Central Region Research Articles

Atherosclerotic cardiovascular disease risk among Ghanaians: A comparison of the risk assessment tools.

ObjectivesRisk stratification is a cornerstone for preventing atherosclerotic cardiovascular disease (ASCVD). Ghana has yet to develop a locally derived and validated ASCVD risk model. A critical first step towards this goal is assessing how the commonly available risk models perform in the Ghanaian population. This study compares the agreement and correlation between four ASCVD risk assessment models commonly used in Ghana. MethodsThe Ghana Heart Study collected data from four regions in Ghana (Ashanti, Greater Accra, Northern, and Central regions) and excluded people with a self-declared history of ASCVD. The 10-year fatal/non-fatal ASCVD risk of participants aged 40–74 was calculated using mobile-based apps for Pooled Cohort Equation (PCE), laboratory-based WHO/ISH CVD risk, laboratory-based Framingham risk (FRS), and Globorisk, categorizing them as low, intermediate, or high risk. The risk categories were compared using the Kappa statistic and Spearman correlation. ResultsA total of 615 participants were included in this analysis (median age 55 [Inter quartile range 46, 64]) years with 365 (59.3 %) females. The WHO/ISH risk score categorized 504 (82.0 %), 58 (9.4 %), and 53 (8.6 %) as low-, intermediate-, and high-risk, respectively. The PCE categorized 345 (56.1 %), 181 (29.4 %), and 89 (14.5 %) as low-, intermediate- and high-risk, respectively. The Globorisk categorized 236 (38.4 %), 273 (44.4 %), and 106 (17.2 %) as low-, intermediate-, and high-risk, respectively. Significant differences in the risk categorization by region of residence and age group were noted. There was substantial agreement between the PCE vs FRS (Kappa = 0.8, 95 % CI 0.7 – 0.8), PCE vs Globorisk (Kappa = 0.6; 95 % CI 0.6 – 0.7), and FRS vs Globorisk (Kappa = 0.6; 95 % CI 0.6 – 0.7). However, there was only fair agreement between the WHO vs Globorisk (Kappa = 0.3; 95 % CI 0.3–0.4) and moderate agreement between the WHO vs PCE and WHO vs FRS. ConclusionThere are significant differences in the ASCVD risk prediction tools in the Ghanaian population, posing a threat to primary prevention. Therefore, there is a need for locally derived and validated tools.

Dengue hemorrhagic fever prediction in coastal area using geographically weighted regression

Dengue hemorrhagic fever (DHF) is still a health problem globally, including in Indonesia. Geographical and climatic conditions in coastal areas are different from other areas, which may impact differences in environmental risk factors for dengue. This study aims to create a prediction model for the incidence of DHF in coastal areas. The research was conducted in Bantul Regency, Indonesia, involving data from 2015-2019. Dengue incidence data were collected from the health office. Climatic data were from climatology station. Data on altitude and shoreline distance were obtained by geographic information system (GIS) processing. Population density and wide settlement area are obtained from the Bureau of Statistics. The geographically weighted regression (GWR) analysis was carried out using GWR4. The results showed that GWR with a weighting of Fixed Bi-Square Kernel obtained an R2 value of 0.7768, better than the global model (R2 0.5254). It indicates that DHF (Y) in Bantul Regency is 77.68% determined by population density (X1), altitude (X2), settlement area (X3), shoreline distance (X4) and rainfall (X5) and the remaining 22.32% are influenced by other variables which are not investigated. Geographically, the predictor variables explain the DHF incidence with a strong category in the central region, and weak in coastal area.

Quantifying the water use efficiency of karst ecosystems and response to environmental factors

Study regionThe study area is located in Guizhou province, the centre of the karst region in southwest China. Study focusAs a typical karst region, Guizhou has long faced challenges with water scarcity. Quantifying water use efficiency (WUE) is crucial for the efficient use of water resources and sustainable management. This study examined the spatio-temporal evolution patterns and its driving factors on WUE in Guizhou using Theil-Sen's slope, partial correlation methods, and the geographic detector model. New hydrological insights for the region(1) The multi-annual mean WUE of non-karst region (NKR, 2.75 gC kg-1 H2O yr-1) is higher than that of karst region (KR, 2.10 gC kg-1 H2O yr-1) during 2001–2020. (2) The rate of increase of WUE was three times higher in KR than in NKR. (3) Precipitation and temperature were identified as the key factors influencing WUE. Interactions between each environmental factors were observed to have both bi-variate and non-linear enhancement effects. Notably, in the NKR, soil moisture, vegetation type and leaf area index were the dominant factors influencing WUE, with interactions between environmental factors had both enhanced and weakened effect on WUE. (4) The synergistic effects of these interactions exceeded the individual or cumulative effects of the two environmental factors. These findings contribute to our understanding of the environmental factors driving changes in WUE in the KR.

Geoscience studies in the Maltese Islands: a gateway to the Central Mediterranean region

Geoscience studies in the Maltese Islands: a gateway to the Central Mediterranean region

A Sociological study of the religious identity of young people in Central Asia and Europe (following the example of Kyrgyz Republic and the Republic of Poland)

The purpose of the article is to determine the situation in the field of religious preferences of young people in the Kyrgyz Republic and the Republic of Poland by studying the specific features and dynamics of the development of traditional beliefs in the Central Asian and European regions. The main methods used in the preparation of the work were the system-analytical method and the statistical method. The characteristic features of different areas of religion in Asia, as well as the origins and root causes of the formation and development of religious trends in Kyrgyzstan, are studied. The key moments in the history of the transformation of the Kyrgyz society in the XVIII-XXI centuries are outlined in the context of the influence of this process on the emergence of specific signs of local religious trends. Different approaches and concepts to the study of the young generation of the Central Asian Republic and Poland are evaluated by considering the qualitative and quantitative results of a number of sociological surveys. The results and conclusions of this work can be used as a basis for the development and implementation of a number of political and social reforms with an emphasis on raising awareness of the issue among the younger generation of Kyrgyzstan.

The influence mechanism of multi-government environmental regulation synergy on corporate environmental responsibility

The United Nations Development Programme (UNDP) calls for enhanced global efforts to achieve the 17 sustainable development goals by 2030, highlighting the crucial role of corporate environmental responsibility (CER) in advancing global sustainability. As a significant participant, China is leveraging its government-led environmental regulation (ER) system, which has a multi-level and multi-sectoral structure, to effectively combat climate change. However, the effect of this ER system, especially collaborative efforts among multiple government subjects, on CER remains unknown. Thus, this paper is the first attempt to investigate the effect and underlying mechanisms of multi-government ER synergy on CER from the perspective of government subject synergy. Using a dataset of Chinese A-share listed manufacturing firms from 2010 to 2021, this study finds the following. First, multi-government ER synergy boosts CER. Direct ER synergy, stemming from joint policy-making across departments, encourages CER in end-of-pipe governance. Indirect ER synergy, arising from administrative hierarchy constraints among multi-level governments, fosters CER in front-end governance. Second, financing constraints and executives’ attention to CER are two key channels through which multi-government ER synergy influences CER. Third, firms with political connections, those in heavily polluting industries, or those located in central and western regions adopt more proactive CER strategies under multi-government ER synergy. This paper expands research on government collaborative governance from the regional macro-perspective to the micro-firm level, providing valuable insights for countries worldwide, particularly emerging economies that share similar characteristics with China, to contain rapidly growing environmental challenges and advance global sustainability.

A ministry to at-risk homeless street youths in the central region of Lusaka, Zambia

The study examined the plight of homeless at-risk street youth who patronize the Lusaka Central Business District. Through observation and interaction, it was revealed that the Seventh-day Adventist Church is not providing an adequate and holistic ministry to the street youth people group. The purpose of this study was to develop, implement, and evaluate a viable intervention and ministry model that seeks to account for both the physical and spiritual needs of street youth. This model is here dubbed the PSR2D model consisting of meeting physical needs, equipping with skills, reform and rehabilitation, and most importantly, discipleship as a way of reaching the street youth. To adequately and meaningfully minister to at-risk street youths, the researcher used the qualitative method to approach the research process. After examining the problem through data derived from focus groups and observations, the researcher designed and implemented a multi-faceted ministry to reach at-risk street youth and thereby create an entering wedge for discipleship. The program started in December 2023 and was completed in March 2024.

Estimated greenhouse gas emissions in the Mbalmayo thermal power plant between 2016-2020 using the genetic-Gaussian algorithm coupling.

The greenhouse gas (GHG) emissions inventories in our context result from the production of electricity from fuel oil at the Mbalmayo thermal power plant between 2016 and 2020. Our study area is located in the Central Cameroon region. The empirical method of the second level of industrialisation was applied to estimate GHG emissions and the application of the genetic algorithm-Gaussian (GA-Gaussian) coupling method was used to optimise the estimation of GHG emissions. Our work is of an experimental nature and aims to estimate the quantities of GHG produced by the Mbalmayo thermal power plant during its operation. The search for the best objective function using genetic algorithms is designed to bring us closer to the best concentration, and the Gaussian model is used to estimate the concentration level. The results obtained show that the average monthly emissions in kilograms (kg) of GHGs from the Mbalmayo thermal power plant are: 526 kg for carbon dioxide (CO2), 971.41 kg for methane (CH4) and 309.41 kg for nitrous oxide (N2O), for an average monthly production of 6058.12 kWh of energy. Evaluation of the stack height shows that increasing the stack height helps to reduce local GHG concentrations. According to the Cameroonian standards published in 2021, the limit concentrations of GHGs remain below 30 mg/m3 for CO2 and 200 μg/m3 for N2O, while for CH4 we reach the limit value of 60 μg/m3. These results will enable the authorities to take appropriate measures to reduce GHG concentrations.

The impact of digital government on natural resource utilization efficiency

Governments wield significant influence in the management of natural resources, and the advent of digital transformation offers a fresh impetus for governments to attain efficacious governance. This manuscript delves into the ramifications of digital government on the efficacy of natural resource utilization, drawing on both theoretical and empirical examinations based on panel data encompassing 30 provinces and cities in China spanning the years 2011–2021. The findings corroborate that digital government engenders a noteworthy enhancement in natural resource utilization efficiency, a conclusion that endures even after stringent tests to ensure reliability and account for potential endogeneity factors. Insights garnered from mechanism tests reveal that the augmentation of natural resource utilization efficiency, stemming from digital government, primarily emanates from the amelioration of government services—a discernible hallmark of a responsive government. Concurrently, when the role of efficient markets is considered, it transpires that marketization can positively regulate the impact of digital government, thereby bolstering its favorable effect on the efficient use of natural resources. Heterogeneity analyses disclose that eastern and central regions display a more pronounced positive effect of digital government on natural resource utilization efficiency in comparison to the western region. Furthermore, this effect is discernible in provinces not reliant on resource-based industries, while its manifestation is less conspicuous in provinces reliant on such sectors. Moreover, provinces boasting a robust digital infrastructure exhibit a more sizable positive effect of digital government on natural resource utilization efficiency. The research articulated herein not only enhances our comprehensive comprehension of the crucial role of digital government but also furnishes policymakers with valuable insights conducive to bolstering natural resource utilization efficiency and achieving sustainable economic and social development.

Neuronal coupling modes show differential development in the early cortical activity networks of human newborns.

The third trimester is a critical period for the development of functional networks that support the lifelong neurocognitive performance; yet the emergence of neuronal coupling in these networks is poorly understood. Here, we used longitudinal high-density electroencephalographic (EEG) recordings from preterm infants during the period from 33 to 45 weeks of conceptional age to characterize early spatiotemporal patterns in the development of local cortical function and the intrinsic coupling modes (phase-phase, amplitude-amplitude, and phase-amplitude correlations). Absolute local power showed a robust increase with conceptional age across the full frequency spectrum, while local phase-amplitude correlations showed sleep state -specific, biphasic development that peaked a few weeks before normal birth. Amplitude-amplitude and distant phase-amplitude correlations decreased globally at nearly all frequencies. In contrast, the phase-phase correlations showed frequency- and region-selective development, with an increase of coupling strength with conceptional age between frontal, central, and occipital regions at low-delta and alpha frequencies together with a wider-spread decrease at other frequencies. Our findings together present the spectrally and spatially differential development of the distinct intrinsic coupling modes during the neonatal period and provide their developmental templates for future basic and clinical research.Significance statement Neuronal activity coupling in cortical networks is a fundamental mechanism underlying higher brain functions. However, emergence of these functional networks within the structural connectome at early maturation is poorly understood. Here, we study the human development of cortical function and distinct neuronal coupling modes (amplitude-amplitude, phase-phase, and phase-amplitude coupling) by investigating longitudinal high-density electroencephalographic recordings in preterm-born infants and discussing their potential links to established neurophysiological processes. Our findings disclose robust, spatially and spectrally specific developmental trajectories for all coupling modes to be used as developmental baselines for future research. The findings together indicate that neuronal coupling modes develop independently during the early neonatal period, supporting the notion that these modes reflect different coupling mechanisms and should be considered separately.

Environmental regulation, industrial structure and energy efficiency: Evidence from 30 provinces in China.

The government's environmental protection policy can significantly contribute to alleviating resource shortages and curbing environmental pollution, but the impact of various policy instruments implemented by the government on energy efficiency is unclear. Based on the panel data of 30 provinces in China from 2005 to 2021, this paper analyses the impact of environmental regulation and the industrial structure on energy efficiency from the perspective of resource taxes. The U-shaped relationship between environmental regulation and energy efficiency and between the optimization of industrial structure can significantly improve energy efficiency, and the optimization of industrial structure is conducive to weakening the initial inhibitory effect of environmental regulation. In addition, the analysis of regional heterogeneity showed that the impact of environmental regulation was stronger in the central and western regions, while the impact of industrial structure was stronger in the eastern and western regions. The conclusions of this study can help to expand the understanding of the relationship between environmental regulation and industrial structure on energy efficiency, provide policy enlightenment for the realization of green development and high-quality development, and provide Chinese examples and experiences for developing countries to improve energy efficiency.

Associations between child marriage and reproductive and maternal health outcomes among young married women in Liberia and Sierra Leone: A cross-sectional study.

Child marriage has been associated with a range of negative maternal and reproductive health outcomes. This study explored these associations in Liberia and Sierra Leone and examined how child marriage intersected with other measures of social disadvantage. Data were derived from 631 and 1,325 married or cohabitating women aged 20-24 interviewed in the 2019-2020 Liberia and 2019 Sierra Leone Demographic and Health Surveys, respectively. Analyses were stratified by country. Regression models examined associations between age at first marriage (<15, 15-17, and 18+ years) and reproductive and maternal health outcomes, as well as interactions between child marriage and measures of social disadvantage. Multivariable regression results were presented as adjusted odds ratios and 95% confidence intervals. Over half of currently married/cohabitating women aged 20-24 in Liberia (52%) and Sierra Leone (54%) married before age 18, and over one in 10 married before age 15. In both countries, after adjusting for other factors, being married before the age of 18 was significantly associated with early fertility, high fertility, and low fertility control. Associations were particularly strong among women who first married before age 15. In Liberia, women who married at age 15-17 had significantly lower odds of skilled attendance at delivery and institutional delivery if they lived in the North Central region. Sierra Leonean women who married before age 15 had lower odds of institutional delivery and lower odds of four or more ANC visits if they lived in the North Western region. This study found clear associations between child marriage and negative reproductive health outcomes in Liberia and Sierra Leone, with stronger associations among women married in early adolescence. Child marriage and region of residence intersected to shape young women's access to skilled attendance at birth and institutional delivery. These findings call for further investigation and targeted intervention.

Is There a Digital Rebound in the Process of Urban Green Development? New Empirical Evidence Using Ensemble Learning Methods

The convergence of digitization and greening is an unavoidable path of modern economic progress. Nonetheless, the digital economy does not consistently align with the principles of green development, potentially leading to a rebound effect in urban digitalization initiatives. To investigate the correlation between the digital rebound effect and urban green development, this study utilizes panel data from Chinese prefecture-level cities spanning from 2011 to 2019. By examining the dual impact of the digital economy on green development, the paper posits a theoretical hypothesis regarding the nonlinear marginal effect of the digital economy. This research demonstrates an inverted U-shaped correlation between the digital economy and urban green development via empirical analyses employing the random forest algorithm and partial dependency plots. It supports the existence of a moderate digital resiliency effect, which eventually reaches a state of stability rather than greatly diminishing the degree of green development in urban areas. In addition, the heterogeneity analysis reveals that the positive effects of the digital economy are more popular in cities located in the eastern and central regions, as well as in the National Comprehensive Pilot Zone for Big Data. However, these effects do not vary significantly among different ranks of cities. The mechanism test found that the information effect and the capital allocation effect are the mechanisms by which the digital economy affects green development, and there is a “U-shaped” relationship between the digital economy and information asymmetry and capital mismatch. According to the study’s results, improving the digital economy’s governance structure continues to make more sense than merely increasing the number of digital inputs.

Some Environmental Factors Causing First Calving Difficulties in Holstein Friesian Cattle

Calving efficiency, an important target in cattle breeding, has been negatively affected by some environmental factors. Therefore, calving difficulty creates negative economic consequences. In this study, it was aimed to investigate the relationship between the first calving difficulty in Holstein Friesian (HF) cows in terms of management and origin factors. The material of the research consists of 1475 calving difficulty records from 5 different enterprises engaged in HF breeding, located in the Central Anatolia Region of Turkey, covering the years from 2013 to 2019. The scoring system used to determine calving difficulty: normal without intervention (ND), normal with intervention (MND), difficult/intervention with equipment (ZD), and abnormal birth (AD). Chi-square tests were performed. In the calving difficulty analysis, the management factor is classified as 1-2-3-4-5 and the origin of the cow is classified as 1 (foreign origin) and 2 (native origin). No findings were observed for MND scores. Total ND, ZD, and AD scores were 1250 (84.74%), 192 (13.01), and 33 (2.25%), respectively. Chi-square test was performed to test the differences among farms. Among the enterprises, the highest ND rate was observed in the 5th enterprise with 90.07%, the minimum ZD rate was observed in the 5th enterprise with 8.45%, and the AD rate was at least 0.66% in the 1st enterprise. The difference between farms was significant for calving difficulty (P

Biodiversity and Wetting of Climate Alleviate Vegetation Vulnerability Under Compound Drought‐Hot Extremes

AbstractGlobal warming has intensified the intensity of compound drought‐hot extremes (CDHEs), posing more severe impacts on human societies and ecosystems than individual extremes. The vulnerability of global terrestrial ecosystems under CDHEs, along with its key influencing factors, remains poorly understood. Based on multiple remote sensing data, we construct a Vine Copula model to appraise vegetation vulnerability under CDHEs, and attribute it to climatic and biotic factors for five different vegetation types. High vulnerability is detected in central and southern regions of North America, eastern and southern regions of South America, Southern Africa, northern and western Europe, and northern and eastern Australia. The drier the climate, the higher will be the vulnerability. Furthermore, biodiversity and biomass are key biotic factors influencing the vulnerability of various vegetation types, such that ecosystems with richer biodiversity and higher biomass have lower vulnerability to CDHEs. The findings deepen understanding of terrestrial ecosystem response to CDHEs.

Oblique projections in the analysis of multislice computed tomography data in gunshot wounds

Background. The purpose is to determine the place and role of oblique projections in the analysis of multislice computed tomography (MSCT) data in gunshot wounds. Materials and me­thods. More than 3,300 MSCT studies performed in wounded and traumatized patients over a certain period in the Military Medical Clinical Center of the Northern Region of the Medical Forces Command were prospectively studied. All the wounded were male, the average age was 42.1 ± 2.4 years. MSCT of the head, thoracic and abdominal organs, pelvis, and limbs was performed. The frequency of using oblique projections and their informativeness were studied. Results. A prospective study demonstrated that coronal, axial, sagittal projections, and 3D modeling were used in 100 % of cases, and in 21.4 % — oblique projections to improve MSCT results. The distribution by localization of MSCT was as follows: head — 32.9 %, neck — 7.6 %, chest organs — 32.2 %, abdominal organs — 22.3 %, limbs — 5.0 %. MSCT in angiomode was performed in 3.5 % of injured and traumatized patients: head — 27.2 %, neck — 18.4 %, chest organs — 28.9 %, abdominal organs — 23.7 %, limbs — 1.8 %. Oblique projections in MSCT data analysis were used when studying the wound channel in 82.3 % of cases, to improve the visualization of vessels during MSCT in angiomode — in 12.6 % and to improve the visualization of bone fracture lines — in 5.1 %. Conclusions. In the structure of MSCT studies, the head, thoracic organs, abdominal organs, neck, and limbs prevail by localization (in descending order). Oblique projections are used is 1/5 of cases and allow to improve the visualization of the direction of the wound channel, vessels during angiography and lines of flat and long tubular bone fractures.

Examining the economic impacts of caregiving among families of children of medical complexity: A qualitative study to inform inclusive economic models.

Children with medical complexity (CMC) represent a heterogeneous group of children with multiple, chronic healthcare conditions. Caregivers of CMC experience a high intensity of caregiving that is often variable, extends across several networks of care, and often lasts for the entirety of the child's life. The economic impacts of caregiving are yet understudied in the CMC context. There have been recognized limitations to the sole use of quantitative methods when developing economic models of disease because they lack direct caregiver voice and context of caregiving activities and existing methods have been noted to be ableist. The purpose of this study was to explore the economic spillover impacts of caregiving among families of CMC using their own words and perspectives with the intent of expanding caregiver-centered perspectives when developing economic models. This study was a secondary analysis of a qualitative study that was conducted to examine family management practices among caregivers of CMC and their social networks. Caregivers of CMC were recruited through a Pediatric Complex Care clinic at an academic medical center in the mid-Atlantic region, USA. This study used inductive qualitative descriptive methods and the use of a template to define features of the person impacted and to define the economic construct as either a direct or indirect/spillover cost. Twenty caregivers were included in this study. Perspectives from the caregivers of CMC revealed several key themes: (1) time investment in caregiving - impacting the primary caregivers; (2) physical and mental health impacts - impacting the child themselves, siblings, and the primary caregivers; (3) impacts to leisure activities and self-care - impacting the child themselves, siblings, and the primary caregivers; (4) impacts to the social network/social capital. The themes described can be operationalized into inclusive family-centered models that represent the impacts of caregiving in the context of the family units of CMC. The use of qualitative methods to expand our development of quantitative economic models can be adapted to other populations where caregivers are involved in care. Caregivers can and should have an active voice in preference-based assessments that are operationalized in economic contexts to make them more inclusive. n/a. RR2-10.2196/14810.

The Experience of the Migration Component of European Identity for the Central Asia Region – ERRATUM

The Experience of the Migration Component of European Identity for the Central Asia Region – ERRATUM

The Influence of Spatial Heterogeneity of Urban Green Space on Surface Temperature

Urban green space (UGS) has been recognized as a key factor in enhancing the urban ecosystem balance, particularly in arid areas. It is often considered an effective means to mitigate the urban heat island (UHI) effect. In this study, the reference comparison method was utilized to optimize the process of nighttime lighting data; the random forest classification method was employed to extract UGS data; and the radiative transfer method was applied in land surface temperature (LST) inversion. Additionally, moving window analysis was conducted to assess the robustness of the results. The objective of this research was to analyze the spatial distribution characteristics of UGS and LST and to explore their bivariate local spatial autocorrelations by calculating four landscape metrics, including the aggregation index (AI), edge density (ED), patch density (PD), and area-weighted mean shape index (Shape_am). It was found that the distribution of UGS in the study area was uneven, with higher temperatures in the eastern and western regions and lower temperatures in the central and southern regions. The results also revealed that ED, PD, and Shape_am were negatively correlated with LST, with correlation coefficients being −0.469, −0.388, and −0.411, respectively, indicating that UGS in these regions were more effective in terms of cooling effect. Conversely, AI was found to be positively correlated with LST (Moran’ I index of 0.449), indicating that surface temperatures were relatively higher in regions of high aggregation. In essence, the fragmented, complex, and evenly distributed green patches in the study area provided a better cooling effect. These findings should persuade decision makers and municipal planners to allocate more UGS in cities for UHI alleviation to improve quality of life and enhance recreational opportunities.

Reporting of Progress toward Eliminating Viral Hepatitis B and C in the Central Asian Region

Eliminating viral hepatitis became a global goal and was targeted by countries worldwide. Using WHO, Google Scholar, PubMed, and other databases, the progress of Central Asian countries (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan) in ending viral hepatitis B and C by 2030 was evaluated and reported. Collected data shows that countries have made significant efforts toward achieving goals in the Global Health Sector Strategy. All countries have national programs focused on hepatitis elimination and have reached the target vaccination coverage against hepatitis B. However, the available information requires regular updates, and public accessibility of data collected by governments should be enhanced. Additionally, countries are recommended to improve harm reduction and treatment services.