Search results for: nuclear wastage management

Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila

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Introduction: The risk factors for the chronicization of postoperative pain are numerous and often intricately intertwined. Among these, the severity of acute postoperative pain is currently recognized as one of the most determining factors. Mastectomy and thoracotomy are described as among the most painful surgeries and the most likely to lead to chronic post-surgical pain (CPSP). Objective: To examine the aspects of acute postoperative pain potentially involved in the development of chronic pain following breast and thoracic surgery. Patients and Methods: A prospective study involving 164 patients was conducted over a six-month period. Postoperative pain (during mobilization) was assessed using a Visual Analog Scale (VAS) at various time points after surgery: Day 0, 1st, 2nd, 5th days, 1st and 6th months. Moderate to severe pain was defined as a VAS score ≥ 4. A comparative analysis (univariate analysis) of postoperative pain intensities at different evaluation phases was performed on patients with and without CPSP to identify potential associations with the risk of chronicization six months after surgery. Results: At the 6th month post-surgery, the incidence of CPSP was 43.0%. Moderate to severe acute postoperative pain (in the first five days) was observed in 64% of patients. The highest pain scores were reported among thoracic surgery patients. Comparative measures revealed a highly significant association between the presence of moderate to severe acute pain, especially lasting for ≥ 48 hours, and the occurrence of CPSP (p-value <0.0001). Likewise, the persistence of subacute pain (up to 4 to 6 weeks after surgery), especially of moderate to severe intensity, was significantly associated with the risk of chronicization at six months (p-value <0.0001). Conclusion: CPSP after breast and thoracic surgery remains a fairly common morbidity that profoundly affects the quality of life. Severe acute postoperative pain, especially if it is prolonged and/or with a slow decline in intensity, can be an important predictive factor for the risk of chronicization. Therefore, more effective and intensive management of acute postoperative pain, as well as longitudinal monitoring of its trajectory over time, should be an essential component of strategies for preventing chronic pain after surgery.

Keywords: chronic post-surgical pain, acute postoperative pain, breast and thoracic surgery, subacute postoperative pain, pain trajectory, predictive factor

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Authors: Xiping Wang，Shuran Yao, Liqin Dai

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Many studies report the winter is getting warmer and the minimum air temperature is obviously rising as the important climate warming evidences. The exacerbated air temperature fluctuation tending to bring more severe weather variation is another important consequence of recent climate change which induced more disasters to crop growth in quite a certain regions. Hebei Province is an important winter wheat growing province in North of China that recently endures more winter freezing injury influencing the local winter wheat crop management. A winter wheat freezing injury assessment Bayesian Network framework was established for the objectives of estimating, assessing and predicting winter wheat freezing disasters in Hebei Province. In this framework, the freezing disasters was classified as three severity degrees (SI) among all the three types of freezing, i.e., freezing caused by severe cold in anytime in the winter, long extremely cold duration in the winter and freeze-after-thaw in early season after winter. The factors influencing winter wheat freezing SI include time of freezing occurrence, growth status of seedlings, soil moisture, winter wheat variety, the longitude of target region and, the most variable climate factors. The climate factors included in this framework are daily mean and range of air temperature, extreme minimum temperature and number of days during a severe cold weather process, the number of days with the temperature lower than the critical temperature values, accumulated negative temperature in a potential freezing event. The Bayesian Network model was evaluated using actual weather data and crop records at selected sites in Hebei Province using real data. With the multi-stage influences from the various factors, the forecast and assessment of the event-based target variables, freezing injury occurrence and its damage to winter wheat production, were shown better scoped by Bayesian Network model.

Keywords: bayesian networks, climatic change, freezing Injury, winter wheat

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Authors: Sergejs Kolesovs, Pavels Semjonovs

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Whey and dairy wastewaters if disposed in the environment without proper treatment, cause serious environmental risks contributing to overall and particular environmental pollution and climate change. Biological treatment of wastewater is considered to be most eco-friendly approach, as compared to the chemical treatment methods. Research shows, that dairy wastewater can potentially be remediated by use of microalgae thussignificantly reducing the content of carbohydrates, P, N, K and other pollutants. Moreover, it has been shown, that use of dairy wastewaters results in higher microalgae biomass production. In recent decades microalgal biomass has entailed a big interest for its potential applications in pharmaceuticals, biomedicine, health supplementation, cosmetics, animal feed, plant protection, bioremediation and biofuels. It was shown, that lipids productivity on whey and dairy wastewater is higher as compared with standard cultivation media and occurred without the necessity of inducing specific stress conditions such as N starvation. Moreover, microalgae biomass production as usually associated with high production costs may benefit from perspective of both reasons – enhanced microalgae biomass or target substances productivity on cheap growth substrate and effective management of whey and dairy wastewaters, which issignificant for decrease of total production costs in both processes. Obviously, it became especially important when large volume and low cost industrial microalgal biomass production is anticipated for further use in agriculture of crops as plant growth stimulants, biopesticides soil fertilisers or remediating solutions. Environmental load of dairy wastewaters can be significantly decreased when microalgae are grown in coculture with other microorganisms. This enhances the utilisation of lactose, which is main C source in whey and dairy wastewaters when it is not metabolised easily by most microalgal species chosen. Our study showsthat certain microalgae strains can be used in treatment of residual sugars containing industrial wastewaters and decrease of their concentration thus approving that further extensive research on dairy wastewaters pre-treatment optionsfor effective cultivation of microalgae, carbon uptake and metabolism, strain selection and choice of coculture candidates is needed for further optimisation of the process.

Keywords: microalgae, whey, dairy wastewaters, sustainability, plant biostimulants

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Authors: Anusha P. Wijesundara, Dulap I. Rathnayake, Nihal D. Perera

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Bathymetric information is fundamental importance to coastal and marine planning and management, nautical navigation, and scientific studies of marine environments. Satellite-derived bathymetry data provide detailed information in areas where conventional sounding data is lacking and conventional surveys are inaccessible. The two empirical approaches of log-linear bathymetric inversion model and non-linear bathymetric inversion model are applied for deriving bathymetry from high-resolution multispectral satellite imagery. This study compares these two approaches by means of geographical error analysis for the site Kankesanturai using WorldView-2 satellite imagery. Based on the Levenberg-Marquardt method calibrated the parameters of non-linear inversion model and the multiple-linear regression model was applied to calibrate the log-linear inversion model. In order to calibrate both models, Single Beam Echo Sounding (SBES) data in this study area were used as reference points. Residuals were calculated as the difference between the derived depth values and the validation echo sounder bathymetry data and the geographical distribution of model residuals was mapped. The spatial autocorrelation was calculated by comparing the performance of the bathymetric models and the results showing the geographic errors for both models. A spatial error model was constructed from the initial bathymetry estimates and the estimates of autocorrelation. This spatial error model is used to generate more reliable estimates of bathymetry by quantifying autocorrelation of model error and incorporating this into an improved regression model. Log-linear model (R²=0.846) performs better than the non- linear model (R²=0.692). Finally, the spatial error models improved bathymetric estimates derived from linear and non-linear models up to R²=0.854 and R²=0.704 respectively. The Root Mean Square Error (RMSE) was calculated for all reference points in various depth ranges. The magnitude of the prediction error increases with depth for both the log-linear and the non-linear inversion models. Overall RMSE for log-linear and the non-linear inversion models were ±1.532 m and ±2.089 m, respectively.

Keywords: log-linear model, multi spectral, residuals, spatial error model

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Authors: Muhammad Suhail Ibrahim, Muhammad Nadeem, Muhammad Sultan, Uzair Sajjad, Khalid Hamid, Tahir Mahmood Qureshi, Sadaf Javaria

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Metabolic disorders, including hypertension, diabetes, cardiovascular disease etc., are major threats to public health and economy. Management and prevention of alarmingly increasing disorders have attracted researchers to explore natural barriers against these disorders. The objective of this study was to explore oats as a potential source of dietary fiber. Extraction of dietary was optimized by response surface methodology, and five indigenous oat cultivars, including SGD2011, Avon, SGD81, PD2LV65, and S2000, were also characterized for techno-functional characteristics, mineral composition and phytochemical quantification. These cultivars varied significantly (p < 0.05) for oil holding capacity, water saturation, and water holding capacity, respectively. SGD81 showed the highest oil-holding capacity, water-holding capacity, and water saturation due to the highest fraction of dietary fiber. The highest values of total phenolic contents, total flavonoid contents, total flavonol contents, 2, 2-Diphenyl-1-picrylhydrazyl radical scavenging activity, and anthocyanin were shown by SGD81, and SGD2011, respectively. All cultivars varied significantly (P<0.05) with respect to phytochemical quantification. Oat cultivars SGD81 and SGD2011 showed the best phenolic acid profile and can be effectively used as a source of nutraceuticals. Beyond the nutritional properties of oats, these also contribute and emerged as potential sources of dietary fiber and have gained attention as nutraceutical cereal crops. This approach offers oats as a natural means of dietary fiber to protect humans from alarmingly increasing metabolic disorders, and its extraction by sonication has made it a sustainable and eco-friendly strategy.

Keywords: oat cultivars, dietary fibers, mineral profile, antioxidant activity, color properties

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Authors: Ayedh Alqahtani

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Many construction firms in Saudi Arabia dedicated to building projects agree that the most important factor in the real estate market is the value that they can give to their customer. These firms understand the value of their client in different ways. Value can be defined as the size of the building project in relationship to the cost or the design quality of the materials utilized in finish work or any other features of building rooms such as the bathroom. Value can also be understood as something suitable for the money the client is investing for the new property. A quality tool is required to support companies to achieve a solution for the building project and to understand and manage the customer’s needs. Quality Function Development (QFD) method will be able to play this role since the main difference between QFD and other conventional quality management tools is QFD a valuable and very flexible tool for design and taking into the account the VOC. Currently, organizations and agencies are seeking suitable models able to deal better with uncertainty, and that is flexible and easy to use. The primary aim of this research project is to incorporate customer’s requirements in the conceptual design of construction projects. Towards this goal, QFD is selected due to its capability to integrate the design requirements to meet the customer’s needs. To develop QFD, this research focused upon the contribution of the different (significantly weighted) input factors that represent the main variables influencing QFD and subsequent analysis of the techniques used to measure them. First of all, this research will review the literature to determine the current practice of QFD in construction projects. Then, the researcher will review the literature to define the current customers of residential projects and gather information on customers’ requirements for the design of the residential building. After that, qualitative survey research will be conducted to rank customer’s needs and provide the views of stakeholder practitioners about how these needs can affect their satisfy. Moreover, a qualitative focus group with the members of the design team will be conducted to determine the improvements level and technical details for the design of residential buildings. Finally, the QFD will be developed to establish the degree of significance of the design’s solution.

Keywords: quality function development, construction projects, Saudi Arabia, quality tools

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Authors: D. A. S. Gamage, B. F. A Basnayake, W. A. J. M. de Costa

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Rice is one of the world’s most important cereals. Increasing food production both to meet in-country requirements and to help overcome food crises is one of the major issues facing Sri Lanka today. However, productive land is limited and has mostly been utilized either for food crop production or other uses. Agriculture plays an important and strategic role in the performance of Sri Lankan national economy. A variety of modern agricultural inputs have been introduced, namely ploughs and harvesters, pesticides, fertilizers and lime. Besides, there are several agricultural institutions developing and updating the management of agricultural sector. Modern agricultural inputs cooperate as a catalyst in raising the productivity. However, in the eagerness of gaining profits from the efficient and productive techniques, this modern agricultural input has affected the environment and living things especially those which have been blended from various chemical substance. The increased pressure to maintain a high level of rice output for consumption has resulted in increased use of pesticides and inorganic fertilizer on rice fields in Sri Lanka. The application of inorganic fertilizer has become a burdened to the country in many ways. The excessive reuse of the ground water resources with a considerable application of organic and chemical fertilizers will lead to a deterioration of the quality and quantity of water. Biochar is a form of charcoal produced through the heating of natural organic materials. It has received significant attention recently for its potential as a soil conditioner, a fertilizer and as a means of storing carbon in a sustainable manner. It is the best solution for managing the agricultural wastes while providing a useful product for increasing agricultural productivity and protecting the environment. The objective of this study was to evaluate rice husk charcoal coated urea as a slow releasing fertilizer and compare the total N, P, K, organic matter in soil and yield of rice production.

Keywords: biochar, paddy husk, soil conditioner, rice straw compost

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Authors: Richa Soni, Vibha Bhatnagar, N. K. Jain

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This study was conducted to develop a computer mediated programme for weight management and physical fitness and examining its efficacy in reducing weight and improving physical fitness in obese adults. A user friendly, computer based programme was developed to provide a simple, quick, easy and user-friendly method of assessing energy balance at individual level. The programme had four main sections viz. personal Profile, know about your weight, fitness and food exchange list. The computer programme was developed to provide facilities of creating individual profile, tracking meal and physical activities, suggesting nutritional and exercise requirements, planning calorie specific menus, keeping food diaries and revising the diet and exercise plans if needed. The programme was also providing information on obesity, underweight, physical fitness. An exhaustive food exchange list was also given in the programme to assist user to make right food choice decisions. The developed programme was evaluated by a panel of 15 experts comprising endocrinologists, nutritionists and diet counselors. Suggestions given by the experts were paned down and the entire programme was modified in light of suggestions given by the panel members and was reevaluated by the same panel of experts. For assessing the impact of the programme 22 obese subjects were selected purposively and randomly assigned to intervention group (n=12) and no information control group. (n=10). The programme group was asked to strictly follow the programme for one month. Significant reduction in the intake of energy, fat and carbohydrates was observed while intake of fruits, green leafy vegetables was increased. The programme was also found to be effective in reducing body weight, body fat percent and body fat mass whereas total body water and physical fitness scores improved significantly. There was no significant alteration observed in any parameters in the control group.

Keywords: body composition, body weight, computer programme, physical fitness

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Authors: Yemisrach Mihertu Amsale

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The purpose of this study was to compare burnout and coping strategies between HIV counselors in face to face and online counseling settings in Addis Ababa. The study was mixed approach design that was quantitative and qualitative. For the quantitative data the participants involved in this study included 64 face to face and 47 online HIV counselors in both counseling settings. In addition, 23 participants were involved to offer qualitative data from both counseling settings. For the purpose of gathering the quantitative data, the instruments, namely, demographic questionnaire, Maslach Burnout Inventory and the COPE questionnaire, were used to gather quantitative data. Qualitative data was also gathered in the FGD Guide and Interview Guide. Thus, this study revealed that HIV counselors in online counseling settings scored high on emotional exhaustion, depersonalization and low in personal accomplishment dimensions of burnout as compared to HIV counselors in face to face setting and the difference was statistically significant in emotional exhaustion and personal accomplishment, but there was no a significant difference on depersonalization dimension of burnout between the two groups. In addition, the present study revealed a statistically significant difference on problem focused coping strategy between the two groups and yet for on the emotion focused coping strategy the difference was not statistically significant. Statistically negative correlation was observed between some demographic variables such as age with emotional exhaustion and depersonalization dimensions of burnout; years of experiences and personal accomplishment dimension of burnout. A statistically positive correlation was also observed between average number of clients served per day and emotional exhaustion. Sex was having a statistically positive correlation with coping strategy. Lastly, a significant positive correlation was also observed in the emotional exhaustion dimension of the burnout and the emotional focused coping strategy. Generally, this study has shown that HIV counselors suffer from moderate to high level of burnout. Based on the findings, conclusions were made and recommendations were forwarded.

Keywords: counseling, burnout management, psychological, behavioral sciences

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Authors: Dimitrios Dimitriou, Maria Sartzetaki

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In the early days of the of civil aviation, airports are totally state-owned companies under the control of national authorities or regional governmental bodies. From that time the picture has totally changed and airports privatisation and airport business commercialisation are key success factors to stimulate air transport demand, generate revenues and attract investors, linked to reliable and resilience of air transport system. Nowadays, airport's corporate strategy deals with policies and actions, affecting essential the business plans, the financial targets and the economic footprint in a regional economy they serving. Therefore, exploring airport corporate strategy is essential to support the decision in business planning, management efficiency, sustainable development and investment attractiveness on one hand; and define policies towards traffic development, revenues generation, capacity expansion, cost efficiency and corporate social responsibility. This paper explores key outputs in airport corporate strategy for different ownership schemes. The airport corporations are grouped in three major schemes: (a) Public, in which the public airport operator acts as part of the government administration or as a corporised public operator; (b) Mixed scheme, in which the majority of the shares and the corporate strategy is driven by the private or the public sector; and (c) Private, in which the airport strategy is driven by the key aspects of globalisation and liberalisation of the aviation sector. By a systemic approach, the key drivers in corporate strategy for modern airport business structures are defined. Key objectives are to define the key strategic opportunities and challenges and assess the corporate goals and risks towards sustainable business development for each scheme. The analysis based on an extensive cross-sectional dataset for a sample of busy European airports providing results on corporate strategy key priorities, risks and business models. The conventional wisdom is to highlight key messages to authorities, institutes and professionals on airport corporate strategy trends and directions.

Keywords: airport corporate strategy, airport ownership, airports business models, corporate risks

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Authors: Amna Khaliq

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In this research paper, a comparison study has been undertaken between Canada and Denmark to analyze the education system between the countries in entrepreneurship. Denmark, a land of high wages and high taxes, and Canada, a land of immigrants and opportunities, have seen a positive relationship in entrepreneurs' growth. They are both considered one of the top ten countries to start a business and to have government support globally. However, education is entirely free to Danish students, including university degrees, compared to Canadians, which can further hurdle for Canadian millennials to grow in the business world—the business experience more growth with educated entrepreneurs with international backgrounds in new immigrants. Denmark has seen a gradual increase in female entrepreneurs over the decade but is still lower than OECD countries. Compassionate management and work-life balance are prioritized in Denmark, unlike in Canada. Danish are early adopters of technology and have excellent infrastructure to support the technology industry, whereas Canada is still a service-oriented and manufacturer-based country. 2018 has been the highest number of opening businesses for Canada and Denmark. Some companies offer high wages, hiring bonuses, flexible working hours, wellness, and mental health benefits during Pandemic to keep the companies running and keep their workers' morale high. Pandemic has taught consumers new patterns to shop online. It is essential now to use technology and automation to increase productivity in businesses. Only those companies will survive that are applying this strategy. The Pandemic has ultimately changed entrepreneurs' and employees' behavior in the business world. Along with Ph.D. professors, entrepreneurs should be allowed to teach at learning intuitions. Millennials turn out to be the most entrepreneurial generation in both countries. Entrepreneurship education will only be beneficial when students create businesses and learn from real-life experiences. Managing physical, mental, emotional, and psychological health while dealing with high pressure in entrepreneurship are soft skills learned through practical work.

Keywords: entrepreneurship education, millennials, pandemic, Denmark, Canada

Procedia PDF Downloads 106

Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue

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Background: To improve the delivery of paediatric healthcare in resource-poor settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (poor adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (Low cost Intervention For disEase control) as an exemplar. Results: A service blueprint is developed which illustrates how the eCCM solution can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.

Keywords: adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint

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Authors: Parth Shah

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The author examines the recent trend where business organizations are significantly reducing their developmental cycle times to stay competitive in today’s global marketspace. The author proposes a rapid systems engineering framework to address late design changes and allow for flexibility (i.e. to react to unexpected or late changes and its impacts) during the product development cycle using a Systems Engineering approach. A System Engineering approach is crucial in today’s product development to deliver complex products into the marketplace. Design changes can occur due to shortened timelines and also based on initial consumer feedback once a product or service is in the marketplace. The ability to react to change and address customer expectations in a responsive and cost-efficient manner is crucial for any organization to succeed. Past literature, research, and methods such as concurrent development, simultaneous engineering, knowledge management, component sharing, rapid product integration, tailored systems engineering processes, and studies on reducing product development cycles all suggest a research gap exist in specifically addressing late design changes due to the shortening of life cycle environments in increasingly competitive markets. The author’s research suggests that 1) product development cycles time scales are now measured in months instead of years, 2) more and more products have interdepended systems and environments that are fast-paced and resource critical, 3) product obsolesce is higher and more organizations are releasing products and services frequently, and 4) increasingly competitive markets are leading to customization based on consumer feedback. The author will quantify effectiveness with respect to success factors such as time-to-market, return-of-investment, life cycle time and flexibility in late design changes by complexity of product or service, number of late changes and ability to react and reduce late design changes.

Keywords: product development, rapid systems engineering, scalability, systems engineering, systems integration, systems life cycle

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Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

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Authors: Sabir Hussain, Muhammad Naeem, Yousif Aldryhim, Susan E. Halbert, Qingjun Wu

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Plant viruses annually cause severe economic losses in crop production and globally, different aphid species are responsible for the transmission of such viruses. Additionally, aphids are also serious pests of trees, and agricultural crops. Al Bahah Province, Kingdom of Saudi Arabia (KSA) has a high native and introduced plant species with a temperate climate that provides ample habitats for aphids. In this study, we surveyed virus-transmitting aphids from the Province to highlight their spatial distributions and hot spot areas for their target control strategies. During our fifteen month's survey in Al Bahah Province, three hundred and seventy samples of aphids were collected using both beating sheets and yellow water pan traps. Consequently, fifty-four aphid species representing 30 genera belonging to four families were recorded from Al Bahah Province. Alarmingly, 35 aphid species from our records are virus transmitting species. The most common virus transmitting aphid species based on number of collecting samples, were Macrosiphum euphorbiae (Thomas, 1878), Brachycaudus rumexicolens (Patch, 1917), Uroleucon sonchi (Linnaeus, 1767), Brachycaudus helichrysi (Kaltenbach, 1843), and Myzus persicae (Sulzer, 1776). The numbers of samples for the forementioned species were 66, 24, 23, 22, and 20, respectively. The widest range of plant hosts were found for M. euphorbiae (39 plant species), B. helichrysi (12 plant species), M. persicae (12 plant species), B. rumexicolens (10 plant species), and U. sonchi (9 plant species). The hottest spot areas were found in Al-Baha, Al Mekhwah and Biljarashi cities of the province on the basis of their abundance. This study indicated that Al Bahah Province has relatively rich aphid diversity due to the relatively high plant diversity in a favorable climatic condition. ArcGIS tools can be helpful for biologists to implement the target control strategies against these pests in the integrated pest management, and ultimately to save money and time.

Keywords: Al Bahah province, aphid-virus interaction, biodiversity, global information system

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Authors: John Olayinka Atoyebi

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Developing countries like Nigeria are facing myriad problems, ranging from economic challenges, lack of no jobs, food insecurity, malnutrition, and poverty. However, tackling some of these menaces is not just a trivial issue neither do some of them require rocket science to fix, but rather the understanding of every individual citizen recognizing their respective roles that they have to play in making the country better, rather than putting all the blames on the Government. Tackling nutrition and food insecurity is a complex problem, but this work examines what an individual can do to improve nutrient consumption. Leafy indigenous vegetables can be termed as functional foods since they are very rich in nutrients, phytochemicals and other beneficial compounds to the body system. These functional foods are the class that provides necessary health benefits beyond basic nutrition. Usually functional foods often contain bioactive compounds, which help the body through the prevention and management of various diseases, as well as improving the overall health of human beings. The analysis carried out on some Nigerian leafy indigenous vegetables in home grown setting revealed, for example, the potential use of Iron (Fe) amount of 318.15ppm in Basella alba (red species) and that of Telfaria Occidentalis (Ugu) with 261.22ppm as being useful to stimulate heme, a necessary precursor and protein in the formation of blood in human being. Moreso, Virnonia amygdalina (ewuro) and water leaf possess anti-bacterial and anti-diabetic properties. They also provide digestive health benefits and support to the body system, including anti-inflammatory properties. Also, medicinal plant like Morinda citrifolia (Noni), which had been found to possess anti-cancer properties, has a Vitamin C amount of 528.85 mg/100g and a total carotenoids amount of 85.50 µg/g. However, despite all these results and potential utilization of these and other indigenous vegetables in Nigeria, there is a gross unawareness and/or non-cognizance of their utilization potentials, as some home garden lacks understanding of the immense nutrition benefits, thus hindering some of the populace to make proper use of these vegetables to enhance their health.

Keywords: developing countries, optimising, leafy vegetables, functional foods

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Authors: James Kralj

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Commercial shellfish aquaculture makes significant contributions to the economy and culture of the Pacific Northwest United States. The industry faces intense pressure to minimize environmental impacts as a result of Federal policies like the Magnuson-Stevens Fisheries Conservation and Management Act and the Endangered Species Act. These policies demand the protection of essential fish habitat and declare several salmon species as endangered. Consequently, numerous projects related to the protection and rehabilitation of eelgrass beds, a crucial ecosystem for countless fish species, have been proposed at both state and federal levels. Both eelgrass beds and commercial shellfish farms occupy the same physical space, and therefore understanding the effects of shellfish aquaculture on eelgrass ecosystems has become a top ecological and economic priority of both government and industry. This study evaluates the organismal communities that eelgrass and oyster aquaculture habitats support. Water samples were collected from Willapa Bay, Washington; Tillamook Bay, Oregon; Humboldt Bay, California; and Sammish Bay, Washington to compare species diversity in eelgrass beds, oyster aquaculture plots, and boundary edges between these two habitats. Diversity was assessed using a novel technique: environmental DNA (eDNA). All organisms constantly shed small pieces of DNA into their surrounding environment through the loss of skin, hair, tissues, and waste. In the marine environment, this DNA becomes suspended in the water column allowing it to be easily collected. Once extracted and sequenced, this eDNA can be used to paint a picture of all the organisms that live in a particular habitat making it a powerful technology for environmental monitoring. Industry professionals and government officials should consider these findings to better inform future policies regulating eelgrass beds and oyster aquaculture. Furthermore, the information collected in this study may be used to improve the environmental sustainability of commercial shellfish aquaculture while simultaneously enhancing its growth and profitability in the face of ever-changing political and ecological landscapes.

Keywords: aquaculture, environmental DNA, shellfish, sustainability

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Authors: Muhammad Zafar Khan, Babar Khan, Muhammad Saeed Awan, Farida Begum

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Livestock depredation has greater significance in pastoral societies like Himalaya-Karakoram-Hindu Kush mountain ranges. The dynamics of depredation by large predators (snow leopard and wolf) and its implications for conservation and livelihoods of local people was investigated by household surveys in Hushey valley of Central Karakoram National Park, Pakistan. We found that, during five years (2008-12) 90% of the households in the valley had lost their livestock to snow leopard and wolf, accounting for 4.3% of the total livestock holding per year. On average each household had to bear a loss of 0.8 livestock head per year, equivalent to Pak Rupees 9,853 (US$ 101), or 10% of the average annual cash income. Majority of the predation incidences occurred during late summer in alpine pastures, mostly at night when animals were not penned properly. The prey animals in most of the cases were females or young ones. Of the total predation incidences, 60% were attributed to snow leopard, 37% to wolf, while in 3% the predator was unknown. The fear of snow leopard is greater than that of wolf. As immediate response on predation, majority of the local people (64%, n=99) preferred to report the case to their village conservation committee, 32% had no response while only 1% tended to kill the predator. The perceived causes of predation were: poor guarding practices (77%); reduction in wild prey (13%) and livestock being the favourite food of predators (10%). The most preferred strategies for predator management, according to the respondents were improved and enhanced guarding of livestock (72%), followed by increasing wild prey (18%) and lethal control (10%). To strike a balance between predator populations and pastoral livelihoods, better animal husbandry practices should be promoted including: improved guarding through collective hiring of skilled shepherds; corral improvement and use of guard dogs.

Keywords: Panthera unica, Canis lupus, Karakoram, human-carnivore conflict, predation

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Authors: Sana Hamdi, Emna Bouazizi, Sami Faiz

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In recent years, real-time spatial applications, like location-aware services and traffic monitoring, have become more and more important. Such applications result dynamic environments where data as well as queries are continuously moving. As a result, there is a tremendous amount of real-time spatial data generated every day. The growth of the data volume seems to outspeed the advance of our computing infrastructure. For instance, in real-time spatial Big Data, users expect to receive the results of each query within a short time period without holding in account the load of the system. But with a huge amount of real-time spatial data generated, the system performance degrades rapidly especially in overload situations. To solve this problem, we propose the use of data partitioning as an optimization technique. Traditional horizontal and vertical partitioning can increase the performance of the system and simplify data management. But they remain insufficient for real-time spatial Big data; they can’t deal with real-time and stream queries efficiently. Thus, in this paper, we propose a novel data partitioning approach for real-time spatial Big data named VPA-RTSBD (Vertical Partitioning Approach for Real-Time Spatial Big data). This contribution is an implementation of the Matching algorithm for traditional vertical partitioning. We find, firstly, the optimal attribute sequence by the use of Matching algorithm. Then, we propose a new cost model used for database partitioning, for keeping the data amount of each partition more balanced limit and for providing a parallel execution guarantees for the most frequent queries. VPA-RTSBD aims to obtain a real-time partitioning scheme and deals with stream data. It improves the performance of query execution by maximizing the degree of parallel execution. This affects QoS (Quality Of Service) improvement in real-time spatial Big Data especially with a huge volume of stream data. The performance of our contribution is evaluated via simulation experiments. The results show that the proposed algorithm is both efficient and scalable, and that it outperforms comparable algorithms.

Keywords: real-time spatial big data, quality of service, vertical partitioning, horizontal partitioning, matching algorithm, hamming distance, stream query

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Authors: T. Yasmin, M. A. Farrelly, B. C. Rogers

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Urban water governance in developing countries faces numerous challenges arising from uncontrolled urban population expansion, water pollution, greater economic push and more recently, climate change impact while undergoing transitioning towards a sustainable system. Sustainability transition requires developing adaptive capacities of the socio-ecological and socio-technical system to be able to deal with complexity. Adaptive capacities deliver strategies to connect individuals, organizations, agencies and institutions at multiple levels for dealing with such complexity. Understanding the level of adaptive capacities for sustainability transformation thus has gained significant research attention within developed countries, much less so in developing countries. Filling this gap, this article develops a conceptual framework for analysing the level of adaptive capacities (if any) within a developing context. This framework then applied to the chronological development of urban water governance strategies in Bangladesh for almost two centuries. The chronological analysis of governance interventions has revealed that crisis (public health, food and natural hazards) became the opportunities and thus opened the windows for experimentation and learning to occur as a deviation from traditional practices. Self-organization and networks thus created the platform for development or disruptions to occur for creating change. Leadership (internal or external) is important for nurturing and upscaling theses development or disruptions towards guiding policy vision and targets as well as championing ground implementation. In the case of Bangladesh, the leadership from the international and national aid organizations and targets have always lead the development whereas more often social capital tools (trust, power relations, cultural norms) act as disruptions. Historically, this has been evident in the development pathways of urban water governance in Bangladesh. Overall this research has shown some level of adaptive capacities is growing for sustainable urban growth in big cities, nevertheless unclear regarding the growth in medium and small cities context.

Keywords: adaptive capacity, Bangladesh, sustainability transformation, water governance

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Authors: Frederick M. Dumisani Xaba, Nokuthula G. Khanyile

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There is a growing demand for greater accountability, transparency and ethical conduct based on sound governance principles in the developing world. Funders, donors and sponsors are increasingly demanding more transparency, better value for money and adherence to good governance standards. The drive towards improved governance measures is largely influenced by the need to ‘plug the leaks’, deal with malfeasance, engender greater levels of accountability and good governance and to ultimately attract further funding or investment. This is the case with the Non-Profit Organizations (NPOs) in South Africa in general, and in the province of KwaZulu-Natal in particular. The paper draws from the good governance theory, stakeholder theory and systems thinking to critically examine the requirements for good governance for the NPO sector from a theoretical and legislative point and to systematically looks at the contours of governance currently among the NPOs. The paper did this through the rigorous examination of the vignettes of cases of governance among selected NPOs based in KwaZulu-Natal. The study used qualitative and quantitative research methodologies through document analysis, literature review, semi-structured interviews, focus groups and statistical analysis from the various primary and secondary sources. It found some good cases of good governance but also found frightening levels of poor governance. There was an exponential growth of NPOs registered during the period under review, equally so there was an increase in cases of non-compliance to good governance practices. NPOs operate in an increasingly complex environment. There is contestation for influence and access to resources. Stakeholder management is poorly conceptualized and executed. Recognizing that the NPO sector operates in an environment characterized by complexity, constant changes, unpredictability, contestation, diversity and divergent views of different stakeholders, there is a need to apply legislative and systems thinking approaches to strengthen governance to withstand this turbulence through a capacity development model that recognizes these contextual and environmental challenges.

Keywords: good governance, non-profit organizations, stakeholder theory, systems theory

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Authors: Sahar Tabarroki, Ahad Nazari

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The design process is one of the most key project processes in the construction industry. Although architects have the responsibility to produce complete, accurate, and coordinated documents, architectural design is accompanied by many errors. A design error occurs when the constraints and requirements of the design are not satisfied. Errors are potentially costly and time-consuming to correct if not caught early during the design phase, and they become expensive in either construction documents or in the construction phase. The aim of this research is to identify the risk factors of architectural design errors, so identification of risks is necessary. First, a literature review in the design process was conducted and then a questionnaire was designed to identify the risks and risk factors. The questions in the form of the questionnaire were based on the “similar service description of study and supervision of architectural works” published by “Vice Presidency of Strategic Planning & Supervision of I.R. Iran” as the base of architects’ tasks. Second, the top 10 risks of architectural activities were identified. To determine the positions of possible causes of risks with respect to architectural activities, these activities were located in a design process modeled by the IDEF0 technique. The research was carried out by choosing a case study, checking the design drawings, interviewing its architect and client, and providing a checklist in order to identify the concrete examples of architectural design errors. The results revealed that activities such as “defining the current and future requirements of the project”, “studies and space planning,” and “time and cost estimation of suggested solution” has a higher error risk than others. Moreover, the most important causes include “unclear goals of a client”, “time force by a client”, and “lack of knowledge of architects about the requirements of end-users”. For error detecting in the case study, lack of criteria, standards and design criteria, and lack of coordination among them, was a barrier, anyway, “lack of coordination between architectural design and electrical and mechanical facility”, “violation of the standard dimensions and sizes in space designing”, “design omissions” were identified as the most important design errors.

Keywords: architectural design, design error, risk management, risk factor

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Authors: Naziema B. Jappie

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Internationalization is very complex and multifaceted and has implications for the entire university sector, and the larger community which it serves. Higher education strategic plans require sustainability on all levels of academic engagement and internationalization contributes to the sustainability because of the global competition but, at the same time, ensures diversity on campuses. Universities all over the world are increasingly recognizing the challenges of globalization and the pressures towards internationalization. The past 25 years of internationalization has faded away, and new challenges have emerged. Although internationalization remains a central strategic objective for all universities, for many leaders and education practitioners it has remained a confused concept. It has various interpretations, and it intersects with numerous other national agendas in higher education domain; it often builds upon narrow notions limited to one of its facets –attracting international student fees for financial sustainability or for ensuring a diverse campus culture. It is essential to have clear institutional views, but it is imperative that everyone reflects on the values and beliefs that underpin the internationalization of higher education and have a global focus. This paper draws together the international experience locally and globally to explore the emerging patterns of strategy and practice in internationalizing higher education. This will highlight some critical notions of how the concepts of internationalization and globalization in the context of higher education is understood by those who lead universities and what new challenges are being created as universities seek to become more international. Institutions cannot simply have bullet points in the strategic plan about recruitment of international students; there has to be a complete commitment to an international strategy of inclusivity. This paper will further examine the leadership styles that ensure transformation together with the goals set out for internationalization. The interviews with the senior leadership are in-depth semi-structured recorded interviews of approximately one-hour to learn about their institutional experiences, promotion, and enhancement of the value of internationalisation to the tertiary education sector and initiating discussions around adding the international relations dimension to the curriculum. This paper will address the issues relevant to the cross-border delivery of higher education. To ensure anonymity throughout this study, the interviewees are identified only by their institutions.

Keywords: challenges, globalization, higher education, internationalization, strategic focus

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Authors: Israel Ropo Orimoloye, Johanes A. Belle, Olusola Adeyemi, Olusola O. Ololade

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With more than 100,000 orbits during the past 20 years, Terra has significantly improved our knowledge of the Earth's climate and its implications on societies and ecosystems of human activity and natural disasters, including drought events. With Terra instrument's performance and the free distribution of its products, this study utilised Terra MOD13Q1 satellite data to assess drought disaster events and its spatiotemporal patterns over the Free State Province of South Africa between 2001 and 2019 for summer, autumn, winter, and spring seasons. The study also used high-resolution downscaled climate change projections under three representative concentration pathways (RCP). Three future periods comprising the short (the 2030s), medium (2040s), and long term (2050s) compared to the current period are analysed to understand the potential magnitude of projected climate change-related drought. The study revealed that the year 2001 and 2016 witnessed extreme drought conditions where the drought index is between 0 and 20% across the entire province during summer, while the year 2003, 2004, 2007, and 2015 observed severe drought conditions across the region with variation from one part to the another. The result shows that from -24.5 to -25.5 latitude, the area witnessed a decrease in precipitation (80 to 120mm) across the time slice and an increase in the latitude -26° to -28° S for summer seasons, which is more prominent in the year 2041 to 2050. This study emphasizes the strong spatio-environmental impacts within the province and highlights the associated factors that characterise high drought stress risk, especially on the environment and ecosystems. This study contributes to a disaster risk framework to identify areas for specific research and adaptation activities on drought disaster risk and for environmental planning in the study area, which is characterised by both rural and urban contexts, to address climate change-related drought impacts.

Keywords: remote sensing, drought disaster, climate scenario, assessment

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Authors: Vaishali Sharma

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The research is an attempt to hunt a scientific and objective method to transform Ajmer's traditional walled city into a living cultural heritage space, exploring urban management methods to elevate local economy and social space in relation to specific cultural-based initiatives. Ajmer is among the oldest and religiously diverse settlements in Rajasthan, that has seen superimposed developments through the eras. With numerous agencies operating towards the development of the town core of Ajmer, it becomes essential to structure development changes in tune with the transformations and the existing heritage. The study was radio-controlled by the subsequent analysis question: What is the way to overcome the genetic social and economic stress inside the communities and revive public life? In order to create necessary interventions at the neighbourhood level, fifteen neighbourhoods were identified. Each of those was analyzed relatively on three major dimensions: Heritage, Social and Local Economy. Each dimension was further broken down into multiple sub-aspects for an overall and exhaustive understanding. The average median values of the responses were used to develop a color-coded matrix to represent the scores in an exceedingly structured quantified manner, moreover, linking it to the spatial structure. Respondent perceptions on numerous dimensions were additionally recorded, so that the proposals are inclusive in nature. The goals are targeted at Ajmer's traditional walled towns, which will make it easier for the community to regulate the rapid transformations and commercialization occurring within the space. The study recommends the necessity for accrued support in methods and policies from the non-public sector, businesses as well as local stakeholders. An expansion, revitalization and maintenance of the major business and heritage corridors, for an increased local and visitor experience, can produce an impetus for promotion of the intangible heritage, to spur the local economic processes, conservation of heritage precincts and upward development.

Keywords: cultural heritage, economic revitalization, neighbourhoods in walled cities, social space, tangible and intangible heritage

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Authors: Buhari Samaila, Sabiu Abdullahi, Buhari Maidamma

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Background: Contrast-enhanced computed tomography (CE-CT) is a technique that uses contrast media to improve image quality and diagnostic accuracy. It is a widely used imaging modality in medical diagnostics, offering high-resolution images for accurate diagnosis. However, concerns regarding the potential adverse effects of contrast media and radiation dose exposure have prompted ongoing investigation and assessment. It is important to assess the effects of contrast media and radiation dose in CE-CT procedures. Objective: This study aims to assess the effects of contrast media and radiation dose in contrast-enhanced computed tomography (CECT) procedures. Methods: A comprehensive review of the literature was conducted to identify studies related to contrast media effects and radiation dose assessment in CECT. Relevant data, including location, type of research, objective, method, findings, conclusion, authors, and year of publications, were extracted, analyzed, and reported. Results: The findings revealed that several studies have investigated the impacts of contrast media and radiation doses in CECT procedures, with iodinated contrast agents being the most commonly employed. Adverse effects associated with contrast media administration were reported, including allergic reactions, nephrotoxicity, and thyroid dysfunction, albeit at relatively low incidence rates. Additionally, radiation dose levels varied depending on the imaging protocol and anatomical region scanned. Efforts to minimize radiation exposure through optimization techniques were evident across studies. Conclusion: Contrast-enhanced computed tomography (CECT) remains an invaluable tool in medical imaging; however, careful consideration of contrast media effects and radiation dose exposure is imperative. Healthcare practitioners should weigh the diagnostic benefits against potential risks, employing strategies to mitigate adverse effects and optimize radiation dose levels for patient safety and effective diagnosis. Further research is warranted to enhance the understanding and management of contrast media effects and radiation dose optimization in CECT procedures.

Keywords: CT, contrast media, radiation dose, effect of radiation

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Authors: Sisay Negash, Zebene Asfaw, Kibreselassie Daniel, Michael Zech

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A significant portion of the Ethiopian landscape features scattered trees that are deliberately managed in crop fields to enhance soil fertility and crop yield in which the compatibility of crops with these trees varies depending on location, tree species, and annual crop type. This study aimed to examine the effects of scattered Vachellia tortilis and Vachellia nilotica trees on selected physico-chemical properties of the soil, as well as the yield and yield components of sorghum in Ethiopia. Vachellia tortilis and Vachellia nilotica were selected on abundance occurrence and managed in crop fields. A randomized complete block design was used, with a distance from the tree canopy (middle, edge, and outside) as a treatment, and five trees of each species served as replications. Sorghum was planted up to 15 meters in the east, west, south, and north directions from the tree trunk to assess growth and yield. Soil samples were collected from the two tree species, three distance factors, three soil depths(0-20cm, 20-40cm, and 40-60cm), and five replications, totaling 45 samples for each tree species. These samples were analyzed for physical and chemical properties. The results indicated that both V. tortilis and V. nilotica significantly affected soil physico-chemical properties and sorghum yield. Specifically, soil moisture content, EC, total nitrogen, organic carbon, available phosphorus and potassium, CEC, sorghum plant height, panicle length, biomass, and yield decreased with increasing distance from the canopy. Conversely, bulk density and pH increased. Under the canopy, sorghum yield increased by 66.4% and 53.5% for V. tortilis and V. nilotica, respectively, due to higher soil moisture and nutrient availability. The study recommends promoting trees in crop fields, management options for new saplings, and further research on root decomposition and nutrient supply.

Keywords: canopy, crop yield, soil nutrient, soil organic matter, yield components

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Authors: Mohammad Mosaddik Rahman

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This study embarks on an exploratory journey to assess the pervasive issue of heavy metal contamination in the water bodies along Chittagong Coast, Bangladesh. Situated along the mesmerizing Bay of Bengal, known for its potential as an emerging tourist haven, economic zone, ship breaking yard, confronts significant environmental hurdles. The core of these challenges lies in the contamination from heavy metals such as lead, cadmium, chromium, and mercury, which detrimentally impact both the ecological integrity and public health of the region. This contamination primarily stems from industrial activities, particularly those involving metallurgical and chemical processes, which release these metals into the environment, leading to their accumulation in soil and water bodies. The study's primary aim is to conduct a thorough assessment of heavy metal pollution levels, alongside an analysis of nutrient variations, focusing on nitrates and nitrites. Methodologically, the study leverages systematic sampling and advanced analytical tools like the Hach 3900 spectrophotometer to ensure precise and reliable data collection. The implications of heavy metal presence are multifaceted, affecting microbial and aquatic life, and posing severe health risks to the local population, including respiratory problems, neurological disorders, and an increased risk of cancer. The results of this study highlight the urgent need for effective mitigation strategies and regulatory measures to address this critical issue. By providing a comprehensive understanding of the environmental and public health implications of heavy metal contamination in Chittagong Coast, this research endeavours to serve as a catalyst for change, emphasising the need for pollution control and advancements in water management policies. It is envisioned that the outcomes of this study will guide stakeholders in collaborating to develop and implement sustainable solutions, ultimately safeguarding the region’s environment and public health.

Keywords: heavy metal, environmental health, pollution control policies, shipbreaking yard

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Authors: Zeina Bourhane, Anders Lanzen, Christine Cagnon, Olfa Ben Said, Cristiana Cravo-Laureau, Robert Duran

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The anthropogenic pressure in coastal areas increases dramatically with the exploitation of environmental resources. Biomonitoring coastal areas are crucial to determine the impact of pollutants on bacterial communities in soils and sediments since they provide important ecosystem services. However, relevant biomonitoring tools allowing fast determination of the ecological status are yet to be defined. Microbial ecology approaches provide useful information for developing such microbial monitoring tools reporting on the effect of environmental stressors. Chemical and microbial molecular approaches were combined in order to determine microbial bioindicators for assessing the ecological status of soil and river ecosystems around the Ichkeul Lake (Tunisia), an area highly impacted by human activities. Samples were collected along soil/river/lake continuums in three stations around the Ichkeul Lake influenced by different human activities at two seasons (summer and winter). Contaminant pressure indexes (PI), including PAHs (Polycyclic aromatic hydrocarbons), alkanes, and OCPs (Organochlorine pesticides) contents, showed significant differences in the contamination level between the stations with seasonal variation. Bacterial communities were characterized by 16S ribosomal RNAs (rRNA) gene metabarcoding. Although microgAMBI indexes, determined from the sequencing data, were in accordance with contaminant contents, they were not sufficient to fully explain the PI. Therefore, further microbial indicators are still to be defined. The comparison of bacterial communities revealed the specific microbial assemblage for soil, river, and lake sediments, which were significantly correlated with contaminant contents and PI. Such observation offers the possibility to define a relevant set of bioindicators for reporting the effects of human activities on the microbial community structure. Such bioindicators might constitute useful monitoring tools for the management of microbial communities in coastal areas.

Keywords: bacterial communities, biomonitoring, contamination, human impacts, microbial bioindicators

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Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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