Search results for: globally convergence

Authors: Amritansh Agarwal, Tejaswi Agarwal

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Forest ecosystem plays very important role in the global carbon cycle. It stores about 80% of all above ground and 40% of all below ground terrestrial organic carbon. There is much interest in the extent of tropical forests and their rates of deforestation for two reasons: greenhouse gas contributions and the impact of profoundly negative biodiversity. Deforestation has many ecological, social and economic consequences, one of which is the loss of biological diversity. The rapid deployment of remote sensing (RS) satellites and development of RS analysis techniques in the past three decades have provided a reliable, effective, and practical way to characterize terrestrial ecosystem properties. Global estimates of tropical deforestation vary widely and range from 50,000 to 170,000 km2 /yr Recent FAO tropical deforestation estimates for 1990–1995 cite 116,756km2 / yr globally. Remote Sensing can prove to be a very useful tool in monitoring of forests and associated deforestation to a sufficient level of accuracy without the need of physically surveying the forest areas as many of them are physically inaccessible. The methodology for the assessment of forest cover using digital image processing (ERDAS) has been followed. The satellite data for the study was procured from USGS website in the digital format. While procuring the satellite data, care was taken to ensure that the data was cloud and aerosol free by making using of FLAASH atmospheric correction technique. The Normalized Difference Vegetation Index (NDVI) has been used as a numerical indicator of the reduction in ground biomass. NDVI = (near I.R - Red)/ (near I.R + Red). After calculating the NDVI variations and associated mean we have analysed the change in ground biomass. Through this paper we have tried to indicate the rate of deforestation over a given period of time by comparing the forest cover at different time intervals. With the help of remote sensing and GIS techniques it is clearly shows that the total forest cover is continuously degrading and transforming into various land use/land cover category.

Keywords: remote sensing, deforestation, supervised classification, NDVI change detection

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Authors: Sophia Anastasiou, Cosmas Nathanailides, Fotini Kakali, Panagiotis Logothetis, Gregorios Kanlis

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The method and rearing conditions of aquaculture may very between different regions and aquaculture sites. Globally, the Aquaculture industry faces a challenge to develop aquaculture methods which safeguard the economic viability of the company, the welfare of farmed fish and final product quality and sustainable development of aquaculture. Marine fish farms in Greece operate in different locations and farmed fish are exposed to a variety of rearing conditions. This paper investigates the variability of product quality and the financial performance of different marine fish farms operating in West Greece. Production parameters of gilthead sea bream fish farm such as feeding regimes, mortalities, fish densities were used to calculate the economic efficiency of six different aquaculture sites from West Greece. Samples of farmed sea bream were collected and lipid content, microbial load and filleting yield of the samples were used as quality criteria. The results indicate that Lipid content, filleting yield and microbial load of fish originating from different fish farms varied significantly with improved quality exhibited in fish farms which exhibited improved Feed conversion rates and lower mortalities. Changes in feeding management practices such as feed quality and feeding regimes have a significant impact on the financial performance of sea bass farms. Fish farms which exhibited improved feeding conversion rates also exhibited increased profitability. Improvements in the FCR explained about 13.4 % of the difference in profitability of the different aquaculture sites. Lower mortality and higher growth rates were also exhibited by the fish farms which exhibited improved FCR. It is concluded that best feeding management practices resulted in improved product quality and profitability.

Keywords: fish quality, aquaculture management, feeding management, profitability

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Authors: Tesfay Gidey, Emiru Birhane, Ashenafi Manaye, Hailemariam Kassa, Tesfay Atsbha, Negasi Solomon, Hadgu Hishe, Aklilu Negussie, Petr Madera, Jose G. Borges

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The globally endangered Dracaena ombet is one of the ten dragon multipurpose tree species in arid ecosystems. Anthropogenic and natural factors are now impacting the sustainability of the species. This study was conducted to prioritize criteria and alternative strategies for the conservation of the species using the analytical hierarchy process (AHP) model by involving all relevant stakeholders in the Desa'a dry Afromontane forest in northern Ethiopia. Information about the potential alternative strategies and the criteria for their evaluation was first collected from experts, personal experiences, and literature reviews. Afterward, they were validated using stakeholders' focus group discussions. Five candidate strategies with three evaluation criteria were considered for prioritization using the AHP techniques. The overall priority ranking value of the stakeholders showed that the ecological criterion was deemed as the most essential factor for the choice of alternative strategies, followed by the economic and social criteria. The minimum cut-off strategy, combining exclosures with the collection of only 5% of plant parts from the species, soil and water conservation, and silviculture interventions, was selected as the best alternative strategy for sustainable D. ombet conservation. The livelihood losses due to the selected strategy should be compensated by the collection of non-timber forest products, poultry farming, home gardens, rearing small ruminants, beekeeping, and agroforestry. This approach may be extended to study other dragon tree species and explore strategies for the conservation of other arid ecosystems.

Keywords: conservation strategies, analytical hierarchy process model, Desa'a forest, endangered species, Ethiopia, overexploitation

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Authors: Sidra Shaw, Sarenna Shaw, Chae Joon Lee, Irimpan Mathews, Eric Koehn

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One of the biggest public health concerns of our time is increasing antimicrobial resistance. As of 2019, the CDC has documented more than 2.8 million serious antibiotic resistant infections in the United States. Currently, antibiotic resistant infections are directly implicated in over 750,000 deaths per year globally. On our current trajectory, British economist Jim O’Neill predicts that by 2050, an additional 10 million people (about half the population of New York) will die annually due to drug resistant infections. As a result, new biochemical pathways must be targeted to generate next generation antibiotic drugs that will be effective against drug resistant bacteria. One enticing target is the biosynthesis of DNA within bacteria, as few drugs interrupt this essential life process. Thymidylate synthase enzymes are essential for life as they catalyze the synthesis of a DNA building block, 2′-deoxythymidine-5′-monophosphate (dTMP). In humans, the thymidylate synthase enzyme (TSase) has been shown to be distinct from the flavin-dependent thymidylate synthase (FDTS) produced by many pathogenic bacteria. TSase and FDTS have distinct structures and mechanisms of catalysis, which should allow selective inhibition of FDTS over human TSase. Currently, C. diff is one of the most antibiotic resistant bacteria, and no drugs that target thymine biosynthesis exist for C. diff. Here we present the initial biochemical characterization of FDTS from C. diff. Specifically, we examine enzyme kinetics and binding features of this enzyme to determine the nature of interaction with ligands/inhibitors and understand the molecular mechanism of catalysis. This research will provide more insight into the targetability of the C. diff FDTS enzyme for novel antibiotic drugs.

Keywords: flavin-dependent thymidylate synthase, FDTS, clostridioides difficile, C. diff, antibiotic resistance, DNA synthesis, enzyme kinetics, binding features

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Authors: Yuanda Ma, Zhiyong Zhang, Zailin Yang, Guanxixi Jiang

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Anisotropy is very common in underground media, such as rock, sand, and soil. Hence, the dynamic response of anisotropy medium under elastic waves is significantly different from the isotropic one. Moreover, underground heterogeneities and structures, such as pipelines, cylinders, or tunnels, are usually made by composite materials, leading to the anisotropy of these heterogeneities and structures. Both the anisotropy of the underground medium and the heterogeneities have an effect on the surface motion of the ground. Aiming at providing theoretical references for earthquake engineering and seismology, the surface motion of anisotropic half-space with a cylindrical anisotropic inclusion embedded under the SH wave is investigated in this work. Considering the anisotropy of the underground medium, the governing equation with three elastic parameters of SH wave propagation is introduced. Then, based on the complex function method and multipolar coordinates system, the governing equation in the complex plane is obtained. With the help of a pair of transformation, the governing equation is transformed into a standard form. By means of the same methods, the governing equation of SH wave propagation in the cylindrical inclusion with another three elastic parameters is normalized as well. Subsequently, the scattering wave in the half-space and the standing wave in the inclusion is deduced. Different incident wave angle and anisotropy are considered to obtain the reflected wave. Then the unknown coefficients in scattering wave and standing wave are solved by utilizing the continuous condition at the boundary of the inclusion. Through truncating finite terms of the scattering wave and standing wave, the equation of boundary conditions can be calculated by programs. After verifying the convergence and the precision of the calculation, the validity of the calculation is verified by degrading the model of the problem as well. Some parameters which influence the surface displacement of the half-space is considered: dimensionless wave number, dimensionless depth of the inclusion, anisotropic parameters, wave number ratio, shear modulus ratio. Finally, surface displacement amplitude of the half space with different parameters is calculated and discussed.

Keywords: anisotropy, complex function method, sh wave, surface displacement amplitude

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Authors: Gustave Semugaza, Anne Zora Gierth, Tommy Mielke, Marianela Escobar Castillo, Nat Doru C. Lupascu

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The generation of Construction and Demolition Waste (CDW) has globally increased enormously due to the enhanced need in construction, renovation, and demolition of construction structures. Several studies investigated the use of CDW materials in the production of new concrete and indicated the lower mechanical properties of the resulting concrete. Many other researchers considered the possibility of using the Hydrated Cement Powder (HCP) to replace a part of Ordinary Portland Cement (OPC), but only very few investigated the use of Recycled Concrete Powder (RCP) from CDW. The partial replacement of OPC for making new concrete intends to decrease the CO₂ emissions associated with OPC production. However, the RCP and HCP need treatment to produce the new concrete of required mechanical properties. The thermal treatment method has proven to improve HCP properties before their use. Previous research has stated that for using HCP in concrete, the optimum results are achievable by heating HCP between 400°C and 800°C. The optimum heating temperature depends on the type of cement used to make the Hydrated Cement Specimens (HCS), the crushing and heating method of HCP, and the curing method of the Rehydrated Cement Specimens (RCS). This research assessed the quality of recycled materials by using different techniques such as X-ray Diffraction (XRD), Differential Scanning Calorimetry (DSC) and thermogravimetry (TG), Scanning electron Microscopy (SEM), and X-ray Fluorescence (XRF). These recycled materials were thermally pretreated at different temperatures from 200°C to 1000°C. Additionally, the research investigated to what extent the thermally treated recycled cement could partially replace the OPC and if the new concrete produced would achieve the required mechanical properties. The mechanical properties were evaluated on the RCS, obtained by mixing the Dehydrated Cement Powder and Recycled Powder (DCP and DRP) with water (w/c = 0.6 and w/c = 0.45). The research used the compressive testing machine for compressive strength testing, and the three-point bending test was used to assess the flexural strength.

Keywords: hydrated cement powder, dehydrated cement powder, recycled concrete powder, thermal treatment, reactivation, mechanical performance

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Authors: Rohin Rameswarapu, Sameer Valsangkar

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Background: Globally, musculoskeletal disorders are the largest single cause of work-related illnesses accounting for over 33% of all newly reported occupational illnesses. Risk factors for MSD need to be delineated to suggest means for amelioration. Material and methods: In this current cross-sectional study, the prevalence of MSDs among workers in an electrical company assembly line, the socio-demographic and job characteristics associated with MSD were obtained through a semi-structured questionnaire. A quantitative assessment of the physical risk factors through the Rapid Upper Limb Assessment (RULA) tool, and measurement of psychosocial risk factors through a Likert scale was obtained. Statistical analysis was conducted using Epi-info software and descriptive and inferential statistics including chi-square and unpaired t test were obtained. Results: A total of 263 workers consented and participated in the study. Among these workers, 200 (76%) suffered from MSD. Most of the workers were aged between 18–27 years and majority of the workers were women with 198 (75.2%) of the 263 workers being women. A chi square test was significant for association between male gender and MSD with a P value of 0.007. Among the MSD positive group, 4 (2%) had a grand score of 5, 10 (5%) had a grand score of 6 and 186 (93%) had a grand score of 7 on RULA. There were significant differences between the non-MSD and MSD group on five out of the seven psychosocial domains, namely job demand, job monotony, co-worker support, decision control and family and environment domains. Discussion: The current cross-sectional study demonstrates a high prevalence of MSD among assembly line works with inherent physical and psychosocial risk factors and recommends that not only physical risk factors, addressing psychosocial risk factors through proper ergonomic means is also essential to the well-being of the employee.

Keywords: musculoskeletal disorders, India, occupational health, Rapid Upper Limb Assessment (RULA)

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Authors: Mualla McManus, Jenna Luche Thaye

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World Health Organisation International Classification of Disease codes were created to define disease including infections in order to guide and educate diagnosticians. Most infectious diseases such as syphilis are clearly defined by their ICD 10 codes and aid/help to educate the clinicians in syphilis diagnosis and treatment globally. However, current ICD 10 codes for relapsing fever Borreliosis and Lyme disease are less clearly defined and can impede appropriate diagnosis especially if the clinician is not familiar with the symptoms of these infectious diseases. This is despite substantial number of scientific articles published in peer-reviewed journals about relapsing fever and Lyme disease. In the USA there are estimated 380,000 people annually contacting Lyme disease, more cases than breast cancer and 6x HIV/AIDS cases. This represents estimated 0.09% of the USA population. If extrapolated to the global population (7billion), 0.09% equates to 63 million people contracting relapsing fever or Lyme disease. In many regions, the rate of contracting some form of infection from tick bite may be even higher. Without accurate and appropriate diagnostic codes, physicians are impeded in their ability to properly care for their patients, leaving those patients invisible and marginalized within the medical system and to those guiding public policy. This results in great personal hardship, pain, disability, and expense. This unnecessarily burdens health care systems, governments, families, and society as a whole. With accurate diagnostic codes in place, robust data can guide medical and public health research, health policy, track mortality and save health care dollars. Better defined ICD codes are the way forward in educating the diagnosticians about relapsing fever and Lyme diseases.

Keywords: WHO ICD codes, relapsing fever, Lyme diseases, World Health Organisation

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Authors: Benbelkacem Ouerdia

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Heterotrophic denitrification has been proven to be one of the most feasible processes for removing nitrate from wastewater and drinking water. In this process, heterotrophic bacteria use organic carbon for both growth and as an electron source. Underground water pollution by nitrates become alarming in Algeria. A survey carried out revealed that the nitrate concentration is in continual increase. Studies in some region revealed contamination exceeding the recommended permissible dose which is 50 mg/L. Worrying values in the regions of Mascara, Ouled saber, El Eulma, Bouira and Algiers are respectively 72 mg/L, 75 mg/L, 97 mg/L, 102 mg/L, and 158 mg/L. High concentration of nitrate in drinking water is associated with serious health risks. Research on nitrate removal technologies from municipal water supplies is increasing because of nitrate contamination. Biological denitrification enables the transformation of oxidized nitrogen compounds by a wide spectrum of heterotrophic bacteria into harmless nitrogen gas with accompanying carbon removal. Globally, denitrification is commonly employed in biological nitrogen removal processes to enhance water quality The study investigated the valorization of a vegetable residue as a carbon source (dates nodes) in water treatment using the denitrification process. Throughout the study, the effect of inoculums addition, pH, and initial concentration of nitrates was also investigated. In this research, a natural organic substance: dates nodes were investigated as a carbon source in the biological denitrification of drinking water. This material acts as a solid substrate and bio-film carrier. The experiments were carried out in batch processes. Complete denitrification was achieved varied between 80 and 100% according to the type of process used. It was found that the nitrate removal rate based on our results, we concluded that the removal of organic matter and nitrogen compounds depended mainly on the initial concentration of nitrate. The effluent pH was mainly affected by the C/N ratio, where a decrease increases pH.

Keywords: biofilm, carbon source, dates nodes, heterotrophic denitrification, nitrate, nitrite

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Authors: Tanka Nath Dahal

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Community-based forestry is seen as a promising instrument for sustainable forest management (SFM) through the purposeful involvement of local communities. Globally, forest area managed by local communities is on the rise. However, transferring management responsibilities to forest users alone cannot guarantee the sustainability of forest management. A monitoring tool, that allows the local communities to track the progress of forest management towards the goal of sustainability, is essential. A case study, including six forest user groups (FUGs), two from each three community-based forestry models—community forestry (CF), buffer zone community forestry (BZCF), and collaborative forest management (CFM) representing three different physiographic regions, was conducted in Nepal. The study explores which community-based forest management model (CF, BZCF or CFM) is doing well in terms of sustainable forest management. The study assesses the overall performance of the three models towards SFM using locally developed criteria (four), indicators (26) and verifiers (60). This paper attempts to quantify the sustainability of the models using sustainability index for individual criteria (SIIC), and overall sustainability index (OSI). In addition, rating to the criteria and scoring of the verifiers by the FUGs were done. Among the four criteria, the FUGs ascribed the highest weightage to institutional framework and governance criterion; followed by economic and social benefits, forest management practices, and extent of forest resources. Similarly, the SIIC was found to be the highest for the institutional framework and governance criterion. The average values of OSI for CFM, CF, and BZCF were 0.48, 0.51 and 0.60 respectively; suggesting that buffer zone community forestry is the more sustainable model among the three. The study also suggested that the SIIC and OSI help local communities to quantify the overall progress of their forestry practices towards sustainability. The indices provided a clear picture of forest management practices to indicate the direction where they are heading in terms of sustainability; and informed the users on issues to pay attention to enhancing the sustainability of their forests.

Keywords: community forestry, collaborative management, overall sustainability, sustainability index for individual criteria

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Authors: Ouerdia Benbelkacem Belouanas

Abstract:

Heterotrophic denitrification has been proven to be one of the most feasible processes for removing nitrate from waste water and drinking water. In this process, heterotrophic bacteria use organic carbon for both growth and as an electron source. Underground water pollution by nitrates become alarming in Algeria. A survey carried out revealed that the nitrate concentration is in continual increase. Studies in some region revealed contamination exceeding the recommended permissible dose which is 50 mg/L. Worrying values in the regions of Mascara, Ouled saber, El Eulma, Bouira and Algiers are respectively 72 mg/L, 75 mg/L, 97 mg/L, 102 mg/L, and 158 mg/L. High concentration of nitrate in drinking water is associated with serious health risks. Research on nitrate removal technologies from municipal water supplies is increasing because of nitrate contamination. Biological denitrification enables transformation of oxidized nitrogen compounds by a wide spectrum of heterotrophic bacteria into harmless nitrogen gas with accompanying carbon removal. Globally, denitrification is commonly employed in biological nitrogen removal processes to enhance water quality. The study investigated the valorization of a vegetable residue as a carbon source (dates nodes) in water treatment using the denitrification process. Throughout the study, the effect of inoculums addition, pH, and initial concentration of nitrates was also investigated. In this research, a natural organic substance: dates nodes were investigated as a carbon source in the biological denitrification of drinking water. This material acts as a solid substrate and bio-film carrier. The experiments were carried out in batch processes. Complete denitrification was achieved varied between 80 and 100% according to the type of process used. It was found that the nitrate removal rate based on our results, we concluded that the removal of organic matter and nitrogen compounds depended mainly on initial concentration of nitrate. The effluent pH was mainly affected by the C/N ratio, where a decrease increases pH.

Keywords: biofilm, carbon source, dates nodes, heterotrophic denitrification, nitrate, nitrite

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Authors: Clotilde Guyon, Nada Jmari, Yen-Chin Li, Jean Denoyel, Noriyuki Fujikado, Christophe Blanchet, David Root, Matthieu Giraud

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Aire induces ectopic expression of a large repertoire of tissue-specific antigen (TSA) genes in thymic medullary epithelial cells (MECs), driving immunological self-tolerance in maturing T cells. Although important mechanisms of Aire-induced transcription have recently been disclosed through the identification and the study of Aire’s partners, the fine transcriptional functions underlied by a number of them and conferred to Aire are still unknown. Alternative cleavage and polyadenylation (APA) is an essential mRNA processing step regulated by the termination complex consisting of 85 proteins, 10 of them have been related to Aire. We evaluated APA in MECs in vivo by microarray analysis with mRNA-spanning probes and RNA deep sequencing. We uncovered the preference of Aire-dependent transcripts for short-3’UTR isoforms and for proximal poly(A) site selection marked by the increased binding of the cleavage factor Cstf-64. RNA interference of the 10 Aire-related proteins revealed that Clp1, a member of the core termination complex, exerts a profound effect on short 3’UTR isoform preference. Clp1 is also significantly upregulated in the MECs compared to 25 mouse tissues in which we found that TSA expression is associated with longer 3’UTR isoforms. Aire-dependent transcripts escape a global 3’UTR lengthening associated with MEC differentiation, thereby potentiating the repressive effect of microRNAs that are globally upregulated in mature MECs. Consistent with these findings, RNA deep sequencing of actinomycinD-treated MECs revealed the increased stability of short 3’UTR Aire-induced transcripts, resulting in TSA transcripts accumulation and contributing for their enrichment in the MECs.

Keywords: Aire, central tolerance, miRNAs, transcription termination

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Authors: Enny Suswati, Supangat Supangat

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Background. Ready-to-eat food products are becoming increasingly popular because consumers are increasingly busy, competitive, and changing lifestyles. Examples of ready-to-eat foods include crispy fried chicken. Escherichia coli is one of the most important causes of food-borne diseases and the most frequent antibiotic-resistant pathogen globally. This study assessed the prevalence and antibiotic resistance profile of E. coli from ready-to-eat crispy fried chicken in Jember city, Indonesia. Methodology. This cross-sectional study was conducted from November 2020 to April 2021 by collecting 81crispy fried chicken samples from 27 food stalls in campus area using a simple random sampling method. Isolation and determination of E. coli use were performed by conventional culture method. An antibiotic susceptibility test was conducted using Kirby Bauer disk diffusion method on the Mueller–Hinton agar. Result. Out of 81crispy fried chicken samples, 77 (95.06%) were positive for E. coli. High E. coli drug resistance was observed on ampicillin, amoxicillin (100%) followed by cefixime (98.72%), erythromycin (97.59%), sulfamethoxazole (93.59%), azithromicin (83.33%), cefotaxime (78.28%), choramphenicol (75.64%), and cefixime (74.36%). On the other hand, there was the highest susceptibility for ciprofloxacin (64.10%). The multiple antibiotic resistance indexes of E. coli isolates varied from 0.4 to 1. The predominant antimicrobial resistance profiles of E. coli were CfmCroAmlAmpAzmCtxSxtCE (n=17), CfmCroAmlCipAmpAzmCtxSxtCE (n=16), and CfmAmlAmpAzmCtxSxtCE (n=5), respectively. Multidrug resistance was also found in the isolates' 76/77 (98.70%). Conclusion. The resistance pattern CfmCroAmlAmpAzmCtxSxtCE was the most common among the E. coli isolates, with 17 showing it. The multiple antibiotic index (MAR index) ranged from 0.4 to 1. Hygienic measures should be rigorously implemented and monitoring resistance of E. coli is required to reduce the risks related to the emergence of multi-resistant bacteria

Keywords: antibacterial drug, ready to eat, crispy fried chicken, escherichia coli

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Authors: Avitus A. Agbor

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Numerous incidents, ranging from trivial to catastrophic, do come to mind when one reflects on hate. The victims of these belong to specific identifiable groups within communities. These experiences evoke discussions on Islamophobia, xenophobia, homophobia, anti-Semitism, racism, ethnic hatred, atheism, and other brutal forms of bigotry. Common to all these is an invisible but portent force that drives all of them: hatred. Such hatred is usually fueled by a profound degree of intolerance (to diversity) and the zeal to impose on others their beliefs and practices which they consider to be the conventional norm. More importantly, the perpetuation of these hateful acts is the unfortunate outcome of an overplay of invectives and hate speech which, to a greater extent, cannot be divorced from hate. From a legal perspective, acknowledging the existence of an undeniable link between hate speech and hate is quite easy. However, both within and without legal scholarship, the notion of “hate speech” remains a conundrum: a phrase that is quite easily explained through experiences than propounding a watertight definition that captures the entire essence and nature of what it is. The problem is further compounded by a few factors: first, within the international human rights framework, the notion of hate speech is not used. In limiting the right to freedom of expression, the ICCPR simply excludes specific kinds of speeches (but does not refer to them as hate speech). Regional human rights instruments are not so different, except for the subsequent developments that took place in the European Union in which the notion has been carefully delineated, and now a much clearer picture of what constitutes hate speech is provided. The legal architecture in domestic legal systems clearly shows differences in approaches and regulation: making it more difficult. In short, what may be hate speech in one legal system may very well be acceptable legal speech in another legal system. Lastly, the cornucopia of academic voices on the issue of hate speech exude the divergence thereon. Yet, in the absence of a well-formulated and universally acceptable definition, it is important to consider how hate speech can be defined. Taking an evidence-based approach, this research looks into the issue of defining hate speech in legal scholarship and how and why such a formulation is of critical importance in the prohibition and prosecution of hate speech.

Keywords: hate speech, international human rights law, international criminal law, freedom of expression

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Authors: Oluwayemisi Femi-Pius, Kazeem Arogundade, Eberechukwu Eke, Jimmy Eko

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Introduction: Globally, community involvement in improving their own health has been widely adopted as a strategy in Sub-Saharan Africa principally to ensure equitable access to essential health care as well as improve the uptake of maternal and newborn health services especially in poor-resource settings. Method: The Saving Mother Giving Life (SMGL) Initiative implemented by Pathfinder International with funding support from USAID conducted a Health Facility Assessment (HFA) and found out that maternal mortality ratio in Cross River State was 812 per 100,000 live birth and perinatal mortality was 160 per 1000 live birth. To reduce maternal and perinatal mortality, Pathfinder International mobilized, selected and trained community members as community volunteers, traditional birth attendants, and emergency transport service volunteer drivers mainly to address the delay in decision making and reaching the health facility among pregnant women. Results: The results showed that maternal mortality ratio in Cross River State decrease by 25% from 812 per 100,000 live birth at baseline to 206 per 100,000 live birth at June 2018 and perinatal mortality reduced by 35% from 160 per 100,000 at baseline to 58 per 1000 live birth at June 2018. Data also show that ANC visit increased from 7,451 to 11,344; institutional delivery increased from 8,931 at baseline to 10,784 in June 2018. There was also a remarkable uptake of post-partum family planning from 0 at baseline to 233 in June 2018. Conclusion: There is clear evidence that community involvement yields positive maternal outcomes and is pivotal for sustaining most health interventions.

Keywords: maternal mortality, Nigeria, pathfinder international, perinatal mortality, saving mother giving life

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Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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Authors: Shahin A. Abdel-Naby, James P. Colgan, Michael S. Pindzola

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A time-dependent close-coupling method is developed to calculate a total, double and triple autoionization rates for hollow atomic ions of four-electron systems. This work was motivated by recent observations of the four-electron Auger process in near K-edge photoionization of C+ ions. The time-dependent close-coupled equations are solved using lattice techniques to obtain a discrete representation of radial wave functions and all operators on a four-dimensional grid with uniform spacing. Initial excited states are obtained by relaxation of the Schrodinger equation in imaginary time using a Schmidt orthogonalization method involving interior subshells. The radial wave function grids are partitioned over the cores on a massively parallel computer, which is essential due to the large memory requirements needed to store the coupled-wave functions and the long run times needed to reach the convergence of the ionization process. Total, double, and triple autoionization rates are obtained by the propagation of the time-dependent close-coupled equations in real-time using integration over bound and continuum single-particle states. These states are generated by matrix diagonalization of one-electron Hamiltonians. The total autoionization rates for each L excited state is found to be slightly above the single autoionization rate for the excited configuration using configuration-average distorted-wave theory. As expected, we find the double and triple autoionization rates to be much smaller than the total autoionization rates. Future work can be extended to study electron-impact triple ionization of atoms or ions. The work was supported in part by grants from the American University of Sharjah and the US Department of Energy. Computational work was carried out at the National Energy Research Scientific Computing Center (NERSC) in Berkeley, California, USA.

Keywords: hollow atoms, autoionization, auger rates, time-dependent close-coupling method

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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: Loyce Nahwera, Joy Wachira, Edwin Kiptolo, Constance Nsibambi, Mshilla Maghanga, Timothy Makubuya

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Introduction: Hypertension is one of the most prominent risk factors for cardiovascular diseases globally, and it can be modified through lifestyle interventions such as exercise. The objective of this study was to investigate the effects of a 12-week aerobic dance programme on systolic blood pressure (SBP) in stage 1 hypertensive individuals. Methods: This study employed an experimental research design. A total of 36 stage 1 hypertensive individuals who were randomly assigned into experimental and control groups completed the study. Systolic BP was measured using a mercury sphygmomanometer at baseline, mid-point and after the program. The experimental group participants trained 3 days a week, 45 minutes per session, at a moderate intensity of 40-60% of maximum oxygen consumption (VO2max) monitored by Garmin heart rate monitors. Data were analyzed using SPSS version 20. The significance level was set at p<0.05. A paired sample t-test was used to compare mean differences within the groups. Results: Data from the 36 participants (22 males and 14 females) (experimental; n=18, control; n=18) show that the experimental group had a mean SBP of 143.83±6.382 mmHg at baseline while the control had a mean of 137.61±6.400 mmHg. Following the end of a 6-week aerobic dance, the mean SBP of the experimental group reduced to 138.06±9.539 mmHg while that of the control marginally decreased to 137.00±8.073 mmHg. At the completion of a 12-week program, the mean SBP of the experimental group reduced to 136.33±9.191 mmHg, while that of the control marginally increased to 139.56±9.954 mmHg. This implies that both the 6-week and 12-week aerobic dance program reduced the SBP of the experimental group by 5.77±7.133 mmHg and 7.50±8.487 mmHg, respectively, while the control group fast reduced marginally by 0.61 before ultimately increasing by 1.95±7.974 mmHg at 12-weeks. The changes were statistically significant (p<0.05) at both 6 and 12 weeks of an aerobic dance program. Conclusion: The study concluded that aerobic dance is an effective non-pharmacological method for managing SBP of stage 1 hypertensive individuals both in the short-term (6 weeks) and long-term (12 weeks).

Keywords: aerobic dance, blood pressure, stage 1 hypertension, systolic blood pressure.

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Authors: Kita R. Ashman, Anthony R. Rendall, Matthew R. E. Symonds, Desley A. Whisson

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Forest cover is decreasing globally, chiefly due to the conversion of forest to agricultural landscapes. In contrast, the area under plantation forestry is increasing significantly. For wildlife occupying landscapes where native forest is the dominant land cover, plantations generally represent a lower value habitat; however, plantations established on land formerly used for pasture may benefit wildlife by providing temporary forest habitat and increasing connectivity. This study investigates the influence of landscape, site, and climatic factors on koala population density in far south-west Victoria where there has been extensive plantation establishment. We conducted koala surveys and habitat characteristic assessments at 72 sites across three habitat types: plantation, native vegetation blocks, and native vegetation strips. We employed a hierarchical modeling framework for estimating abundance and constructed candidate multinomial N-mixture models to identify factors influencing the abundance of koalas. We detected higher mean koala density in plantation sites (0.85 per ha) than in either native block (0.68 per ha) or native strip sites (0.66 per ha). We found five covariates of koala density and using these variables, we spatially modeled koala abundance and discuss factors that are key in determining large-scale distribution and density of koala populations. We provide a distribution map that can be used to identify high priority areas for population management as well as the habitat of high conservation significance for koalas. This information facilitates the linkage of ecological theory with the on-ground implementation of management actions and may guide conservation planning and resource management actions to consider overall landscape configuration as well as the spatial arrangement of plantations adjacent to the remnant forest.

Keywords: abundance modelling, arboreal mammals plantations, wildlife conservation

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Authors: N. R. Prasannakumar, M. N. Maruthi

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The whitefly, Bemisia tabaci (Gennadius) (Hemiptera; Aleyrodidae) is a highly polyphagous pest reported to infest over 600 plant hosts globally. About 42 genetic groups/cryptic species of B. tabaci exist in the world on different hosts. The species have variable behaviour with respect to feeding, development and transmission of viral diseases. Feeding on diverse host plants affect both whitefly development and the population of the endosymbionts harboured by the insects. Due to changes in the level of endosymbionts, the virus transmission efficiency by the vector also gets affected. We investigated these interactions on five host plants – egg plant, tomato, beans, okra and cotton - using a single whitefly species Asia 1 infected with three different bacteria Portiera, Wolbachia and Arsenophonus. The Asia 1 transmits the Tomato leaf curl Bangalore virus (ToLCBV) effectively and thus was used in the interaction studies. We found a significant impact of hosts on whitefly growth and development; eggplant was most favourable host, while okra and tomato were least favourable. Among the endosymbiotic bacteria, the titre of Wolbachia was significantly affected by feeding of B. tabaci on different host plants whereas Arsenophonus and Portiera were unaffected. When whitefly fed on ToLCBV-infected tomato plants, the Arsenophonus population was significantly increased, indicating its previously confirmed role in ToLCBV transmission. Further, screening of total proteins of B. tabaci Asia 1 genetic group interacting with ToLCBV coat protein was carried out using Y2H system. Some of the proteins found to be interacting with ToLCBV CP were HSPs 70kDa, GroEL, nucleoproteins, vitellogenins, apolipophorins, lachesins, enolase. The reported protein thus would be the potential targets for novel whitefly control strategies such as RNAi or novel insecticide target sites for sustainable whitefly management after confirmation of genuine proteins.

Keywords: cDNA, whitefly, ToLCBV, endosymbionts, Y2H

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Authors: Naomi Huang Wenya, Xin Xiaohui, Vijaya Rao, Wong Ting Hway, Chow Kah Hoe Pierce, Tan Hiang Khoon

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Background: The majority of the cancelled elective surgeries caused by the COVID-19 pandemic globally were estimated to occur in low- and middle-income countries (LMICs), where surgical services had long been in short supply even before the pandemic. Therefore, minimising disruption to existing surgical care in LMICs is of crucial importance during a pandemic. This study aimed to explore contributory factors to the continuity of surgical care in LMICs, in the face of a pandemic. Methods: Semi-structured interviews were conducted over zoom, with surgical leaders of 25 tertiary hospitals from 11 LMICs in South and Southeast Asia, from September to October 2020. Key themes were subsequently identified from the interview transcripts, using Braun and Clarke's method of thematic analysis. Results: The COVID-19 pandemic affected all surgical services of participating institutions but to varying degrees. Overall, elective surgeries suffered the gravest disruption, followed by outpatient surgical care, and finally, emergency surgeries. Keeping healthcare workers safe and striving for continuity of essential surgical care emerged as notable response strategies observed across all participating institutions. Conclusion: This study suggested that four factors are important for the resilience of surgical care against COVID-19: adequate COVID-19 testing capacity and effective institutional infection control measures, designated COVID-19 treatment facilities, a whole-system approach to balancing pandemic response and meeting essential surgical needs, and active community engagement. These findings can inform healthcare institutions in other countries, especially LMICs, in their effort to tread a fine line between preserving healthcare capacity for pandemic response and protecting surgical services against pandemic disruption.

Keywords: COVID-19, pandemic, LMICs, continuity of surgical service

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Authors: Samuel Kehinde Okunade, Daniel Sunday Tolorunshagba

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Globally women are classified to be part of the vulnerable group in any environment. In a conflict-ridden environment, women being vulnerable often suffer the consequences as it relates to security and access to basic social services such as medical care. This is the situation in border communities in Nigeria where cross-border crimes are on the rife, thus, putting women at a disadvantaged position and, eventually, victims of such inimical activities. Border communities in the Saki/Iseyin area of Oyo state are a case in point where the lives of inhabitants are daily threatened most, especially women. In light of the above, this article examined the security situation of the Saki/Iseyin area of Oyo State with a view to ascertaining its status in terms of safety of lives and property. This paper also explored the experiences of women in the border communities within the area as it relates to their safety, the safety of their children, access to good health facilities in their immediate environment, and above all, how they have been able to cope or manage the situation. The qualitative research model was adopted utilizing a phenomenological case study approach. A Focused Group Discussion was conducted with 10 pregnant women and 10 mothers in Okerete and Abugudu communities while a Key Informant Interview was conducted with the women leaders in both communities of the Saki/Iseyin border area of Oyo State. The findings of the study revealed the poor state of basic infrastructure. So bad to a point that inhabitants of these communities no longer see themselves as Nigerians because they have been neglected by the government for too long. The only solution is for the government to embark on developmental projects within these communities so that they can live a good life just as those in the cities do. More importantly, this will increase the loyalty of these communities to the Nigeria state by defending and resisting all forms of cross-border criminal activities that go on along the porous borders.

Keywords: security, women, Saki/Iseyin border area, cross-border criminalities, basic infrastructure

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Authors: Nishantha Giguruwa

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This research investigates the transformative potential of smart container farming, building upon the successful cultivation of Japanese mushrooms at Sakai Farms in Aichi Prefecture, Japan, under the strategic collaboration with the Daikei Group. Inspired by this success, the study focuses on establishing an advanced urban strawberry farming laboratory with the aim of understanding strawberry farming technologies, fostering collaboration, and strategizing marketing approaches for both local and global markets. Positioned within the business framework of Sakai Farms and the Daikei Group, the study underscores the sustainability and forward-looking solutions offered by smart container farming in agriculture. The global significance of strawberries is emphasized, acknowledging their economic and cultural importance. The detailed examination of strawberry farming intricacies informs the technological framework developed for smart containers, implemented at Sakai Farms. Integral to this research is the incorporation of controlled bee pollination, a groundbreaking addition to the smart container farming model. The study anticipates future trends, outlining avenues for continuing exploration, stakeholder collaborations, policy considerations, and expansion strategies. Notably, the author expresses a strategic intent to approach the global market, leveraging the foreign student/faculty base at Ritsumeikan Asia Pacific University, where the author is affiliated. This unique approach aims to disseminate the research findings globally, contributing to the broader landscape of agricultural innovation. The integration of controlled bee pollination within this innovative framework not only enhances sustainability but also marks a significant stride in the evolution of urban agriculture, aligning with global agricultural trends.

Keywords: smart container farming, urban agriculture, strawberry farming technologies, controlled bee pollination, agricultural innovation

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Authors: Smruti Mahapatra, Dipankar Biswas, Richard Um, Michael Meggyesy, Riccardo Serra, Noah Gorelick, Steven Marra, Amir Manbachi, Mark G. Luciano

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Intracranial pressure (ICP) is profoundly regulated by the effects of cardiac pulsation and the volume of the incoming blood. Furthermore, these effects on ICP are incremented by the presence of a rigid skull that does not allow for changes in total volume during the cardiac cycle. These factors play a pivotal role in cerebrospinal fluid (CSF) dynamics and distribution, with consequences that are not well understood to this date and that may have a deep effect on the Central Nervous System (CNS) functioning. We designed this study with two specific aims: (a) To study how pulsatility influences local CSF flow, and (b) To study how modulating intracranial pressure affects drug distribution throughout the SAS globally. In order to achieve these aims, we built an elaborate in-vitro model of the SAS closely mimicking the dimensions and flow rates of physiological systems. To modulate intracranial pressure, we used an intracranially implanted, cardiac-gated, volume-oscillating balloon (CADENCE device). Commercially available dye was used to visualize changes in CSF flow. We first implemented two control cases, seeing how the tracer behaves in the presence of pulsations from the brain phantom and the balloon individually. After establishing the controls, we tested 2 cases, having the brain and the balloon pulsate together in sync and out of sync. We then analyzed the distribution area using image processing software. The in-sync case produced a significant increase, 5x times, in the tracer distribution area relative to the out-of-sync case. Assuming that the tracer fluid would mimic blood flow movement, a drug introduced in the SAS with such a system in place would enhance drug distribution and increase the bioavailability of therapeutic drugs to a wider spectrum of brain tissue.

Keywords: blood-brain barrier, cardiac-gated, cerebrospinal fluid, drug delivery, neurosurgery

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Authors: Okwara O. S., Osunsina I. O. O., Pitan O. R., Afolabi C. G.

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Rice (Oryza sativa L.) belongs to the family poaceae and has become the most popular food. Globally, this crop is been faced with the menace of vertebrate pests, of which birds and rodents are the most implicated. The study avian and rodents’ infestations and the evaluation of attributable losses was carried out in 2020 and 2021 with the objectives of identifying the types of bird and rodent species associated with lowland rice and to determine the infestation levels, damage intensity, and the crop loss induced by these pests. The experiment was laid out in a split plot arrangement fitted into a Randomized Complete Block Design (RCBD), with the main plots being protected and unprotected groups and the sub-plots being four rice varieties, Ofada, WITA-4, NERICA L-34, and Arica-3. Data collection was done over a 16-week period, and the data obtained were transformed using square root transformation model before Analysis of Variance (ANOVA) was done at 5% probability level. The results showed the infestation levels of both birds and rodents across all the treatment means of thevarieties as not significantly different (p > 0.05) in both seasons. The damage intensity by these pests in both years were also not significantly different (p > 0.05) among the means of the varieties, which explains the diverse feeding nature of birds and rodents when it comes to infestations. The infestation level under the protected group was significantly lower (p < 0.05) than the infestation level recorded under the unprotected group.Consequently, an estimated crop loss of 91.94 % and 90.75 % were recorded in 2020 and 2021, respectively, andthe identified pest birds were Ploceus melanocephalus, Ploceus cuculatus, and Spermestes cucullatus. Conclusively, vertebrates pest cause damage to lowland rice which could result to a high percentage crop loss if left uncontrolled.

Keywords: pests, infestations, evaluation, losses, rodents, avian

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Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

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Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

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Authors: Saeed M. Alshahrani

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This research integrated blockchain technology to reform medical records management in healthcare informatics. It was aimed at resolving the limitations of centralized systems by establishing a secure, decentralized, and user-centric platform. The system was architected with a sophisticated three-tiered structure, integrating advanced cryptographic methodologies, consensus algorithms, and the Fast Healthcare Interoperability Resources (HL7 FHIR) standard to ensure data security, transaction validity, and semantic interoperability. The research has profound implications for healthcare delivery, patient care, legal compliance, operational efficiency, and academic advancements in blockchain technology and healthcare IT sectors. The methodology adapted in this research comprises of Preliminary Feasibility Study, Literature Review, Design and Development, Cryptographic Algorithm Integration, Modeling the data and testing the system. The research employed a permissioned blockchain with a Practical Byzantine Fault Tolerance (PBFT) consensus algorithm and Ethereum-based smart contracts. It integrated advanced cryptographic algorithms, role-based access control, multi-factor authentication, and RESTful APIs to ensure security, regulate access, authenticate user identities, and facilitate seamless data exchange between the blockchain and legacy healthcare systems. The research contributed to the development of a secure, interoperable, and decentralized system for managing medical records, addressing the limitations of the centralized systems that were in place. Future work will delve into optimizing the system further, exploring additional blockchain use cases in healthcare, and expanding the adoption of the system globally, contributing to the evolution of global healthcare practices and policies.

Keywords: healthcare informatics, blockchain, medical records management, decentralized architecture, data security, cryptographic algorithms

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Authors: Barun K. De

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Acquired immunodeficiency syndrome (AIDS) is caused by two types of human immunodeficiency viruses, collectively designated HIV. HIV infection is spreading globally particularly in developing countries. Before an individual is diagnosed with HIV, the disease goes through different phases. First there is an acute early phase that is followed by an established or chronic phase. Subsequently, there is a latency period after which the individual becomes immunodeficient. It is in the acute phase that an individual is highly infectious due to a high viral load. Presently, HIV diagnosis involves use of tests that do not detect the acute phase infection during which both the viral RNA and p24 antigen are expressed. Instead, these less sensitive tests detect antibodies to viral antigens which are typically sero-converted later in the disease process following acute infection. These antibodies are detected in both asymptomatic HIV-infected individuals as well as AIDS patients. Studies indicate that early diagnosis and treatment of HIV infection can reduce medical costs, improve survival, and reduce spreading of infection to new uninfected partners. Newer 4th generation combination antigen/antibody tests are highly sensitive and specific for detection of acute and established HIV infection (HIV1 and HIV2) enabling immediate linkage to care. The CDC (Center of Disease Control, USA) recently recommended an algorithm involving three different tests to screen and diagnose acute and established infections of HIV-1 and HIV-2 in a general population. Initially a 4th generation combo test detects a viral antigen p24 and specific antibodies against HIV -1 and HIV-2 envelope proteins. If the test is positive it is followed by a second test known as a differentiation assay which detects antibodies against specific HIV-1 and HIV-2 envelope proteins confirming established infection of HIV-1 or HIV-2. However if it is negative then another test is performed that measures viral load confirming an acute HIV-1 infection. Screening results of a Phoenix area population detected 0.3% new HIV infections among which 32.4% were acute cases. Studies in the U.S. indicate that this algorithm effectively reduces HIV infection through immediate treatment and education following diagnosis.

Keywords: new algorithm, HIV, diagnosis, infection

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Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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