Search results for: ethical principles

Authors: Natasha Bhate

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Contraception is important in helping to reduce maternal and infant mortality rates by allowing women to control the number and spacing in-between their children. It also reduces the need for unsafe abortions. Women worldwide use contraception; however, the contraceptive prevalence rate is still relatively low in Central American countries like Guatemala. There is also an unmet need for contraception in Guatemala, which is more significant in rural, indigenous women due to barriers preventing contraceptive use. The study objective was to investigate and analyse the current barriers women face, in Guatemala, Panajachel and the surrounding areas, in using contraception, with a view of identifying ways to overcome these barriers. This included exploring the contraceptive barriers women believe exist and the influence of males in contraceptive decision making. The study took place at a charity in Panajachel, Guatemala, and had a cross-sectional, qualitative design to allow an in-depth understanding of information gathered. This particular study design was also chosen to help inform the charity with qualitative research analysis, in view of their intent to create a local reproductive health programme. A semi-structured interview design, including photo facilitation to improve cross-cultural communication, with interpreter assistance, was utilized. A pilot interview was initially conducted with small improvements required. Participants were recruited through purposive and convenience sampling. The study host at the charity acted as a gatekeeper; participants were identified through attendance of the charity’s women’s-initiative programme workshops. 20 participants were selected and agreed to study participation with two not attending; a total of 18 participants were interviewed in June 2017. Interviews were audio-recorded and data were stored on encrypted memory sticks. Framework analysis was used to analyse the data using NVivo11 software. The University of Leeds granted ethical approval for the research. Religion, language, the community, and fear of sickness were examples of existing contraceptive barrier themes recognized by many participants. The influence of men was also an important barrier identified, with themes of machismo and abuse preventing contraceptive use in some women. Women from more rural areas were believed to still face barriers which some participants did not encounter anymore, such as distance and affordability of contraceptives. Participants believed that informative workshops in various settings were an ideal method of overcoming existing contraceptive barriers and allowing women to be more empowered. The involvement of men in such workshops was also deemed important by participants to help reduce their negative influence in contraceptive usage. Overall, four recommendations following this study were made, including contraceptive educational courses, a gender equality campaign, couple-focused contraceptive workshops, and further qualitative research to gain a better insight into men’s opinions regarding women using contraception.

Keywords: barrier, contraception, machismo, religion

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Authors: Chuan Yang, Jing Bie, Yueh-Lung Lin, Zhong Wang

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Transportation planning is an academic integration discipline combining research and practice with the aim of mobility and accessibility improvements at both strategic-level policy-making and operational dimensions of practical planning. Transportation planning could build the linkage between traffic and social development goals, for instance, economic benefits and environmental sustainability. The transportation planning analysis and evaluation tend to apply empirical quantitative approaches with the guidance of the fundamental principles, such as efficiency, equity, safety, and sustainability. Space syntax theory has been applied in the spatial distribution of pedestrian movement or vehicle flow analysis, however rare has been written about its application in transportation planning. The correlated relationship between the variables of space syntax analysis and authentic observations have declared that the urban configurations have a significant effect on urban dynamics, for instance, land value, building density, traffic, crime. This research aims to explore the potentials of applying Space Syntax methodology to evaluate urban transportation planning through studying the effects of urban configuration on cities transportation performance. By literature review, this paper aims to discuss the effects that urban configuration with different degrees of integration and accessibility have on three elementary components of transportation planning - transportation efficiency, transportation safety, and economic agglomeration development - via intensifying and stabilising the nature movements generated by the street network. And then the potential and limits of Space Syntax theory to study the performance of urban transportation and transportation planning would be discussed in the paper. In practical terms, this research will help future research explore the effects of urban design on transportation performance, and identify which patterns of urban street networks would allow for most efficient and safe transportation performance with higher economic benefits.

Keywords: transportation planning, space syntax, economic agglomeration, transportation efficiency, transportation safety

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Authors: Juan José Mesas, Luis Sainz

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The motivation for the development of this paper lies in the need for energy networks to reduce losses, improve performance, optimize their operation and try to benefit from the interconnection capacity with other networks enabled for other energy carriers. These interconnections generate interdependencies between some energy networks and others, which requires suitable models and methods for their analysis. Traditionally, the modeling and study of energy networks have been carried out independently for each energy carrier. Thus, there are well-established models and methods for the steady-state analysis of electrical networks, gas networks, and thermal networks separately. What is intended is to extend and combine them adequately to be able to face in an integrated way the steady-state analysis of networks with multiple energy carriers. Firstly, the added value of multi-energy networks, their operation, and the basic principles that characterize them are explained. In addition, two current aspects of great relevance are exposed: the storage technologies and the coupling elements used to interconnect one energy network with another. Secondly, the characteristic equations of the different energy networks necessary to carry out the steady-state analysis are detailed. The electrical network, the natural gas network, and the thermal network of heat and cold are considered in this paper. After the presentation of the equations, a particular case of the steady-state analysis of a specific multi-energy network is studied. This network is represented graphically, the interconnections between the different energy carriers are described, their technical data are exposed and the equations that have previously been presented theoretically are formulated and developed. Finally, the two iterative numerical resolution methods considered in this paper are presented, as well as the resolution procedure and the results obtained. The pros and cons of the application of both methods are explained. It is verified that the results obtained for the electrical network (voltages in modulus and angle), the natural gas network (pressures), and the thermal network (mass flows and temperatures) are correct since they comply with the distribution, operation, consumption and technical characteristics of the multi-energy network under study.

Keywords: coupling elements, energy carriers, multi-energy networks, steady-state analysis

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Authors: Bikram K. Das, Kalyan K. Chattopadhyay

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The advent of 2-D materials in the last decade has induced a fresh spur of growth in fuel cell technology as these materials have some highly promising traits that can be exploited to felicitate Oxygen Reduction Reaction (ORR) in an efficient way. Among the various 2-D carbon materials, graphyne (Gy) and graphdiyne (Gdy)1 with their intrinsic non-uniform charge distribution holds promises in this purpose and it is expected2 that substitutional Nitrogen (N) doping could further enhance their efficiency. In this regard, dispersive force corrected density functional theory is used to map the oxygen reduction reaction (ORR) kinetics of five different kinds of N doped graphyne and graphdiyne systems (namely αGy, βGy, γGy, RGy and 6,6,12Gy and Gdy) in alkaline medium. The best doping site for each of the Gy/ Gdy system is determined comparing the formation energies of the possible doping configurations. Similarly, the best di-oxygen (O₂) adsorption sites for the doped systems are identified by comparing the adsorption energies. O₂ adsorption on all N doped Gy/ Gdy systems is found to be energetically favorable. ORR on a catalyst surface may occur either via the Eley-Rideal (ER) or the Langmuir–Hinschelwood (LH) pathway. Systematic studies performed on the considered systems reveal that all of them favor the ER pathway. Further, depending on the nature of di-oxygen adsorption ORR can follow either associative or dissociative mechanism; the possibility of occurrence of both the mechanisms is tested thoroughly for each N doped Gy/ Gdy. For the ORR process, all the Gy/Gdy systems are observed to prefer the efficient four-electron pathway but the expected monotonically exothermic reaction pathway is found only for N doped 6,6,12Gy and RGy following the associative pathway and for N doped βGy, γGy and Gdy following the dissociative pathway. Further computation performed for these systems reveals that for N doped 6,6,12Gy, RGy, βGy, γGy and Gdy the overpotentials are 1.08 V, 0.94 V, 1.17 V, 1.21 V and 1.04 V respectively depicting N doped RGy is the most promising material, to carry out ORR in alkaline medium, among the considered ones. The stability of the ORR intermediate states with the variation of pH and electrode potentials is further explored with Pourbiax diagrams and the activities of these systems in the alkaline medium are compared with the prior reported B/N doped identical systems for ORR in an acidic medium in terms of a common descriptor.

Keywords: graphdiyne, graphyne, nitrogen-doped, ORR

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Authors: Raana Babadi Fathipour

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The production of dairy holds significant importance in the sustenance of billions of individuals worldwide, as they rely on milk and its derived products for daily consumption. In addition to being a source of essential nutrients crucial for human well-being, such as proteins, fats, vitamins, and minerals; dairy items are witnessing an increasing demand worldwide. Amongst all the factors contributing to the quality and safety assurance of dairy products, the strong focus lies on maintaining high standards in raw milk procurement. Raw milk serves as an externally nutritious medium for various microorganisms due to its inherent properties. This poses a considerable challenge for the dairy industry in ensuring that microbial contamination is minimized throughout every stage of the value chain. Despite implementing diverse process technologies—both conventional and innovative—the occurrence of microbial spoilage still results in substantial losses within this industry context. Moreover, milk and dairy products have been associated with numerous cases of foodborne illnesses across the globe. Various pathogens such as Salmonella serovars, Campylobacter spp., Shiga toxin-producing Escherichia coli, Listeria monocytogenes, and enterotoxin producing Staphylococcus aureus are commonly identified as the culprits behind these outbreaks in the dairy industry. The effective management of food safety within this sector necessitates a proactive and risk-based approach to reform. However, this strategy presents difficulties for developing nations where informal value chains dominate the dairy sector. Whether operating on a small or large scale or falling within formal or informal realms, it is imperative that the dairy industry adheres to principles of good hygiene practices and good manufacturing practices. Additionally, identifying and managing potential sources of contamination is crucial in mitigating challenges pertaining to quality and safety precautions.

Keywords: dairy value chain, microbial contamination, food safety, hygiene

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Authors: Maryam Zahmatkesh

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Middle managers form a significant occupational category in organisations. They undertake a vital role, as they sit between the operational and strategic roles. Traditionally they were acting as diplomat administrators, and were only in power to meet the demands of professionals. Following the introduction of internal market, in line with the principles of New Public Management, middle managers have been considered as change agents. More recently, in the debates of middle managers, there is emphasis on entrepreneurialism and enacting strategic role. It was assumed that granting autonomy to the local organisations and the inception of semi-autonomous hospitals (Foundation Trusts in England and Board of Trustees in Iran) would give managers more autonomy to act proactively and innovatively. This thesis explores the hospital middle managers’ perception of and responses to public management reforms (in particular, hospital autonomy) in England and Iran. In order to meet the aims of the thesis, research was undertaken within the interpretative paradigm, in line with social constructivism. Data were collected from interviews with forty-five middle managers, observational fieldwork and documentary analysis across four teaching university hospitals in England and Iran. The findings show the different ways middle managers’ autonomy is constrained in the two countries. In England, middle managers have financial and human recourses, but their autonomy is constrained by government policy and targets. In Iran, middle managers are less constrained by government policy and targets, but they do not have financial and human resources to exercise autonomy. Unbalanced autonomy causes tension and frustration for middle managers. According to neo-institutional theory, organisations are deeply embedded within social, political, economic and normative settings that exert isomorphic and internal population-level pressures to conform to existing and established modes of operation. Health systems which are seeking to devolve autonomy to middle managers must appreciate the multidimensional nature of the autonomy, as well as the wider environment that organisations are embedded, if they are about to improve the performance of managers and their organisations.

Keywords: autonomy, healthcare organisations, middle managers, new public management

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Authors: Ilyes Athimni, Mouna Bouzazi, Mongi Boulehmi, Ahmed Ferchichi

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The principles of good governance, universal values, and digitization are among the tools to fight corruption and improve the quality of service delivery. In recent years, these tools have become one of the most controversial topics in the field of education and a concern of many international organizations and institutions against the problem of corruption. Corruption in the education sector, particularly in higher education, has negative impacts on the quality of education systems and on the quality of administrative or educational services. Currently, the health crisis due to the spread of the COVID-19 pandemic reveals the difficulties encountered by education systems in most countries of the world. Due to the poor governance of these systems, many educational institutions were unable to continue working remotely. To respond to these problems encountered by most education systems in many countries of the world, our initiative is to propose a methodology to reinvent education systems based on global values and digital technologies. This methodology includes a work strategy for educational institutions, whether in the provision of administrative services or in the teaching method, based on information and communication technologies (ICTs), intelligence artificial, and intelligent agents. In addition, we will propose a supervisory law that will be implemented and monitored by intelligent agents to improve accountability, transparency, and accountability in educational institutions. On the other hand, we will implement and evaluate a field experience by applying the proposed methodology in the operation of an educational institution and comparing it to the traditional methodology through the results of teaching an educational program. With these specifications, we can reinvent quality education systems. We also expect the results of our proposal to play an important role at local, regional, and international levels in motivating governments of countries around the world to change their university governance policies.

Keywords: artificial intelligence, corruption in education, distance learning, education systems, ICTs, intelligent agents, good governance

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Authors: Kevin Baxter, Ron Grove, James Pitney, John Harrison, Ozlem Gumus

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The purpose of this research is to determine the mediating effect of effectiveness of the training provided by Northwestern University’s School of Police Staff and Command (SPSC), on the ability of law enforcement mid-level managers to learn transformational and authentic leadership traits. This study will also evaluate the leadership styles, of course, graduates compared to non-attendees using a static group comparison design. The Louisiana State Police pay approximately $40,000 in salary, tuition, housing, and meals for each state police lieutenant attending the 10-week program of the SPSC. This school lists the development of transformational leaders as an increasing element. Additionally, the SPSC curriculum addresses all four components of authentic leadership - self-awareness, transparency, ethical/moral, and balanced processing. Upon return to law enforcement in roles of mid-level management, there are questions as to whether or not students revert to an “autocratic” leadership style. Insufficient evidence exists to support claims for the effectiveness of management training or leadership development. Though it is widely recognized that transformational styles are beneficial to law enforcement, there is little evidence that suggests police leadership styles are changing. Police organizations continue to hold to a more transactional style (i.e., most senior police leaders remain autocrats). Additionally, research in the application of transformational, transactional, and laissez-faire leadership related to police organizations is minimal. The population of the study is law enforcement mid-level managers from various states within the United States who completed leadership training presented by the SPSC. The sample will be composed of 66 active law enforcement mid-level managers (lieutenants and captains) who have graduated from SPSC and 65 active law enforcement mid-level managers (lieutenants and captains) who have not attended SPSC. Participants will answer demographics questions, Multifactor Leadership Questionnaire, Authentic Leadership Questionnaire, and the Kirkpatrick Hybrid Evaluation Survey. Analysis from descriptive statistics, group comparison, one-way MANCOVA, and the Kirkpatrick Evaluation Model survey will be used to determine training effectiveness in the four levels of reaction, learning, behavior, and results. Independent variables are SPSC graduates (two groups: upper and lower) and no-SPSC attendees, and dependent variables are transformational and authentic leadership scores. SPSC graduates are expected to have higher MLQ scores for transformational leadership traits and higher ALQ scores for authentic leadership traits than SPSC non-attendees. We also expect the graduates to rate the efficacy of SPSC leadership training as high. This study will validate (or invalidate) the benefits, costs, and resources required for leadership development from a nationally recognized police leadership program, and it will also help fill the gap in the literature that exists between law enforcement professional development and transformational and authentic leadership styles.

Keywords: training effectiveness, transformational leadership, authentic leadership, law enforcement mid-level manager

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Authors: Sheikh Omar Sillah

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Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Darius Jakimavicius

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Artificial intelligence is the subject of intense debate in the international arena, identified both as a technological breakthrough and as a component of the strategic stability effect. Both the kinetic and non-kinetic development of AI and its application in the national strategies of the great powers may trigger a change in the security situation. Artificial intelligence is generally faster, more capable and more efficient than humans, and there is a temptation to transfer decision-making and control responsibilities to artificial intelligence. Artificial intelligence, which, once activated, can select and act on targets without further intervention by a human operator, blurs the boundary between human or robot (machine) warfare, or perhaps human and robot together. Artificial intelligence acts as a force multiplier that speeds up decision-making and reaction times on the battlefield. The role of humans is increasingly moving away from direct decision-making and away from command and control processes involving the use of force. It is worth noting that the autonomy and precision of AI systems make the process of strategic stability more complex. Deterrence theory is currently in a phase of development in which deterrence is undergoing further strain and crisis due to the complexity of the evolving models enabled by artificial intelligence. Based on the concept of strategic stability and deterrence theory, it is appropriate to develop further research on the development and impact of AI in order to assess AI from both a scientific and technical perspective: to capture a new niche in the scientific literature and academic terminology, to clarify the conditions for deterrence, and to identify the potential uses, impacts and possibly quantities of AI. The research problem is the impact of artificial intelligence developed by great powers on strategic stability. This thesis seeks to assess the impact of AI on strategic stability and deterrence principles, with human exclusion from the decision-making and control loop as a key axis. The interaction between AI and human actions and interests can determine fundamental changes in great powers' defense and deterrence, and the development and application of AI-based great powers strategies can lead to a change in strategic stability.

Keywords: artificial inteligence, strategic stability, deterrence theory, decision making loop

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Authors: Simmi Chopra

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In the last few years, there has been a surge of Autoimmune diseases that have become more like an epidemic all over the world. The reasons vary from stress, insufficient sleep, smoking, genetics, environmental pollution, adulterated foods, and a diet full of “the deadly white,” which is white sugar and white flour. Most of the people diagnosed with these diseases are given steroids, opioids, supplements, or elimination diets to manage their lives, but most of them continue suffering to varying degrees. On the other hand, Ayurveda can help manage autoimmune problems effectively. Ayurveda is a 5000 years old holistic medical system from India that has an individualistic approach where health problems are looked at from the lens of balancing body and mind and by targeting the root cause of the problem. A combination of diet and lifestyle according to Ayurvedic principles, Ayurvedic herbal formulations and Ayurvedic therapies can help in the management of autoimmune and other chronic diseases. Panchkarma, which is an intense six weeks detox method, helps balance our body and mind, and has been very effective in managing autoimmune problems. The paper will introduce the basic concepts of Ayurveda and describe the terminologies- doshas, agni and ama. The paper will discuss the importance of diet and lifestyle according to the individual’s imbalance in the three functional parameters - doshas, which govern every aspect of our body and mind, our cells and tissues. The significance of agni, which can be correlated to digestive strength and ama, which can be correlated to toxins that are formed in our body leading to health problems, will be outlined. The Ayurvedic pathophysiology of autoimmune diseases will be discussed with emphasis on Rheumatoid arthritis, Multiple sclerosis and Psoriasis. Ayurvedic management will be discussed for these autoimmune conditions. As Ayurveda is an individualistic system, one protocol will not work for everyone. Therefore, case studies with Ayurvedic protocols for the above autoimmune disease will be presented. Conclusion: Ayurveda can help in managing as well as arresting the progression of autoimmune problems. Ayurveda is an ancient medical system, is much more needed today than ever. It is a tried and tested holistic system which has been practiced for the past many generations in India.

Keywords: ayurveda, autoimmune, diseases, nutrition

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Authors: Cristian Matti, Valerie Fowles, Eva Enyedi, Piotr Pogorzelski

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The system mapping process can be defined as a knowledge service where a team of facilitators, experts and practitioners facilitate a guided conversation, enable the exchange of information and support an iterative curation process. System mapping processes rely on science-based tools to introduce and simplify a variety of components and concepts of socio-technical systems through metaphors while facilitating an interactive dialogue process to enable the design of co-created maps. System maps work then as “artifacts” to provide information and focus the conversation into specific areas around the defined challenge and related decision-making process. Knowledge management facilitates the curation of that data gathered during the system mapping sessions through practices of documentation and subsequent knowledge co-production for which common practices from data science are applied to identify new patterns, hidden insights, recurrent loops and unexpected elements. This study presents empirical evidence on the application of these techniques to explore mechanisms by which visual tools provide guiding principles to portray system components, key variables and types of data through the lens of climate change. In addition, data science facilitates the structuring of elements that allow the analysis of layers of information through affinity and clustering analysis and, therefore, develop simple indicators for supporting the decision-making process. This paper addresses methodological and empirical elements on the horizontal learning process that integrate system mapping through visual tools, interpretation, cognitive transformation and analysis. The process is designed to introduce practitioners to simple iterative and inclusive processes that create actionable knowledge and enable a shared understanding of the system in which they are embedded.

Keywords: indicators, knowledge management, system mapping, visual tools

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Authors: Shang-Hsin Ou, Yang-Chun Lin, Ke-Hao Cheng

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The year 2021 marked a historic drought in Taiwan, posing unprecedented challenges due to record-low rainfall and inadequate reservoir storage. The central region experienced water scarcity, leading to the implementation of "Groundwater Utilization at Construction Sites" for drought-resilient livelihood water supply. This study focuses on the establishment process of temporary groundwater treatment plants at construction sites in Taichung City, serving as a reference for future emergency response and the utilization of construction site groundwater. To identify suitable sites for groundwater reuse projects, site selection operations were carried out based on relevant water quality regulations and assessment principles. Subsequently, the planning and design of temporary water treatment plants were conducted, considering the water quality, quantity, and on-site conditions of groundwater wells associated with construction projects. The study consolidates the major water treatment facilities at each site and addresses encountered challenges during the establishment process. Practical insights gained from operating temporary groundwater treatment plants are presented, including improvements related to stable water quality, water quantity, equipment operation, and hydraulic control. In light of possible future droughts, this study provides an outlook and recommendations to expedite and improve the setup of groundwater treatment plants at construction sites. This includes considering on-site water abstraction, treatment, and distribution conditions. The study's results aim to offer practical guidelines for effectively establishing and managing such treatment plants, while offering experiences and recommendations for other regions facing similar emergencies, water shortages, and drought situations. These endeavors contribute to ensuring sustainable water supply for drought-resilient livelihoods and maintaining societal stability.

Keywords: drought resilience, groundwater treatment, construction site, water supply

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Authors: Ana M. G. Sperandio, Adriana A. C. Rosa, Jussara C. Guarnieri

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This study consists of a research of the Post Occupancy Assessment (POA) of Medicinal Gardens' project of Urban Social Center’s square, in the city of 'Santa Barbara d'Oeste', located in the interior of Sao Paulo, Brazil. In view of the fact that community gardens, as well as medicinal gardens, are based on innumerable functions. The addition to the pedagogical function rescues people from their origins through (re)contact with the land, as a vehicle for social integration. Bearing in mind the project has the potential to fight hunger among the low-income population, to treat some diseases, also works as a strategy of environmental recovery especially of idle land. Such as very often only accumulate weeds and garbage, and therefore, must be considered in the Municipal Master Plan for the activity to be regulated. Objective: Identify on implantation the medicinal plants' value and principles for the promotion of a healthy city. Methodology: Application of the walkthrough, where it is possible to affirm that this instrument has three routes: one officer applied within the urban social center and two complementary ones, one being about 3 miles and the other being almost 5,5 miles. Results: Through a dialogical course, one can observe the benefits that the community medicinal gardens bring to the local population. In addition, it is consistent with the proposal for the community to be enabled to access collective care with home orientations that rescue the local and regional culture making the physical environment. This project aims at promoting more pleasant and inclusive through the actions of the caregiver, local leadership and the co-participation of local government. Although with the aim of increasing the supply value and improving the living conditions of social groups and interrelationship. Conclusion: This type of urban intervention, which articulates social participation, rescue of medicinal cultures and local knowledge, intersectoriality, social inclusion, among other premises connected with health promotion, and the city presents a potential for reverberation of practices in social networks with the objective of meeting the healthy city strategies.

Keywords: healthy city, healthy urban planning, medicinal gardens, social participation

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Authors: Jakub Gren

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The recent transfer of banking supervision to the ECB has expanded its influence as of a non-majoritarian and technocratic policy-shaper in EU supervisory policies. To fulfil the main policy objectives of the Single Supervisory Mechanism, the ECB has been tasked with building a single supervisory approach to supervised banks across the euro area and is now exclusively responsible for direct supervision of the largest ‘significant’ euro area banks and the oversight of the remaining ‘less significant’ banks. This enhanced supranational position of the ECB significantly alters the EU institutional order and creates powerful incentives to actively pursue integrationist agenda by the ECB. However, this drastic shift has a little impact upon adapting the ECB’s new supervisory mandate to the requirements of democratic legitimacy. Whereas the ECB’s strong pre-crisis independence and limited accountability could be reconciled with democratic principles through a clearly articulated price stability mandate, independence and limited accountability in the context of a more complex supervisory mandate is problematic. Hence, in order to ensure the democratic legitimacy of the ECB/SSM’s supervisory policies, the ECB’s supervisory mandate requires both a lower scope of independence and higher accountability requirements. To address this situation, organizational separation (“Chinese Wall”) between the ECB monetary and supervisory arms was introduced. This separation includes different reporting lines and the relocation of the ECB’s monetary function to a new building complex while leaving its supervisory function at the Euro-tower (“Two Towers”). This paper argues that these measures are not sufficient to establish proper checks and balances on the ECB’s powers to pursue euro zone’s wide supervisory policies. As a remedy, this contribution suggests that the ECB’s Treaties-embedded independence, as set out by art. 130 TFEU, designed to carry out its monetary function shall not be fully applicable to its supervisory function. Indeed functional and conditional reading of this provision to ECB supervisory function could enhance the legitimacy of future ECB’s supervisory action.

Keywords: accountability and transparency, democratic governance, financial management, rule of law

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Authors: Eric Agyekum, Dominic Asitanga

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Ghana is widely considered asa beacon of democracy in sub-Saharan Africa. With a relatively free media, the country was ranked30thin the world and third in Africaon the 2021 Press Freedom Index. Despite the democratic gains, itis one of the most politically polarized nations in the world. Ghana’spolitical division is evident in the current hunglegislature, where each of the two dominant political parties has 137 members, with an independent member occupying the remaining one seat. Misinformation and fake newsthrive in systems with acuteideological and political differences(Imelda et al, 2021; Azzimonti&Fernandes, 2018; Spohr, 2017) and Ghana is no exception. The information disorder problem has been exacerbatedby the COVID-19 pandemic, with its attendant conspiracy theories and speculations, making it difficult for the media and fact-checking organizations to verifyall claims and flag false information. In Ghana, fact-checking agencies like Ghana Fact, Dubawa Ghana, and some mainstream news media organizations have been fact-checking political claims, COVID-19 conspiracy theories, and many others. However, it is not clear if the audience consumeand attach prominence to these fact-checked stories or even visit the websites of the fact-checking agencies to read the content. Nekmat (2020) opine that though the literature on fact-checking suggest that fact-checked stories can alter readers’ beliefs, very few studies have investigated the patronage and the potential of fact-checks to deter users from sharing false news with others, particularly on social media. In response to Nekmat, this study has been initiated to examine the perception and attitude of the audience in Ghana towards fact-checks. Anchored on the principles of the nudge theory, this study will investigate how fact-checked stories alters readers’ behavioural patterns. A survey will be conducted to collect data from sampled members of the Ghanaian society.

Keywords: fact-checking, information disorder, nudge theory, political polarization

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Authors: Kwasi Sarfo, Bernard Okoampah Otu

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

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

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Authors: Ayo Osisanya, Promise Ebuka Okonkwo

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Reduced hearing sensitivity among the elderly has been attributed to some risk factors and influence of age-related degenerative conditions such as diabetes, cardiovascular disease, Alzheimer’s disease, bipolar disorder, and hypertension. Hearing loss; especially the age-related type (presbycusis), has been reported as one of the global burden affecting the general well-being and quality of life of the elderly with hypertension. Thus, hearing loss has been observed to be associated with hypertension and functional decline in elderly, as this condition makes them experience poor communication, fatigue, reduced social functions, mood-swing, and withdrawal syndrome. Emerging research outcomes indicate a strong relationship between hypertension and reduced auditory performance among the elderly. Therefore, this study determined the prevalence, types, and patterns of hearing loss associated with hypertension, with a bid to suggesting comprehensive management strategies and a model of creating awareness towards promoting good healthy living among the elderly in Nigeria. One hundred and seventy-two elderly, aged 65–85 with hypertension were purposively selected from patients undergoing treatment for hypertension in some tertiary hospitals in southwest Nigeria for the study. Participants were suggested to Pure-Tone Audiometry (PTA) through the use of Maico 53 Diagnostic Audiometer to determine the degree, types ad patterns of hearing loss among the elderly with hypertension. Results showed that 148 (86.05%) elderly with hypertension presented with different degrees, types, and patterns of hearing loss. Out of this number, 123 (83.11%) presented with bilateral hearing loss, while 25 (16.89%) had unilateral hearing loss. Degree of hearing loss, 74 moderate hearing loss, 118 moderately severe and 50 severe hearing loss. 36% of the hearing loss appeared as flat audiometric configuration, 24% were slopping, 19% were rising, while 21% were tough-shaped audiometric configurations. The findings showed high prevalence of hearing loss among the elderly with hypertension in Southwest, Nigeria. Based on the findings, management of elderly with hypertension should include regular audiological rehabilitation and total adherence to hearing conservation principles, otological management, regulation of blood pressure and adequate counselling / follow-up services.

Keywords: auditory performance, elderly, hearing loss, hypertension

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Authors: Alex Fedoseyev

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This study explores Generalized Hydrodynamic Equations (GHE) for the simulation of turbulent flows. The GHE was derived from the Generalized Boltzmann Equation (GBE) by Alexeev (1994). GBE was obtained by first principles from the chain of Bogolubov kinetic equations and considered particles of finite dimensions, Alexeev (1994). The GHE has new terms, temporal and spatial fluctuations compared to the Navier-Stokes equations (NSE). These new terms have a timescale multiplier τ, and the GHE becomes the NSE when τ is zero. The nondimensional τ is a product of the Reynolds number and the squared length scale ratio, τ=Re*(l/L)², where l is the apparent Kolmogorov length scale, and L is a hydrodynamic length scale. The turbulence phenomenon is not well understood and is not described by NSE. An additional one or two equations are required for the turbulence model, which may have to be tuned for specific problems. We show that, in the case of the GHE, no additional turbulence model is needed, and the turbulent velocity profile is obtained from the GHE. The 2D turbulent channel and circular pipe flows were investigated using a numerical solution of the GHE for several cases. The solutions are compared with the experimental data in the circular pipes and 2D channels by Nicuradse (1932, Prandtl Lab), Hussain and Reynolds (1975), Wei and Willmarth (1989), Van Doorne (2007), theory by Wosnik, Castillo and George (2000), and the relevant experiments on Superpipe setup at Princeton, data by Zagarola (1996) and Zagarola and Smits (1998), the Reynolds number is from Re=7200 to Re=960000. The numerical solution data compared well with the experimental data, as well as with the approximate analytical solution for turbulent flow in channel Fedoseyev (2023). The obtained results confirm that the Alexeev generalized hydrodynamic theory (GHE) is in good agreement with the experiments for turbulent flows. The proposed approach is limited to 2D and 3D axisymmetric channel geometries. Further work will extend this approach by including channels with square and rectangular cross-sections.

Keywords: comparison with experimental data. generalized hydrodynamic equations, numerical solution, turbulent boundary layer, turbulent flow in channel

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Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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Authors: Ketaki D. Belsare, Nicholas F. Polizzi, Lior Shtayer, William F. DeGrado

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Nature utilizes metalloproteins to perform chemical transformations with activities and selectivities that have long been the inspiration for design principles in synthetic and biological systems. The chemical reactivities of metalloproteins are directly linked to local environment effects produced by the protein matrix around the metal cofactor. A complete understanding of how the protein matrix provides these interactions would allow for the design of functional metalloproteins. The de novo computational design of proteins have been successfully used in design of active sites that bind metals like di-iron, zinc, copper containing cofactors; however, precisely designing active sites that can bind small molecule ligands (e.g., substrates) along with metal cofactors is still a challenge in the field. The de novo computational design of a functional metalloprotein that contains a purposefully designed substrate binding site would allow for precise control of chemical function and reactivity. Our research strategy seeks to elucidate the design features necessary to bind the cofactor protoporphyrin IX (hemin) in close proximity to a substrate binding pocket in a four helix bundle. First- and second-shell interactions are computationally designed to control orientation, electronic structure, and reaction pathway of the cofactor and substrate. The design began with a parameterized helical backbone that positioned a single histidine residue (as an axial ligand) to receive a second-shell H-bond from a Threonine on the neighboring helix. The metallo-cofactor, hemin was then manually placed in the binding site. A structural feature, pi-bulge was introduced to give substrate access to the protoporphyrin IX. These de novo metalloproteins are currently being tested for their activity towards hydroxylation and epoxidation. The de novo designed protein shows hydroxylation of aniline to 4-aminophenol. This study will help provide structural information of utmost importance in understanding de novo computational design variables impacting the functional activities of a protein.

Keywords: metalloproteins, protein design, de novo protein, biocatalysis

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Authors: Ulriikka Savela-Huovinen, Hanni Muukkonen, Auli Toom

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The development of workplace as a learning environment has been emphasized in research field of workplace learning. The prior literature on sensory performance emphasized the individual’s competences as assessor, while the competences in the collaborative interactional and knowledge creation practices as workplace learning method are not often mentioned. In the present study aims to find out what kinds of competences and contexts are central when assessor conducts food sensory evaluation in authentic professional context. The aim was to answer the following questions: first, what kinds of competences does sensory evaluation require according to assessors? And second, what kinds of contexts for sensory evaluation do assessors report? Altogether thirteen assessors from three Finnish food companies were interviewed by using semi-structural thematic interviews to map practices and development intentions as well as to explicate already established practices. The qualitative data were analyzed by following the principles of abductive and inductive content analysis. Analysis phases were combined and their results were considered together as a cross-analysis. When evaluated independently required competences were perception, knowledge of specific domains and methods and cognitive skills e.g. memory. Altogether, 42% of analysis units described individual evaluation contexts, 53% of analysis units described collaborative interactional contexts, and 5% of analysis units described collaborative knowledge creation contexts. Related to collaboration, analysis reviewed learning, sharing and reviewing both external and in-house consumer feedback, developing methods to moderate small-panel evaluation and developing product vocabulary collectively between the assessors. Knowledge creation contexts individualized from daily practices especially in cases product defects were sought and discussed. The study findings contribute to the explanation that sensory assessors learn extensively from one another in the collaborative interactional and knowledge creation context. Assessors learning and abilities to work collaboratively in the interactional and knowledge creation contexts need to be ensured in the development of the expertise.

Keywords: assessor, collaboration, competences, contexts, learning and practices, sensory evaluation

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Authors: Ramzi Suleiman

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Recently, the author proposed an observationally-based relativity theory termed information relativity theory (IRT). The theory is simple and is based only on basic principles, with no prior axioms and no free parameters. For the case of a body of mass in uniform rectilinear motion relative to an observer, the theory transformations uncovered a matter-dark matter duality, which prescribes that the sum of the densities of the body's baryonic matter and dark matter, as measured by the observer, is equal to the body's matter density at rest. It was shown that the theory transformations were successful in predicting several important phenomena in small particle physics, quantum physics, and cosmology. This paper extends the theory transformations to the cases of rotating disks and spheres. The resulting transformations for a rotating disk are utilized to derive predictions of the radial distributions of matter and dark matter densities in rotationally supported galaxies based solely on their observed rotation curves. It is also shown that for galaxies with flattening curves, good approximations of the radial distributions of matter and dark matter and of the dark matter fraction could be obtained from one measurable scale radius. Test of the model on five galaxies, chosen randomly from the SPARC database, yielded impressive predictions. The rotation curves of all the investigated galaxies emerged as accurate traces of the predicted radial density distributions of their dark matter. This striking result raises an intriguing physical explanation of gravity in galaxies, according to which it is the proximal drag of the stars and gas in the galaxy by its rotating dark matter web. We conclude by alluding briefly to the application of the proposed model to stellar systems and black holes. This study also hints at the potential of the discovered matter-dark matter duality in fixing the standard model of elementary particles in a natural manner without the need for hypothesizing about supersymmetric particles.

Keywords: dark matter, galaxies rotation curves, SPARC, rotating disk

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Authors: Hande Aladağ, Gökçe Aydın

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The world’s population is increasing continuously and rapidly. Moreover, there are other problems such as the decline of natural energy resources, global warming, and environmental pollution. These facts have made sustainability an important and primary topic from future planning perspective. From this perspective, constituting sustainable cities and communities can be considered as one of the key issues in terms of sustainable development goals. The concept of sustainable cities can be evaluated under three headings such as green/sustainable buildings, self – contained cities and sustainable transportation. This study only concentrates on how to form and support a sustainable urban transportation system to contribute to the sustainable urbanization. Urban transportation system inevitably requires many engineering projects with various sizes. Engineering projects generally have four phases, in the following order: Planning, design, construction, operation. The order is valid but there are feedbacks from every phase to every phase in its upstream. In this regard, engineering projects are iterative processes. Sustainability is an integrated and comprehensive concept thus it should be among the primary concerns in every phase of transportation projects. In the study, a meta-analysis will be performed on the related studies in the literature. It is targeted and planned that, as a result of the findings of this meta-analysis, a framework for the list of principles and actions for sustainable transport will be formed. The meta-analysis will be performed to point out and clarify sustainability approaches in every phase of the related engineering projects, with also paying attention to the iterative nature of the process and relative contribution of the action for the outcomes of the sustainable transportation system. However, the analysis will not be limited to the engineering projects, non-engineering solutions will also be included in the meta-analysis. The most important contribution of this study is a determination of the outcomes of a sustainable urban transportation system in terms of energy efficiency, resource preservation and related social, environmental and economic factors. The study is also important because it will give light to the engineering and management approaches to achieve these outcomes.

Keywords: meta-analysis, sustainability, sustainable cities, sustainable urban transportation, urban transportation

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Authors: Kabiru Adamu

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The Nigerian electricity industry was deregulated and privatized in 2005 and 2014 in line with global trend and practice. International and multilateral lending institutions advised developing countries, Nigeria inclusive, to adopt deregulation and privatization as part of reforms in their electricity sectors. The ideological basis of these reforms are traceable to neoliberalism. Neoliberalism is an ideology that believes in the supremacy of free market and strong non-interventionist competition law as against government ownership of the electricity market. This ideology became a state practice and a blue print for the deregulation and privatization of the electricity markets in many parts of the world. The blue print was used as a template for the privatization of the Nigerian electricity industry. In this wise, this paper, using documentary analysis and review of academic literatures, examines neoliberalism as an ideology and model of economic governance for the electricity supply industry in Nigeria. The paper examines the origin of the ideology, it features and principles and how it was used as the blue print in designing policies for electricity reforms in both developed and developing countries. The paper found out that there is gap between the ideology in theory and in practice because although the theory is rational in thinking it is difficult to be implemented in practice. The paper argues that the ideology has a mismatched effect and this has made its application in the electricity industry in many developing countries problematic and unsuccessful. In the case of Nigeria, the article argues that the template is also not working. The article concludes that the electricity sectors in Nigeria have failed to develop into competitive market for the benefit of consumers in line with the assumptions and promises of the ideology. The paper therefore recommends the democratization of the electricity sectors in Nigeria through a new system of public ownership as the solution to the failure of the neoliberal policies; but this requires the design of a more democratic and participatory system of ownership with communities and state governments in charge of the administration, running and operation of the sector.

Keywords: electricity, energy governance, neo-liberalism, regulation

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Authors: Nattapol Pourprasert

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This research is to study qualitative research having two objectives: 1. to study comparison of private sector of government to compare with ASEAN Member States, 2. to study trend of private enterprise administration of ASEAN Member States. The results are: (1) Thai people focus on personal resource administrative system, (2) Indonesia focuses on official system by good administrative principles, (3) Malaysia focuses on technology development to service people, (4) Philippines focuses on operation system development, (5) Singapore focuses on public service development, (6) Brunei Darussalam focuses on equality in government service of people, (7) Vietnam focuses on creating government labor base and develop testing and administration of operation test, (8) Myanmar focuses on human resources development, (9) Laos focuses on form of local administration, (10) Cambodia focuses on policy revolution in personal resources. The result of the second part of the study are: (1) Thailand created government personnel to be power under qualitative official structural event, (2) Indonesia has Bureaucracy Reform Roadmap of Bureaucracy Reform and National Development Plan Medium Term, (3) Malaysia has database for people service, (4) Philippines follows up control of units operation by government policy, (5) Singapore created reliability, participation of people to set government policy people’s demand, (6) Brunei Darussalam has social welfare to people, (7) Vietnam revolved testing system and administration including manpower base construction of government effectively, (8) Myanmar creates high rank administrators to develop country, (9) Laos distributes power to locality, and (10) Cambodia revolved personnel resource policy.

Keywords: public administration development, ASEAN member states, private sector, government

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Authors: G. Vishnu, T. V. Bharat

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Rainfall plays a major role in the stability of natural slopes in tropical and subtropical regions. These slopes usually have high slope angles and are stable during the dry season. The critical rainfall intensity that might trigger a landslide may not be the highest rainfall. In addition to geological discontinuities and anthropogenic factors, water content, suction, and hydraulic conductivity also play a role. A thorough geotechnical investigation with the principles of unsaturated soil mechanics is required to predict the failures in these cases. The study discusses three landslide events that had occurred in residual hills of Guwahati, India. Rainfall data analysis, history image analysis, land use, and slope maps of the region were analyzed and discussed. The landslide occurred on June (24, 26, and 28) 2020, on the respective sites, but the highest rainfall was on June (6 and 17) 2020. The factors that lead to the landslide occurrence is the combination of critical events initiated with rainfall, causing a reduction in suction. The sites consist of a mixture of rocks and soil. The slope failure occurs due to the saturation of the soil layer leading to loss of soil strength resulting in the flow of the entire soil rock mass. The land-use change, construction activities, other human and natural activities that lead to faster disintegration of rock mass may accelerate the landslide events. Landslides in these slopes are inevitable, and the development of an early warning system (EWS) to save human lives and resources is a feasible way. The actual time of failure of a slope can be better predicted by considering all these factors rather than depending solely on the rainfall intensities. An effective EWS is required with less false alarms in these regions by proper instrumentation of slope and appropriate climatic downscaling.

Keywords: early warning system, historic image analysis, slope instrumentation, unsaturated soil mechanics

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Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Quantity and quality of sleep have been reported to be significant risk factors for obesity and development of metabolic disorders such as type 2 diabetes mellitus (T2DM). The relationship between diabetes and sleep quantity was reported to be U-shaped, which means increased or decreased sleeping hours can increase the risk of diabetes. The plasma glucagon levels were found to continuously decrease during night-time sleep in healthy individuals, independently of blood glucose and insulin levels. The disturbance of the circadian rhythm is also important and has been linked with an increased the chance of diabetes incidence. There is a lack of research on sleep patterns on Saudis with T2DM and how this is affected by Ramadan fasting. Aim: To assess the sleeping patterns of Saudis with T2DM (before, during, and after Ramadan), using two different techniques and relate this to their HbA1c levels. Method: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Their sleeping patterns were assessed by a self-administered questionnaire (before, during, and after Ramadan). The assessment included the daily total sleeping hours (DTSH), and total night-time sleeping hours (TNTSH) of the participants. In addition, sleeping patterns of 36 patients, randomly selected from the 82 participants, were further tracked during and after Ramadan by using Fitbit Flex 2™ accelerometer. Blood samples were collected in each period for measuring HbA1c. Results: Questionnaire analysis revealed that the sleeping patterns significantly changed between the periods, with shorter hours during Ramadan (P < 0.001 for DTSH, and P < 0.001 for TNTSH). These findings were confirmed by the Fitbit data, which also indicated significant shorter sleeping hours for the DTSH, and the TNTSH during Ramadan (P < 0.001 and P < 0.001, respectively). Although there were no significant correlations between the questionnaire and Fitbit data, the TNTSH were shorter among the participants in all periods by both techniques. The mean HbA1c significantly varied between periods, with lowest level during Ramadan. Although the statistical tests did not show significant variances in the mean HbA1c between the groups of participants regarding their hours of sleeping, the lowest mean HbA1c was observed in the group of participants who slept for 6-8 hours and had longer night-time sleeping hours. Conclusion: A short sleep duration, and absence of night-time sleep were significantly observed among the majority of the study population during Ramadan, which could suppress the full benefits of Ramadan fasting for diabetic patients. This study showed that there is a good agreement between the findings of the questionnaire and the Fitbit device for evaluating sleeping patterns in a Saudi population. A larger study is needed in the future to investigate the impact of Ramadan fasting on sleep quality and quantity and its relationship with health and disease.

Keywords: Diabetes, Fasting, Fitbit, HbA1c, IPAQ, Ramadan, Sleep

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Authors: Ranjot Kaur, Om P. Katare, Anupama Sharma, Sarah R. Dennison, Kamalinder K. Singh, Bhupinder Singh

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Respiratory microbial infections being among the top leading cause of death worldwide are difficult to treat as the microbes reside deep inside the airways, where only a small fraction of drug can access after traditional oral or parenteral routes. As a result, high doses of drugs are required to maintain drug levels above minimum inhibitory concentrations (MIC) at the infection site, unfortunately leading to severe systemic side-effects. Therefore, delivering antimicrobials directly to the respiratory tract provides an attractive way out in such situations. In this context, current study embarks on the systematic development of lung lia pid-modified chitosan nanoparticles for inhalation of voriconazole. Following the principles of quality by design, the chitosan nanoparticles were prepared by ionic gelation method and further coated with major lung lipid by precipitation method. The factor screening studies were performed by fractional factorial design, followed by optimization of the nanoparticles by Box-Behnken Design. The optimized formulation has a particle size range of 170-180nm, PDI 0.3-0.4, zeta potential 14-17, entrapment efficiency 45-50% and drug loading of 3-5%. The presence of a lipid coating was confirmed by FESEM, FTIR, and X-RD. Furthermore, the nanoparticles were found to be safe upto 40µg/ml on A549 and Calu-3 cell lines. The quantitative and qualitative uptake studies also revealed the uptake of nanoparticles in lung epithelial cells. Moreover, the data from Spraytec and next-generation impactor studies confirmed the deposition of nanoparticles in lower airways. Also, the interaction of nanoparticles with DPPC monolayers signifies its biocompatibility with lungs. Overall, the study describes the methodology and potential of lipid-coated chitosan nanoparticles in futuristic inhalation nanomedicine for the management of pulmonary aspergillosis.

Keywords: dipalmitoylphosphatidylcholine, nebulization, DPPC monolayers, quality-by-design

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