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During the last few decades painstaking efforts have been made to eliminate iodine deficiency throughout the world. Todays in regions where dietary iodine intake is adequate or borderline, the main focus is increasing dietary iodine supply in the target population during pregnancy and the first years of life. Objective: The aim of this study was to obtain longitudinal data on urinary iodine excretion and the changes of maternal thyroid parameters in two groups of healthy women with mild-to-moderate iodine deficiency and iodine sufficiency residing in an iodine replete area of Tehran capital city of IR Iran, for more than one decade. Research designs and methods: The present study is part of a cohort study, investigating the relative influences of iodine intake on thyroid size and function of mothers and their infants during and after pregnancy. A total of 500 pregnant women enrolled from two mother-child health care centers and was divided into group I, with median urinary iodine excretion (MUIE) < 150 µg/L, and group II with MUIE ≥ 150 µg/L. Sonographic thyroid volume measurement, urinary iodine excretion and thyroid function tests were measured sequentially in all pregnant women during the three trimesters (T) of pregnancy. Results: The mean ± SD age of the participants was 25.1 ± 5.1 years. The MUIE in group I and II in the first, second and third trimester were 123 and 250 µg/L, 127 and 166 µg/L, 120 and 150 µg/L, respectively. The MUIE in the third trimester of pregnancy in group I did not differ significantly from the values in the first and second trimesters (p = 0.67), but it did decline significantly in group II (p < 0.001). The median thyroid volume of subjects, in the first, second and third trimesters were 7.8, 8.2 and 8.1 ml in group I and 7.5, 8.0 and 8.4 ml in group II, respectively. No difference in thyroid volume was found between two groups in each of the three trimesters of pregnancy (p > 0.05). The mean (± SD) TSH concentration of subjects in first, second and third trimester was 2.3(± 2.6), 2.1(± 1.8), 2.3(± 1.7) mIU/L in group I and 2.1(± 3.1), 2.1(± 1.8) and 2.0(± 1.3) mIU/L in group II, respectively. The trend of TSH rising in group I was 26.7% and in group II it was 13.3%. The mean TSH value in three trimesters did not differ significantly in either groups (p > 0.05). The mean (± SD) total T4 concentrations of subjects in first, second and third trimesters were 13.2(± 3.4), 13.8(± 3.3), 13.0(± 2.9) µg/dl in group I and 13.1(± 3.2), 13.7(± 2.9), 13.4(± 3.2) µg/dl in group II, respectively. The mean total T4 value in three trimesters did not differ significantly in either groups (p > 0.05). There was no correlation between the thyroid volume and three observed parameters (UIE, total T4 and TSH) during the pregnancy in either groups. Conclusion: Even in areas with well-established universal salt iodization program, pregnancy could be a risk of having iodine deficiency and systematic dietary fortification needs to be implemented in this vulnerable group.

Coronavirus disease 2019 (COVID-19) had affected both developed and developing countries too. The first case in Nepal was confirmed on 23 January 2020. It was also the first recorded case of COVID-19 in South Asia. Nepal reported its first COVID-19 death on May 16. At the end of October, the number of death stood 937 and 1126 on 9 November. In September and October, deaths doubled, and with winter setting in, fatalities may skyrocket. Among the total CP cases in Nepal nearly 50% are from the Capital Kathmandu. So, Kathmandy is the new epicenter of COVID-19 in Nepal. There are no proper community-based isolation centres and ICU beds are also still limited. Due to increasing trend of COVID-19 cases and death people have fear of psychological stress. A study shows at least one symptom of psychological distress whereas 32% suffered from two or more symptoms of psychological distress such as restlessness, fearfulness, anxiety and worry and sadness. Despite limited resources, the government’s major challenges are early diagnosis, management of confirmed cases, contact tracing, and implementing some public health measures to reduce the infection’s transmissibility.

The childhood obesity is increased more than three folds in last two decades in developed world. There is nutritional transition seen in the developing world including India. The westernization in diet of the Indian population along with prosperity brings the brunt of overweight and obesity. This has future implications of liver diseases, heart diseases, hypertension, hyperlipidaemia, insulin resistance; malignancies. Mumbai is the prosperous city and an economical capital of India. Also, the rampant use junk food, common outdoor eating’s, no grounds to play for children make the high likelihood that the prevalence of obesity to be higher than rest of the country. It can profoundly affect children’s physical health, social, and emotional well-being and self-esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits of the entire family. Treating and preventing childhood obesity helps protect the child’s health and has tremendous impact on child’s Physical and academic performance. And hence we at Aastha Bariatrics took initiative and launched ECHO... for a change (‘E’radicating ‘C’Hild ‘H’ood ‘O’besity), a pan Mumbai campaign against childhood obesity. This campaign was done in 15 high schools across Mumbai, which covered in total of 9000 students.

Taphonomic study was first time conducted in Kuala Lumpur, capital city of Malaysia. In this research model, male Oryctolagus cunicullus weighed 1.8-2.6 kg each were killed by Dolethal intravenously at the ear region. In Phase 1 study, eight subjects were wrapped in a sack and cemented within a container to be compared with the other four controls at each location labelled A (ground) and B (manmade freshwater pond). Phase 2 involved duplicating set of 15 cemented samples comparable to 1 control made up to total of 32 subjects which were all put into a compact polytank containing freshwater to simulate a case study. Taphonomic changes were observed and scored using TBS system incorporating of fresh stage, early decomposition stage, advanced decomposition stage and skeletonisation stage. The ambient temperature of surroundings with 28.81C±4.21°C and 29.21°C±4.57°C (mean±S.D.) while relative humidity of air with 74.49 %±14.61% and 79.15%±16.32% (mean±S.D.) were recorded for Phase 1 and Phase 2 study respectively. Time taken for ground control exposed and wrapped carcasses to reach first sign of skeletonised stage were four days and five days respectively. Whilst freshwater controls reached initial skeletonised stage within one week for exposed carcass and two weeks for wrapped carcass. Within the control and cemented sample carcasses, TBS scores increased from initial stages of decomposition and become plateau after advanced decomposition. The cementing factor have superseded the wrapping factor due to its stronger physical barrier effect to slow down the decomposition more than half compared to controls based on Multiple way ANOVA test. Phase 2 study has demonstrated more accurately on the decomposition rate of the cemented samples. It showed that wrapping and cementing factors have delayed the decomposition process of the rabbit carcasses about 4 times to reach the initial stage of skeletonisation compared to the control carcasses. There was absence of insect activity within the cemented samples, hence the microorganism activity would be the only contributor to the decaying process within the cemented samples at slower rate comparing to the exposed or wrapped controls.

This study provides an update to a previous study exploring time to restoration of adjudicative competence within an Outpatient Competence Restoration Program (OCRP). Authors examined the probability of restoration for individuals referred for outpatient competence restoration in the U.S. capital, and revisited the requirements of American Law, taking a closer look at how programmatic changes improve restoration and encourage adherence. Competence to stand trial remains a critical screening function of the judicial system to ensure that defendants have a basic understanding of courtroom procedures. Competency restoration is therefore an attempt to protect both the integrity of the system and the rights of defendants. Aggregate data from the OCRP’s previous four years of competence restoration efforts were reviewed for demographic characteristics, restoration rates, and time to restoration. Poisson regression modeling identified probability differences in restoration between sequential restoration periods. Since our initial analysis, the DC OCRP has been successful in restoring 97 of 345 participants (28.1%), with referral rates increasing from year to year. 39.2% are now restored after the 3rd round of competency restoration. Poisson regression modeling of individuals attaining competence during six successive restoration periods showed that differences for the first five rounds of restoration were not statistically significant (p = 0.418). In the 6th round, however, the difference in percentage of restored participants was statistically significant compared to previous rounds (irr = 0.32; p = 0.0001). We discuss the policy implications, especially those that suggest that the DC OCRP has improved its ability to restore competence beyond the 1st round of restoration.

Objective: The study aimed to describe the epidemiological profile of the homeless population and report the social impact on healthcare services provided by a voluntary initiative during one-year of follow-up. Method: This is an investigational study, carried out in an important capital-city of southern Brazil, which included 509 individuals in 2019. Findings were divided into three segments: sociodemographic, substance use/abuse and impact on healthcare. Results: The sociodemographic profile found was predominantly male, white, single, heterosexual, educated in elementary or high school, in regular use of legal and/or illegal substances, and living as homeless for less than a year. The impact of assistance provided on the perception of individuals who returned in subsequent actions was evident. Conclusion: The significant increase in the number of homeless people in large urban centers can benefit from the support of non-profit organizations to address the deficiencies faced in accessing basic health services. Based on this, we seek to advance in the development of new policies that improve local healthcare for the vulnerable population, to be more assertive to their needs.

Introduction: Although worldwide maternal and neonatal mortalities have decreased, but Achieving sustainable development goals remains an unfinished agenda and global challenge. This study aimed to predict neonatal and maternal index based on development and demographic indicators.Methods: In this ecologic study, the dependent variables were Maternal mortality ratio (MMR), Neonatal mortality rate (NMR), and Under 5 Mortality Rate (U5MR) and the independent variables were Gender gap index (GGI) and its four components, human development, life expectancy, total fertility rate, and population growth. Data conducted using international secondary data published data bases of health metrics from 2016 to 2018 in 149 countries from WHO (World Health Organization), World Economic Forum, UNICEF (United Nations Children's Fund), and UNDP (United Nations Development Programme). Data analysis was performed using correlation model in Stata version 14.1 software.Results: In this study, economic participation and total fertility rate are positively and educational attainment, Human Capital Index and life expectancy are negatively associated with MMR. Human Capital Index, Educational attainment, and Life expectancy are negatively associated with NMR. Economic participation and total fertility rate are positively and educational attainment, Human Capital Index and life expectancy are negatively associated with U5MR. Discussion: To reduce the maternal and neonatal mortality rate, it is important to pay attention to indirect causes such as equal conditions for men and women to demographic and population indices such as economic participation, educational attainment, Human Capital Index and life expectancy.

Background and objectives: This paper is aimed at excavating the factors responsible for RHD events and vis-à-vis establishing severity levels of RHD patients referred to Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu’s capital city of Bhutan. Methods: By taking notorious advantage of the data gathered over the past five years (2016-2020) from RHD patients across 20 districts of Bhutan, about 232 RHD patients are involved in this study recorded in JDWNRH by the Cardiology Department. Besides descriptive methods, multivariate linear regression models augmented by the multinomial logistic regression models had been applied to establish the causual links. Results: The findings revealed that RHD prevailed amongst the young populace of Bhutan, especially females. Variables like age, frequency of visits, number of diagnostics, levels of education and region had been found as predictors of RHD prevalence. Other socio-demographic factors like occupation and status of employment did not affect the RHD prevalence. The multinomial logistic regression results indicated that higher levels of education as an important factor for not making the patient fall into the category of ‘severe.’ Age has been constantly found to be a highly significant variable contributing to RHD events and a quadratic relationship is revealed between age and the severity of RHD. Conclusion and implications for translation: This study pigeonholed the significant factors responsible for RHD events and entailed severity levels by gender and age. The findings of this study also provide additional important insights into developing public health policies and programs. 

In administrative and economic science, factor analysis models are essential for their explanatory capacity of institutional responses to risk events. The objective of this document was to contrast a model that explains the emergence of corporate governance dimensions in the face of the pandemic. An exploratory study was carried out based on a systematic review of the literature from 2020 to 2023, considering the search by keywords in Google scholar and Microsoft academic, as well as the judges from a public university in the center of Mexico. The results show that corporate identity explains the university’s response to the pandemic. In relation to the state of the art, the scope and limits of the model are discussed in other proposals.

Background: Worldwide, obesity in adolescents is an epidemiological concern. Overweight and obesity are associated with comorbidities in adult life, such as increased risk of hypertension and other non-communicable diseases. This study investigated possible differences between traditional lipid markers and Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL) subfractions in a population-wide representative sample of Brazilian adolescents. Methods: The individuals included in the study comprise a subsample of the 2015 Health Survey of São Paulo (ISA-Capital 2015). LDL and HDL particle sizes were determined by the Lipoprint® System (Quantimetrix Corporation). Results: 272 Brazilian adolescents with a mean age of 15.2 ± 2.2 years, of which 47.8% (n = 130) are boys. Analysis of LDL subfractions showed an increase in LDL 2 content in girls (5.7% vs. 5.1%; p = 0.047). This result was associated with a higher content of large LDL in girls (17.8% vs. 13.5%; p < 0.001) and a significant, lower content of small LDL (1.7% vs. 3.4%; p = 0.002). When obesity was considered, we observed that regardless of being overweight, girls had higher large and small LDL than boys. However, when a large to small LDL ratio was calculated, girls with no excess weight had higher values than boys with no excess weight (10.6 vs. 9.3; p = 0.038), and these had lower LDL ratio than overweight boys (9.3 vs. 13.5; p = 0.016). On the other hand, boys had higher HDL 2 content than girls (8.9% vs. 8.0%; p = 0.017), which was associated with increased large HDL values in boys (1.9% vs. 1.7%; p = 0.047). Regression analysis was performed according to gender, the sum of very low-density lipoprotein (VLDL) + intermediate density lipoprotein (IDL) C + IDL B subfractions was adjusted for age and body mass index (BMI), showing that girls had lower atherogenic lipid profile (β = 0.987; CI = 0.977-0.998; p = 0.017) than boys. When the regression analysis was performed according to BMI, large LDL in adolescents with no excess weight presented a lower atherogenic lipid profile (β = 1.040; CI = 1.000-1.082; p = 0.049), adjusted for age and sex, than overweight adolescents.Conclusion: Regardless of excess weight, girls showed a cardioprotective profile more associated with a favorable distribution of LDL subfractions than boys, reinforcing the relevance of evaluating qualitative aspects of lipoproteins in addition to the traditional cholesterol content.

This paper examines the effects of globalization on nations, focusing on economic, social, and cultural dimensions. It analyzes the roles of protectionism and globalization in shaping consumer welfare and producer earnings through qualitative methods and the Customs Union theory framework. The study discusses the benefits and drawbacks of globalization in the context of World Trade Organization (WTO) regulations. The findings indicate that globalization has intensified financial flows between countries, which can exacerbate economic crises. Countries with abundant human resources can capitalize on the international division of labor to specialize in high-value sectors, while those with limited resources risk falling behind in the digital landscape. This division of labor fosters specialization and improves production efficiency through targeted education. However, multinational corporations often impede cost-effective production in developing nations, underscoring the necessity to restructure research and development to facilitate technology adoption in underdeveloped areas. This restructuring can help close the technological gap and encourage equitable participation in the global economy. Jel code Classification: D6: Welfare economics, Fo1 Global outlook, F40: General F4: Macroeconomics aspects of international trade and finance

Foreign bodies of the esophagus are part of the traumatic emergencies in ENT. They are most often encountered in children, whereas in adults they occur in a particular context and are rarely overlooked.This was a 48-year-old patient from a neighboring country referred by a colleague for a history of neglected laryngeal contusion with infectious cervical fistula evolving for 2 years. Further questioning revealed a notion of accidental ingestion of dentures. The first endoscopy was of capital interest in especially in the diagnosis and management of this long-retained foreign body. The extraction under general anesthesia was done by a combined endoscopic and external approach. The postoperative course was marked by superinfection and swallowing disorders.Cervical suppurations secondary to esophageal foreign bodies are rare, especially in adults. Clinicians should consider this possibility in the face of any chronic cervical suppuration that resists treatment.