okoampah Otu

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The 1992 constitution of the Republic of Ghana recognises the authority and roles of traditional leaders and considers them as being entrusted with fiduciary responsibility over land in their respective territories. The new land act, Act 1036 of 2020, in buttressing the fiduciary role of traditional leaders in land matters, inserted the traditional leaders’ accountability clause. Many traditional leaders have expressed their misgivings about the insertion of this clause. Therefore, there appears to be a misunderstanding of the concept of fiduciary in land management in Ghana. The objective of this study is to examine the concept of fiduciary in respect of allodial rights holders in land management and administration and how this concept is perceived and applied by traditional leaders. The study seeks to provide insights into the discrepancy between fiduciary theory and its practical implementation in Ghana. The study is based on a qualitative empirical research approach and adopts in-depth interviews as a primary method of data collection. The study also adopts the theory of New Institutionalism of social anthropology in analysing and interpreting the findings. The data for this study was collected over a period of one year, from July 2022 to July 2023, as part of one of the author's PhD dissertation. The collected data were carefully analysed using the principles of thematic analysis, identifying key themes and patterns. This study does not seek to pursue the discussions from a legal standpoint but from a social anthropological perspective and argues that the concept of fiduciary in theory is far different from what pertains in practice and that traditional leaders’ assumptions and application of this concept contribute to the alienation of customary and communal land at the expense of their subjects. This study deepens our understanding of the continuous expropriation of communal landholders in many rural communities in Africa in the era of global land grabbing, which worsens their poverty levels. It also explains further the theory of new institutionalism of social anthropology by highlighting how the theory manifests in practice in the case of Ghana.

Keywords: fiduciary, customary land tenure, allodial rights, land alienation, communal land, Ghana

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Authors: Fabiola Xavier Leal, Lara Campanharo, Sueli Aparecida Rodrigues Lucas

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The phenomenon of judicialization in health policy brings with it a great deal of problematization, but in general, it means that some issues that were previously solved by traditional political bodies are being decided by the Judiciary bodies. It is, therefore, a controversial topic that has generated many reflections both in the academic and political fields, considering that not only a dispute of public funds is at stake, but also the debate on access to social rights provided for in the Brazilian Federal Constitution of 1988 and in the various public policies, such as healthcare. With regard to the phenomenon in the Mental Health Policy focusing on people who use drugs, the disputes that permeate this scenario are evident: moral, cultural, sanitary, economic, psychological aspects. There are also the individual and collective dimensions of suffering. And in this process, we all question: What is the role of the Brazilian State in this matter? In this context, another question that needs to be answered is the amount spent on this procedure in the state of Espírito Santo (ES), Brazil (in the last 04 years, around R$121,978,591.44 were paid only for compulsory hospitalization of individuals) in the field in question, which is the financing of the services of the Psychosocial Care Network (RAPS). Therefore, this article aims to problematize the phenomenon of judicialization in Mental Health Policy through the compulsory hospitalization of people who use drugs in Espírito Santo (ES). We proposed a study that sought to understand how this has been occurring and making an impact on the provision of RAPS services in the Espírito Santo scenario. Therefore, the general objective of this study is to analyze the expenses with compulsory hospitalizations for drug use carried out by the State Health Department (SESA) between 2014 and 2019, in which we will seek to identify its destination and the impact of these actions on public health policy. For the purposes of this article, we will present the preliminary data of this study, such as the amount spent by the state and the receiving institutions. For data collection, the following data sources were used: documents available publicly on the Transparency Portal (payments made per year, institutions that received, subjects hospitalized, period and the amount of the daily rates paid); as well as the processes generated by SESA through its own system - ONBASE. For qualitative analysis, content analysis was used; and for quantitative analysis, descriptive statistics was used. Thus, we seek to problematize the issue of judicialization for compulsory hospitalizations, considering the current situation in which this resource has been widely requested to legitimize the war on drugs. This scenario highlights the moral-legal discourse, pointing out strategies through the control of bodies and through faith as an alternative.

Keywords: compulsory hospitalization, drugs, judicialization, mental health

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Authors: Anka Gorgiev, Chris Martin, Nikolaos Dimitriadis, Dimitrios V. Nikolaidis

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This paper is part of a doctoral research study aimed to identify behavioral indicators for the existence of the new marketing paradigm. Neuromarketing is becoming a growing trend in the marketing industry worldwide and it is capturing a lot of interest among the members of academia and the practitioner community. However, it is still not very clear how big of an impact neuromarketing might have in the following years. In an effort to get closer to an answer, this study investigates behavioral intentions and willingness to adopt neuromarketing and its practices by the marketing professionals, including academics, practitioners, students, researchers, experts and journal editors. The participants in the study include marketing professionals at different levels of neuromarketing fluency with residency in the United States of America and the South East Europe. The total of 19 participants participated in the interviews, all of whom belong to more than one group of marketing professionals. The authors use qualitative research approach and open-ended interview questions specifically developed to assess ideas, beliefs and opinions that marketing professionals hold towards neuromarketing. In constructing the interview questions, the authors have used the theory of planned behavior, the prototype willingness model and the technology acceptance model as a theoretical framework. Previous studies have not explicitly investigated the behavioral intentions of marketing professionals to engage in neuromarketing behavior, which is described here as a tendency to apply neuromarketing assumptions and tools in usual marketing practices. This study suggests that the marketing professionals believe that neuromarketing can contribute to the business in a positive way and outlines the main advantages and disadvantages of adopting neuromarketing as identified by the participants. In addition, the study reveals an emerging image of an exemplar company that is perceived to be using neuromarketing, including the most common characteristics and attributes. These findings are believed to be crucial in facilitating a way for neuromarketing field to have a broader impact than it currently does by recognizing and understanding the limitations that such exemplars imply and how that has an effect on the decision-making of marketing professionals.

Keywords: behavioral intentions, marketing paradigm, neuromarketing adoption, theory of planned behavior

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Authors: Okan Cakir, Okan Tatli

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Acute motor and sensory axonal neuropathy (AMSAN) syndrome usually occurs following a postviral infection in two to four weeks and is a polyneuropathy characterized by axonal and sensorial degeneration as a rare variant of Gullian-Barre syndrome. In our case, we wanted to mention that a rare case of AMSAN Syndrome due to prior surgery. A 61-year-old male case admitted to emergency department with complaints of weakness in feet, numbness and incapability to walk. In his history, it was learned that endovascular aneurysm repair (EVAR) had applied for abdominal aort aneurysm two weeks ago before admission, his complaints had been for a couple of days increasingly and bilaterally, and there had been no infection disease history for four weeks. In physical examination, general status was good, vital signs were stable, and there was a mild paresis in dorsal flexion of feet in bilaterally lower extremities. No nuchal rigidity was determined. Other system examinations were normal. Urea:52 mg/dL (normal range: 15-44 mg/dL), creatinine: 1,05 mg/dL (normal range: 0,81-1,4 mg/dL), potassium: 3,68 mmol/L (normal range: 3,5-5,5 mmol/L), glycaemia: 142 mg/dL, calcium: 9,71 mg/dL (normal range: 8,5-10,5 mg/dL), erythrocyte sedimentation rate (ESR): 74 mm/h (normal range: 0-15 mm/h) were determined in biochemical tests. The case was consulted to neurology department and hospitalized. In performing electromyography, it was reported as a bilateral significant axonal degeneration with sensory-motor polyneuropathy. Normal ranges of glycaemia and protein levels were detected in lumbal punction. Viral markers and bucella, toxoplasma, and rubella markers were in normal range. Intravenous immunoglobulin (IVIG) was applied as a treatment, physical treatment programme was planned and the case discharged from neurology department. In our case, we mentioned that it should be considered polyneuropathy as an alternative diagnosis in cases admitting symptoms like weakness and numbness had a history of prior surgery.

Keywords: AMSAN Syndrome, emergency department, prior surgery, weakness

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Authors: Satoko Yamasaki, Hiromi Kawasaki, Kotomi Yamashita, Susumu Fukita, Kei Sounai

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People are susceptible to rumors when the cause of their health problems is unknown or invisible. In order for individuals to be unaffected by rumors, they need basic knowledge and correct information. Community health nursing classes use cases where basic knowledge of radiation can be utilized on a regular basis, thereby teaching that basic knowledge is important in preventing anxiety caused by rumors. Nursing students need to learn that preventive activities are essential for public health nursing care. This is the same methodology used to reduce COVID-19 anxiety among individuals. This study verifies the learning effect concerning the basic knowledge of radiation necessary for case consultation by emergency distance learning. Sixty third-year nursing college students agreed to participate in this research. The knowledge tests conducted before and after classes were compared, with the chi-square test used for testing. There were five knowledge questions regarding distance lessons. This was considered to be 5% significant. The students’ reports which describe the results of responding to health consultations, were analyzed qualitatively and descriptively. In this case study, a person living in an area not affected by radiation was anxious about drinking water and, thus, consulted with a student. The contents of the lecture were selected the minimum amount of knowledge used for the answers of the consultant; specifically hot spots, internal exposure risk, food safety, characteristics of cesium-137, and precautions for counselors. Before taking the class, the most correctly answered question by students concerned daily behavior at risk of internal exposure (52.2%). The question with the fewest correct answers was the selection of places that are likely to be hot spots (3.4%). All responses increased significantly after taking the class (p < 0.001). The answers to the counselors, as written by the students, were 'Cesium is strongly bound to the soil, so it is difficult to transfer to water' and 'Water quality test results of tap water are posted on the city's website.' These were concrete answers obtained by using specialized knowledge. Even in emergency distance learning, the students gained basic knowledge regarding radiation and created a document to utilize said knowledge while assuming the situation concretely. It was thought that the flipped classroom method, even if conducted remotely, could maintain students' learning. It was thought that setting specific knowledge and scenes to be used would enhance the learning effect. By changing the case to concern that of the anxiety caused by infectious diseases, students may be able to effectively gain the basic knowledge to decrease the anxiety of residents due to infectious diseases.

Keywords: effect of class, emergency distance learning, nursing student, radiation

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Authors: C. Mayuren, C. K. Paul Wang, K. Purushotham, C. Dinesh Kumar

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Diabetes Mellitus (DM) is one of the most common non-communicable diseases globally. Although significant advances have led to better understanding of the condition and the development of effective therapies and preventive strategies, the pathway to cure remains elusive and DM prevails as a serious medical challenge in the 21st century. Oxidative stress has been suggested to contribute to the progression and pathophysiological conditions of diabetes. Madecassoside (MA) a major pentacyclic triterpenoid, has been demonstrated to possess various biological activities. However, no attempt has been made to study the antioxidant activity in diabetic rats. Therefore, the present study is aimed to evaluate the antioxidant effect of MA on streptozotocin-nicotinamide induced type-2 diabetes in Sprague-Dawley rats. The study protocol was approved by the institutional ethical committee prior to the conduct of research. Adult male Sprague-Dawley rats weighing 250-300 g were used in the study. The animals were rendered diabetic with a single intraperitoneal dose of streptozotocin (65 mg/kg) and nicotinamide (110 mg/kg). The diabetic animals after a stabilisation period of 14 days received various treatments (Madecassoside 50 mg/kg; Glimepiride 2.5 mg/kg) suspended in 0.5% carboxymethyl cellulose orally, for a period of 28 days. The animals fasted overnight after the last treatment were sacrificed and the pancreas, liver and kidneys were isolated. The weighted quantity of the samples of various treatments were homogenised in ice-cold condition and were subjected to lipid peroxidation, catalase and superoxide dismutase assay. The data’s obtained were subjected to statistical analysis. Diabetic rats showed significant increase in lipid peroxidation and decrease in enzymatic antioxidant levels. All the treated groups had significantly higher SOD, CAT and reduced LPO activity in the pancreas, liver and kidney. Results suggest madecassoside to have potential antioxidant effect against the diabetic model. However further investigations are necessary to study the mechanism at the cellular level.

Keywords: antioxidant, diabetes, madecassoside, nicotinamide, streptozotocin

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Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

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Authors: Birendra Kumar Bista, Rhitik Bista, Prafulla Koirala, Lokendra Mandal, Nikrsh Raj Shrestha, Vivek Kattel

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Introduction: Poorly controlled diabetes is associated with cause and poor outcome of stroke. High blood sugar reduces cerebral blood flow, increases intracranial pressure, cerebral edema and neuronal death, especially among patients with poorly controlled diabetes.1 SGLT2 inhibitors are associated with 50% reduction in hemorrhagic stroke compared with placebo. SGLT2 inhibitors decrease cardiovascular events via reducing glucose, blood pressure, weight, arteriosclerosis, albuminuria and reduction of atrial fibrillation.2,3 No study has been documented in low income countries to see the role of post stroke SGLT2 inhibitors on diabetic patients at and after ICU admission. Aims: The aim of the study was to measure the 12 months outcome of diabetic patients with acute stroke admitted in ICU set up with naïve SGLT2 inhibitors add on therapy. Method: It was prospective cohort study carried out in a 250 bedded tertiary neurology care hospital at the province capital Biratnagar Nepal. Diabetic patient with acute stroke admitted in ICU from 1st January 2022 to 31st December 2022 who were not under SGLT2 inhibitors were included in the study. These patients were managed as per hospital protocol. Empagliflozin was added to the alternate enrolled patients. Empagliflozin was continued at the time of discharged and during follow up unless contraindicated. These patients were followed up for 12 months. Outcome measured were mortality, morbidity requiring readmission or hospital visit other than regular follow up, SGLT2 inhibitors related adverse events, neuropsychiatry comorbidity, functional status and biochemical parameters. Ethical permission was taken from hospital administration and ethical board. Results: Among 147 diabetic cases 68 were not treated with empagliflozin whereas 67 cases were started the SGLT2 inhibitors. HbA1c level and one year mortality was significantly low among patients on empaglifozin arm. Over a period of 12 months 427 acute stroke patients were admitted in the ICU. Out of them 44% were female, 61% hypertensive, 34% diabetic, 57% dyslipidemia, 26% smoker and with median age of 45 years. Among 427 cases 4% required neurosurgical interventions and 76% had hemorrhagic CVA. The most common reason for ICU admission was GCS<8 (51%). The median ICU stay was 5 days. ICU mortality was 21% whereas 1 year mortality was 41% with most common reason being pneumonia. Empaglifozin related adverse effect was seen in 11% most commonly lower urinary tract infection in 6%. Conclusion: Empagliflozin can safely be started among acute stroke with better Hba1C control and low mortality outcome compared to treatment without SGLT2 inhibitor.

Keywords: diabetes, ICU, mortality, SGLT2 inhibitors, stroke

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Authors: Kalayanee Senasu

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This research investigates the influences of different factors on the happiness of Thai people, including both general factors and sustainable ones. Additionally, this study also monitors Thai people’s happiness via Thai Happiness Index developed in 2017. Besides reflecting happiness level of Thai people, this index also identifies related important issues. The data were collected by both secondary related data and primary survey data collected by interviewed questionnaires. The research data were from stratified multi-stage sampling in region, province, district, and enumeration area, and simple random sampling in each enumeration area. The research data cover 20 provinces, including Bangkok and 4-5 provinces in each region of the North, Northeastern, Central, and South. There were 4,960 usable respondents who were at least 15 years old. Statistical analyses included both descriptive and inferential statistics, including hierarchical regression and one-way ANOVA. The Alkire and Foster method was adopted to develop and calculate the Thai happiness index. The results reveal that the quality of household economy plays the most important role in predicting happiness. The results also indicate that quality of family, quality of health, and effectiveness of public administration in the provincial level have positive effects on happiness at about similar levels. For the socio-economic factors, the results reveal that age, education level, and household revenue have significant effects on happiness. For computing Thai happiness index (THaI), the result reveals the 2018 THaI value is 0.556. When people are divided into four groups depending upon their degree of happiness, it is found that a total of 21.1% of population are happy, with 6.0% called deeply happy and 15.1% called extensively happy. A total of 78.9% of population are not-yet-happy, with 31.8% called narrowly happy, and 47.1% called unhappy. A group of happy population reflects the happiness index THaI valued of 0.789, which is much higher than the THaI valued of 0.494 of the not-yet-happy population. Overall Thai people have higher happiness compared to 2017 when the happiness index was 0.506.

Keywords: happiness, quality of life, sustainability, Thai Happiness Index

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Authors: Hasan Muslemani, Xi Liang, Kathi Kaesehage, Francisco Ascui, Jeffrey Wilson

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The creation of a market for lower-carbon steel products, here called ‘green steel’, has been identified as an important means to support the introduction of breakthrough emission reduction technologies into the steel sector. However, the definition of what ‘green’ entails in the context of steel production, the implications on the competitiveness of green steel products in local and international markets, and the necessary market mechanisms to support their successful market penetration remain poorly explored. This paper addresses this gap by holding semi-structured interviews with international sustainability experts and commercial managers from leading steel trade associations, research institutes and steelmakers. Our findings show that there is an urgent need to establish a set of standards to define what ‘greenness’ means in the steelmaking context; standards that avoid market disruptions, unintended consequences, and opportunities for greenwashing. We also highlight that the introduction of green steel products will have implications on product competitiveness on three different levels: 1) between primary and secondary steelmaking routes, 2) with traditional, lesser green steel, and 3) with other substitutable materials (e.g. cement and plastics). This paper emphasises the need for steelmakers to adopt a transitional approach in deploying different low-carbon technologies, based on their stage of technological maturity, applicability in certain country contexts, capacity to reduce emissions over time, and the ability of the investment community to support their deployment. We further identify market mechanisms to support green steel production, including carbon border adjustments and public procurement, highlighting a need for implementing a combination of complementary policies to ensure the products’ roll-out. The study further shows that the auto industry is a likely candidate for green steel consumption, where a market would be supported by price premiums paid by willing consumers, such as those of high-end luxury vehicles.

Keywords: green steel, decarbonisation, business model innovation, market analysis

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