Search results for: project management maturity

Authors: Synthia A. Sari

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The transparent nomination and selection process is the first step to obtaining qualified members of board. It is believed as the representative (agent) of the owners, members of the board must consist of competent and professional people. However, the development of transparent and ideal nomination and selection process in Indonesian State-owned enterprises (SOEs) has been based on relatively little research. Considering the relative importance attached by boards to conduct their roles in their principal’s interest in a variety of governance tasks in state-owned enterprises, the primary aim of this paper is to shed light on the extent of nomination and selection process impact performance of the board in implementing good corporate governance in Indonesian SOEs. The exploratory nature of this study led to the adoption of a qualitative research methodology which uses semi-structured interviews and publically available documents to collect a range of data pertaining board nomination and selection and the work of boards. Interviews were conducted with four informants from three Indonesian SOEs and Ministry of SOEs. Findings in this study demonstrate unclear job description and expectations board members as a result of unclear functions of the board in Indonesian SOEs make transparent and accountable nomination and selection process hard to conduct. This situation is vulnerable to the influences from political interest and that even the process itself can degenerate into situations of political interference. In the end, it leads to choosing the wrong person for membership of the board. This study makes a significant contribution to several fields; the human resource management, corporate governance, and Southeast studies by addressing the basic research gaps of board selection process issues in Indonesian SOEs. The gap is addressed by providing a more coherent framework for effective nomination and selection system which reflects more clearly the real experiences of those actually involved at board level.

Keywords: board selection and nomination process, Indonesian stated-owned enterprises, good corporate governance, political influence

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Authors: Milagros S. Salibad, Levita B. Grana

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The presence and role of Indigenous Peoples (IPs) residing in key biodiversity, protected, and watershed areas within the ancestral domain in the Caraga region, Mindanao, Philippines, hold immense significance. Recognizing their importance and rights, this study aimed to determine the level of biodiversity conservation practices and extent of environmental stewardship among the Mamanwas, Manobos, and Higaonons, assess potential differences in these practices, and identify factors that facilitate or hinder them. Employing an explanatory sequential mixed-method research design, 421 respondents participated through a researcher-made questionnaire. Additional data were collected through focus group discussions, key informant interviews, researcher field notes, community immersions, and secondary sources. The results revealed a high level of biodiversity conservation practices across the three IP groups, with variations influenced by their cultural and traditional practices, awareness, and access to resources and information. Each group exhibited unique environmental practices shaped by their distinct cultures, traditions, and customary knowledge. They have a strong sense of ownership and responsibility towards their ancestral lands and territories and adopt traditional knowledge and practices that promote sustainable resource management and biodiversity conservation. These practices align with the Indigenous Peoples Rights Act (IPRA), also known as Republic Act No. 8371. Various facilitating and hindering factors influenced their conservation efforts. To uphold the region's biodiversity resources, it is recommended that government agencies continue to evaluate and monitor the sustainability of IPs' local biodiversity conservation practices. Additionally, efforts should be made to involve IP communities as essential contributors and stakeholders in these conservation endeavors.

Keywords: biodiversity, conservation, indigenous peoples, traditional knowledge, environmental stewardship

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Authors: Paolo Di Pietro, Matteo Lelli, Kinjal Parmar

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Water hazards are consistently identified as among the highest global risks in terms of impact. Riverbank protection plays a key role in flood risk management. For erosion control and scour protection, flexible solutions like gabions & mattresses are being used since quite some time now. The efficacy of erosion control systems depends both on the ability to prevent soil loss underneath, as well as to maintain their integrity under the effects of the water flow. The paper presents the results of a research carried out at the Colorado State University on the performance of double twisted wire mesh products, known as Reno Mattresses, used as soil erosion control system. Mattresses were subjected to various flow conditions on a 10m long flume where they were placed on a 0.30 m thick soil layer. The performance against erosion was evaluated by assessing the effect of the stone motion inside the mattress combined with the condition of incipient soil erosion underneath, in relationship to the mattress thickness, the filling stone properties and under variable hydraulic flow regimes. While confirming the stability obtained using a conventional design approach (commonly referred to tractive force theories), the results of the research allowed to introduce a new performance limit based on incipient soil erosion underneath the revetment. Based on the research results, the authors propose to express the shear resistance of mattresses used as soil erosion control system as a function of the size of the filling stones, their uniformity, their unit weight, the thickness of the mattress, and the presence of vertical connecting elements between the mattress lid and bottom.

Keywords: Reno Mattress, riverbank protection, hydraulics, full scale tests

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Authors: Pradakshina Sharma, Jagriti Narang

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Due to the critical significance in the early identification of infectious diseases, electrochemical sensors have garnered considerable interest. Here, we develop a detection platform for the chikungunya virus by rationally implementing the extremely high charge-transfer efficiency of a ternary nanocomposite of graphene oxide, silver, and gold (G/Ag/Au) (CHIKV). Because paper is an inexpensive substrate and can be produced in large quantities, the use of electrochemical paper analytical device (EPAD) origami further enhances the sensor's appealing qualities. A cost-effective platform for point-of-care diagnostics is provided by paper-based testing. These types of sensors are referred to as eco-designed analytical tools due to their efficient production, usage of the eco-friendly substrate, and potential to reduce waste management after measuring by incinerating the sensor. In this research, the paper's foldability property has been used to develop and create 3D multifaceted biosensors that can specifically detect the CHIKVX-ray diffraction, scanning electron microscopy, UV-vis spectroscopy, and transmission electron microscopy (TEM) were used to characterize the produced nanoparticles. In this work, aptamers are used since they are thought to be a unique and sensitive tool for use in rapid diagnostic methods. Cyclic voltammetry (CV) and linear sweep voltammetry (LSV), which were both validated with a potentiostat, were used to measure the analytical response of the biosensor. The target CHIKV antigen was hybridized with using the aptamer-modified electrode as a signal modulation platform, and its presence was determined by a decline in the current produced by its interaction with an anionic mediator, Methylene Blue (MB). Additionally, a detection limit of 1ng/ml and a broad linear range of 1ng/ml-10µg/ml for the CHIKV antigen were reported.

Keywords: biosensors, ePAD, arboviral infections, point of care

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Authors: Yifan Hou, Haibo Liu, Le Jiang, Wandong Su, Binqing Wang

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Road defect detection is crucial for modern urban management and infrastructure maintenance. Traditional road defect detection methods mostly rely on manual labor, which is not only inefficient but also difficult to ensure their reliability. However, existing deep learning-based road defect detection models have poor detection performance in complex environments and lack robustness to multi-scale targets. To address this challenge, this paper proposes a distinct detection framework based on the one stage algorithm network structure. This article designs a deep feature extraction network based on RCSDarknet, which applies channel shuffling to enhance information fusion between tensors. Through repeated stacking of RCS modules, the information flow between different channels of adjacent layer features is enhanced to improve the model's ability to capture target spatial features. In addition, a multi-scale feature fusion mechanism with weighted dual flow paths was adopted to fuse spatial features of different scales, thereby further improving the detection performance of the model at different scales. To validate the performance of the proposed algorithm, we tested it using the RDD2022 dataset. The experimental results show that the enhancement algorithm achieved 84.14% mAP, which is 1.06% higher than the currently advanced YOLOv8 algorithm. Through visualization analysis of the results, it can also be seen that our proposed algorithm has good performance in detecting targets of different scales in complex scenes. The above experimental results demonstrate the effectiveness and superiority of the proposed algorithm, providing valuable insights for advancing real-time road defect detection methods.

Keywords: roads, defect detection, visualization, deep learning

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Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. Methods: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.

Keywords: modified WHO partograph, completion, public health institutions, Addis Ababa, Ethiopia

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Authors: O.F. Akinmoladun, F.N. Fon, C.T. Mpendulo, O. Okoh

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The sustainability of livestock production is under threat as a result of water scarcity, fluctuating precipitation, and high environmental temperature. These combined stressors have impacted negatively on general animal production and welfare, necessitating a very reliable and cost-effective management practices, especially in arid and water-limited regions of the world. Instead of the above, this study was designed to investigate the growth performance and physiological response of water-restricted Xhosa ear-lobe goats fed diets supplemented with single or multiple vitamin C (VC) during summer. The total forty-eight goats used for the experiment were balanced for body weight and randomly assigned to the seven treatment groups (seven goats/treatment): GI (W100%); GII (W70%); GIII (W50%); GIV (W70%+3g/day VC); GV ((W50% +3g/day VC); GVI (W70%+3g/d VC+extra 5g on every eight-day); GVII (W50%+3g/d VC+extra 5g on every eight-day). The design was a complete randomized design and VC was administered per os. At the end of the 75-day feeding trial, GIII (W50%) animals were the most affected (P<0.05) and the effect was more pronounced in their body condition scores (BCs). Weight loss and depression in feed intake due to water restriction (P<0.05) were attenuated by VC treated groups (GIV-GVII). Changes in body thermal gradient (BTG) and rectal temperature (RcT) were similar (P>0.05) across the various experimental groups. The attenuation effect of VC was significant in responses to respiratory rate (RR) and cortisol. Supplementation of VC (either single or multiple) did not significantly (P>0.05) improve water restriction effect on body condition scores (BCs) and FAMACHA©. The current study found out that Xhosa ear lobe goats can adapt to the prevailing bioclimatic changes and limited water intake. However, supplementation of vitamin C can be beneficial at modulating these stressful stimuli. Continuous consistencies in the outcome of vitamin C on water-stressed animals can help validate recommendations especially to farmers in the arid and water-limited regions across the globe.

Keywords: vitamin C, Xhosa ear-lobe, thermotolerance, water stress

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Authors: Hamida Memon, Muhammad Sanan

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A 34-year-old male with no prior health issues presented with a wound in his left leg exhibiting active pus discharge, intense inflammation, pain radiating from the buttocks to the knee, foot drop, and skin darkening. Four years prior, he sustained an untreated dislocation of the hip joint and acetabulum from a road traffic accident. Initial nerve conduction studies (NCS) and electromyography (EMG) revealed severe axonotomesis of the left sciatic nerve and reduced compound muscle action potential in the left common peroneal nerve. Despite normal venous flow, edema and cellulitis were noted. Follow-up NCS/EMG in 2022 showed improvement, but in 2023, the patient experienced recurrent infection and underwent surgical intervention with tissue culture. Postoperative care included antibiotics and pain management. NCS/EMG in 2024 indicated decreased nerve amplitudes and conduction velocities, consistent with moderate axonotmesis and ongoing recovery, alongside incidental right S1 radiculopathy. General lab tests and abdominal imaging were normal. The patient was treated with Pregabalin and Neurobion for neuropathic pain and nerve support and is currently under observation by a tertiary sector hospital for treatment. This case underscores the critical importance of prompt treatment for hip dislocations to prevent long-term complications such as neuropathy and avascular necrosis. Delays in treatment significantly increase the risk of severe outcomes, highlighting the need for timely intervention. Overall, the case illustrates the challenges of managing complex nerve injuries and the importance of comprehensive care for optimal recovery.

Keywords: sciatic nerve neuropathy, hip dislocation, acetabular fracture, radiculopathy

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Authors: Tereza Dolečková

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Following article provides the comparison of international norms and standards formulating personal expenses, and then it illustrates the national concept of personal expenses of the Ministry of Defence. Then a new salary system of soldiers and the importance of the service appraisal in the context of personal expenses of the Ministry of Defence are explained. The first part of the article includes formulation of the approach to the definition of personal expenses within the international norms and standards and also within the Ministry of Defence of the Czech Republic. The structure of employees of the Ministry of Defence of the Czech Republic in years 2012 – 2014 and the amount of military expenses and the share of salary expenses of the Ministry of total expenses of the Ministry are clarified there, also the comparison of the amount of military expenses in chosen member states of the North Atlantic Treaty Organization is done. The salary system of professional soldiers in connection with the amendment of the Act No. 221/1999 Coll. on Professional Soldiers is clarified in the second part of this article. The amendment significantly regulates the salary items of soldiers but changes are also in the service appraisal of soldiers which reflects one of seven salary items of soldiers – the performance bonus. The aim of this article is to clarify different approach to define personal expenses with emphasis on the Ministry of Defence of the Czech Republic which overlaps to the service appraisal of soldiers of the Army of the Czech Republic and their salary system in connection with personal expenses of the Ministry of Defence of the Czech Republic. The efficient and objective system of the service appraisal and the use of its results are connected to the principles of the career advancement; only the best soldiers can advance in the system of the service careers to higher positions. That is why it is necessary to improve the service appraisal so it would provide the maximum information about the performance of a soldier and it would also motivate the soldier in his development. The attention should be paid to the service appraisal of the soldiers of the Army of the Czech Republic to achieve as much objectivity as possible.

Keywords: career, human resource management and development, personal expenses, salary system of soldiers, service appraisal of soldiers, the Army of the Czech Republic

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Authors: Muhammad Ashfaq

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Main theme: This prime focus of this study is on the role of digital technology in crime prevention, with special focus on Cellular Forensic Unit, Capital City Police Peshawar-Khyber Pakhtunkhwa-Pakistan. Objective(s) of the study: The prime objective of this study is to provide statistics, strategies and pattern of analysis used for crime prevention in Cellular Forensic Unit of Capital City Police Peshawar, Khyber Pakhtunkhwa-Pakistan. Research Method and Procedure: Qualitative method of research has been used in the study for obtaining secondary data from research wing and Information Technology (IT) section of Peshawar police. Content analysis was the method used for the conduction of the study. This study is delimited to Capital City Police and Cellular Forensic Unit Peshawar-KP, Pakistan. information technologies.Major finding(s): It is evident that the old traditional approach will never provide solutions for better management in controlling crimes. The best way to control crimes and promotion of proactive policing is to adopt new technologies. The study reveals that technology have transformed police more effective and vigilant as compared to traditional policing. The heinous crimes like abduction, missing of an individual, snatching, burglaries and blind murder cases are now traceable with the help of technology.Recommendation(s): From the analysis of the data, it is reflected that Information Technology (IT) expert should be recruited along with research analyst to timely assist and facilitate operational as well as investigation units of police .A mobile locator should be Provided to Cellular Forensic Unit to timely apprehend the criminals .Latest digital analysis software should be provided to equip the Cellular Forensic Unit.

Keywords: crime-prevention, cellular-forensic unit-pakistan, crime prevention-digital-pakistan, crminology-pakistan

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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Authors: Said Ghalem

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Honey is primarily composed of sugars: glucose and fructose. Depending honey, it's either fructose or glucose predominates. More the fructose concentration and the less the glycemic index (GI) is high. Thus, changes in the insulin response shows a decrease of the amount of insulin secreted at an increased fructose honey. Honey is also a compound that can reduce the lipid in the blood. Several studies on animals, but which remain to be checked in humans, have shown that the honey can have interesting effects when combined with other molecules: associated with Metformin (a medicine taken by diabetics), it shows the benefits and effects of diabetes preserves the tissue; associated ginger, it increases the antioxidant activity and thus avoids neurologic complications, neuropathic. Molecular modeling techniques are widely used in chemistry, biology, and the pharmaceutical industry. Most of the currently existing drugs target enzymes. Inhibition of DPP-4 is an important approach in the treatment of type 2 diabetes. We have chosen for the inhibition of DPP-4 the following molecules: Linagliptin (BI1356), Sitagliptin (Januvia), Vildagliptin, Saxagliptin, Alogliptin, and Metformin (Glucophage), that are involved in the disease management of type 2 diabetes and added to honey. For this, we used software Molecular Operating Environment. A Wistar rat study was initiated in our laboratory with a well-studied protocol; after sacrifice, according to international standards and respect for the animal This theoretical approach predicts the mode of interaction of a ligand with its target. The honey can have interesting effects when combined with other molecules, it shows the benefits and effects of honey preserves the tissue, it increases the antioxidant activity, and thus avoids neurologic complications, neuropathic or macrovascular. The organs, especially the kidneys of Wistar, shows that the parameters to renal function let us conclude that damages caused by diabetes are slightly perceptible than those observed without the addition of a high concentration of fructose honey.

Keywords: honey, molecular modeling, DPP4 enzyme, metformin

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Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

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Authors: Alexandra Von Guionneau, William Sloper, Charlotte Burford

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The benefits of exercise for the prevention and management of chronic disease are well established and the importance of primary care practitioners in promoting exercise is becoming increasingly recognized. However, those with severe manifestations of the chronic disease are managed in a secondary care setting. Secondary care practitioners, therefore, have a role to play in promoting physical activity. Methods: In order to assess secondary care doctors’ knowledge of the Chief Medical Officer’s guidelines for physical activity, a 12-question survey was administered to staff working in a district general hospital in South England during team and unit meetings. Questions related to knowledge of the current guidelines for both 19 - 64 year olds and older adults (65 years and above), barriers to exercise discussion or prescription and doctors’ own exercise habits. Responses were collected anonymously and analyzed using SPSS Version 24.0. Results: 96 responses were collected. Doctors taking part in the survey ranged from foundation years (26%) to consultants (40%). 17.7% of participants knew the guidelines for moderate intensity activity for 19 - 64 year olds. Only one participant knew all of the guidance for both 19 - 64 year olds and older adults. While 71.6% of doctors felt they were adequately informed about how to exercise, only 45.6% met the minimum recommended guidance for moderate intensity activity. Conclusion: More work is needed to promote the physical activity guidelines and exercise prescription to doctors working within a secondary care setting. In addition, doctors require more support to personally meet the recommended minimum level of physical activity.

Keywords: exercise is medicine, exercise prescription, physical activity guidelines, exercise habits

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Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

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Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

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Authors: Mahsa Tavakoli, Seyed Mohammad Hojjati, Yahya Kooch

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Considering that coal mining is one of the important industrial activities, it may cause damages to environment. According to the author’s best knowledge, the effect of traditional coal mining activities on plant biodiversity has not been investigated in the Hyrcanian forests. Therefore, in this study, the effect of coal mining activities on vegetation and tree diversity was investigated in Hyrcanian forest, North Iran. After filed visiting and determining the mine, 16 plots (20×20 m²) were established by systematic-randomly (60×60 m²) in an area of 4 ha (200×200 m²-mine entrance placed at center). An area adjacent to the mine was not affected by the mining activity, and it is considered as the control area. In each plot, the data about trees such as number and type of species were recorded. The biodiversity of vegetation cover was considered 5 square sub-plots (1 m²) in each plot. PAST software and Ecological Methodology were used to calculate Biodiversity indices. The value of Shannon Wiener and Simpson diversity indices for tree cover in control area (1.04±0.34 and 0.62±0.20) was significantly higher than mining area (0.78±0.27 and 0.45±0.14). The value of evenness indices for tree cover in the mining area was significantly lower than that of the control area. The value of Shannon Wiener and Simpson diversity indices for vegetation cover in the control area (1.37±0.06 and 0.69±0.02) was significantly higher than the mining area (1.02±0.13 and 0.50±0.07). The value of evenness index in the control area was significantly higher than the mining area. Plant communities are a good indicator of the changes in the site. Study about changes in vegetation biodiversity and plant dynamics in the degraded land can provide necessary information for forest management and reforestation of these areas.

Keywords: vegetation biodiversity, species composition, traditional coal mining, Caspian forest

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Authors: N. N. Lingaraju, A. Sathish, K. N. Geetha, C. A. Srinivasamurthy, S. Bhaskar

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Studies on spent wash utilization as a nutrient source through 'Effect of distillery spentwash application on soil properties and yield of maize (Zea may L.) and finger millet (Eleusine coracana (L.) G)' was carried out in Malavalli Taluk, Mandya District, Karnataka State, India. The study was conducted in fourteen different locations of Malavalli (12) and Maddur taluk (2) involving maize and finger millet as a test crop. The spentwash was characterized for various parameters like pH, EC, total NPK, Na, Ca, Mg, SO₄, Fe, Zn, Cu, Mn and Cl content. It was observed from the results that the pH was slightly alkaline (7.45), EC was excess (23.3 dS m⁻¹), total NPK was 0.12, 0.02, and 1.31 percent respectively, Na, Ca, Mg and SO₄ concentration was 664, 1305, 745 and 618 (mg L⁻¹) respectively, total solid content was quite high (6.7%), Fe, Zn, Cu, Mn, values were 23.5, 5.70, 3.64, 4.0 mg L⁻¹, respectively. The crops were grown by adopting different crop management practices after application of spentwash at 100 m³ ha⁻¹ to the identified farmer fields. Soil samples were drawn at three stages i.e., before sowing of crop, during crop growth stage and after harvest of the crop at 2 depths (0-30 and 30-60 cm) and analyzed for pH, EC, available K and Na parameters by adopting standard procedures. The soil analysis showed slightly acidic reaction (5.93), normal EC (0.43 dS m⁻¹), medium available potassium (267 kg ha⁻¹) before application of spentwash. Application of spentwash has enhanced pH level of soil towards neutral (6.97), EC 0.25 dS m⁻¹, available K2O to 376 kg ha⁻¹ and sodium content of 0.73 C mol (P+) kg⁻¹ during the crop growth stage. After harvest of the crops soil analysis data indicated a decrease in pH to 6.28, EC of 0.22 dS m⁻¹, available K₂O to 316 kg ha⁻¹ and Na 0.52 C mol (P⁺) kg⁻¹ compared with crop growth stage. The study showed that, there will be enhancement of potassium levels if the spentwash is applied once to dryland. The yields of both the crops were quantified and found to be in the range of 35.65 to 65.55 q ha⁻¹ and increased yield to the extent of 13.36-22.36 percent as compared to control field (11.36-22.33 q ha⁻¹) in maize crop. Also, finger millet yield was increased with the spentwash application to the extent of 14.21-20.49 percent (9.5-17.73 q ha⁻¹) higher over farmers practice (8.15-14.15 q ha⁻¹).

Keywords: distillery spentwash, finger millet, maize, waste water

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Authors: F. Gallop, C. Ward, M. Zaky, M. Vaghela, R. Sabaratnam

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Nitrous oxide (N₂O) has been used in anaesthesia for over 150 years owing to advantageous physical and pharmacological properties. However, with a global warming potential of 310, we have an urgent responsibility to reduce its usage and emission. Anecdotal evidence in our hospital trust suggests minimal N₂O usage, yet our theatres receive a staggering supply. This warranted further investigation. We used a data collection tool to prospectively capture quantitative and qualitative data regarding N₂O cases during one week: this recorded demographics, N₂O indications, clinical management, and total N₂O consumption in litres. In addition, N₂O usage in dental sedation suites and paediatric theatres was separately quantified. Pipeline supply data was acquired from British Oxygen Company accounts. We captured 490 cases. 4% (n=19) used N₂O, 63% (n=12) of these in dental theatres. Common N₂0 indications were induction speed (37%) and rapidly increasing anaesthesia depth (32%). In adult cases, N₂O was always used intraoperatively rather than solely at induction. 74% (n=14) of anaesthetists reported environmental concern over using N₂O. The week’s total N₂O usage was 8109 litres, amounting to 421,668 litres annually. However, the annual N₂O pipeline supply is 2,997,000 litres; an enormous 1.8 million Kg of CO₂. Our results supportively demonstrate that the N₂O pipeline supply greatly exceeds its clinical use. Acknowledging clinical areas not audited, the discrepancy between supply and usage suggests approximately 2.5 million litres of yearly wastage. We consequently recommend terminating the N₂O pipeline supply in minimally used areas, eliminating 1.5 million Kg of CO₂ emissions. High usage clinical areas could consider portable N₂O cylinders as an alternative. In Sweden, N₂O destruction technology is routinely used to minimise CO₂ emissions. Our results support National Health System investment in similar infrastructure.

Keywords: anaesthesia, environment, medical gases, nitrous oxide, sustainability

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Authors: Sunday Nathaniel Obasi, Chiamak Chinasa Obasi

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Soil characterization and classification provide the basic information necessary to create a functional evaluation and soil classification schemes. Fertility capability classification (FCC) on the other hand is a technical system that groups the soils according to kinds of problems they present for management of soil physical and chemical properties. This research was carried out in Ebonyi state, southeastern Nigeria, which is an agrarian state and a leading rice producing part of southeastern Nigeria. In order to maximize the soil and enhance the productivity of rice in Ebonyi soils, soil classification, and fertility classification information need to be supplied. The state was grouped into three locations according to their agricultural zones namely; Ebonyi north, Ebonyi central and Ebonyi south representing Abakaliki, Ikwo and Ivo locations respectively. Major rice growing areas of the soils were located and two profile pits were sunk in each of the studied zones from which soils were characterized, classified and fertility capability classification (FCC) developed. Soil classification was done using United State Department of Agriculture (USDA) Soil Taxonomy and correlated with World Reference Base for soil resources. Results obtained classified Abakaliki 1 and Abakaliki 2 as Typic Fluvaquents (Ochric Fluvisols). Ikwo 1 was classified as Vertic Eutrudepts (Eutric Vertisols) while Ikwo 2 was classified as Typic Eutrudepts (Eutric Cambisols). Ivo 1 and Ivo 2 were both classified as Aquic Eutrudepts (Gleyic Leptosols). Fertility capability classification (FCC) revealed that all studied soils had mostly loamy topsoils and subsoils except Ikwo 1 with clayey topsoil. Limitations encountered in the studied soils include; dryness (d), low ECEC (e), low nutrient capital reserve (k) and water logging/ anaerobic condition (gley). Thus, FCC classifications were Ldek for Abakaliki 1 and 2, Ckv for Ikwo 1, LCk for Ikwo 2 while Ivo 1 and 2 were Legk and Lgk respectively.

Keywords: soil classification, soil fertility, limitations, modifiers, Southeastern Nigeria

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Authors: David Ahiamadia, Ramilan Thiagarajah, Peter Tozer

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In Sub Saharan Africa, farm typologies have been used as a practical way to address heterogeneity among farming systems which is mostly done by grouping farms into subsets with similar characteristics. Due to the complexity in farming systems among farm households, it is not possible to formulate policy recommendations for individual farmers. As a result, this study employs a multivariate statistical approach using Principal Component Analysis (PCA) coupled with cluster analysis to reduce heterogeneity in a 615-household data set from the Africa Rising Baseline Evaluation Survey for 25 farming communities in Northern Ghana. Variables selected for the study were mostly socio-economic, production potential, production intensity, production orientation, crop diversity, food security, resource endowments, and climate risk variables. To avoid making some individuals in the subpopulation worse off when aclimate risk intervention is broadly implemented, the findings of the study also account for diversity in climate risk perception among the different farm types identified and their response strategies towards climate risk. The climate risk variables used in this study involve the most severeclimate shock types perceived by the household, household response to climate shock type, and reason for crop failure (i.e., maize, rice, and groundnut). Eventually, four farm types, each with an adequate level of homogeneity in climate risk perception and response strategies, were identified. Farm type 1 and 3 were wealthy with a lower degree of climate risk perception compared to farm type 2 and 4. Also, relatively wealthy farmers used asset liquidation as a climate risk management strategy, whereas poor farmers resorted to engaging in spiritual activities such as prayers, sacrifices, and divine consultations.

Keywords: smallholder, households, climate risk, variables, typologies

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Authors: Logan Carmichael

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As the world’s governments seek to increasingly digitize their service provisions, there exists a subsequent and fully valid concern about the security underpinning these digital governance provisions. Estonia, a small and innovative Baltic nation, has been refining both its digital governance structure and cybersecurity mechanisms for over three decades and has been praised as global ‘best practice’ in both fields. However, the security of the Estonian digital governance system has been ever-evolving and significantly shaped by cybersecurity crises. This paper examines said crises – 2007 cyberattacks on Estonian government, banks, and news media; the 2017 e-ID crisis; the ongoing COVID-19 pandemic; and the 2022 Russian invasion of Ukraine – and how governance decision-making following these crises has shaped the cybersecurity of the digital governance structure in Estonia. This paper employs a blended constructivist and historical institutionalist theoretical approach as a useful means to view governance and decision-making in the wake of cybersecurity incidents affecting the Estonian digital governance structure. Together, these theoretical groundings frame the topics of cybersecurity and digital governance in an Estonian context through a lens of ideation and experience, as well as institutional path dependencies over time and cybersecurity crises as critical junctures to study. Furthermore, this paper takes a qualitative approach, employing discourse analysis, policy analysis, and elite interviewing of Estonian officials involved in digital governance and cybersecurity in order to glean nuanced perspectives into the processes that followed these four crises. Ultimately, the results of this paper will offer insight into how governments undertake policy-driven change following cybersecurity crises to ensure sufficient security of their digitized service provisions. This paper’s findings are informative not only in continued decision-making in the Estonian system but also in other states currently implementing a digital governance structure, for which security mechanisms are of the utmost importance.

Keywords: cybersecurity, digital governance, Estonia, crisis management, governance in crisis

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Authors: Thanom Kaeniam

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ST-Elevation Myocardial Infarction (STEMI) is a state of sudden death of the heart muscle due to sudden blockage of the artery. STEMI patients are usually in critical condition and with a potential opportunity for sudden death. Therefore, management guidelines for safety in caring and referring STEMI patients are needed. The objective of this developmental research was to assess the effectiveness of using the guidelines for caring and referring STEMI patients at the Accident and Emergency Department of Songkhla Hospital. The subjects of the study were 22 nurses in the emergency room, and doctors on duty in the accident and emergency room selected using purposive sampling with inclusion criteria. The research instruments were the guidelines for caring and referring STEMI patients, and record forms for the effectiveness of using the guidelines for caring and referring STEMI patients (a general record form for STEMI patients, a record form for SK administering, a referring record form for PCI, and a record form for dead patient in the accident and emergency room and during referring). The instruments were tested for content validity by three experts, and the reliability was tested using Kuder-Richardson 20 (KR20). The descriptive statistic employed was the percentage. The outcomes of using the guidelines for caring and referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department revealed that before using the guidelines in 2009, 2010, and 2011, there were 84, 73, and 138 STEMI patients receiving services at the accident and emergency room, of which, only 9, 32, and 48 patients were referred for PCI/SK medications, or 10.74; 43.84; and 34.78 percent, and the death rates were 10.71; 10.95; and 11.59 percent, respectively. However, after the use of the guidelines in 2012, 2013, and 2014, there were 97, 77, and 57 patients, of which, the increases to 77, 72, and 55 patients were referred for PCI /SK medications or 79.37; 93.51; and 96.49 percent, and the death rates were reduced to 10.30; 6.49; and 1.76 percent, respectively. The results of the study revealed that the use of the guidelines for caring and referring STEMI patients at the Accident and Emergency Department increased the effectiveness and quality of nursing, especially in terms of SK medication, caring and referring patients for PCI to reduce the death rate.

Keywords: outcomes, guidelines for caring, referring, myocardial infarction, STEMI

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Authors: Gertrude I. Hewapathirana, Loi A. Nguyen, Mohammed M. Mostafa

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Artificial intelligence (AI) technologies and tools are swiftly integrating into many functions of all organizations as a competitive drive to enhance innovations, productivity, efficiency, faster and precise decision making to keep up with rapid changes in the global business arena. Despite increasing research on AI technologies in production, manufacturing, and information management, AI in human resource disciplines is still lagging. Though a few research studies on HR informatics, recruitment, and HRM in general, how to integrate AI in other HR functional disciplines (e.g., compensation, training, mentoring and coaching, employee motivation) is rarely researched. Many inconsistencies of research hinder developing up-to-date knowledge on AI in HR disciplines. Therefore, exploring eight research questions, using bibliometric network analysis combined with a meta-analysis of published research literature. The authors attempt to generate knowledge on the role of AI in improving the efficiency of HR functional disciplines. To advance the knowledge for the benefit of researchers, academics, policymakers, and practitioners, the study highlights the types of AI innovations and outcomes, trends, gaps, themes and topics, fast-moving disciplines, key players, and future directions.AI in HR informatics in high tech firms is the dominant theme in many research publications. While there is increasing attention from researchers and practitioners, there are many gaps between the promise, potential, and real AI applications in HR disciplines. A higher knowledge gap raised many unanswered questions regarding legal, ethical, and morale aspects of AI in HR disciplines as well as the potential contributions of AI in HR disciplines that may guide future research directions. Though the study provides the most current knowledge, it is limited to peer-reviewed empirical, theoretical, and conceptual research publications stored in the WoS database. The implications for theory, practice, and future research are discussed.

Keywords: artificial intelligence, human resources, bibliometric analysis, research directions

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Authors: Radegunda Kessy, Justus Ochieng, Victor Afari-Sefa, Takemore Chagomoka, Ngoni Nenguwo

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Vegetables are excellent sources of dietary fiber, vitamins, and minerals which constitute an indispensable constituent of diets, but in Tanzania and other Sub-Saharan African countries, they are not readily available all year round due to seasonal variations in the production cycle. Drying of vegetables is one of the traditional methods for food preservation known to man. The Dodoma and Singida regions of Tanzania are characterized by semi-arid agro-climate, thereby experiencing short seasonal supply of fresh vegetables followed by long drought in which dried vegetables become an alternative to meet high household demands. A primary survey of 244 of rural consumers was carried out to understand how knowledge, attitudes, and perceptions of rural consumers affect consumption of dried vegetables. The sample respondents were all found to be aware of open sun drying of vegetables while less than 50% of them were aware of solar-dried vegetables. Consumers were highly concerned with the hygiene, nutritional values, taste, drying method, freshness, color of dried vegetables, timely availability and easiness of cooking as important factors they consider before they purchase dried vegetables. Logit model results show that gender, income, years of consuming dried vegetables, awareness of the importance of solar dried vegetables vis-à-vis sun-dried alternatives and employment status influenced rural consumer’s decision to purchase dried vegetables. Preference on dried vegetables differs across the regions which are also important considerations for any future planned interventions. The findings imply that development partners and policymakers need to design better social marketing and promotion techniques for the enhanced adoption of solar drying technology, which will greatly improve the quality and utilization of dried vegetables by target households.

Keywords: dried vegetables, postharvest management, sun drying, solar drying

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Authors: Guo Rui, Cao Xinhu

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In recent decades, the world has endured severe challenges in light of climate change, epidemics, geopolitics, terrorism, economic uncertainties, as well as regional conflicts and rivalries. The appropriate use of critical infrastructures (Cis) is confronted. Ports, as typical Cis cover more than 80% of the global freight movement. Within this context, even the minimal disruption of port operations could cause malfunction of the holistic supply chain network and substantial economic losses. Hence, it is crucial to evaluate port performance from the perspective of resilience. Research on resilience and risk/safety management has been increasing, however, it needs more attention, as it could prevent potential socio-economic losses and inspire decision-makers to make resilience-based decisions to answer the challenges, such as COVID-19. To facilitate better moves from decision-makers, ports need to identify proper factors influencing port resilience. Inappropriately influenced factor selection could have a cascading effect on undesirable port performances. Thus, a systematic evaluation of factors is essential to stimulate the improvement process of port resilience investigation. This study zooms into container ports considering their critical role in international trade and global supply chains. 440 articles are selected after relevance ranking, and consequently, 62 articles are scrutinized after the title and abstract screening. Forty-one articles are included for bibliographic analysis in the end. It is found that there is no standardized index system to measure port resilience. And most studies evaluate port resilience merely in the recovery phase. Only two articles cover absorption, adaption and recovery state. However, no literature involves the prevention state. Hence, a uniform resilience index system is expected with a clear resilience definition. And port safety and security should also be considered while evaluating port resilience.

Keywords: port resilience, port safety and security, literature review, index system, port performance

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Authors: Ashneel Ajay Singh, Naoki Suzuki, Kazumi Sakuramoto, Swastika Roshni, Paras Nath, Alok Kalla

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Albacore tuna (Thunnus alalunga) is one of the commercially important species of tuna in the North Pacific region. Despite the long history of albacore fisheries in the Pacific, its ecological characteristics are not sufficiently understood. The effects of changing climate on numerous commercially and ecologically important fish species including albacore tuna have been documented over the past decades. The objective of this study was to explore and elucidate the relationship of environmental variables with the stock parameters of albacore tuna. The relationship of the North Pacific albacore tuna recruitment (R), spawning stock biomass (SSB) and recruits per spawning biomass (RPS) from 1970 to 2012 with the environmental factors of sea surface temperature (SST), Pacific decadal oscillation (PDO), El Niño southern oscillation (ENSO) and Pacific warm pool index (PWI) was construed. SST and PDO were used as independent variables with SSB to construct stock reproduction models for R and RPS as they showed most significant relationship with the dependent variables. ENSO and PWI were excluded due to collinearity effects with SST and PDO. Model selections were based on R2 values, Akaike Information Criterion (AIC) and significant parameter estimates at p<0.05. Models with single independent variables of SST, PDO, ENSO and PWI were also constructed to illuminate their individual effect on albacore R and RPS. From the results it can be said that SST and PDO resulted in the most significant models for reproducing North Pacific albacore tuna R and RPS time series. SST has the highest impact on albacore R and RPS when comparing models with single environmental variables. It is important for fishery managers and decision makers to incorporate the findings into their albacore tuna management plans for the North Pacific Oceanic region.

Keywords: Albacore tuna, El Niño southern oscillation, Pacific decadal oscillation, sea surface temperature

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Authors: Bello, A., Muhammed Ibrahim Abba., Abdullahi, M., Dauda, Sabo, & Shittu, A. T.

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This study investigated the Predictors of Lecturers Knowledge Sharing Acceptance on Open Educational Resources (OER) in North-East Nigerian in Universities. The study population comprised of 632 lecturers of Federal Universities in North-east Nigeria. The study sample covered 338 lecturers who were selected purposively from Adamawa, Bauchi and Borno State Federal Universities in Nigeria. The study adopted a prediction correlational research design. The instruments used for data collection was the questionnaire. Experts in the field of educational technology validated the instrument and tested it for reliability checks using Cronbach’s alpha. The constructs on lecturers’ acceptance to share OER yielded a reliability coefficient of; α = .956 for Performance Expectancy, α = .925; for Effort Expectancy, α = .955; for Social Influence, α = .879; for Facilitating Conditions and α = .948 for acceptance to share OER. the researchers contacted the Deanery of faculties of education and enlisted local coordinators to facilitate the data collection process at each university. The data was analysed using multiple sequential regression statistic at a significance level of 0.05 using SPSS version 23.0. The findings of the study revealed that performance expectancy (β = 0.658; t = 16.001; p = 0.000), effort expectancy (β = 0.194; t = 3.802; p = 0.000), social influence (β = 0.306; t = 5.246; p = 0.000), collectively indicated that the variables have a predictive capacity to stimulate lecturer’s acceptance to share their resources on OER repository. However, the finding revealed that facilitating conditions (β = .053; t = .899; p = 0.369), does not have a predictive capacity to stimulate lecturer’s acceptance to share their resources on OER repository. Based on these findings, the study recommends among others that the university management should consider adjusting OER policy to be centered around actualizing lecturers career progression.

Keywords: acceptance, lecturers, open educational resources, knowledge sharing

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Authors: Taimaz Larimian, Negin Sadeghi

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Very little is known about the impacts of urban security on the level of social sustainability within the cities of developing countries. Urban security is still struggling to find its position in the social sustainability agenda, despite the significant role of safety and security on different aspects of peoples’ lives. This paper argues that urban safety and security should be better integrated within the social sustainability framework. With this aim, this study investigates the hypothesized relationship between social sustainability and Crime Prevention through Environmental Design (CPTED) approach at the neighborhood scale. This study proposes a model of key influential dimensions of CPTED analyzed into localized factors and sub-factors. These factors are then prioritized using pairwise comparison logic and fuzzy group Analytic Hierarchy Process (AHP) method in order to determine the relative importance of each factor on achieving social sustainability. The proposed model then investigates social sustainability in six case study neighborhoods of Isfahan city based on residents’ perceptions of safety within their neighborhood. Mixed method of data collection is used by using a self-administered questionnaire to explore the residents’ perceptions of social sustainability in their area of residency followed by an on-site observation to measure the CPTED construct. In all, 150 respondents from selected neighborhoods were involved in this research. The model indicates that CPTED approach has a significant direct influence on increasing social sustainability in neighborhood scale. According to the findings, among different dimensions of CPTED, ‘activity support’ and ‘image/ management’ have the most influence on people’s feeling of safety within studied areas. This model represents a useful designing tool in achieving urban safety and security during the development of more socially sustainable and user-friendly urban areas.

Keywords: crime prevention through environmental design (CPTED), developing countries, fuzzy analytic hierarchy process (FAHP), social sustainability

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Authors: Pawan Kumar Gupta, Sumana Ghosh

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Parkinson's Disease (PD) is a long-term neurodegenerative movement disorder of the central nervous system with vast symptoms related to the motor system. The common symptoms of PD are tremor, rigidity, bradykinesia/akinesia, and postural instability, but the clinical symptom includes other motor and non‐motor issues. The motor symptoms of the disease are consequence of death of the neurons in a region of the midbrain known as substantia nigra pars compacta, leading to decreased level of a neurotransmitter known as dopamine. The cause of this neuron death is not clearly known but involves formation of Lewy bodies, an abnormal aggregation or clumping of the protein alpha-synuclein in the neurons. Unfortunately, there is no cure for PD, and the management of this disease is challenging. Therefore, it is critical for a patient to be diagnosed at early stages. A limited choice of drugs is available to improve the symptoms, but those become less and less effective over time. Apart from that, with rapid growth in the field of science and technology, other methods such as multi-area brain stimulation are used to treat patients. In order to develop advanced techniques and to support drug development for treating PD patients, an accurate mathematical model is needed to explain the underlying relationship of dopamine secretion in the brain with the hand tremors. There has been a lot of effort in the past few decades on modeling PD tremors and treatment effects from a computational point of view. These models can effectively save time as well as the cost of drug development for the pharmaceutical industry and be helpful for selecting appropriate treatment mechanisms among all possible options. In this review paper, an effort is made to investigate studies on PD modeling and analysis and to highlight some of the key advances in the field over the past centuries with discussion on the current challenges.

Keywords: Parkinson's disease, deep brain stimulation, tremor, modeling

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Authors: Zinhle Cindi, Collet Dandara, Mpiko Ntsekhe, Edson Makambwa, Miguel Larceda

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Background: Warfarin is the most commonly used drug in the management of thromboembolic disease. However, there is a huge variability in the time, number of doses or starting doses for patients to achieve the required international normalised ratio (INR) which is compounded by a narrow therapeutic index. Many genetic-association studies have reported on European and Asian populations which have led to the designing of specific algorithms that are now being used to assist in warfarin dosing. However, very few or no studies have looked at the pharmacogenetics of warfarin in African populations, yet, huge differences in dosage requirements to reach the same INR have been observed. Objective: We set out to investigate the distribution of 3 SNPs CYP4F2 c.1347C > T, VKORC1 g.-1639G > A and VKORC1 c.1173C > T among South African Mixed Ancestry (MA) and Black African patients. Methods: DNA was extracted from 383 participants and subsequently genotyped using PCR/RFLP for the CYP4F2 c.1347 (V433M) (rs2108622), VKORC1 g.-1639 (rs9923231) and VKORC1 c.1173 (rs9934438) SNPs. Results: Comparing the Black and MA groups, significant differences were observed in the distribution of the following genotypes; CYP4F2 c.1347C/T (23% vs. 39% p=0.03). All VKORC1 g.-1639G > A genotypes (p < 0.006) and all VKORC1 c.1173C > T genotypes (p < 0.007). Conclusion: CYP4F2 c.1347T (V433M) reduces CYP4F2 protein levels and therefore expected to affect the amount of warfarin needed to block vitamin k recycling. The VKORC1 g-1639A variant alters transcriptional regulation therefore affecting the function of vitamin k epoxide reductase in vitamin k production. The VKORC1 c.1173T variant reduces the enzyme activity of VKORC1 consequently enhancing the effectiveness of warfarin. These are preliminary results; more genetic characterization is required to understand all the genetic determinants affecting how patients respond to warfarin.

Keywords: algorithms, pharmacogenetics, thromboembolic disease, warfarin

Procedia PDF Downloads 256