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Multiple estimates exist of global monetary and multidimensional poverty, but populations at risk of social exclusion still lack a worldwide estimate. This paper fills this gap by providing the first estimates of the share and number of populations at risk of social exclusion worldwide. The paper contributes to the literature in three important respects. First, it develops a conceptual framework of social exclusion that emphasizes the relative, multidimensional, and dynamic features of exclusion. Second, it proposes a macro-counting methodology that allows measuring populations at risk of exclusion based on identity, circumstances, and socioeconomic conditions, while advancing a protocol to avoid double counting of individuals at risk of social exclusion. Third, the empirical strategy provides to the best of our knowledge, the first estimates of populations at risk of social exclusion by dimensions of exclusion on a global and regional scale. Overall, we estimate that between 2.33 and 2.43 billion people—roughly 32 per cent of the global population—are at risk of social exclusion. The South Asia and East Asia and Pacific regions contain 1.3 billion such people, with India and China alone home to 840 million of them. Meanwhile, 52 per cent of sub-Saharan Africa's population is vulnerable to exclusion, the greatest share of any region. Our findings have important policy implications. While antipoverty policies can support household consumption and smooth its volatility among the poor, they are unlikely to address social exclusion stemming from ethnic, racial, or gender discrimination. Therefore, addressing exclusion necessitates a suite of multiple interventions tailored to distinct groups and sustained over time. [ABSTRACT FROM AUTHOR]

Background: Little is known about the effectiveness and implementation of psychosocial interventions for psychosis in low- and middle-income countries (LMICs). In South Asia, specialist psychiatric resources are scarce. Support for psychosis often falls on the family or caregiver which can increase feelings of burden, impact caregivers' wellbeing, and increase mental health stigma. Psychosocial interventions are increasingly used for psychosis in South Asia and could reduce relapse and symptoms, reduce caregiver burden, conserve cost and resources. The aim of this review was to appraise the effectiveness and implementation readiness of psychosocial interventions for people with psychosis in South Asia. Method: A systematic search was conducted on MEDLINE, PsycINFO, Global Health, and Web of Science. The review was prospectively registered on PROSPERO (CRD42022329254). Studies were rated on two scales assessing quality and implementation readiness. Results: Twenty-six papers were included, nine intervention-types including community-based interventions/assertive outreach; CaCBTp; FAP; psychoeducation; cognitive retraining/rehabilitation; social cognition/skills; family/ caregiver intervention; telehealth intervention; yoga-based intervention in six South Asian countries. Findings suggest a multicomponent community-based intervention (MCBI) was the most implementation ready due to its standardisation, good clinical outcomes for patients and caregivers, and training and cost evaluations. Conclusion: Of the included studies, MCBI and community-based outreach interventions utilising lay health workers appear to be the most implementation ready and are suggested to best address the treatment gap in South Asia. [ABSTRACT FROM AUTHOR]

Background: Women in South Asia often return to their natal home during pregnancy, for childbirth, and stay through the postpartum period—potentially impacting access to health care and health outcomes in this important period. However, this phenomenon is understudied (and not even named) in the demographic or health literature, nor do we know how it impacts health. Objective: The aim of this study is to measure the magnitude, timing, duration, risk factors and impact on care of this phenomenon, which we name Temporary Childbirth Migration. Methods: Using data from 9,033 pregnant and postpartum women collected in 2019 in two large states of India (Madhya Pradesh and Bihar) we achieve these aims using descriptive statistics and logistic regression models, combined with qualitative data from community health workers about this practice. Results: We find that about one third of women return to their natal home at some point in pregnancy or postpartum, mostly clustered close to the time of delivery. Younger, primiparous, and non-Hindu women were more likely to return to their natal home. Women reported that they went to their natal home because they believed that they would receive better care; this was born out by our analysis in Bihar, but not Madhya Pradesh, for prenatal care. Conclusions: Temporary childbirth migration is common, and, contrary to expectations, did not lead to disruptions in care, but rather led to more access to care. Contribution: We describe a hitherto un-named, underexplored yet common phenomenon that has implications for health care use and potentially health outcomes. [ABSTRACT FROM AUTHOR]

The Belt and Road Initiative (BRI) is a development plan proposed by China that aims to build a new platform for international cooperation and create new drivers of shared development. South Asia is a key area in the Belt and Road Initiative, including eight countries. As the BRI implemented, China's trade with South Asia has been gradually strengthened. This paper explores the influencing factors of China-South Asia trade under the background of the BRI by using Gravity Model of Trade. The results show that economic growth in China and South Asia, increase of savings rate and improvement of industrialization in South Asia has a significant positive effect on China-South Asia trade. While the development gap between China and South Asia has negative effect on China-South Asia trade. [ABSTRACT FROM AUTHOR]

This paper uses firm-level data worldwide to investigate productivity gaps between female and male-managed companies in developing and developed countries and compare the outcomes obtained for different regions in the world. The main aim is to shed some light on the debate around the existence of performance differences when females participate in managerial activities. The main results indicate that it is crucial to distinguish between female management and female ownership and the confluence between both. We find that when the firms have a top female manager and ownership is exclusively male, firms show higher average labor productivity. We argue that firms owned by males belong to male-dominated corporate culture and would only select a female manager if she is more competent than potential male candidates. These results are very heterogeneous among regions, of which South Saharan Africa, East Asia, and South Asia are driving the main results. [ABSTRACT FROM AUTHOR]

The study aims to investigate how foreign direct investment (FDI) and green innovation (GI) impact environmental quality in South Asia. Moreover, this study examines the moderating role of GI between FDI and environmental sustainability. We use panel data from 1995 to 2018 for five South Asian nations namely, Pakistan, India, Bangladesh, Sri Lanka, and Nepal. For the empirical analysis, we used 1st generation cointegration like Pedroni and Kao, and 2nd generation cointegration tests like Westerlund. Moreover, for the long-run relationship, we employ fully modified least squares (FMOLS) and dynamic ordinary least squares (DOLS) estimation. The study's empirical results suggest that GI significantly enhances ecological sustainability in South Asian economies; however, FDI degrades the environmental quality. Furthermore, the results suggest that GI significantly moderates the nexus of FDI and ecological sustainability in South Asia. It is recommended that South Asian countries increase green innovation with FDI so that environmental quality can be assured for the region's sustainable development. [ABSTRACT FROM AUTHOR]

Globally, 21 percent of young women are married before their 18th birthday. Despite some progress in addressing child marriage, it remains a widespread practice, in particular in South Asia. While household predictors of child marriage have been studied extensively in the literature, the evidence base on macro-economic factors contributing to child marriage and models that predict where child marriage cases are most likely to occur remains limited. In this paper we aim to fill this gap and explore region-level indicators to predict the persistence of child marriage in four countries in South Asia, namely Bangladesh, India, Nepal and Pakistan. We apply machine learning techniques to child marriage data and develop a prediction model that relies largely on regional and local inputs such as droughts, floods, population growth and nightlight data to model the incidence of child marriages. We find that our gradient boosting model is able to identify a large proportion of the true child marriage cases and correctly classifies 77% of the true marriage cases, with a higher accuracy in Bangladesh (92% of the cases) and a lower accuracy in Nepal (70% of cases). In addition, all countries contain in their top 10 variables for classification nighttime light growth, a shock index of drought over the previous and the last two years and the regional level of education, suggesting that income shocks, regional economic activity and regional education levels play a significant role in predicting child marriage. Given the accuracy of the model to predict child marriage, our model is a valuable tool to support policy design in countries where household-level data remains limited. [ABSTRACT FROM AUTHOR]

This research explores the link between stock markets and banking deposits in South Asian (Pakistan, India, Sri Lanka, Nepal) countries. This study empirically examines the systemic risk potential of financial institutions in South Asia using current systemic risk statistics. Yearly data on stock prices and banking deposits from January 2000 to December 2020 were analyzed using a two-stage process. In the first phase, we measure VaR (value at risk), and in the second step, we measure the DCC GARCH model for our empirical analysis. The study findings reveal systemic risk spillover between the stock markets of South Asian countries and the relevant country's banking system deposits. The policymakers can use our study findings to create a more sustainable financial sector. [ABSTRACT FROM AUTHOR]

Nitrogen (N) is one of the primary macronutrients required for crop growth and yield. This nutrient is especially limiting wheat yields in the dry and low fertile agro-ecologies having low N in the root zone soil strata. Moreover, majority of farmers in India and South Asia are small to marginal with meagre capacity to invest in costly nitrogen fertilizers. Therefore, there is an immense need to identify lines that use nitrogen efficiently. A set of 50 diverse wheat genotypes consisting of indigenous germplasm lines (05), cultivars released for commercial cultivation (23) and selected elite lines from CIMMYT nurseries (22) were evaluated in an alpha-lattice design with two replications, a six-rowed plot of 2.5m length for 24 agro morphological, physiological and NUE related traits during two consecutive crop seasons in an N-depleted precision field under two different N levels of 50%-N50 (T1) and 100%-N100 (T2) of recommended N, i.e., 100 kg/ha. Analysis of variance revealed significant genetic variation among genotypes for all the traits studied. About 11.36% yield reduction was observed at reduced N levels. Significant correlations among NUE traits and yield component traits were observed which indicated pivotal role of N remobilization to the grain in enhancing yield levels. Among N-insensitive genotypes identified based on their yielding ability at low N levels, UASBW13356, UASBW13358, UASBW13354, UASBW13357 and KRL1-4 showed their inherent genotypic plasticity toward N application. The genotypes with more yield and high to moderate NUtE can be used as parents for the breeding of N efficient genotypes for marginal agro-ecologies. Low N tolerant genotypes identified from the current investigation may be further utilized in the identification of genomic regions responsible for NUE and its deployment in wheat breeding programs. The comprehensive data of 24 traits under different nitrogen levels for diverse genotypes from India and global sources (mainly CIMMYT) should be useful for supporting breeding for NUE and thus will be of great help for small and marginal farmers in India and South Asia. [ABSTRACT FROM AUTHOR]

There is increasing evidence from South Asia and internationally that intimate partner violence (IPV) is strongly associated with self-harm, however its association with suicide and self-harm has not been extensively examined, nor has this relationship been explored at a national level. Using national datasets, area-level variation in IPV, suicide and self-harm in Sri Lanka were examined. In addition, the association between individual level exposure to past-year IPV and non-fatal self-harm by any household member were explored in a series of multi-level logistic regression models, adjusting for age. Similar patterns in the distribution of suicide and IPV were found, with higher rates evident in post-conflict districts, specifically Batticaloa, Kilinochchi, and Mullaitivu. Experience of past year IPV and its various forms were strongly associated with household-level self-harm in the past year (adjusted odds ratio [AOR] = 3.83 95% CI 2.27–6.46). A similar magnitude was found for physical/sexual abuse (AOR 5.17 95% CI 2.95–9.05) and psychological abuse (AOR 4.64 95% CI 2.50–7.00). A dose-response association was also evident for frequency of abuse, with an increasing risk of household-level self-harm for women reporting abuse 'less often' (AOR 2.95 95% CI 1.46–5.92), and abuse experienced 'daily, weekly, or monthly' (AOR 4.83 95% CI 2.59–9.00), compared to no abuse. This study contributes to a growing body of evidence on the relationship between IPV and suicidal behaviour in South Asia. Addressing IPV and its various forms should be a priority for suicide prevention in Sri Lanka, alongside trauma-informed approaches in post-conflict settings. [ABSTRACT FROM AUTHOR]

Global shortages of N95 respirators have led to an urgent need of N95 decontamination and reuse methods that are scientifically validated and available world-wide. Although several large scale decontamination methods have been proposed (hydrogen peroxide vapor, UV-C); many of them are not applicable in remote and low-resource settings. Heat with humidity has been demonstrated as a promising decontamination approach, but care must be taken when implementing this method at a grassroots level. Here we present a simple, scalable method to provide controlled humidity and temperature for individual N95 respirators which is easily applicable in low-resource settings. N95 respirators were subjected to moist heat (>50% relative humidity, 65–80°C temperature) for over 30 minutes by placing them in a sealed container immersed in water that had been brought to a rolling boil and removed from heat, and then allowing the containers to sit for over 45 minutes. Filtration efficiency of 0.3–4.99 μm incense particles remained above 97% after 5 treatment cycles across all particle size sub-ranges. This method was then repeated at a higher ambient temperature and humidity in Mumbai, using standard utensils commonly found in South Asia. Similar temperature and humidity profiles were achieved with no degradation in filtration efficiencies after 6 cycles. Higher temperatures (>70°C) and longer treatment times (>40 minutes) were obtained by insulating the outer vessel. We also showed that the same method can be applied for the decontamination of surgical masks. This simple yet reliable method can be performed even without electricity access using any heat source to boil water, from open-flame stoves to solar heating, and provides a low-cost route for N95 decontamination globally applicable in resource-constrained settings. [ABSTRACT FROM AUTHOR]

This study establishes a risk index system to evaluate the financial risks of foreign agricultural investment in Belt and Road countries. Agricultural foreign investment risk prevention has emerged as a crucial concern across various sectors globally. We assess the four key dimensions such as political and military risk, economic market risk, social and cultural risk, and resource and environmental risk. We employ the Vertical and Horizontal Leveling Method and Entropy Weighting Method (VHSD-EM) for measuring and analyzing foreign agricultural investment risk levels in Belt and Road countries from 2014 to 2021. Moreover, we used spatial correlation analysis, the Getis-Ord Gi* statistic, to identify hot and cold spots of agricultural foreign investment risks. First political & military, and environmental risks are the main influencing factors of agricultural foreign investment risk. The average AFDI level exceeded in Southeast and South Asia, and certain spillover effects were found in Southeast Asia. Second, the Belt and Road" initiative effectively reduces the risk of AFDI and helps to weaken the spillover effect among fellow countries. A significant spillover effect in AFDI from neighboring countries can lead to high-risk areas for sustained AFDI formation. Third to address such challenges, the Chinese government has prerequisites to enhance foreign agricultural investments in Belt and Road countries and establish a measurement index for agricultural investment risks. Government needs to establish a public service system to enhance the development of large-scale multinational agricultural enterprises. Foreign cooperation is essential for multi and bilateral investment negotiation and optimizing the financial tools to mitigate agricultural foreign direct investment risk in Belt and Road countries. [ABSTRACT FROM AUTHOR]

Background: Many low-income countries continue to have high fertility levels and unmet need for family planning (FP) despite progress in increasing access to modern contraceptive methods and in reducing the total fertility rate (TFR). Health facilities in sub-Saharan Africa (SSA) and South Asia (SA) are thought to be unable to adequately deal with the burden of high unmet FP demands due to their weaker health systems. As a result, determining the readiness of health facilities that offer FP services is critical for identifying weaknesses and opportunities for continued development of FP health systems in those regions. Service Provision Assessment (SPA) tools—which break down health systems into measurable, trackable components—are one useful way to assess service readiness and the ability of health institutions to deliver FP services. Methods: Using data from nationally representative SPA surveys, we conducted a study that aimed to: (1) evaluate healthcare facilities' readiness to provide FP services; and (2) identify the factors that affect FP service readiness. Using a cross-sectional survey design, we used data from SPA surveys conducted in 10 low-resource SA and SSA countries: Afghanistan, Bangladesh, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Tanzania, and the Democratic Republic of the Congo (DRC). We analyzed data from public and private health facilities in Afghanistan (84), Bangladesh (1,303), Kenya (567), Malawi (810), Namibia (357), Nepal (899), Rwanda (382), Senegal (334), Tanzania (933), and the DRC (1,061) for a total of 6,730 facilities. We used 17 items/indicators recommended by the Service Availability and Readiness Assessment to measure a health facility's readiness to provide FP services across four domains. Results: Only 3.6% to 34.1% of the health facilities were reporting at least 75% (12–13 of 17) of the relevant items for FP service provision. Most of the health facilities in the countries under investigation suffered from lack of readiness, meaning that they did not fulfill at least 75% of the standards (12–13 items of 17 items on the availability of trained staff and guidelines, equipment, and commodities components). The factors associated with higher readiness scores varied among the 10 countries analyzed. Regression models showed that increases in the number of FP healthcare providers available at a health facility and infection control measures for FP exams were factors linked to increased readiness scores in all 10 countries. The low readiness of health facilities to provide FP services in the countries studied showed that the health systems in these low-resource settings faced significant problems with providing FP services. Differences in country-specific variability in the characteristics linked with better preparedness ratings could be attributed to data collected across different years in different nations or to country-specific healthcare financing policies. Conclusions: To increase a health facility's readiness to offer FP services, country-specific factors must be addressed, in addition to common factors found in all 10 countries. Further research is required to determine the causes of country-level differences in FP tracer item availability to develop targeted and effective country-specific strategies to improve the quality of FP services in the SA and SSA regions and address unmet need for FP. [ABSTRACT FROM AUTHOR]

In recent years, the landscape ecological security of Xishuangbanna in southwest China has become an essential factor affecting the cross-border ecological security in South Asia and Southeast Asia. Based on the change of land use in Xishuangbanna, with the help of "3S" technology, landscape ecology theory, and gray prediction model, the spatial and developmental trends of landscape ecological security in Xishuangbanna from 1996–2030 could be determined. In more than 20 years, the woodland landscape area in Xishuangbanna decreased, and the fragmentation of construction land has increased overall. In 1996, the overall landscape ecological safety was good, with 63.5% of the total area of grade I and II. In 2003, the proportion of the grade I and grade II areas decreased, with landscape ecological security problems appearing. In 2010, the overall landscape ecological security area reached 74.5%, the largest proportion in more than 20 years. The grade V area accounted for only 9% and was mainly distributed on the border of Menghai County and central Jinghong City. In 2017, The grade IV and V areas was further increased, and the ecological security problem intensified. The prediction results showed that from 2023 to 2030, the regions of grades I and II increased, but the proportion of level V regions increased. Furthermore, the grade IV transformed to grade V rapidly, reaching its highest value in more than 20 years. From 1996 to 2030, the landscape ecological security space significantly evolved, showing an evident "east-south" trend in movement and eventually shifting to the southeast. [ABSTRACT FROM AUTHOR]

Access to adequate and nutritious food is important for the current and future health of adolescent girls. Interventions often focus on the individual as responsible for their own health ignoring the complex structural issues that underlie optimal nutrition. In South Asia gender inequalities have been noted as an important determinant of poor nutrition among women and their young children, but analysis of adolescent girls' diets and what influences these are rarely undertaken. Therefore, we sought to analyse the factors affecting what and where girls' eat and what affects their behaviour in the plains of Nepal, using a cultural-ecological approach. We analysed a secondary qualitative dataset of focus group discussions with adolescent girls aged 12–19 years old, young mothers, mothers-in-law, and older female key informants. Eating was heavily influenced by patriarchal norms. Boys had preferential access to food, money, and freedom of movement to appreciate their future role in providing for the family. Food was an investment, and boys were perceived to have more nutritional need than girls. Girls were not perceived to be a good return on investment of food, and eating practices sought to prepare them for life as a subservient daughter-in-law and wife. Obedience and sacrifice were valued in girls, and they were expected to eat less and do more housework than boys. Girls' eating and behaviour was constrained to maintain self and family honour. Interventions should acknowledge cultural influences on eating and engage multiple actors in addressing harmful gender norms which limit eating and prevent girls from reaching their potential. [ABSTRACT FROM AUTHOR]

Objective: Mental health problems among older adults are becoming a growing public health concern in South Asia due to continued changes in population dynamics caused by declining fertility rates and increasing life expectancy. This scoping review aimed to explore and summarize evidence about mental health interventions and their impacts on geriatric mental health and highlight gaps and areas for future research. Methods: We searched six electronic databases and additional sources for experimental/non-experimental studies evaluating the effectiveness of geriatric mental health interventions in eight countries in the South Asia region from the date of inception of each database up to August 5, 2022. Following the preliminary screening, we extracted data from the eligible articles using a Microsoft Excel data extraction worksheet. We followed Joanna Briggs Institute (JBI) guidelines for this scoping review and reported evidence adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Results: From a total of 3432 potential articles retrieved, 19 were included in this review following pre-determined eligibility criteria. Across studies, mental health interventions can be broadly categorized into the following types– 1) traditional Yoga, Tai chi, or other meditative movements; 2) behavioral, occupational, or learning-based interventions; 3) tech-based interventions; 4) music therapy; and 5) new healthcare model. The evidence was predominantly based on India (n = 16), whereas three articles were identified from Pakistan. No article was found from six other South Asian countries. Depression and anxiety were the most frequent mental health outcomes, followed by quality of life, cognitive function, self-esteem, physical performance, and many more. Conclusion: Although limited, this review found various interventions that have varying effects on different geriatric mental health outcomes. A handful of evidence on mental health intervention in South Asia indicates a lack of acknowledgment that may develop a serious paucity of geriatric mental health practice. Therefore, future researchers are encouraged to conduct empirical studies to understand disease burden, including associated factors of geriatric mental health, which may help to construct contextually appropriate mental health interventions in this region. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of smoking is high among people living with severe mental illness (SMI). Evidence on feasibility, acceptability and effectiveness of smoking cessation interventions among smokers with SMI is lacking, particularly in low- and middle-income countries. We aim to test the feasibility and acceptability of delivering an evidence-based intervention,i.e., the IMPACT smoking cessation support for people with severe mental illness in South Asia (IMPACT 4S) intervention that is a combination of behavioural support and smoking cessation pharmacotherapies among adult smokers with SMI in India and Pakistan. We will also test the feasibility and acceptability of evaluating the intervention in a randomised controlled trial. Methods: We will conduct a parallel, open label, randomised controlled feasibility trial among 172 (86 in each country) adult smokers with SMI in India and Pakistan. Participants will be allocated 1:1 to either Brief Advice (BA) or the IMPACT 4S intervention. BA comprises a single five-minute BA session on stopping smoking. The IMPACT 4S intervention comprises behavioural support delivered in upto 15 one-to-one, face-to-face or audio/video, counselling sessions, with each session lasting between 15 and 40 minutes; nicotine gum and/or bupropion; and breath carbon monoxide monitoring and feedback. Outcomes are recruitment rates, reasons for ineligibility/non-participation/non-consent of participants, length of time required to achieve required sample size, retention in study and treatments, intervention fidelity during delivery, smoking cessation pharmacotherapy adherence and data completeness. We will also conduct a process evaluation. Results: Study will address- uncertainty about feasibility and acceptability of delivering smoking cessation interventions, and ability to conduct smoking cessation trials, among adult smokers with SMI in low- and middle-income countries. Conclusions: This is to inform further intervention adaptation, and the design and conduct of future randomised controlled trials on this topic. Results will be disseminated through peer-review articles, presentations at national, international conferences and policy-engagement forums. Trial registration: ISRCTN34399445 (Updated 22/03/2021), ISRCTN Registry https://www.isrctn.com/. [ABSTRACT FROM AUTHOR]

Objective: Anemia and Diabetes Mellitus (DM) are amongst major clinical and public health challenges in South Asia that influence the progression of chronic health problems in this population. Despite a growing body of research on these problems, there is a lack synthesized evidence on the burden of anemia among people with DM in this region. This meta-analytic review was conducted to estimate the prevalence of anemia among people with DM in South Asia. Methods: A systematic search of the literature was conducted in five primary databases and additional sources up to July 29, 2022, that reported the prevalence of anemia among DM patients in any of the eight South Asian countries. Observational studies that met pre-determined eligibility criteria according to the protocol registered in PROSPERO (CRD42022348433) were included in this meta-analysis. Random effect models were used to estimate pooled prevalence. Results: Of the 40 eligible studies, 38 underwent meta-analysis representing 14,194 participants with DM. The pooled prevalence of anemia was 45% (95% CI: 37.0–54.0, I2 = 99.28%, p = 0.00) among diabetic people in South Asia. In sub-group analysis, the pooled prevalence of anemia was higher in females (48%, 95% CI: 37.0–60.0, I2 = 98.86%, p = 0.00) compared to males (39%, 95% CI: 29.0–48.0, I2 = 98.18%, p = 0.00). Diabetic patients with older age (≥ 50 years) reported higher pooled estimates of anemia (48%, 95% CI: 38.0–58.0, I2 = 99.07%) than younger age group (< 50 years) (34%, 95% CI: 21.0–47.0, I2 = 98.83%). In addition, we found variation in pooled prevalence estimates of anemia considering the type of DM, such as type 1 reported 2% (95% CI: 0.00–4.00), type-2 reported 48% (95% CI: 40.0–56.0, I2 = 98.94%), and Gestational diabetes mellitus (GDM) reported 6% (95% CI: 3.00–12.0). Conclusion: High pooled estimates of anemia among diabetic patients in South Asia, including publication bias, warrants further clinical and public health research following standard research methods to understand the more context-specific epidemiological insights and evidence. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate how genres vary and figure out the factors that generate genre variation. The quantitative multi-dimensional analysis is used to examine genre variation of cross-border e-commerce English in South Asia. The texts in the observed corpus collected from four country websites of Daraz, a significant cross-border e-commerce platform, were tagged and analyzed using Multidimensional Analysis Tagger and SPSS statistical software. The results of linear regression analysis, independent sample t-test and Analysis of Variance show salient differences between the observed corpus and reference corpus. The research also indicates that four sub-corpora from country Websites are brought into line with each other. They show salient differences (p<0.05) with the general corpus in two dimensions of linguistic variation. The findings indicate that variables that lead to the cross-border e-commerce English genre variation might be attributable to cultural backgrounds, regional market sizes, and fundamental internet facilities. In conclusion, these findings lend significant empirical support to systemic functional theories and suggest further research in the application of a multi-dimensional analysis approach in the cross-border e-commerce English genre. [ABSTRACT FROM AUTHOR]

A large literature has demonstrated the link between poverty and mental ill-health. Yet, the potential causal effects of poverty alleviation measures on mental disorders are not well-understood. In this systematic review, we summarize the evidence of the effects of a particular kind of poverty alleviation mechanism on mental health: the provision of cash transfers in low- and middle-income countries. We searched eleven databases and websites and assessed over 4,000 studies for eligibility. Randomized controlled trials evaluating the effects of cash transfers on depression, anxiety, and stress were included. All programs targeted adults or adolescents living in poverty. Overall, 17 studies, comprising 26,794 participants in Sub-Saharan Africa, Latin America, and South Asia, met the inclusion criteria of this review. Studies were critically appraised using Cochrane's Risk of Bias tool and publication bias was tested using funnel plots, egger's regression, and sensitivity analyses. The review was registered in PROSPERO (CRD42020186955). Meta-analysis showed that cash transfers significantly reduced depression and anxiety of recipients (dpooled = -0.10; 95%-CI: -0.15, -0.05; p<0.01). However, improvements may not be sustained 2–9 years after program cessation (dpooled = -0.05; 95%-CI: -0.14, 0.04; ns). Meta-regression indicates that impacts were larger for unconditional transfers (dpooled = -0.14; 95%-CI: -0.17, -0.10; p<0.01) than for conditional programs (dpooled = 0.10; 95%-CI: 0.07, 0.13; p<0.01). Effects on stress were insignificant and confidence intervals include both the possibility of meaningful reductions and small increases in stress (dpooled = -0.10; 95%-CI: -0.32, 0.12; ns). Overall, our findings suggest that cash transfers can play a role in alleviating depression and anxiety disorders. Yet, continued financial support may be necessary to enable longer-term improvements. Impacts are comparable in size to the effects of cash transfers on, e.g., children's test scores and child labor. Our findings further raise caution about potential adverse effects of conditionality on mental health, although more evidence is needed to draw robust conclusions. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) is a mental disorder that can occur after trauma. Although inflammatory markers such as cytokines are found altered in trauma and PTSD, there is no consensus regarding which can be considered as biomarkers. Studies from South Asia region is also rare. We studied cytokines among trauma affected patients and matched healthy controls. Fifty patients (cases) with trauma, visiting the University hospital in Kathmandu and thirty-nine healthy controls were selected, and the levels of cytokines were determined using a Luminex IS 200. We compared the levels of the cytokines in thirty-four age and gender matched pairs of case and control among three groups: healthy volunteers, cases diagnosed as PTSD, and cases without PTSD. Among the 34 pair-matched cases and controls, IL-6 was significantly higher in both PTSD positive cases [2.43 (0.00–14.54) pg/ml; p = 0.004] and PTSD negative cases [3.00 (0.92–3.86) pg/ml; p = 0.005], than in controls [0.39 (0.00–11.38) pg/ml]. IL-1β was significantly higher in PTSD positive cases [0.17 (0.00–5.27) pg/ml; p = 0.011] than in controls 0.00 (0.00–0.12) pg/ml. Other cytokines did not show significant differences. IL-6 was higher in both the trauma affected groups and IL-1β was higher in the trauma affected group with PTSD when compared to healthy controls. This supports the immune system activation hypothesis after trauma. [ABSTRACT FROM AUTHOR]

This study aims to identify and examine the different perception of benefit sharing in the sharing of international rivers in China, South Asia and Southeast Asia. Using the Q-Method, this study undertakes an in-depth analysis of the views of 35 experts of the field on hydrodiplomacy, international water law, benefit sharing and ecological benefits compensation. The results of the quantitative and qualitative analysis help to innovatively identify three streams of views among the participants, respectively described as supporters, idealists and pragmatists, each displaying strong geographical association to the three Asian regions. Supporters from Southeast Asia and pragmatists from China share much common ground on issues such as the types of benefits to share in international rivers, potentially providing the conceptual foundation for international cooperation. Idealists from South Asia prioritize and emphasise the role and importance of environmental benefits and ecological protection, yet differ greatly from the others on practical issues such as the inclusion of direct economic benefits and ecological compensation for using resources. This study contributes to the understanding of the theory and practice of benefit sharing in international rivers, as well as providing new perspectives to the interpretation and practice of hydrodiplomacy in Asian regions. [ABSTRACT FROM AUTHOR]

The post Covid-19 era steer towards stakeholder thinking, which demands to look for sustainable solutions in terms of other epidemics and food security is one of the most notable for the developing world. In South Asia, China Pakistan Economic Corridor could be an avenue for multi-layered socio-economic assistance where Pakistan can seek solution for one epidemic (food security) while engaged with the effects of pandemic through studying all the stakeholders. This could be a roadmap for the west-east or developed-underdeveloped countries reliance on one another for food security through economic corridor alike settings. Academically, it has been projected by the plethora of research that holistically and inclusively, stakeholder analysis is lacking in the available reservoir of research. Methodologically, the stakeholder analysis was performed in three layers–identification, investigation through social networks, and communication by prioritization matrix. The findings suggested that apart from stakeholders' differences in regard to interest, influence and knowledge, all of them agreed with the argument that China Pakistan Economic Corridor has enviably and irrefutably positive effects on food security. The policy implications project the need for integrated reports of various ministries to be unidirectional for having synergical effect and taking all the stakeholders into consideration as leaving any group behind will repeat the past results. [ABSTRACT FROM AUTHOR]

Background: Naswar is a moist, non-chewable, and smokeless tobacco product ensconced in the buccal vestibule or floor of the mouth. Consumption of naswar is very popular in South Asia, especially Pakistan. This cross-sectional study compared the periodontal clinical parameters amongst mild, moderate, and severe naswar users. Methods: 318 naswar users, categorized into three equal groups (n = 106) severe naswar users, moderate naswar users, and mild naswar users were drawn for this study. Bleeding on probing, pocking depth, gingival recession, and attachment loss were assessed using the UNC-15 probe and compared among the three groups of naswar users. Data analysis was done with the help of SPSS. Statistical significance was deliberated at p value ≤0.05. Results: 28.9 ± 7.6 years was the mean age presentation. The mean % of bleeding on probing score was 61.95% in severe naswar users, 56.62% in moderate naswar users, and 51.23% in mild naswar users with a p-value of 0.001*. In severe, moderate, and mild naswar users the probing pocket depth (4-6mm) were 35.14%, 30.95%, and 23.21% respectively. 26.78% severe naswar users were having mean percentage for probing pocket depth (>6m) followed by moderate naswar users (17.26%) and mild naswar users (17.26%) with a significant p-value (0.001*). Clinical attachment loss (CAL) was 2.50 percent in light naswar users, 3.0 percent in moderate naswar users, and 4.25 percent in severe naswar users. Clinical attachment loss (CAL) was 2.50 percent in light naswar users, 3.0 percent in moderate naswar users, and 4.25 percent in severe naswar users. Severe naswar users had a high mean percentage of gingival recession (23.21%), whereas light 13.67 percent and moderate 14.88 percent naswar users had a smaller difference. Conclusions: Clinical periodontal parameters were more worsen in heavy naswar users compared to moderate and light naswar users. [ABSTRACT FROM AUTHOR]

The research on crop genetic enhancement has created a continuous flow of new, improved germplasm for the benefit of farmers and consumers of the Global South during and after the Green Revolution. Understanding farmers' heterogeneous preferences for varietal traits in different market segments and incorporating the prominent ones in crop breeding programs are expected to facilitate a faster diffusion of these new varieties. Albeit knowing little about farmers' trait preferences in South Asia, public-sector breeding programs prioritize yield enhancement and risk reduction over other varietal traits. Against this backdrop, we examined wheat farmers' preferences for varietal traits in Central India, where the prevailing varietal turnover rate has been meager. We conducted a ranking exercise among 120 individuals, followed by a sex-disaggregated survey with a choice experiment among 420 farm-households in 2019. The lowest varietal turnover rate was observed for the socially marginalized castes. Most women respondents were not actively involved in making decisions related to wheat cultivation, including varietal selection. However, the results indicate that marginalized caste and women farmers are open to experimentation with new varieties, as shown by their positive willingness to pay for improved varietal traits. Across the gender and caste groups, grain quality attributes (especially chapati quality) were ranked high, above the yield-enhancing and risk-ameliorating traits. From the observed patterns, one could deduce that developing and disseminating improved varieties with better grain quality and targeting women and marginalized social groups in varietal dissemination programs could enhance farmer adoption of new, improved germplasm and wheat productivity in Central India. [ABSTRACT FROM AUTHOR]

Objective: Theological beliefs play an important role in cultural norms and could impact women's prenatal and postpartum decisions in South Asia, which has a high burden of disease in children and pregnant women. The aim of this study is to identify any associations religion may have in affecting a woman's decision-making ability, and how that in turn affects maternal and child health, at a group level in multiple South Asian countries. Study design: Cross-sectional study utilizing secondary data analysis. Methods: We used Demographic and Health Surveys (DHS) between 2014 and 2018 in Afghanistan, Bangladesh, India, Maldives, Myanmar, Nepal, and Pakistan. Not every country's survey asked about religion, so we imputed these results based on Census data. We assessed maternal and child health through a composite coverage index (CCI), which accounts for family planning, attendance of a skilled attendant at birth, antenatal care, BCG vaccinations, 3 doses of diphtheria-tetanus-pertussis vaccine, measles vaccine, oral rehydration therapy, and seeking care if the child has pneumonia. The relationship between religion, women's empowerment, and CCI was assessed through linear regression models. Results: The sample included 57,972 mothers who had children aged 12–23 months. CCI is observed to be affected by family income, in addition to religion and country. CCI was higher in Hindus (2.8%, 95% CI: 2.4%, 3.1%) and Buddhists (2.0%, 95% CI: 1.2%, 2.9%) than Muslims. Mother's age, education, income, decision-making autonomy, and attitude towards beatings were all related to CCI. In a model stratified by religion, age, education, and income were significant predictors of CCI for both Muslims and non-Muslims, but were more impactful among Muslims. Conclusion: Though multiple imputation had to be used to fill in gaps in religion data, this study demonstrates that maternal and child health outcomes continue to be a concern in South Asia, especially for Muslim women. Given the importance of religious beliefs, utilizing a simple indicator, such as the CCI could be helpful for monitoring these outcomes and provides a tangible first step for communities to address gaps in care resulting from disparities in maternal empowerment. [ABSTRACT FROM AUTHOR]

The emergence of Neolithic economies and their spread through Eurasia was one of the most crucial transitions of the Holocene, with different mechanisms of diffusion—demic, cultural—being proposed. While this phenomenon has been exhaustively studied in Europe, with repeated attempts to model the speed of Neolithic diffusion based on radiocarbon dates, much less attention has been devoted to the dispersal towards the East, and in particular to South Asia. The Neolithic in the latter region at least partly derived from southwest Asia, given the presence of "founder crops" such as wheat and barley. The process of their eastward diffusion, however, may have been significantly different to the westward dispersal, which was mainly due to demic diffusion, as local domesticates were already available and farming was already practiced in parts of South Asia. Here, we use radiocarbon dates specifically related to the spread of the southwest Asian Neolithic crops to model the speed of dispersal of this agricultural package towards South Asia. To assess potential geographical and environmental effects on the dispersal, we simulate different speeds depending on the biomes being crossed, employing a genetic algorithm to search for the values that most closely approach the radiocarbon dates. We find that the most important barrier to be crossed were the Zagros mountains, where the speed was lowest, possibly due to topography and climate. A large portion of the study area is dominated by deserts and shrublands, where the speed of advance, albeit closer to the range expected for demic diffusion, was lower than observed in Europe, which can also potentially be attributed to environmental constraints in the adaptation of the crops. Finally, a notable acceleration begins in the Indus valley, exceeding the range of demic diffusion in the tropical and subtropical environments east of the Indus. We propose that the latter is due to the rapid diffusion among populations already familiar with plant cultivation. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has changed the course of human development. In this manuscript we analyze the long-term effect of COVID-19 on poverty at the country-level across various income thresholds to 2050. We do this by introducing eight quantitative scenarios that model the future of Sustainable Development Goal 1 (SDG1) achievement using alternative assumptions about COVID-19 effects on both economic growth and inequality in the International Futures model. Relative to a scenario without the pandemic (the No COVID scenario), the COVID Base scenario increases global extreme poverty by 73.9 million in 2020 (the range across all scenarios: 43.5 to 155.0 million), 63.6 million in 2030 (range: 9.8 to 167.2 million) and 57.1 million in 2050 (range: 3.1 to 163.0 million). The COVID Base results in seven more countries not meeting the SDG1 target by 2030 that would have achieved the target in a No COVID scenario. The most pessimistic scenario results in 17 more countries not achieving SDG1 compared with a No COVID scenario. The greatest pandemic driven increases in poverty occur in South Asia and sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Considerable confusion and uncertainty persist on the cultural and chronological contexts of Holocene microlithic assemblages reported from South Asia. The paucity of securely dated sites with microlithic remains has compounded the confusion. Evidence from sites securely attributed to the Mesolithic based on a holistic approach (including direct evidence of plant and animal exploitation strategies) is needed to provide a better understanding of Mesolithic lithic tool-kits. This study uses morphometric and statistical methods to assess the nature of the Holocene hunter-gatherer microlithic tools-kit from a radiometrically secured chronological context at Vaharvo Timbo, a recently excavated Mesolithic site in North Gujarat (India). The assemblage is further compared with the nearby contemporary site of Loteshwar to highlight similarities and differences within hunter-gatherer lithic assemblages, understanding which can provide detailed information about subsistence strategies as well as patterns of settlement and mobility. The results show general standardisation between these two sites regarding raw materials and manufacturing technique but variation in the relative abundance of tool types between these two sites, despite their close proximity, indicating diverse strategies of resource exploitation by the Holocene hunter-gatherer groups in western India. [ABSTRACT FROM AUTHOR]

Background: Neonatal mortality remains a public health problem in the developing world. Globally, around 2.5 million neonatal deaths are reported annually with the highest mortality concentrated in sub-Saharan Africa and South Asia. In comparison with countries demonstrating the lowest neonatal mortality, the risk of mortality is over 30 times higher in sub-Saharan Africa. Ethiopia is among the countries with a high neonatal mortality rate, and the burden of this mortality remains unreported in many pastoralist areas such as Somali Regional State, Eastern Ethiopia. We aimed to investigate factors associated with neonatal mortality in public Hospitals of the Somali Regional State in Eastern Ethiopia. Methods: A facility-based cross-sectional study was conducted from May 1st to 30th, 2020 in three public Hospitals of Somali Regional State in Eastern Ethiopia. A total of 510 neonates admitted to neonatal intensive care units from January 2018 to December 2019 were enrolled in the study. The charts of neonates were randomly selected and retrieved. Data were collected using a pretested and validated structured questionnaire. The collected were entered into Epidata version 3.1 and exported to SPSS version 22 (IBM SPSS Statistics, 2013) for further analysis. Descriptive statistics were carried out using frequency tables, proportions, and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using adjusted odds ratio (AOR) with 95% Confidence Interval (CI). Statistical significance was considered at a p-value <0.05. Results: Overall, the neonatal mortality was 18.6% [95%CI (15.31, 22.30)], equating to a rate of 186 per 1000 live births. The most common causes of mortality were prematurity (44.6%), low birth weight (33.5%), and birth asphyxia (27.6%). In the final model of multivariable analysis, predictors such as: lack of antenatal care follow-up[AOR = 3.71, 95%CI (2.13, 6.44)], neonatal sepsis [AOR = 1.84, 95%CI (1.07, 3.19], preterm birth [AOR = 2.20, 95%CI (1.02, 4.29], and birth asphyxia [AOR = 2.40, 95%CI(1.26,4.43)], and birth weight of less than 2500gms[AOR = 3.40, 95%CI(1.92, 6.01)] were statistically associated with neonatal mortality. Conclusion: In this study, the neonatal mortality rate was high compared to national and global targets because one in five neonates dies due to preventable causes. Modifiable and non-modifiable risk factors were identified as predictors. This result calls for all stakeholders to provide due attention to low birth weight and premature babies. Early identification and management of birth asphyxia and neonatal sepsis are also very crucial to reduce the risks of neonatal deaths. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore energy prices and their impact on household consumption under the condition of Keynesian consumption theory in South Asian countries over the 1995–2020 periods. By employing the panel ordinary least square model estimation technique, the study attempted to find the relationship between household income and consumption under the theory of Keynesian consumption function. Furthermore, we investigated the relationship between household consumption and environmental sustainability, policy mix variables, and energy pricing. First of all, this study confirms the existence of Keynesian consumption theory in these economies of South Asia. Furthermore, energy pricing, environmental sustainability, and inflation rate are the factors that inducing toward high household consumption in South Asia. Considering the policy mix factors, inflation rate contribution positively while tax rate inducing this consumer for low household consumption. Based on the empirical analysis, this study suggested some parameters to these Asian economies particularly and other similar economies generally. [ABSTRACT FROM AUTHOR]

Objective: We assessed the association between household decision-making and mental well-being among Asian immigrant women residing in Korea. We also investigated if the impact varies by the regional origin and examined potential factors for joint decision-making. Methods: We conducted a cross-sectional study using the Korean National Survey of Multicultural Families 2015 and logistic regression. We analyzed data from 11,188 married immigrant women ages 20 to 59 who were originally from East Asia or Southeast/South Asia and co-living with their spouses. We defined households as joint-decision, wife-decision, or husband-decision based on who decides how living expenses are spent. Mental well-being encompassed a depressive mood for two consecutive weeks, and life and marital satisfaction. Results: After controlling for covariates, we showed that immigrant women in husband-decision households were more likely to have depressive mood (odds ratio [OR] 1.26, 95% confidence interval [CI]: 1.14–1.38), poorer life satisfaction (OR 1.49, 95% CI: 1.24–1.78), and poorer marital satisfaction (OR 1.81, 95% CI: 1.47–2.22) than women in joint-decision households. Immigrant women in wife-decision households had a similar but slightly lower odds of poor mental well-being. This association was less prominent for Southeast/South Asian origin than East Asian origin, while the age-adjusted prevalence rates of poor mental well-being among them were higher than their East Asian counterparts. Factors that restricted the odds of husband-decision did not necessarily guarantee wife-decision. Conclusions: This study suggests one-sided decision-making can be a risk factor for immigrant women's poor mental well-being, while joint decision-making is protective. Differences across regional origins suggest domestic decision-making might be a less important predictor for mental well-being in immigrants more occupied with adapting to the host society. Factors for joint decision-making should be addressed to improve the mental well-being of immigrant women. [ABSTRACT FROM AUTHOR]

Mineral soda alumina (m-Na-Al) glass is a common glass production group found around the Indo-Pacific region. In Iron Age Taiwan, its presence dates back to the early 1st millennium AD. This research discusses m-Na-Al glass beads excavated from Iron Age sites in Taiwan. No production sites for m-Na-Al have been found, but microstructural analysis suggests m-Na-Al glass appears to originate around South Asia and is exchanged widely. SEM-EDS and EPMA were used to analyse red, orange, yellow, green and blue m-Na-Al glass. The microstructure of the glass shows the presence of plagioclase and alkali feldspar relics in the glass, suggesting a low manufacturing temperature. Copper-based colourants are identified in red, orange, blue and green glass, while lead tin oxide is used in yellow and green glass. It appears that various types of copper-containing raw materials were procured by craftspeople, and a self-reduction process for producing red and orange glass is tentatively proposed. Additionally, the microstructure of yellow glass reveals different colouring paths were used. These results increase our understanding of the selection of raw materials, and provide an impetus for further research on the cross craft interaction between glass and copper production. [ABSTRACT FROM AUTHOR]

Introduction: Women experience high rates of depression, particularly during pregnancy and the postpartum periods. Using population-based data from Bangladesh and Pakistan, we estimated the burden of antenatal depression, its risk factors, and its effect on preterm birth. Methods: The study uses the following data: maternal depression measured between 24 and 28 weeks of gestation using the 9–question Patient Health Questionnaire (PHQ-9); data on pregnancy including an ultrasound before 19 weeks of gestation; data on pregnancy outcomes; and data on woman's age, education, parity, weight, height, history of previous illness, prior miscarriage, stillbirth, husband's education, and household socioeconomic data collected during early pregnancy. Using PHQ-9 cutoff score of ≥12, women were categorized into none to mild depression or moderate to moderately severe depression. Using ultrasound data, preterm birth was defined as babies born <37 weeks of gestation. To identify risk ratios (RR) for antenatal depression, unadjusted and adjusted RR and 95% confidence intervals (CI) were calculated using log- binomial model. Log-binomial models were also used for determining the effect of antenatal depression on preterm birth adjusting for potential confounders. Data were analyzed using Stata version 16 (StataCorp LP). Results: About 6% of the women reported moderate to moderately severe depressive symptoms during the antenatal period. A parity of ≥2 and the highest household wealth status were associated with an increased risk of depression. The overall incidence of preterm birth was 13.4%. Maternal antenatal depression was significantly associated with the risk of preterm birth (ARR, 95% CI: 1.34, 1.02–1.74). Conclusion: The increased risk of preterm birth in women with antenatal depression in conjunction with other significant risk factors suggests that depression likely occurs within a constellation of other risk factors. Thus, to effectively address the burden of preterm birth, programs require developing and providing integrated care addressing multiple risk factors. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) estimates 2.1 billion people lack access to safely managed water. Cloth filtration is often employed in rural and developing communities of South Asia for point-of-use water treatment, but bacteria and viruses are too small for efficient removal by this filtration method. Chitosan is a biodegradable, cationic, organic polymer derived from the chemical treatment of chitin that acts as a coagulant and flocculant of contaminant of microbes and other particles in water, thereby facilitating filtration of microbes. This research 1) evaluated the use of chitosan acetate as a pre-treatment coagulation-flocculation process followed by cloth filtration for microbial reductions and 2) assessed floc particle size under three stirring conditions. E. coli KO11 bacteria and MS2 coliphage virus removals were quantified using culture-based methods. Chitosan acetate coagulation-flocculation pre-treatment of water, followed by cloth filtration, met or exceeded the protective (2-star) WHO performance levels for bacteria (2 log10 reduction) and viruses (3 log10 reduction), and filtrate turbidity was consistently reduced to < 1 NTU, meeting United States Environmental Protection Agency (EPA) and WHO targets. [ABSTRACT FROM AUTHOR]

Economic vulnerability is an important indicator to measure regional coordination, health and stability. Despite the importance of vulnerabilities, this is the first study that presents 26 indicators selected from the dimensions of the domestic economic system, external economic system and financial system in the Belt and Road Initiative (BRI) countries. A quantitative analysis is conducted to analyze the characteristics of spatial heterogeneity of vulnerability of the economic subsystems and the comprehensive economic system of the BRI countries and the main influencing factors of the comprehensive economic system vulnerability (CESV) are identified based on obstacle degree model. The results show that the CESV of the East Asia, South Asia and ASEAN countries are lower than that of the Middle Eastern Europe, Central Asia and West Asia countries. The CESV of the BRI countries are generally in the middle level and the average vulnerability index of highly vulnerable countries is twice as much as that of lowly vulnerable countries. In addition, in terms of the vulnerability of the three subsystems, the spatial distribution of vulnerability of the domestic economic system (DESV) and financial system (FSV) is basically consistent with the spatial distribution pattern of CESV, both of which are low in East Asia and South Asia and high in West Asia and Central Asia. While, the vulnerability of external economic system (EESV) shows a different spatial pattern, with vulnerability of West Asia, Central Asia and ASEAN higher than that of East Asia and South Asia. The main obstacle factors influencing the CESV of BRI countries include GDP growth rate, saving ratio, ratio of bank capital to assets, service industry level, industrialization level and loan rate. Therefore, the key way to maintain the stability and mitigate the vulnerability of the economic system of BRI countries is to focus on the macroeconomic development and operation, stimulate the economy and market vitality, promote the development of industries, especially the service and secondary industries, and optimize the economic structure, banking system and financial system. [ABSTRACT FROM AUTHOR]

Conservation agriculture-based sustainable intensification (CASI) technologies comprising zero-tillage with crop residue retention (>30%) on the soil surface, diversified cropping systems, and balanced nutrient management are recognized as operative and efficacious strategies to ensure food security in the parts of South Asia. The present investigation was a component of CASI technologies undertaken in the farmers' field of Malda (old alluvial Inceptisol) Coochbehar (recent alluvial Entisol) district, West Bengal (subtropical eastern India). This study was conducted to evaluate the short-term impact of contrasting tillage (zero and conventional) and cropping systems (rice–wheat and rice–maize) on total organic carbon (TOC) and its fractions, viz., labile pool-1 (LP1), labile pool-2 (LP2) and recalcitrant carbon (RC) fractions after 4-year trial of conservation agriculture (CA) in the old and recent alluvial soils. Soil samples were collected from three depths (0–5, 5–10, and 10–20 cm), and thus, our study was focused on two factors, viz., cropping system and tillage. Results pointed that TOC along with LP1, LP2, and RC fractions under rice–maize (RM) cropping system were significantly (p<0.05) greater (15–35%) over rice–wheat (RW) system as a result of higher residue biomass addition. Zero-tillage (ZT) improved the C fractions by 10–20% over conventional tillage (CT) in all aspects. TOC and its fractions were observed to be greater under the ZT system in the topmost soil depths (0–5 and 5–10 cm), but the same system failed to improve these at 10–20 cm. Interestingly, the CT increased all the fractions at 10–20 cm depth due to the incorporation of crop residues. The concentration of TOC along with its fractions decreased with increasing soil depth was evident. Comparatively, all the C fractions, including TOC were maximum in soils from Malda sites as compared to Coochbehar sites because of a higher amount of residue biomass application, higher clay content, and greater background content of C in these soils. All the studied C fractions showed a significant correlation (r = >0.635; p<0.01) with TOC among all the soil depths in both the districts but the relationship with soil texture showed some interesting results. TOC fractions were significantly correlated (p<0.01) with clay particles indicating that its higher stabilization with clay in old alluvial Inceptisol (Malda); while in recent alluvial Entisol (Coochbehar), sand particle showed its strong relation with TOC fractions. Higher stratification ratio (SR) in the ZT system suggested that the concentration of TOC and its fractions are confined to the upper soil layers whereas in the case of CT, by and large, the distribution of these was comparatively high in subsequent soil depths due to residue incorporation effect. The concentration of C fractions in soils followed the order: TOC > RC > LP2 > LP1. The present investigation concluded that ZT under the RM system increases the turnover rates of C in both soil types but the amount of clay influences the stabilization/storage of C. [ABSTRACT FROM AUTHOR]

Background: The nursing education system has evolved with an increased emphasis on student-centred education, such as implementing flipped classroom pedagogy. Given the promising positive educational outcomes, the trend of using flipped classroom pedagogy has become increasingly popular in undergraduate nursing education. However, little is known about how these flipped classroom methods impact on nursing educational practices in limited-resource settings situated in South Asia. Objective: To assess the feasibility of implementing flipped classroom pedagogy in undergraduate nursing education from the nursing students' perspective. Methods: This mixed-methods study employed a quantitative survey and six focus group discussions conducted in three state universities in Sri Lanka. The Nursing Students' Readiness for Flipped Classroom (NSR-FC) questionnaire was used to collect quantitative data. The semi-structured focus group discussions were conducted by using 18 reflective and open-ended questions. Descriptive statistics and multivariate analysis of variance methods were employed when analysing quantitative data. An inductive thematic analysis approach was used to summarize the focus group discussions. Results: The questionnaire survey revealed that nursing students reported high levels of personal, technical, and pedagogical readiness across all three universities, while environmental readiness was perceived as low. The inductive thematic analysis identified three themes, namely: enablers, challenges, and benefits. Specifically, nursing students valued the student-centred approach. They were ready to utilize their own devices to overcome limited technological provision; however, a short training session about how to engage in the flipped classroom was desirable. Also, their exposure to basic educational technology was perceived as adequate and they were aware of the positive outcomes of flipped classroom pedagogy. Conclusion: Nursing students were ready to enrol in a flipped classroom programme. The provision of technological resources in the education environment was identified as a great challenge for flipped classroom implementation. Overall, the findings indicate there are promising feasibilities for the flipped classroom implementation. [ABSTRACT FROM AUTHOR]

Background: The infant mortality rate (IMR) is a critical indicator of population health, but its measurement is subject to response bias in countries without complete vital registration systems who rely instead on birth histories collected via sample surveys. One of the most salient bias is the fact that child deaths in these birth histories tend to be reported with a large amount of heaping at age 12 months. Because of this issue, analysts and international agencies do not directly use IMR estimates based on surveys such as Demographic and Health Surveys (DHS); they rely instead on mortality models such as model life tables. The use of model life tables in this context, however, is arbitrary, and the extent to which this approach appropriately addresses bias in DHS-based IMR estimates remains unclear. This hinders our ability to monitor IMR levels and trends in low-and middle-income countries. The objective of this study is to evaluate age heaping bias in DHS-based IMR estimates and propose an improved method for adjusting this bias. Methods and findings: Our method relies on a recently-developed log-quadratic model that can predict age-specific mortality by detailed age between 0 and 5. The model's coefficients were derived from a newly constituted database, the Under-5 Mortality Database (U5MD), that represents the mortality experience of countries with high-quality vital registration data. We applied this model to 204 DHS surveys, and compared unadjusted IMR values to IMR values adjusted with the log-quadratic model as well as with the classic model life table approach. Results show that contrary to existing knowledge, age heaping at age 12 months rarely generates a large amount of bias in IMR estimates. In most cases, the unadjusted IMR values were not deviating by more than +/- 5% from the adjusted values. The model life table approach, by contrast, introduced an unwarranted, downward bias in adjusted IMR values. We also found that two regions, Sub-Saharan Africa and South Asia, present age patterns of under-5 mortality that strongly depart from the experience represented in the U5MD. For these countries, neither the existing model life tables nor the log-quadratic model can produce empirically-supported IMR adjustments. Conclusions: Age heaping at age 12 months produces a smaller amount of bias in DHS-based IMR estimates than previously thought. If a large amount of age heaping is present in a survey, the log-quadratic model allows users to evaluate, and whenever necessary, adjust IMR estimates in a way that is more informed by the local mortality pattern than existing approaches. Future research should be devoted to understanding why Sub-Saharan African and South Asian countries have such distinct age patterns of under-five mortality. [ABSTRACT FROM AUTHOR]

Introduction: Diarrhea is responsible for the death of more than 90% of under-five children in low and lower-middle income countries. Regionally, South Asia and sub-Saharan Africa accounted for 88% of deaths with the same age group. Therefore, the aim of this study was to determine the prevalence and associated factors of diarrhea among children under-five years in sub-Saharan Africa. Methods: The appended, most recent demographic and health survey datasets of 34 sub-Saharan African countries were used to determine the prevalence and associated factors of diarrhea among under-five children in the region. A total weighted sample of 330,866 under-five children were included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of diarrhea among under five children in sub-Saharan Africa. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for those potential factors included in the final model. Result: The overall prevalence of diarrhea in this study was 15.3% (95% CI: 15.1–15.4). Those children of mothers aged 15–24 (AOR = 1.26; 95% CI: 1.23, 1.30) and 25–34 years (AOR = 1.15; 95%CI: 1.12, 1.18), those children of mothers with no education (AOR = 1.69; 95%CI: 1.57–1.82), primary education (AOR = 1.73; 95%CI: 1.61–1.86) and secondary education (AOR = 1.49; 95%CI: 1.38–1.59) had higher odds of having diarrhea. Those children from poorest (AOR = 1.14; 95%CI: 1.10, 1.19), poorer (AOR = 1.12; 95%CI: 1.08–1.17), middle (AOR = 1.06; 95%CI: 1.02, 1.10), and richer (AOR = 1.14; 95%CI: 1.04–1.12) households had higher chance of having diarrhea compared to their counterparts. Conclusion: This study found that the prevalence of childhood diarrhea morbidity in sub-Saharan Africa was high. Maternal age, wealth index, maternal education, maternal occupation, age of child, time of initiation of breast feeding and time to get water source were significantly associated with diarrhea. Therefore, intervention through health education and health promotion for mothers/caretakers who are poor, less educated, and young should be designed to prevent diarrhea in the region. [ABSTRACT FROM AUTHOR]