Stratified Approach Research Articles

Identifying Progression-Specific Alzheimer’s Subtypes Using Multimodal Transformer

Alzheimer’s disease (AD) is the most prevalent neurodegenerative disease, yet its current treatments are limited to stopping disease progression. Moreover, the effectiveness of these treatments remains uncertain due to the heterogeneity of the disease. Therefore, it is essential to identify disease subtypes at a very early stage. Current data-driven approaches can be used to classify subtypes during later stages of AD or related disorders, but making predictions in the asymptomatic or prodromal stage is challenging. Furthermore, the classifications of most existing models lack explainability, and these models rely solely on a single modality for assessment, limiting the scope of their analysis. Thus, we propose a multimodal framework that utilizes early-stage indicators, including imaging, genetics, and clinical assessments, to classify AD patients into progression-specific subtypes at an early stage. In our framework, we introduce a tri-modal co-attention mechanism (Tri-COAT) to explicitly capture cross-modal feature associations. Data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (slow progressing = 177, intermediate = 302, and fast = 15) were used to train and evaluate Tri-COAT using a 10-fold stratified cross-testing approach. Our proposed model outperforms baseline models and sheds light on essential associations across multimodal features supported by known biological mechanisms. The multimodal design behind Tri-COAT allows it to achieve the highest classification area under the receiver operating characteristic curve while simultaneously providing interpretability to the model predictions through the co-attention mechanism.

Transforming Arid and Semi-Arid Areas to be Food Secure: The Role of Small-Scale Irrigation Projects

The primary aim of this research was to evaluate the contribution of irrigation-based initiatives towards ensuring food security. The specific objectives encompassed assessing the role of labor within small-holder irrigation projects in bolstering food security, analyzing the impact of external donor assistance on food security outcomes within these projects, and appraising the extent of governmental backing for small-holder irrigation endeavors in the pursuit of food security goals. Employing a descriptive survey methodology, the study was conducted within various small-holder irrigation projects. The research population consisted of 1303 members affiliated with the irrigation schemes, alongside 12 agricultural officers. Utilizing a simple random sampling technique, two agricultural extension officers were selected from the irrigation schemes, while a stratified sampling approach identified 66 irrigation scheme members for participation in the study. Data collection primarily relied on the administration of questionnaires. Findings revealed that the majority of farmers predominantly relied on their labor or that of family members, with minimal utilization of hired labor observed in small-scale irrigation ventures. Consequently, labor scarcity emerged as a notable challenge within these projects. Furthermore, the study highlighted that a significant proportion of small-holder irrigation initiatives benefited from external donor support. To address labor shortages, the research suggested incentivizing specialized labor while recommending collaborative efforts among farmers to engage specialists in crop management, thereby enhancing crop productivity within the schemes.

Enhancing crop yields and farm income through climate-smart agricultural practices in Eastern India

Climate-induced increase in temperature and rainfall variability severely threaten the agricultural sector and food security in the Indian state of Odisha. Climate-smart agricultural (CSA) practices, such as crop rotation and integrated soil management, help farmers adapt to climate risk and contribute to a reduction in greenhouse gas (GHG) emissions. Therefore, this paper examines the impact of CSA practices on yield and income in vulnerable semi-arid districts of Odisha—Balangir, Kendrapara, and Mayurbhanj. We use primary survey data from 494 households collected in 2019–2020, using a multi-stage stratified sampling approach and structured questionnaire. Propensity score matching (PSM) and the two-stage least square method (2SLS) have been used to analyze the impact of CSA on income and productivity. Two instrument variables, namely distance to the extension office and percentage of adopters in a village, are used to control self-selection bias and endogeneity in our model. Both models show a positive and significant impact of the adoption of CSA on farmers’ productivity and income. The study sheds light on the significant contribution of CSA practices in fostering sustainable income growth amid environmental challenges. Overall, our results suggest that small and marginal farmers of Eastern India, a highly environmentally vulnerable area, can significantly improve their income and productivity by adopting CSA technology. Hence, policymakers should scale the adoption of CSA technology through effective extension programs.

Diphtheria and Tetanus Immunity Status among Greek Adults: Results from a Nationwide Seroprevalence Study

Diphtheria and tetanus could lead to serious morbidity. We aimed to evaluate immunity levels by measuring specific IgG antibodies for diphtheria and tetanus in serum samples from a nationally expanded sample of the Greek population. A geographically stratified sampling approach based on regional units (NUTS level 2) was applied by considering variables such as age group (30–80+) and sex. In total, 1201 persons (47.7% males and 52.3% females) participated in the survey. Bivariate analysis revealed a negative relationship between diphtheria and tetanus median antibody titers and age. The overall seropositivity rate for diphtheria IgG antibodies (≥0.10 IU/mL) was estimated at 31.5%. Regarding tetanus, the total seropositivity rate was estimated at 59.5% (tetanus IgG antibodies ≥0.10 IU/mL). Logistic regression analysis indicated that age groups <40 years and 40–59 years were independently associated with tetanus seropositivity. Logistic regression also revealed that male sex and being aged 60–69 years were independent risk factors for diphtheria-related seropositivity. Lastly, being resident of some regions was an independent risk factor for both diphtheria- and tetanus-related seropositivity. The present study shows that Greek adults are still not completely immune to diphtheria and tetanus. It is likely possible to achieve optimal immunization coverage by implementing serviceable public health initiatives after comprehending real community needs.

Factors That Influence Student’s Decisions In Choosing Universitas Mikroskil

This research aims to determine the factors influencing students' decisions in choosing Mikroskil University. This type of research is associative with a quantitative approach. The variables used in this study to measure students' decisions are service quality, promotion, and facilities of the university. The number of samples used in this research is 310 respondents, namely students from all study programs at Mikroskil University using the probability sampling method with a proportional stratified random sampling approach. From the adjusted R-square value, a value of 0.785 is obtained, which when multiplied by 100 yields 78.500 per cent. This indicates that the contribution of each independent variable to influence the dependent variable is 78.500 per cent, meaning that the variables of service quality, promotion, and university facilities contribute 78.500 per cent to students' decision variables in choosing Mikroskil University, while the remaining 21.500 per cent is influenced by other variables beyond the scope of this research.

Age, gender, and self-concept as predictors of solid waste management among residents in cross river state, Nigeria

This research investigated the correlation between individuals' age, attitude, and practices in handling solid waste in Cross River State, Nigeria. The study formulated three hypotheses to guide its direction and utilised a survey research design. The participants included 1,106 individuals selected through random sampling from a population of 6,923 using a stratified approach. The researchers developed a questionnaire, which six experts validated, and its reliability was assessed using Cronbach's alpha method. Various statistical methods were employed to test the hypotheses at a significance level of 0.05, including simple regression, one-way analysis of variance (ANOVA), and an independent t-test. The outcomes revealed that age, gender, and self-concept influenced solid waste management practices within the studied population. Specifically, males and individuals with a strong self-concept exhibited more active engagement in solid waste management than their female and low-self-concept counterparts. The data indicated that respondents aged 38 and above demonstrated the highest level of involvement in solid waste management, followed by those aged 18-27. Conversely, respondents aged 28-37 exhibited the lowest extent of engagement in solid waste management practices. This study has valuable implications for policymakers, waste management professionals, and community stakeholders. The insights can guide the development of evidence-based strategies to encourage responsible waste management behaviours, thereby contributing to a cleaner and more sustainable future.

Effect of Digital Marketing on the Financial Performance of Microfinance Institutions in Rwanda

In this study, the effect of digital marketing on the efficiency of microfinance institutions in the Musanze region was specifically examined. The goal was to assess the effect of digital marketing on the financial performance of the selected MFIs in Musanze district. The specific objectives of the study were to examine the effect of Social Media Marketing on performance of MFIs in Musanze district, to analyze the effect of Influencer Marketing on the performance of MFIs, to ascertain the effect of Mobile Marketing on the performance of MFIs, while also assuring the satisfaction of their staff and that they are operating efficiently to increase revenues. The goals also include implementing technology, measuring the effectiveness of microfinance institutions in the nation that have lagged behind in the marketing sector, and identifying the usual digital marketing channels used by Rwanda's microfinance institutions. The probability sampling technique (Simple Random Sampling) was used in conjunction with stratified sampling approach. This study gathered information from 154 employees at 14 microfinance organizations using a quantitative approach. Both descriptive and inferential statistics were used for the data analysis. The binary regression model and SPSS 24 SOFTWARE were also used for data analysis. The study's findings demonstrate that digital marketing significantly improves how microfinance businesses run. According to respondents, Digital marketing's contribution to the expansion of the loan portfolio is frequently considered to be of negligible importance. This study suggests that microfinance institutions can more fully utilize technology to ensure that their daily tasks are done.

Using Stratified Sampling to Improve LIME Image Explanations

We investigate the use of a stratified sampling approach for LIME Image, a popular model-agnostic explainable AI method for computer vision tasks, in order to reduce the artifacts generated by typical Monte Carlo sampling. Such artifacts are due to the undersampling of the dependent variable in the synthetic neighborhood around the image being explained, which may result in inadequate explanations due to the impossibility of fitting a linear regressor on the sampled data. We then highlight a connection with the Shapley theory, where similar arguments about undersampling and sample relevance were suggested in the past. We derive all the formulas and adjustment factors required for an unbiased stratified sampling estimator. Experiments show the efficacy of the proposed approach.

Exploring the Mediating Role of Organizational Commitment in the Relationship between Corporate Social Responsibility and Employee Performance: Evidence from Henan's Universities

Aims: This study aims to examine the mediating role of organizational commitment in the relationship between Corporate Social Responsibility (CSR) and employee performance within Henan's universities, highlighting the strategic importance of CSR in enhancing organizational effectiveness and employee outcomes. Study Design: This study utilized a cross-sectional survey methodology to explore the relationships among Corporate Social Responsibility (CSR), Organizational Commitment (OC), and Employee Performance (EP) within Henan's higher education sector. A stratified random sampling approach was employed to select faculty and administrative staff from universities engaged in CSR initiatives. The analysis, conducted through Structural Equation Modeling and mediation analysis, aimed to understand both direct and indirect effects of CSR on employee performance, with a particular focus on the mediating role of organizational commitment. Place and Duration of Study: Zhengzhou University, Henan University, Henan Normal University, Henan Agricultural University and Henan Polytechnic University, in December 2023. Methodology: The study adopted a quantitative research design using a cross-sectional survey method to explore CSR's impact on organizational commitment and employee performance in Henan's universities. A stratified random sampling strategy was utilized to select faculty and administrative staff from universities engaged in CSR, aiming for a sample size of 328 to ensure statistical significance. Validated scales measured CSR, organizational commitment, and employee performance, with data analysis conducted through Structural Equation Modeling and bootstrapping for mediation effects. Results: In this study, the impact of Corporate Social Responsibility (CSR) on Employee Performance (EP) and Organizational Commitment (OC) within Henan's universities was examined. Findings indicate that CSR positively influences EP both directly and via OC, serving as a mediator. Significant relationships were confirmed: CSR to EP (β=0.433), CSR to OC (β=0.825), and OC to EP (β=0.442), all highly statistically significant (p<0.001). Mediation analysis showed CSR impacts EP through OC, accounting for about 45.73% of the effect. This underscores CSR's dual role in enhancing performance directly and by fostering organizational commitment. Conclusion: This study not only underscores the pivotal role of Corporate Social Responsibility (CSR) in enhancing employee performance within Henan's universities but also sheds light on the crucial mediating role of Organizational Commitment (OC). The dual pathway through which CSR influences employee performance underlines the significance of integrating CSR into the core strategic management practices of educational institutions. It signals to university administrators and policy-makers that CSR initiatives are not just external obligations but essential strategies for cultivating a committed and high-performing workforce. This realization opens up avenues for universities to re-evaluate and strengthen their CSR strategies, ensuring they are aligned with both organizational goals and employee values. Moreover, it encourages educational institutions to view CSR as a lever for organizational improvement and a bridge to deeper engagement with employees, ultimately contributing to the advancement of educational quality and societal contributions.

Harmony in nature: understanding the cultural and ecological aspects of plant use in Ladakh

BackgroundTraditional knowledge (TK) in Ladakh encapsulates a repository of experimental wisdom cultivated over millennia. Despite this cultural wealth, dwindling interest among the younger generations in the region’s age-old practices underscores the urgency to document TK. The current study investigates the diverse usage of plants in Surru, Wakha and Lower Indus valleys of Western Ladakh exploring the influence of socioeconomic and ecological factors.MethodsA stratified random sample approach was adopted to select 540 respondents for gathering information of useful plants through interviews and questionnaires. Participant observation, questionnaires, open-ended and semi-structured interviews were conducted for data collection. Free listing was done to create an extensive list of plants and their uses. Ethnobotanical metrics such as relative frequency of citation (RFC), relative importance index (RI), cultural value (CV) index and cultural importance (CI) index were computed to assess species applicability. Additionally, one-way analysis of variance (ANOVA) was utilized to discern significant differences in knowledge levels based on valleys, gender, education and religion using TK as a response variable.ResultsAltogether, we recorded 246 plant species under various ethnobotanical uses from Western Ladakh. These include medicinal (126), fodder (124), wild ornamentals (86), food (81), fuel wood (54), dye (20), religious (31) and others (34). Novel plant reports include Berberis brandisiana Ahrendt and Dactylorhiza kafiriana Renz. The dominant plant family is Asteraceae with 35 species. Suru valley exhibits the highest number of cited plants followed by Wakha-chu and Lower Indus valleys (192, 168 and 152 species, respectively).ConclusionDisparities in plant use understanding are evident among different groups, prompting further investigation through intercultural comparisons. Plants such as Arnebia euchroma, Juniperus semiglobosa, and Artemisia species emerge with cultural importance. Gender, valley affiliation, religious background and the remoteness of a village all influence local plant knowledge. These variations are linked to socioeconomic disparities among communities.

Genetics of chronic respiratory disease.

Chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), asthma and interstitial lung diseases are frequently occurring disorders with a polygenic basis that account for a large global burden of morbidity and mortality. Recent large-scale genetic epidemiology studies have identified associations between genetic variation and individual respiratory diseases and linked specific genetic variants to quantitative traits related to lung function. These associations have improved our understanding of the genetic basis and mechanisms underlying common lung diseases. Moreover, examining the overlap between genetic associations of different respiratory conditions, along with evidence for gene-environment interactions, has yielded additional biological insights into affected molecular pathways. This genetic information could inform the assessment of respiratory disease risk and contribute to stratified treatment approaches.

A Refinement of Ratio Estimation in Ranked Set Sampling and Stratified Ranked Set Sampling Approaches

Estimation of population mean is a persistent subject issue in sampling surveys and many discrete efforts have been paid by various researchers to enhance the precision of the estimates by utilizing the correlated auxiliary information. In connection with this an improved version of ratio estimator are presented in this paper under the ranked set sampling scheme and stratified ranked set sampling scheme. Comparison amongst estimators is made in terms of Mean Square Errors ( ) and Percentage Relative Efficiencies ( ). The expression for  of the proposed estimator is pinned-down to first order of approximations. It turns out from both simulation studies as well as real data set that the proposed estimator dominates its existing counterpart estimators.

Rural households' livelihood adaptation strategies in the face of changing climate: A case study from Pakistan

Rural and agricultural communities' adaptation to climate change has gained significant attention owing to many countries' vulnerability to climate change risks. A similar trend has been witnessed in South Asia, a highly climate-vulnerable region, where research has grown dramatically considering the agriculture sector's vulnerability to climate-induced disasters. However, little attention has been paid to the adaptation of the livelihoods of rural households. This research, therefore, takes the case of Pakistan to explore livelihood adaptation strategies of rural households to climate change and investigate the factors that expedite or halt the adoption of livelihood diversification strategies. A multistage sampling design is used in this research, where 480 rural households from the Punjab province of Pakistan were selected and interviewed using stratified and random sampling approaches. A multivariate probit (MVP) regression model is employed to analyze the factors affecting households' adoption of livelihood adaptation strategies. The results show that besides adaptation of agronomic operations (agricultural adaptation strategies), rural households in the study area employed a wide range of strategies to adapt their livelihoods to climate change. These strategies include poultry and livestock farming, value addition of farm produce, trading of animals and farm commodities, small businesses (shops, etc.), daily wage labor, horticultural crop farming, and non-farming jobs. The estimates of the MVP model revealed that respondents' education, household size, income, access to a credit facility, access to farm advisory services, and access to climate forecasts have significantly influenced the choice of livelihood adaptation strategies. Based on these findings, this research recommends that the authorities should make efforts to improve farmers' understanding of the adaptation of climate change risks and educate them to adopt multiple livelihood options to improve the resilience of their livelihoods to climate-induced risks. This research has important policy implications for other countries with similar socio-economic features.

THE ROLE OF SECONDARY SCHOOL PRINCIPALS IN THE UPPER GALILEE REGION IN ACTIVATING THE USE OF EDUCATIONAL TECHNOLOGY TOOLS

The aim of the study was to identify the role of secondary school principals in the Upper Galilee region in activating the use of educational technology tools and to detect variances owing to gender, job title, and years of experience. The descriptive survey method was utilised to fulfil the study's aims. The researcher created a questionnaire with (24) items. The stratified random sampling approach was used to choose the study sample, which consisted of (285) persons from all administrators and teachers of secondary schools in the Upper Galilee region. The findings revealed that secondary school principals in the Upper Galilee region have an important role in activating the usage of technology tools. Education was moderate, and there were no statistically significant differences at the significance level (α=0.05) due to the job title variable, but there were statistically significant differences at the significance level (α=0.05) due to the years of experience variable. In favour of teachers with less than ten years of experience, and the presence of statistically significant gender inequalities in favour of males.

Supplemental Nutrition Assistance Program and Adherence to Antihypertensive Medications

Nonadherence to antihypertensive medications is associated with uncontrolled blood pressure, higher mortality rates, and increased health care costs, and food insecurity is one of the modifiable medication nonadherence risk factors. The Supplemental Nutrition Assistance Program (SNAP), a social intervention program for addressing food insecurity, may help improve adherence to antihypertensive medications. To evaluate whether receipt of SNAP benefits can modify the consequences of food insecurity on nonadherence to antihypertensive medications. A retrospective cohort study design was used to assemble a cohort of antihypertensive medication users from the linked Medical Expenditure Panel Survey (MEPS)-National Health Interview Survey (NHIS) dataset for 2016 to 2017. The MEPS is a national longitudinal survey on verified self-reported prescribed medication use and health care access measures, and the NHIS is an annual cross-sectional survey of US households that collects comprehensive health information, health behavior, and sociodemographic data, including receipt of SNAP benefits. Receipt of SNAP benefits in the past 12 months and food insecurity status in the past 30 days were assessed through standard questionnaires during the study period. Data analysis was performed from March to December 2021. Status of SNAP benefit receipt. The main outcome, nonadherence to antihypertensive medication refill adherence (MRA), was defined using the MEPS data as the total days' supply divided by 365 days for each antihypertensive medication class. Patients were considered nonadherent if their overall MRA was less than 80%. Food insecurity status in the 30 days prior to the survey was modeled as the effect modifier. Inverse probability of treatment (IPT) weighting was used to control for measured confounding effects of baseline covariates. A probit model was used, weighted by the product of the computed IPT weights and MEPS weights, to estimate the population average treatment effects (PATEs) of SNAP benefit receipt on nonadherence. A stratified analysis approach was used to assess for potential effect modification by food insecurity status. This analysis involved 6692 antihypertensive medication users, of whom 1203 (12.8%) reported receiving SNAP benefits and 1338 (14.8%) were considered as food insecure. The mean (SD) age was 63.0 (13.3) years; 3632 (51.3%) of the participants were women and 3060 (45.7%) were men. Although SNAP was not associated with nonadherence to antihypertensive medications in the overall population, it was associated with a 13.6-percentage point reduction in nonadherence (PATE, -13.6 [95% CI, -25.0 to -2.3]) among the food-insecure subgroup but not among their food-secure counterparts. This analysis of a national observational dataset suggests that patients with hypertension who receive SNAP benefits may be less likely to become nonadherent to antihypertensive medication, especially if they are experiencing food insecurity. Further examination of the role of SNAP as a potential intervention for preventing nonadherence to antihypertensive medications through prospectively designed interventional studies or natural experiment study designs is needed.

Using the TPB model to determine factors affecting e-learning adoption in Jordanian higher education

The purpose of this study was to use the TPB Model to identify the variables influencing the adoption of e-learning in Jordanian higher education. The worldwide trend towards e-learning has resulted in considerable operational changes for Jordan's higher education institutions (HEI). There were 850 students in the sample. The proportionate stratified random sample approach was used to select them at random from the general population. To gather information, a questionnaire was developed. The tool's validity and dependability were guaranteed. An analysis of regression was done to evaluate the associations between the constructs. The findings demonstrated that attitude (AT), subjective norm (SN), and perceived behavioral control (PBC) significantly influence behavioral intention (BI). In light of the results, the researchers proposed rerunning the study in various contexts (such as additional Jordanian universities) in order to assess the validity of the enlarged research model. The sample could comprise both actual users of online learning and non-users in order to compare the findings and ascertain why e-learning is being adopted or not. The study's findings provide a framework for understanding the factors influencing faculty members' and students' intents to use e-learning at Jordanian institutions, which can be useful for students, policymakers, and system developers.

A history of recurrent pregnancy loss is associated with increased perinatal complications, but not necessarily a longer birth interval: a population study spanning 18 years.

Is there a difference in the time interval between the first and second live births among individuals with and without recurrent pregnancy loss (RPL)? Primary RPL (two or more pregnancy losses before the first live birth) is associated with a shorter time interval between the first and second live births compared with individuals without RPL, but this association is reversed in patients with secondary RPL (RPL patients with no or one pregnancy loss before the first live birth). There is limited information regarding the ability to have more than one child for patients with RPL. Previous studies have investigated the time to live birth and the live birth rate from the initial presentation to clinical providers. Most of the previous studies have included only patients treated at specialized RPL clinics and thus may be limited by selection bias, including patients with a more severe condition. We conducted a population-based retrospective cohort study of 184241 participants who delivered in British Columbia, Canada, and had at least two recorded live births between 2000 and 2018. The aim was to study the differences in the time interval between the first and second live births and the prevalence of pregnancy complications in patients with and without RPL. Additionally, 198319 individuals with their first live birth between 2000 and 2010 were studied to evaluate cumulative second live birth rates. Among individuals with at least two recorded live births between 2000 and 2018, 12321 patients with RPL and 171920 participants without RPL were included. RPL was defined as at least two pregnancy losses before 20 weeks gestation. Patients with primary RPL had at least two pregnancy losses occurring before the first live birth, while patients with secondary RPL had no or one pregnancy loss before the first live birth. We compared the time interval from the first to second live birth in patients with primary RPL, those with secondary RPL, and participants without RPL using generalized additive models to allow for a non-linear relationship between maternal age and time interval between first and second live births. We also compared prevalence of pregnancy complications at the first and second live births between the groups using non-parametric Kruskal-Wallis H test and Fisher's exact test for continuous and categorical variables, respectively. We assessed the cumulative second live birth rates in patients with primary RPL and those without RPL, among participants who had their first live birth between 2000 and 2010. Cox proportional hazards model was used to estimate and compare hazard ratios between the two groups using a stratified modelling approach. The adjusted time interval between the first and second live births was the longest in patients with secondary RPL, followed by individuals without RPL, and the shortest time interval was observed in patients with primary RPL: 4.34 years (95% CI: 4.09-4.58), 3.20 years (95% CI: 3.00-3.40), and 3.05 years (95% CI: 2.79-3.32). A higher frequency of pregnancy losses was associated with an increased time interval between the first and second live births. The prevalence of pregnancy complications at the first and second live births, including gestational diabetes, hypertensive disorder of pregnancy, preterm birth, and multiple gestations was significantly higher in patients with primary RPL compared with those without RPL. The cumulative second live birth rate was significantly lower in patients with primary RPL compared with individuals without RPL. This study may be limited by its retrospective nature. Although we adjusted for multiple potential confounders, there may be residual confounding due to a lack of information about pregnancy intentions and other factors, including unreported pregnancy losses. The results of this study provide information that will help clinicians in the counselling of RPL patients who desire a second child. This study was supported in part by a grant from the Canadian Institutes of Health Research (CIHR): Reference Number W11-179912. M.A.B. reports research grants from CIHR and Ferring Pharmaceutical. He is also on the advisory board for AbbVie, Pfizer, and Baxter. The other authors report no conflict of interest. NCT04360564.

Use of Genomics to Develop Novel Therapeutics and Personalize Hypertension Therapy.

Hypertension is a prevalent public health problem, contributing to >10 million deaths annually. Though multiple therapeutics exist, many patients suffer from treatment-resistant hypertension or try several medications before achieving blood pressure control. Genomic advances offer mechanistic understanding of blood pressure variability, therapeutic targets, therapeutic response, and promise a stratified approach to treatment of primary hypertension. Cyclic guanosine monophosphate augmentation, aldosterone synthase inhibitors, and angiotensinogen blockade with silencing RNA and antisense therapies are among the promising novel approaches. Pharmacogenomic studies have also been done to explore the genetic bases underpinning interindividual variability in response to existing therapeutics. A polygenic approach using risk scores is likely to be the next frontier in stratifying responses to existing therapeutics.

The formalization of microenterprises in middle-income countries: informal institutions as a mechanism to address institutional incongruenceLa formalización de las microempresas en los países de ingresos medios: las instituciones informales como mecanismo para abordar la incongruencia institucionalA formalização de microempresas em países de renda média: instituições informais como mecanismo de enfrentamento da incongruência institucional

Purpose The purpose of this study is to investigate the role of sales, as a proxy for size, in moderating the impact of institutional incongruence between formal and informal institutions on the formalization of microenterprises in middle-income countries in Latin America. Design/methodology/approach The paper uses a probit regression model to examine business formalization as a binary outcome of formal and informal institutions. Data was collected through interviews and surveys across 52 municipalities in the Metropolitan Region of Santiago, Chile. The study used a stratified sampling approach and was conducted between November 2022 and January 2023. Findings The results offer three key insights into the formalization of microenterprises in middle-income countries. First, we show that formal institutions do not significantly influence formalization decisions among microentrepreneurs in middle-income countries, challenging the traditional belief that formal institutions alone significantly influence formalization in these contexts. Second, we show that informal institutions are significant predictors of informality, especially among smaller microenterprises. Third, we highlight that the smaller the business, the stronger the negative effect of informal institutions on formalization, and thus, the institutional incongruence between formal and informal institutions decreases for larger businesses. Originality/value This paper contributes to management literature by shedding light on the drivers of formalization in middle-income countries, a departure from most formalization studies wherein the focus is primarily on low-income economies. The findings suggest that policymakers in middle-income countries should focus on enabling microenterprise growth through sales, rather than targeting specific demographic groups or relying solely on formal institutional enforcement to promote formalization.

Distribution of exchangeable cobalt in low-land rice cultivated soils in Sri Lanka as affected by the differences in climate, soil and water source

Cobalt (Co) is considered a beneficial element for plants. However, when soils contain excessive amounts of Co, it could cause phytotoxicity. Despite this, the current status of Co in Sri Lankan rice-cultivated soils is not known. Therefore, this study was conducted to (i) determine the distribution of exchangeable Co concentration, and (ii) examine the interactive effects of climatic zone (CZ), agro-climatic zone (ACZ), soil order, water source, and their interactions in determining exchangeable Co concentration in lowland rice fields in Sri Lanka. A total of 8,292 soil samples representing six ACZs, six soil orders, and three water sources were collected using a stratified random sampling approach. Cobalt was extracted in 0.01 M CaCl2 and measured using Inductively Coupled Plasma Mass Spectrophotometry. Exchangeable Co concentration ranged between 0.03-2,409 μg kg−1 with a mean value of 185.9 μg kg−1. Over 77.5% of the soil samples tested were Co deficient, i.e. <250 μg kg−1. Samples collected from the Intermediate zone, particularly Intermediate zone Mid country, had higher Co concentration than that reported in other ACZs (p<0.05). Among the soil orders, Histosols had higher (232 μg kg−1) and Vertisols had lower (91 μg kg−1) Co concentrations (p<0.05). Moreover, Co concentration was negatively correlated with soil pH (r=−0.3391, p<0.0001) and rice crop productivity (r=−0.1512, p<0.0001). Although exchangeable Co concentration in rice cultivated soils was low, it is important to implement strategies such as proper waste management, treatment of industrial effluents, and the use of safer and more sustainable practices in the chemical and mining industries to minimize further accumulation of Co exceeding the critical limit (i.e. 30 - 40 mg Co kg−1 rice grain), and to ensure the safety of rice production in situations where geological and anthropogenic activities can increase soil exchangeable Co concentration.