Search results for: geographic bias

Authors: Fatema-Tuz-Zohra Khanam, Ali Al-Naji, Asanka G. Perera, Kim Gibson, Javaan Chahl

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Conventional contact-based vital signs monitoring sensors such as pulse oximeters or electrocardiogram (ECG) may cause discomfort, skin damage, and infections, particularly in neonates with fragile, sensitive skin. Therefore, remote monitoring of the vital sign is desired in both clinical and non-clinical settings to overcome these issues. Camera-based vital signs monitoring is a recent technology for these applications with many positive attributes. However, there are still limited camera-based studies on neonates in a clinical setting. In this study, the heart rate (HR) and respiratory rate (RR) of eight infants at the Neonatal Intensive Care Unit (NICU) in Flinders Medical Centre were remotely monitored using a digital camera applying color and motion-based computational methods. The region-of-interest (ROI) was efficiently selected by incorporating an image decomposition method. Furthermore, spatial averaging, spectral analysis, band-pass filtering, and peak detection were also used to extract both HR and RR. The experimental results were validated with the ground truth data obtained from an ECG monitor and showed a strong correlation using the Pearson correlation coefficient (PCC) 0.9794 and 0.9412 for HR and RR, respectively. The RMSE between camera-based data and ECG data for HR and RR were 2.84 beats/min and 2.91 breaths/min, respectively. A Bland Altman analysis of the data also showed a close correlation between both data sets with a mean bias of 0.60 beats/min and 1 breath/min, and the lower and upper limit of agreement -4.9 to + 6.1 beats/min and -4.4 to +6.4 breaths/min for both HR and RR, respectively. Therefore, video camera imaging may replace conventional contact-based monitoring in NICU and has potential applications in other contexts such as home health monitoring.

Keywords: neonates, NICU, digital camera, heart rate, respiratory rate, image decomposition

Procedia PDF Downloads 105

Authors: Haritha Saranga

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Service quality has become an important driver of competition in manufacturing industries of late, as many products are being sold in conjunction with service offerings. With increase in computational power and data capture capabilities, it has become possible to analyze and estimate various aspects of service quality at the granular level and determine their impact on business performance. In the current study context, dealer level, model-wise warranty data from one of the top two-wheeler manufacturers in India is used to estimate service quality of individual dealers and its impact on warranty related costs and sales performance. We collected primary data on warranty costs, number of complaints, monthly sales, type of quality upgrades, etc. from the two-wheeler automaker. In addition, we gathered secondary data on various regions in India, such as petrol and diesel prices, geographic and climatic conditions of various regions where the dealers are located, to control for customer usage patterns. We analyze this primary and secondary data with the help of a variety of analytics tools such as Auto-Regressive Integrated Moving Average (ARIMA), Seasonal ARIMA and ARIMAX. Study results, after controlling for a variety of factors, such as size, age, region of the dealership, and customer usage pattern, show that service quality does influence sales of the products in a significant manner. A more nuanced analysis reveals the dynamics between product quality and service quality, and how their interaction affects sales performance in the Indian two-wheeler industry context. We also provide various managerial insights using descriptive analytics and build a model that can provide sales projections using a variety of forecasting techniques.

Keywords: service quality, product quality, automobile industry, business analytics, auto-regressive integrated moving average

Procedia PDF Downloads 120

Authors: Umm E. Aimen Minhas, Sameen Tahira, Haneen Kamran, Syed Saad Ul Hassan, Haris Bin Khalid, Hadia Nadeem, Ahmed Sanan

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In coronary artery bypass grafting (CABG) patients, vasodilators play a key role in optimizing graft patency by preventing vasospasm and enhancing blood flow. Limited literature is available comparing the effectiveness of various vasodilators on IMA flow in CABG patients. Thus, the rationale for conducting this Network-meta-analysis is to identify the most efficacious vasodilator for increasing IMA flow in CABG patients. A systematic search of 3 databases yielded 357 studies, with 19 meeting inclusion criteria (18 RCTs, 1 observational study). The primary outcome was IMA flow, with secondary outcomes including central venous pressure (CVP) and mean arterial pressure (MAP). Analyses were conducted on an intention-to-treat basis using the net meta package in R. A frequentist random-effects model was employed, with consistency assessed via node-splitting and heterogeneity evaluated. The risk of bias was assessed using RoB 2 and ROBINS-I tools. Out of 92 possible pairwise comparisons, 11 were direct, and 3 included both direct and indirect evidence. Network ranking identified milrinone as the most effective vasodilator for improving IMA flow (SMD: 1.12; 95% CI: 0.36–1.87), followed by nitroglycerin (SMD: 0.51; 95% CI: 0.01–1.00). On the contrary, CO₂ insufflation significantly reduced IMA flow (SMD: -1.17; 95% CI: -2.28 to -0.06). Dobutamine significantly increased CVP, favoring placebo, with no notable differences in MAP across interventions. This analysis positions milrinone as a potentially superior agent for enhancing IMA flow in CABG, warranting its consideration as a first-line therapy. However, moderate to high heterogeneity and limited direct evidence highlight the need for more head-to-head trials.

Keywords: IMA flow, vasodilators, CABG, milrinone, cardiac outcomes

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Authors: I GD Yudha Partama, A. Kanno, Y. Akamatsu, R. Inui, M. Goto, M. Sekine

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The aerial photogrammetry of shallow water bottoms has the potential to be an efficient high-resolution survey technique for shallow water topography, thanks to the advent of convenient UAV and automatic image processing techniques Structure-from-Motion (SfM) and Multi-View Stereo (MVS)). However, it suffers from the systematic overestimation of the bottom elevation, due to the light refraction at the air-water interface. In this study, we present an empirical method to correct for the effect of refraction after the usual SfM-MVS processing, using common software. The presented method utilizes the empirical relation between the measured true depth and the estimated apparent depth to generate an empirical correction factor. Furthermore, this correction factor was utilized to convert the apparent water depth into a refraction-corrected (real-scale) water depth. To examine its effectiveness, we applied the method to two river sites, and compared the RMS errors in the corrected bottom elevations with those obtained by three existing methods. The result shows that the presented method is more effective than the two existing methods: The method without applying correction factor and the method utilizes the refractive index of water (1.34) as correction factor. In comparison with the remaining existing method, which used the additive terms (offset) after calculating correction factor, the presented method performs well in Site 2 and worse in Site 1. However, we found this linear regression method to be unstable when the training data used for calibration are limited. It also suffers from a large negative bias in the correction factor when the apparent water depth estimated is affected by noise, according to our numerical experiment. Overall, the good accuracy of refraction correction method depends on various factors such as the locations, image acquisition, and GPS measurement conditions. The most effective method can be selected by using statistical selection (e.g. leave-one-out cross validation).

Keywords: bottom elevation, MVS, river, SfM

Procedia PDF Downloads 300

Authors: Jia-Jane Shuai

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Purpose of this research aims to improve understanding of the nature of online religion by examining the religious social websites. What motivates individual users to use the online religious social websites, and which factors affect those motivations. We survey various online religious social websites provided by different religions, especially the Taiwanese folk religion. Based on the theory of the Content Analysis and Social Network Analysis, religious social websites and religious web activities are examined. This research examined the folk religion websites’ presentation and contents that promote the religious use of the Internet in Taiwan. The difference among different religions and religious websites also be compared. First, this study used keywords to examine what types of messages gained the most clicks of “Like”, “Share” and comments on Facebook. Dividing the messages into four media types, namely, text, link, video, and photo, reveal which category receive more likes and comments than the others. Meanwhile, this study analyzed the five dialogic principles of religious websites accessed from mobile phones and also assessed their mobile readiness. Using the five principles of dialogic theory as a basis, do a general survey on the websites with elements of online religion. Second, the project analyzed the characteristics of Taiwanese participants for online religious activities. Grounded by social network analysis and text mining, this study comparatively explores the network structure, interaction pattern, and geographic distribution of users involved in communication networks of the folk religion in social websites and mobile sites. We studied the linkage preference of different religious groups. The difference among different religions and religious websites also be compared. We examined the reasons for the success of these websites, as well as reasons why young users accept new religious media. The outcome of the research will be useful for online religious service providers and non-profit organizations to manage social websites and internet marketing.

Keywords: content analysis, online religion, social network analysis, social websites

Procedia PDF Downloads 169

Authors: Leng Jian-Wei, Wang Lai-Jun, Li Ye

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In order to measure and analyze the transportation situation within the counties of Shaanxi province over a certain period of time and to promote the province's future transportation planning and development, this paper proposes a reasonable layout plan and compares model rationality. The study uses entropy weight method to measure the transportation advantages of 107 counties in Shaanxi province from three dimensions: road network density, trunk line influence and location advantage in 2013 and 2021, and applies spatial autocorrelation analysis method to analyze the spatial layout and development trend of county-level transportation, and conducts ordinary least square (OLS)regression on transportation impact factors and other influencing factors. The paper also compares the regression fitting degree of the Geographically weighted regression(GWR) model and the OLS model. The results show that spatially, the transportation advantages of Shaanxi province generally show a decreasing trend from the Weihe Plain to the surrounding areas and mainly exhibit high-high clustering phenomenon. Temporally, transportation advantages show an overall upward trend, and the phenomenon of spatial imbalance gradually decreases. People's travel demands have changed to some extent, and the demand for rapid transportation has increased overall. The GWR model regression fitting degree of transportation advantages is 0.74, which is higher than the OLS regression model's fitting degree of 0.64. Based on the evolution of transportation advantages, it is predicted that this trend will continue for a period of time in the future. To improve the transportation advantages of Shaanxi province increasing the layout of rapid transportation can effectively enhance the transportation advantages of Shaanxi province. When analyzing spatial heterogeneity, geographic factors should be considered to establish a more reliable model

Keywords: traffic dominance, GWR model, spatial autocorrelation analysis, temporal and spatial evolution

Procedia PDF Downloads 89

Authors: Mohamed Aboelghar, Ayman Abou Hadid, Usama Albehairy, Asmaa Khater

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Sustainable agricultural development of the desert areas of Egypt under the pressure of irrigation water scarcity is a significant national challenge. Existing water harvesting techniques on the northwest coast of Egypt do not ensure the optimal use of rainfall for agricultural purposes. Basin-scale hydrology potentialities were studied to investigate how available annual rainfall could be used to increase agricultural production. All data related to agricultural production included in the form of geospatial layers. Thematic classification of Sentinal-2 imagery was carried out to produce the land cover and crop maps following the (FAO) system of land cover classification. Contour lines and spot height points were used to create a digital elevation model (DEM). Then, DEM was used to delineate basins, sub-basins, and water outlet points using the Soil and Water Assessment Tool (Arc SWAT). Main soil units of the study area identified from Land Master Plan maps. Climatic data collected from existing official sources. The amount of precipitation, surface water runoff, potential, and actual evapotranspiration for the years (2004 to 2017) shown as results of (Arc SWAT). The land cover map showed that the two tree crops (olive and fig) cover 195.8 km2 when herbaceous crops (barley and wheat) cover 154 km2. The maximum elevation was 250 meters above sea level when the lowest one was 3 meters below sea level. The study area receives a massive variable amount of precipitation; however, water harvesting methods are inappropriate to store water for purposes.

Keywords: water catchements, remote sensing, GIS, sustainable agricultural development

Procedia PDF Downloads 117

Authors: Liliane Ventura, Mauro Masili

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Ultraviolet (UV) protection is critical for sunglasses, and mydriasis, as well as miosis, are relevant parameters to consider. The literature reports that for sunglasses, ultraviolet protection is critical because sunglasses can cause the opposite effect if the lenses do not provide adequate UV protection due to the greater dilation of the pupil when wearing sunglasses. However, the scientific literature does not properly quantify to support this rationale. The reasoning may be misleading by ignoring not only the inherent absorption of UV by the sunglass lens materials but also by ignoring the absorption of the anterior structures of the eye, i.e., the cornea and aqueous humor. Therefore, we estimate the pupil diameter and calculate the solar ultraviolet influx through the pupil of the human eye for two situations of an individual wearing and not wearing sunglasses. We quantify the dilation of the pupil as a function of the luminance of the surrounding. Therefore, we calculate the influx of solar UV through the pupil of the eye for two situations for an individual wearing sunglass and for the eyes free of shade. A typical boundary condition for the calculation is an individual in an upright position wearing sunglasses, staring at the horizon as if the sun is in the zenith. The calculation was done for the latitude of the geographic center of the state of São Paulo (-22º04'11.8'' S) from sunrise to sunset. A model from the literature is used for determining the sky luminance. The initial approach is to obtain pupil diameter as a function of luminance. Therefore, as a preliminary result, we calculate the pupil diameter as a function of the time of day, as the sun moves, for a particular day of the year. The working range for luminance is daylight (10⁻⁴ – 10⁵ cd/m²). We are able to show how the pupil adjusts to brightness change (~2 - ~7.8 mm). At noon, with the sun higher, the direct incidence of light on the pupil is lower if compared to mid-morning or mid-afternoon, when the sun strikes more directly into the eye. Thus, the pupil is larger at midday. As expected, the two situations have opposite behaviors since higher luminance implies a smaller pupil. With these results, we can progress in the short term to obtain the transmittance spectra of sunglasses samples and quantify how light attenuation provided by the spectacles affects pupil diameter.

Keywords: sunglasses, UV protection, pupil diameter, solar irradiance, luminance

Procedia PDF Downloads 83

Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid

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Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.

Keywords: cytomegalovirus, lymphoma, cancer, microbiology

Procedia PDF Downloads 223

Authors: Yusuf Hussaini Atulukwu, Daramola Japheth, Tabitit S. Tabiti, Daramola Elizabeth Lara

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In view of the recent limitations faced by the township concerning poorly constructed and in some cases non - existence of drainage facilities that resulted into incessant flooding in some parts of the community poses threat to life,property and the environment. The research seeks to address this issue by showing the spatial distribution of drainage network in Bida Urban using Geographic information System techniques. Relevant features were extracted from existing Bida based Map using un-screen digitization and x, y, z, data of existing drainages were acquired using handheld Global Positioning System (GPS). These data were uploaded into ArcGIS 9.2, software, and stored in the relational database structure that was used to produce the spatial data drainage network of the township. The result revealed that about 40 % of the drainages are blocked with sand and refuse, 35 % water-logged as a result of building across erosion channels and dilapidated bridges as a result of lack of drainage along major roads. The study thus concluded that drainage network systems in Bida community are not in good working condition and urgent measures must be initiated in order to avoid future disasters especially with the raining season setting in. Based on the above findings, the study therefore recommends that people within the locality should avoid dumping municipal waste within the drainage path while sand blocked or weed blocked drains should be clear by the authority concerned. In the same vein the authority should ensured that contract of drainage construction be awarded to professionals and all the natural drainages caused by erosion should be addressed to avoid future disasters.

Keywords: drainage network, spatial, digitization, relational database, waste

Procedia PDF Downloads 335

Authors: Maatouk Mohamed, Nouira Mariem, Hamdi Kbir Gh, Mahjoubi M. F., Ben Moussa M.

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Background and aim: Preoperative biliary drainage (PBD) has been introduced to lower bilirubin levels and to control the negative effects of obstructive jaundice in patients with malignant obstructive jaundice undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD is still not clear. Delaying surgery by 4 to 6 weeks is the commonly accepted practice. However, delayed PD has been shown to decrease the rate of resection and adversely affect the tumor grading and prognosis. Thus, the purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD prior to PD: short or prolonged in terms of postoperative morbidity and survival outcomes. Methods: Trials were searched in PubMed, Science Direct, Google Scholar, and Cochrane Library until November 2022. Studies using PBD in patients with malignant obstructive jaundice that compared short duration group (SDG) (surgery performed within 3-4 weeks) with prolonged duration group (PDG) (at least 3-4 weeks after PBD) were included in this study. The risk of bias was assessed using the Rob v2 and Robins-I tools. The priori protocol was published in PROSPERO (ID: CRD42022381405). Results: Seven studies comprising 1625 patients (SDG 870, PDG 882) were included. All studies were non-randomized, and only one was prospective. No significant differences were observed between the SDG and PDG in mortality (OR= 0.59; 95% CI [0.30, 1.17], p=0.13), major morbidity (Chi² = 30.28, p <0.00001; I² = 87%), pancreatic fistula (Chi² = 6.61, p = 0.25); I² = 24%), post pancreatectomy haemorrhage (OR= 1.16; 95% CI [0.67, 2.01], p=0.59), positive drainage culture (OR= 0.36; 95% CI [0.10, 1.32], p=0.12), septic complications (OR= 0.78; 95% CI [0.23, 2.72], p=0.70), wound infection (OR= 0.08, p=0.07), operative time (MD= 0.21; p=0.21). Conclusion: Early surgery within 3 or 4 weeks after biliary drainage is both safe and effective. Thus, it is reasonable to suggest early surgery following PBD for patients having resectable periampullary cancers.

Keywords: preoperative biliary drainage, pancreatic cancer, pancreatic surgery, complication

Procedia PDF Downloads 69

Authors: Vladimir Klepikov

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To develop the programs to supply crude oil to North European refineries, it is necessary to take into account the refineries’ location, crude refining capacity, and the transport infrastructure capacity. Among the countries of the region, we include those having a marine boundary along the Northern Sea and the Baltic Sea (from France in the west to Finland in the east). The paper envisages the geographic allocation of the refineries and contains the evaluation of the refineries’ capacities for the region under review. The sustainable operations of refineries in the region are determined by the transportation system capacity to supply crude oil to them. The assessment of capacity of crude oil transportation to the refineries is conducted. The research is performed for the period of 2005/2015, using the quantitative analysis method. The countries are classified by the refineries’ aggregate capacities and the crude oil output on their territory. The crude oil output capacities in the region in the period under review are determined. The capacities of the region’s transportation system to supply crude oil produced in the region to the refineries are revealed. The analysis suggested that imported raw materials are the main source of oil for the refineries in the region. The main sources of crude oil supplies to North European refineries are reviewed. The change in the refineries’ capacities in the group of countries and each particular country, as well as the utilization of the refineries' capacities in the region in the period under review, was studied. The input suggests that the bulk of crude oil is supplied by marine and pipeline transport. The paper contains the assessment of the crude oil transportation by pipeline transport in the overall crude oil cargo flow. The refineries’ production rate for the groups of countries under the review and for each particular country was the subject of study. Our study yielded the trend towards the increase in the crude oil refining at the refineries of the region and reduction in the crude oil output. If this trend persists in the near future, the cargo flow of imported crude oil and the utilization of the North European logistics infrastructure may increase. According to the study, the existing transport infrastructure in the region is able to handle the increasing imported crude oil flow.

Keywords: European region, infrastructure, oil terminal capacity, pipeline capacity, tanker draft

Procedia PDF Downloads 174

Authors: Manasa Kalla, Narasimha Raju Chebrolu, Ashok Chatterjee

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We have studied the quantum transport properties of a single molecular transistor in the presence of an external magnetic field using the Keldysh Green function technique. We also used the Anderson-Holstein-Caldeira-Leggett Model to describe the single molecular transistor that consists of a molecular quantum dot (QD) coupled to two metallic leads and placed on a substrate that acts as a heat bath. The phonons are eliminated by the Lang-Firsov transformation and the effective Hamiltonian is used to study the effect of an external magnetic field on the spectral density function, Tunneling Current, Differential Conductance and Spin polarization. A peak in the spectral function corresponds to a possible excitation. In the presence of a magnetic field, the spin-up and spin-down states are degenerate and this degeneracy is lifted by the magnetic field leading to the splitting of the central peak of the spectral function. The tunneling current decreases with increasing magnetic field. We have observed that even the differential conductance peak in the zero magnetic field curve is split in the presence electron-phonon interaction. As the magnetic field is increased, each peak splits into two peaks. And each peak indicates the existence of an energy level. Thus the number of energy levels for transport in the bias window increases with the magnetic field. In the presence of the electron-phonon interaction, Differential Conductance in general gets reduced and decreases faster with the magnetic field. As magnetic field strength increases, the spin polarization of the current is increasing. Our results show that a strongly interacting QD coupled to metallic leads in the presence of external magnetic field parallel to the plane of QD acts as a spin filter at zero temperature.

Keywords: Anderson-Holstein model, Caldeira-Leggett model, spin-polarization, quantum dots

Procedia PDF Downloads 185

Authors: Maryam Kheirollahpour, Mahmoud Danaee, Amir Faisal Merican, Asma Ahmad Shariff

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Background: The presence of nonlinearity among the risk factors of eating behavior causes a bias in the prediction models. The accuracy of estimation of eating behaviors risk factors in the primary prevention of obesity has been established. Objective: The aim of this study was to explore the potential of a hybrid model of structural equation modeling (SEM) and Artificial Neural Networks (ANN) to predict eating behaviors. Methods: The Partial Least Square-SEM (PLS-SEM) and a hybrid model (SEM-Artificial Neural Networks (SEM-ANN)) were applied to evaluate the factors affecting eating behavior patterns among university students. 340 university students participated in this study. The PLS-SEM analysis was used to check the effect of emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) on different categories of eating behavior patterns (EBP). Then, the hybrid model was conducted using multilayer perceptron (MLP) with feedforward network topology. Moreover, Levenberg-Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The Tangent/sigmoid function was used for the input layer while the linear function applied for the output layer. The coefficient of determination (R²) and mean square error (MSE) was calculated. Results: It was proved that the hybrid model was superior to PLS-SEM methods. Using hybrid model, the optimal network happened at MPLP 3-17-8, while the R² of the model was increased by 27%, while, the MSE was decreased by 9.6%. Moreover, it was found that which one of these factors have significantly affected on healthy and unhealthy eating behavior patterns. The p-value was reported to be less than 0.01 for most of the paths. Conclusion/Importance: Thus, a hybrid approach could be suggested as a significant methodological contribution from a statistical standpoint, and it can be implemented as software to be able to predict models with the highest accuracy.

Keywords: hybrid model, structural equation modeling, artificial neural networks, eating behavior patterns

Procedia PDF Downloads 157

Authors: Aparna Lal, Ashwin Swaminathan, Teisa Holani

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Background: Clostridium difficile infections (CDIs) have been on the rise globally. In Australia, rates of CDI in all States and Territories have increased significantly since mid-2011. Identifying risk factors for CDI in the community can help inform targeted interventions to reduce infection. Methods: We examine the role of neighbourhood socio-economic status, demography, testing practices and the number of residential aged care facilities on spatial patterns in CDI incidence in the Australian Capital Territory. Data on all tests conducted for CDI were obtained from ACT Pathology by postcode for the period 1st January 2004 through 31 December 2014. Distribution of age groups and the neighbourhood Index of Relative Socio-economic Advantage Disadvantage (IRSAD) were obtained from the Australian Bureau of Statistics 2011 National Census data. A Bayesian spatial conditional autoregressive model was fitted at the postcode level to quantify the relationship between CDI and socio-demographic factors. To identify CDI hotspots, exceedance probabilities were set at a threshold of twice the estimated relative risk. Results: CDI showed a positive spatial association with the number of tests (RR=1.01, 95% CI 1.00, 1.02) and the resident population over 65 years (RR=1.00, 95% CI 1.00, 1.01). The standardized index of relative socio-economic advantage disadvantage (IRSAD) was significantly negatively associated with CDI (RR=0.74, 95% CI 0.56, 0.94). We identified three postcodes with high probability (0.8-1.0) of excess risk. Conclusions: Here, we demonstrate geographic variations in CDI in the ACT with a positive association of CDI with socioeconomic disadvantage and identify areas with a high probability of elevated risk compared with surrounding communities. These findings highlight community-based risk factors for CDI.

Keywords: spatial, socio-demographic, infection, Clostridium difficile

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Authors: Joseph F. Cabrera, Rachael Dela Cruz

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This study specifically examines patterns that define ethnoracially diverse neighborhoods. Ethnoracial diversity is important as it facilitates cross-racial interactions within neighborhoods which have been theorized to be associated with such outcomes as intergroup harmony, the reduction of racial and ethnic prejudice and discrimination, and increases in racial tolerance. Los Angeles (LA) is an ideal location to study ethnoracial spatial patterns as it is one of the most ethnoracially diverse cities in the world. A large influx of Latinos, as well as Asians, have contributed to LA’s urban landscape becoming increasingly diverse over several decades. Our dataset contains all census tracts in Los Angeles County in 2016 and incorporates Census and ACS demographic and spatial data. We quantify ethnoracial diversity using a derivative of Simpson’s Diversity Index and utilize this measure to test previous literature that suggests Latinos are one of the key drivers of changing ethnoracial spatial patterns in Los Angeles. Preliminary results suggest that there has been an overall increase in ethnoracial diversity in Los Angeles neighborhoods over the past sixteen years. Patterns associated with this trend include decreases in predominantly white and black neighborhoods, increases in predominantly Latino and Asian neighborhoods, and a general decrease in the white populations of the most diverse neighborhoods. A similar pattern is seen in neighborhoods with large Latino increases- a decrease in white population, but with an increase in Asian and black populations. We also found support for previous research that suggests increases in Latino and Asian populations act as a buffer, allowing for black population increases without a sizeable decrease in the white population. Future research is needed to understand the underlying causes involved in many of the patterns and trends highlighted in this study.

Keywords: race, race and interaction, racial harmony, social interaction

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Authors: Novee Lor C. Leyso, Maylin C. Palatino

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Under-five malnutrition continues to persist in the Philippines, particularly in the island Province of Marinduque, with prevalence of some forms of malnutrition even worsening in recent years. Local spatial cluster detection provides a spatial perspective in understanding this phenomenon as key in analyzing patterns of geographic variation, identification of community-appropriate programs and interventions, and focused targeting on high-risk areas. Using data from a province-wide household-based census conducted in 2014–2016, this study aimed to determine and evaluate spatial clusters of under-five malnutrition, across the province and within each municipality at the individual level using household location. Malnutrition was defined as weight-for-age z-score that fall outside the 2 standard deviations from the median of the WHO reference population. The Kulldorff’s elliptical spatial scan statistic in binomial model was used to locate clusters with high-risk of malnutrition, while adjusting for age and membership to government conditional cash transfer program as proxy for socio-economic status. One large significant cluster of under-five malnutrition was found southwest of the province, in which living in these areas at least doubles the risk of malnutrition. Additionally, at least one significant cluster were identified within each municipality—mostly located along the coastal areas. All these indicate apparent geographical variations across and within municipalities in the province. There were also similarities and disparities in the patterns of risk of malnutrition in each cluster across municipalities, and even within municipality, suggesting underlying causes at work that warrants further investigation. Therefore, community-appropriate programs and interventions should be identified and should be focused on high-risk areas to maximize limited government resources. Further studies are also recommended to determine factors affecting variations in childhood malnutrition considering the evidence of spatial clustering found in this study.

Keywords: Binomial model, Kulldorff’s elliptical spatial scan statistic, Philippines, under-five malnutrition

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Authors: Salimah Hasnah, Namratha Radhakrishnan

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Communities play a vital role in mobilizing people and resources for the benefit of all. Since time immemorial, communities have been spear heading different activities ranging from disaster management, palliative care, local economic development and many more with laudable success. Urban agriculture is one such activity where communities can prove to make a real difference. Farming activities in cities across different developed countries have proved to have favorable outcomes in the form of increased food security, neighborhood revitalization, health benefits and local economic growth. However, urban agriculture in the developing nations have never been prioritized as an important planning tool to cater to the basic needs of the public. Urban agricultural practices are being carried out in a fragmented fashion without a formal backing. The urban dwellers rely heavily on their far-off rural counterparts for daily food requirements. With the onset of the pandemic and the recurring lockdowns, the significance of geographic proximity and its impact on the availability of food to the public are gradually being realized around the globe. This warrants a need for localized food systems by shortening the distance between production and consumption of food. The significance of communities in realizing these urban farming benefits is explored in this paper. A case-study approach is adopted to understand how different communities have overcome barriers to urban farming in cities. The applicability of these practices is validated against the state of Kerala in India wherein different community centered approaches have been successful in the past. The existing barriers are assessed and way forward to achieve a self-sufficient localized food systems is formulated with the key lessons from the case studies. These recommendations will be helpful to successfully establish and sustain farming activities in urban areas by leveraging the power of communities.

Keywords: community-centric, COVID-19, drivers and barriers, local food system, urban agriculture

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Authors: Moses Obenade, Henry U. Okeke, Francis I. Okpiliya, Eugene J. Aniah

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Population growth in Eleme has been rapid over the past 75 years with its attendant pressure on the natural resources of the area. Between 1937 and 2006 the population of Eleme grew from 2,528 to 190,194 and is projected to be above 265,707 in 2016 based on an annual growth rate of 3.4%. Using the combined technologies of Geographic Information Systems (GIS), remote sensing (RS) and Demography techniques as its methodology, this paper examines the environmental implications of rapid population growth on land use dynamics in Eleme between 1986 and 2015. The study reveals that between 1986 and 2006, Built-up area and Farmland increased by 72.67 and 12.77% respectively, while light and thick vegetation recorded a decrease of -6.92 and -61.64% respectively. Water body remains fairly constant with minimal changes. Also, between 2006 and 2015 covering a period of 9 years, Built-up area further increased by 53% with an annual growth rate of 2.32 km2 gaining more land area on the detriment of other land uses. Built-up area has an annual growth rate of 2.32km2 and is expected to increase from 18.67km2 in 2006 to 41.87km2 in 2016.The observed Land used/Land cover dynamics is derived by the demographic characteristics of the Study area. Eleme has a total area of 138km2 out of which the Federal Government of Nigeria compulsorily acquired an estimated area of 59.34km2 for industrial purposes excluding acquisitions by the Rivers State Government. It is evident from the findings of this study that the carrying capacity of Eleme ecosystem is under threat due to the current population growth and land consumption rates. Therefore, measures such as use of appropriate technologies in farming techniques, waste management; investment in family planning and female empowerment, maternal health and education, afforestation programs; and amendment of Land Use Act of 1978 are recommended.

Keywords: population growth, Eleme, land use, GIS and remote sensing

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: According to the World Health Organization, caesarean section delivery rates of more than 10-15% caesarean section deliveries in any specific geographic region in the world are not justifiable. The aim of the study was to describe the level and analyse determinants of caesarean section delivery in Addis Ababa. Methods: Data was collected in Addis Ababa using a structured questionnaire administered to 901 women aged 15-49 years through a stratified two-stage cluster sampling technique. Binary logistic regression model was employed to identify predictors of caesarean section delivery. Results: Among the 835 women who delivered their last birth at healthcare facilities, 19.2% of them gave birth by caesarean section. About 9.0% of the caesarean section births were due to mother’s request or service provider’s influence without any medical indication. The caesarean section delivery rate was much higher than the recommended rate particularly among the non-slum residents (27.2%); clients of private healthcare facilities (41.1%); currently married women (20.6%); women with secondary (22.2%) and tertiary (33.6%) level of education; and women belonging to the highest wealth quintile household (28.2%). The majority (65.8%) of the caesarean section clients were not informed about the consequences of caesarean section delivery by service providers. The logistic regression model shows that older age (30-49), secondary and above education, non-slum residence, high-risk pregnancy and receiving adequate antenatal care were significantly positively associated with caesarean section delivery. Conclusion: Despite the unreserved effort towards achieving MDG 5 through safe skilled delivery assistance among others, the high caesarean section rate beyond the recommend limit, and the finding that caesarean sections done without medical indications were also alarming. The government and city administration should take appropriate measures before the problems become setbacks in healthcare provision. Further investigations should focus on the effect of caesarean section delivery on maternal and child health outcomes in the study area.

Keywords: Addis Ababa, caesarean section, mode of delivery, slum residence

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Authors: Vasileiou Apostolos, Theodosiou Chrysa, Tsitroulis Ioannis, Maris Fotios

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The severity of extreme phenomena is due to their ability to cause severe damage in a small amount of time. It has been observed that floods affect the greatest number of people and induce the biggest damage when compared to the total of annual natural disasters. The detection of potential flood-prone areas constitutes one of the fundamental components of the European Natural Disaster Management Policy, directly connected to the European Directive 2007/60. The aim of the present paper is to develop a new methodology that combines geographical information, fuzzy logic and multi-criteria evaluation methods so that the most vulnerable areas are defined. Therefore, ten factors related to geophysical, morphological, climatological/meteorological and hydrological characteristics of the basin were selected. Afterwards, two models were created to detect the areas pronest to flooding. The first model defined the gravitas of each factor using Analytical Hierarchy Process (AHP) and the final map of possible flood spots were created using GIS and Boolean Algebra. The second model made use of the fuzzy logic and GIS combination and a respective map was created. The application area of the aforementioned methodologies was in Ardas basin due to the frequent and important floods that have taken place these last years. Then, the results were compared to the already observed floods. The result analysis shows that both models can detect with great precision possible flood spots. As the fuzzy logic model is less time-consuming, it is considered the ideal model to apply to other areas. The said results are capable of contributing to the delineation of high risk areas and to the creation of successful management plans dealing with floods.

Keywords: analytical hierarchy process, flood prone areas, fuzzy logic, geographic information system

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Authors: Armand Okende, Benjamin Beaumont

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Introduction: Deforestation is a change in the structure and composition of flora and fauna, which leads to a loss of biodiversity, production of goods and services and an increase in fires. It concerns vast territories in tropical zones particularly; this is the case of the territory of Bolobo in the current province of Maï- Ndombe in the Democratic Republic of Congo. Indeed, through this study between 2001 and 2018, we believe that it was important to show and analyze quantitatively the important forests changes and analyze quantitatively. It’s the overall objective of this study because, in this area, we are witnessing significant deforestation. Methodology: Mapping and quantification are the methodological approaches that we have put forward to assess the deforestation or forest changes through satellite images or raster layers. These satellites data from Global Forest Watch are integrated into the GIS software (GRASS GIS and Quantum GIS) to represent the loss of forest cover that has occurred and the various changes recorded (e.g., forest gain) in the territory of Bolobo. Results: The results obtained show, in terms of quantifying deforestation for the periods 2001-2006, 2007-2012 and 2013-2018, the loss of forest area in hectares each year. The different change maps produced during different study periods mentioned above show that the loss of forest areas is gradually increasing. Conclusion: With this study, knowledge of forest management and protection is a challenge to ensure good management of forest resources. To do this, it is wise to carry out more studies that would optimize the monitoring of forests to guarantee the ecological and economic functions they provide in the Congo Basin, particularly in the Democratic Republic of Congo. In addition, the cartographic approach, coupled with the geographic information system and remote sensing proposed by Global Forest Watch using raster layers, provides interesting information to explain the loss of forest areas.

Keywords: deforestation, loss year, forest change, remote sensing, drivers of deforestation

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Authors: Cristina Cirone, Katrina Cirone, Monali S. Malvankar-Mehta

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Purpose: An increased risk of visual impairment has been observed in individuals lacking a balanced diet. The purpose of this paper is to characterize the relationship between plant-based diets and specific ocular outcomes among adults. Design: Systematic review and meta-analysis. Methods: This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. The databases MEDLINE, EMBASE, Cochrane, and PubMed, were systematically searched up until May 27, 2021. Of the 503 articles independently screened by two reviewers, 21 were included in this review. Quality assessment and data extraction were performed by both reviewers. Meta-analysis was conducted using STATA 15.0. Fixed-effect and random-effect models were computed based on heterogeneity. Results: A total of 503 studies were identified which then underwent duplicate removal and a title and abstract screen. The remaining 61 studies underwent a full-text screen, 21 progressed to data extraction and fifteen were included in the quantitative analysis. Meta-analysis indicated that regular consumption of fish (OR = 0.70; CI: [0.62-0.79]) and skim milk, poultry, and non-meat animal products (OR = 0.70; CI: [0.61-0.79]) is positively correlated with a reduced risk of visual impairment (age-related macular degeneration, age-related maculopathy, cataract development, and central geographic atrophy) among adults. Consumption of red meat [OR = 1.41; CI: [1.07-1.86]) is associated with an increased risk of visual impairment. Conclusion: Overall, a pescatarian diet is associated with the most favorable visual outcomes among adults, while the consumption of red meat appears to negatively impact vision. Results suggest a need for more local and government-led interventions promoting a healthy and balanced diet.

Keywords: plant-based diet, pescatarian diet, visual impairment, systematic review, meta-analysis

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Authors: Dawit Thomas

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Feeding and weaning practices vary from culture to culture and depend on different child-rearing values. The socio-cultural dimensions that influence the acceptable infant feeding practices are varied and complex. Understanding cultural differences in beliefs and practices relating to infant feeding is important to enhance designing programs for delivering successful psychological, social, physiological and economic well-being of mothers and infants. The main purpose of this study was exploring mothers infant feeding practices in the context of Hadiyya culture. After purposively selecting Harche Huyaya Uyaya Kebele eight infant feeding mothers were selected using snowball sampling technique. The study employed interviews and focus group discussion. The study found out early initiation and prolonged breastfeeding and early complementary feeding in some instances immediately after birth. In addition, infants were not forced to wean unless the mothers encounter pressing issues like pregnancy and health related problems. Furthermore, the main weaning techniques were putting unpleasant materials on the tip of nipples and sending infants to grandparents home. The study also found out gender difference in weaning, i.e., early initiation of weaning for girls. This can be indicative of gender-based bias on weaning practice. Finally, health extension workers, office of women and children affairs and Hadiyya Zone Tourism office should organize awareness raising programs to preserve vital infant feeding practices like prolonged breastfeeding and length of weaning. In addition, the offices should raise awareness among communities on negative side effects of sending infant to grandparents home that may weaken infant-mothers attachment and create favorable ground for the development of phobia.

Keywords: feeding, infant, practices, weaning

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Authors: Shahla Bukhtair

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A paradigm presents a consensus view of a particular or collective community, accepted into by the members of that community, either consciously pronounced or, more likely, simply assumed and not intentionally acknowledged but is articulated. Paradigm shift is based on the behavioral attitude of the community. Change is inexorable. The world is suffering with the innovative creation of globalization. Media boosted this paradigm shift all over the world. Globalization is a vigorous process which impacts differentially on various cultures around the world. The outcome of the globalization is permeates cultural boundaries and in the process results in the spread of Western ideologies and values across the world. The term flourished in 20th century. Globalization is regarded as having substantial impact on such crises through its encouragement of conflicts rather than conciliation; through opportunities of expression, various groups get benefit with it. Identity crisis refers to inflexible mechanism i.e. cultural and political conflicts among polarized groups, which struggle with each other over the definition of a national identity. Violence is not only a kind of physical but it also psychological as well. Due to identity crisis, a person is having an issue of fear, anxiety, and lack of security. Everything has negative and positive aspects. Newspaper columns, magazine articles, films, made-for-TV movies, television special reports, and talk shows are all public arenas where images of political agenda of their own interest are constructed, debated, and reproduced. From these resources, individuals construct their own conceptions of what is normal and acceptable. This bias affects images in the media, and in turn has a negative effect on public development in a society. This paper investigates the relationship between globalization and cultural war, identity crisis and the role of violence. Objectives: - To determine which type of media plays an important role in shaping perceptions and attitudes of public negatively; - To analyze the impact of globalization on identity crisis, violence and global culture (positive and negative).

Keywords: paradigm shift, globalization, identity crisis, cultural war

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Authors: Malay K. Pramanik

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In recent years, climate change has become a major threat and has been widely documented in the geographic distribution of many plant species. However, the impacts of climate change on the distribution of ecologically vulnerable medicinal species remain largely unknown. The identification of a suitable habitat for a species under climate change scenario is a significant step towards the mitigation of biodiversity decline. The study, therefore, aims to predict the impact of current, and future climatic scenarios on the distribution of the threatened Garcinia indica across the northern Western Ghats using Maximum Entropy (MaxEnt) modelling. The future projections were made for the year 2050 and 2070 with all Representative Concentration Pathways (RCPs) scenario (2.6, 4.5, 6.0, and 8.5) using 56 species occurrence data, and 19 bioclimatic predictors from the BCC-CSM1.1 model of the Intergovernmental Panel for Climate Change’s (IPCC) 5th assessment. The bioclimatic variables were minimised to a smaller number of variables after a multicollinearity test, and their contributions were assessed using jackknife test. The AUC value of 0.956 ± 0.023 indicates that the model performs with excellent accuracy. The study identified that temperature seasonality (39.5 ± 3.1%), isothermality (19.2 ± 1.6%), and annual precipitation (12.7 ± 1.7%) would be the major influencing variables in the current and future distribution. The model predicted 10.5% (19318.7 sq. km) of the study area as moderately to very highly suitable, while 82.60% (151904 sq. km) of the study area was identified as ‘unsuitable’ or ‘very low suitable’. Our predictions of climate change impact on habitat suitability suggest that there will be a drastic reduction in the suitability by 5.29% and 5.69% under RCP 8.5 for 2050 and 2070, respectively. Finally, the results signify that the model might be an effective tool for biodiversity protection, ecosystem management, and species re-habitation planning under future climate change scenarios.

Keywords: Garcinia Indica, maximum entropy modelling, climate change, MaxEnt, Western Ghats, medicinal plants

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Authors: Malak Alasli

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Hungarians come to use geographic names that are foreign to their environment and language in diverse settings, hence the aim of trying to adapt them to their own linguistic context. The Maghreb region (Morocco, Algeria, and Tunisia) uses both Arabic and French in presenting the place names. Consequently, the lexicographical treatment of the toponym will, therefore, consist of both the presentation of the toponymic term and the pronunciation of the entries. The motivation behind this approach is the need for a better identification of the place in question by avoiding ambiguities, and for more respect to the heritage by conforming to the right use of toponyms both in written as well as in oral practice. The goal is to provide Hungarians with a set of data by attempting a system of transliteration from French/Arabic to Hungarian, where the place names of the Maghreb are transliterated for more efficient usage. To examine the importance of toponyms’ pronunciation, the latter were collected from several 20th and 21st Hungarian school atlases. Most people meet, for the first time, foreign place names in school, hence the choice of solely extracting place names from school atlases as sample data. Interviews targeted university students, where they were asked to pronounce the place names collected. Results revealed the intricacy behind the pronunciation. Two main conclusions emerged; Hungarian students encountered challenges reading the toponyms, and Arabic speakers could not identify the names either, which causes a cut in communication. Ergo, the importance of elaborating on the pronunciation of toponyms. Concordance is where you find variants of a name. Therefore, a chart was put forward including all the name variants obtained from various references with their Arabic transcription indicating any changes that may have occurred, and the origin of the denomination (Roman, Berber, etc.). A case will also be added for comments and observations. This work embraces a dual purpose. It will provide information to Hungarians on the official names of foreign places in case of occurring changes; for instance, 'El-goléa, Algeria' (used in a latest edition of a school atlas) has now the official name of 'El Ménia'. It will also serve as a reference for knowing the correct and precise forms of place names’ pronunciation.

Keywords: concordance, onomastics, settlement names, school atlases

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Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

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In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: early stage prediction, heart rate variability, linear and non-linear analysis, sudden cardiac death

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Authors: A. Al Hajeri, M. E. Minton, B. Haskins, F. H. Cummins

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The pre-hospital endotracheal intubation is fraught with difficulties; one solution offered has been video laryngoscopy (VL) which permits better visualization of the glottis than the standard method of direct laryngoscopy (DL). This method has resulted in a higher first attempt success rate and fewer failed intubations. However, VL has mainly been evaluated by experienced providers (experienced anesthetists), and as such the utility of this device for those whom infrequently intubate has not been thoroughly assessed. We sought to evaluate this equipment to determine whether in the hands of novice providers this equipment could prove an effective airway management adjunct. DL and two VL methods (C-Mac with distal screen/C-Mac with attached screen) were evaluated by simulating practice on a Laerdal airway management trainer manikin. Twenty Emergency Medical Technicians (basics) were recruited as novice practitioners. This group was used to eliminate bias, as these clinicians had no pre-hospital experience of intubation (although they did have basic airway skills). The following areas were assessed: Time taken to intubate, number of attempts required to successfully intubate, ease of use of equipment VL (attached screen) took on average longer for novice clinicians to successfully intubate and had a lower success rate and reported higher rating of difficulty compared to DL. However, VL (with distal screen) and DL were comparable on intubation times, success rate, gastric inflation rate and rating of difficulty by the user. This study highlights the routine use of VL by inexperienced clinicians would be of no added benefit over DL. Further studies are required to determine whether Emergency Medical Technicians (Paramedics) would benefit from this airway adjunct, and ascertain whether after initial mastery of VL (with a distal screen), lower intubation times and difficulty rating may be achievable.

Keywords: direct laryngoscopy, endotracheal intubation, pre-hospital, video laryngoscopy

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Authors: Riddhi Chopra

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While China’s friendship with a number of countries has waxed and waned over the decades, Sino-Pak relationship is said to have withstood the vicissitudes of larger international politics as well as changes in regional and domestic currents. Pakistan, one of the first countries to recognize the People’s Republic of China, thus providing China with a corridor into the energy rich Muslim states which was reciprocated with a continual stream of no-strings-attached military hardware and defense-related assistance from Beijing. The joint enmity towards India also provided the initial thrust to a burgeoning Sino-Pak friendship. This paper intends to provide a profound analysis of the strategic relation between China-Pakistan and examine India as a determining factor. The Pakistan-China strategic relationship has been conventionally viewed by India as a zero sum game, wherein any gains accrued by Pakistan or China through their partnership is seen as a direct detriment to the evolution of India-Pakistan or India-China relation. The paper evaluates various factors which were crucial for the synthesis of such a strong relation and presents a comprehensive study of the various policies and programs that have been undertaken by the two countries to tie India to South Asia and reduce its sphere of influence. The geographic dynamics is said to breed a natural coalition, dominating the strategic ambitions of both Beijing and Islamabad hence directing their relationship. In addition to the obvious geopolitical factors, there are several dense collaborations between the two nations knitting a relatively close partnership. Moreover, an attempt has been made to assess the irritants in China-Pak relations and the initiatives taken by the two to further strengthen it. Current trends in diplomatic, economic and defense cooperation – along with the staunch affinity rooted in history and consistent geo-strategic interests – points to a strong and strengthening relationship, significant in directing India’s foreign and security policies. This paper seeks to analyze the changing power dynamics of the China-Pak nexus with external actors such as US and India with an ulterior motive of their own and predict the change in power dynamics between the four countries.

Keywords: China, Pakistan, India, strategy

Procedia PDF Downloads 268