Drought, temperature, and moisture availability: understanding the drivers of isotopic decoupling in native pine species of the Nepalese Himalaya.

The Himalayas experienced long-term climate changes and recent extreme weather events that affected plant growth and the physiology of tree species at high-elevation sites. This study presents the first statistically robust δ18OTR chronologies for two native pine species, Pinus roxburghii, and Pinus wallichiana, in the lower Nepalese Himalaya. The isotope chronologies exhibited 0.88‰ differences in overall mean isotope values attributed to varying elevations (460-2000 m asl). Comparative analysis of climate response using data sets from different sources and resolutions revealed the superiority of the APHRODITE (Asian Precipitation - Highly-Resolved Observational Data Integration Towards Evaluation) data set calibrated for the South Asian Summer Monsoon (SASM)-dominated region. Both species exhibited negative correlations with monsoon precipitation and positive correlations with temperature. However, during the peak monsoon season (July-August), daily resolved climate data disentangled statistically insignificant relationships, and revealed that δ18OTR is influenced by atmospheric moisture. Both congeneric species showed a decoupling between the chronologies after 1995. However, no significant change in air moisture origin and monsoon regime between the study sites was observed, indicating a consistent dominant moisture source during different monsoon seasons. Besides, we also observed the decreased inter-series correlation of both δ18OTR chronologies after 1995, with P. wallichiana experiencing a steeper decrease than P. roxburghii. The weakening correlations between and within the chronologies coincided with a regional drought during 1993-1995 in both sites, highlighting the strong regulation of local climate on the impact of regional extreme climate events. Our findings emphasise the importance of employing climate data with optimal spatial and temporal resolution for improved δ18OTR-climate relationships at the intra-annual scale while considering the influence of site-specific local environmental conditions. Assessing climate data sets with station data is vital for accurately interpreting climate change's impact on forest response and long-term climate reconstructions.

Social withdrawal behaviour in Nepalese infants and the relationship with future neurodevelopment; a longitudinal cohort study.

BACKGROUND: Social withdrawal in infants may be a signal of distress and a precursor for non-optimal development. OBJECTIVE: To examine the relationship between infant social withdrawal and neurodevelopment up to 4 years in Nepalese children. METHODS: A total of 597 Nepalese infants 6-11 months old were assessed with the modified Alarm Distress Baby Scale (m-ADBB), and of these, 527 with the Bayley Scales of Infant and Toddler Development 3rd edition (Bayley-III) during early childhood, and the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) and NEPSY-II subtests at 4 years. We examined whether social withdrawal defined by the m-ADBB was associated with neurodevelopmental scores in regression models. RESULTS: Children socially withdrawn in infancy had lower Bayley-III language scores (-2.6 (95% CI -4.5, -0.7)) in early childhood. This association seems to be driven by the expressive communication subscale (-0.7 (95% CI -1.0, -0.3)), but not the receptive communication subscale (-0.2 (95% CI -0.6, 0.1)). There were no differences in the other Bayley-III scores or the WPPSI-IV and NEPSY-II scores at 4 years in children who were socially withdrawn or not. CONCLUSION: Social withdrawal in infancy was reflected in early language development but not cognitive functioning at 4 years.

Unmet Primary Health Care Needs among Nepalese Immigrant Population in Canada.

BACKGROUND: Immigrants represent over one-fifth (21.9%) of the Canadian population, which is an increasing trend. Primary care is a gateway to accessing the healthcare system for the majority of Canadians seeking medical services; however, Canada reported a growing shortage of healthcare providers, mainly primary care practitioners. Canadians, including immigrants, encounter many unmet healthcare needs due to various reasons. This study aimed to assess unmet healthcare (UHC) needs and associated factors among Nepalese immigrants residing in Calgary. METHODS: A cross-sectional study using a self-administered questionnaire was conducted in 2019. UHC needs were measured based on a single-item question: "During the past 12 months, was there ever a time that you felt you needed medical help, but you did not receive it". A follow-up question was asked to learn about associated unmet needs factors, and the responses were categorized into availability, accessibility, and acceptability. Descriptive and multivariable logistic regression was employed to assess the association between UHC needs and its predictors by using STATA version 14.2. RESULTS: Of 401 study participants, nearly half of the participants (n = 187; 46.63%) reported UHC needs, which was not significantly different among male and female participants (p = 0.718). UHC needs were nearly two times higher among those aged 26-45 (AOR 1.93) and those ≥56 years (AOR 2.17) compared to those under 25 years of age. The top reasons reported for unmet needs were long waits to access care (67.91%), healthcare costs (57.22%), and lack of knowing where to get help (31.55%). Overall, "services availability when required" was a leading obstacle that accounted for UHC needs (n = 137, 73.26%). Nearly two-thirds (n = 121, 64.71%) of participants reported that "accessibility of services" was a barrier, followed by "acceptability (n = 107, 57.22%). Those who reported UHC needs also reported an impact on their lives personally and economically. The most commonly reported personal impact was mental health impact, including worry, anxiety, and stress (67.38%). The most common economic impact reported due to UHC needs was increased use of over-the-counter drugs (33.16%) and increased healthcare costs (17.20%). CONCLUSIONS: UHC needs are presented in the Nepalese immigrant population. Accessibility to healthcare is limited for several reasons: waiting time, cost, distance, and unavailability of services. UHC needs impact individuals' personal health, daily life activities, and financial capacity. Strategies to improve access to PHC for disadvantaged populations are crucial and need to be tackled effectively.

Barriers and facilitating factors to healthcare accessibility among Nepalese migrants during COVID-19 crisis in Japan: an exploratory sequential mixed methods study.

BACKGROUND: The COVID-19 pandemic has highlighted the need for global unity and timely access to healthcare for all including multilingual and intercultural societies. This study aimed to identify barriers to healthcare access due to the COVID-19 crisis among Nepalese migrants in Japan and explore ways to counter these barriers, both in routine and crisis situations. METHODS: This study used an exploratory sequential mixed-methods study design. The researchers conducted 11 focus group discussions including 89 participants and an online survey involving 937 respondents. The integration of focus group discussions and logistic regression analysis from the survey was reported via a 'joint display'. RESULTS: Twenty-six themes on barriers to and six on facilitators of healthcare accessibility were identified by the focus group discussions among which 17 barriers like lack of knowledge of health insurance, language barriers, lack of hotline services, unawareness of available services, fear of discrimination etc. had significant association in our logistic regression analysis after adjusting for all confounders. Similarly, the only facilitator that had a significant impact, according to the multivariable logistic regression analysis, was receiving health information from Nepali healthcare professionals (OR = 1.36, 95% CI = (1.01 - 1.82), p-value < 0.05). CONCLUSION: The study suggests the need for a crisis information hub which could be coordinated by the Nepal embassy or concerned authorities, flexible policies for active deployment of Nepalese health workers and volunteers, accessible hotlines in the Nepali language, and incorporation of Nepali telehealth services in Japan.

Health and wellbeing of Nepalese migrant workers in Gulf Cooperation Council (GCC) countries: A mixed-methods study.

Introduction: Migrant workers support low- and middle-income economies through remittances, often bearing considerable health risks with long-term consequences. This study aims to understand the health and wellbeing issues of Nepalese migrant workers in Gulf Cooperation Council (GCC) countries, a major destination for low-skilled Nepalese workers. Methodology: We conducted a mixed-methods study in Dhading district of Nepal. A pilot survey was carried out with returnee migrants from GCC countries to understand key health and wellbeing issues faced by workers. In addition, in-depth interviews were conducted with a subset of these returnee migrants and their families, and related stakeholders. These aimed to understand broader societal and policy implications in relation to labour migration. Quantitative data from the survey were analysed using descriptive statistics and thematic analysis was used for qualitative interviews. Results: 60 returnee migrants (58 males, 2 females) took part in the survey (response rate, 100%). Median age of the survey participants was 34 (IQR, 9) years and 68% had completed school level education. Returnee migrants reported suffering from various physical and mental health issues during their stay in GCC countries including cold/fever (42%), mental health problems (25%) and verbal abuse (35%). 20 participants took part in the qualitative study:10 returnee migrants (8 males, 2 females), four family members (female spouses) and six key stakeholders working in organizations related to international migration. Interview participants reported severe weather conditions resulting in physical health problems (e.g. pneumonia, dehydration and kidney disease) as well as mental health issues (including anxiety, loneliness and depression). Participants raised concerns about the usefulness and appropriateness of pre-departure training, and the authenticity of medical tests and reports in Nepal. Female migrants reported facing stigma after returning home from abroad. Language difficulties, alongside issues related to payment, insurance and support at work were cited as barriers to accessing healthcare in destination countries. Conclusion: Our study shows that Nepalese migrant workers experience severe weather conditions and suffer from various physical and mental health issues, including workplace abuse and exploitation. The study highlights an urgent need for strategies to enforce compulsory relevant pre-departure orientation and appropriate medical screening in Nepal, and fair employment terms and full health insurance coverage in destination countries. Greater collaboration between the Nepalese government and GCC countries is needed to ensure necessary legislation and regulatory frameworks are in place to safeguard the health and wellbeing of migrant workers.

The dimensional and morphological assessment of the frontal sinus in sex estimation among different populations.

BACKGROUND: The purpose of the present study was to determine the dimorphic potential of the frontal sinus (FS) index, area, and the combination of both variables to ascertain its accuracy in sex discrimination among Bosnian, Chinese, and Nepalese. METHODS: A retrospective study analyzed the digital standardized lateral cephalometric of 654 Bosnian, Chinese, and Nepalese adult patients (116 females, 102 males; age range 17-40 years). The following FS parameters were analyzed: The maximum height, width, and area of the FS, and the ratio of height and width was calculated as the FS index. The measurements were analyzed using logistic regression analysis for the FS index, area, and combined FS index and area. RESULTS: Statistically significant differences were observed between the mean values of the FS index and the area between females and males in each population. The highest frequency of bilateral absence of FS was detected among females, specifically in Chinese (6.6%). Logistic regression equation derived from the present study differentiated between sexes with higher classification percentages for the FS index and area with 62.4%, 75.2%, and 78.4% among Bosnian, Chinese, and Nepalese subjects, respectively. CONCLUSIONS: The results of the present study highlight the implications of the combined FS index and area as a reliable approach in sex estimation in forensic science whenever both the FS structure and lateral cephalometric are available.

Application of the London Atlas of Tooth Development and Eruption in Panoramic Xrays for the Age Estimation.

BACKGROUND: The age estimation of the individual by the forensic experts ascertains the chronological age of an individual. The possibility that the person being examined may be younger or older than a certain age threshold makes this process crucial, as it will establish whether or not the person is an adult under the law. The aim of this study was to test the applicability of the London Atlas of tooth development and eruption in Nepalese subset population. METHODS: The London Atlas for age estimation was tested in 350 digital panoramic radiographs from the patients between four and twenty-four years visiting Tribhuvan University Teaching Hospital, Institute of Medicine, Nepal. RESULTS: The mean values of the estimated age were higher in both the sexes, which was statistically not significant. Both the sexes showed an excellent positive correlation, and was significant with a p value of <0.001. The age estimation upto 10 years group classification was nearly accurate with less than 1 and 2.5 years variation in males and females respectively. The accuracy was good in 16-18 years group with maximum deviation of ±2.5 years. The accuracy was poor in more than 18 years group, as the variability was more than 5 years. CONCLUSIONS: The London Atlas method was best suited for less than 18 years of age and was not very accurate in the age group of 13-14 and 14-15 years where most of the polymorphisms were noted.

Mental Health First Aid Training with the Nepalese Community in Australia: An Evaluation of Effects on Knowledge, Confidence, Intentions, Willingness to have Contact and Stigmatizing Attitudes.

The aim of this study was to evaluate the effectiveness of Mental Health First Aid (MHFA) training amongst the Nepalese community in Australia by exploring the impact on knowledge about mental health first aid, confidence and intentions to help, willingness to have contact and stigmatizing attitudes towards people with mental illness. We hypothesized that since MHFA has been extensively evaluated with other communities and has been found to be effective, it would therefore be effective with this community as well. MHFA training was conducted by an accredited Nepalese-Australian MHFA Instructor with 162 participants from the Nepalese community in four states of Australia. Participants completed an evaluation questionnaire prior to the training (pre-test) and at the end of the training (post-test). The evaluation questionnaire assessed participants? knowledge about what was taught in the course, ability to recognize depression as described in a vignette, confidence in providing help, intentions to provide help, and willingness to have contact and stigmatizing attitudes towards people with mental illness. There were large improvements from pre-test to post-test in knowledge, confidence and intentions to help, medium improvements in willingness to have contact, small-to-medium improvements in stigmatizing attitudes and small improvements in recognition of depression. Participants gave high ratings of the course and the instructor. MHFA training produced improvements in knowledge, confidence, intentions, willingness to have contact and stigmatizing attitudes. The training was also well received. Further research is needed to assess persistence of these effects following the course and any changes in mental health first aid provided to the community.

Patient-Identified Solutions to Primary Care Access Barriers in Canada: The Viewpoints of Nepalese Immigrant Community Members.

BACKGROUND: Accessing healthcare for immigrants in Canada is complicated by many difficulties. With the continued and upward trend of immigration to Canada, it is crucial to identify the solutions to the barriers from the perspectives of different immigrant communities as they encounter them including the relatively smaller and less studied population groups of immigrants. As such, Nepalese immigrants in Canada are a South Asian ethnic group who have their own distinct language, culture, and socio-economic backgrounds, however, their experience with accessing healthcare in Canada is scarce in the literature. METHODS: We conducted 12 focus group discussions with first-generation Nepalese immigrants who had experiences with primary care use in Canada. Informed consent and demographic information were obtained before each focus group discussion. The verbatim transcription of the focus groups was analyzed using thematic analysis. RESULTS: The participants expressed a range of potential solutions to overcome the barriers, which we presented using the socio-ecological framework into 4 different levels. This includes individual-, community-, service provider-, and government/policy-levels. Individual-level actions included improving self-awareness and knowledge of health in general and navigating the healthcare system and proactively improving the language skills and assimilating into the Canadian culture. Examples of community-level actions included community events to share health information with immigrants, health literacy programs, and driving/carpooling to clinics or hospitals. Actions at the service provider level were mainly focused on enhancing communications, cultural competency training for providers, and ensuring to hire primary care workforce representing various ethnocultural backgrounds. Overall, focus group participants believed that the provincial and federal government, as appropriate, should increase support for dental and vision care support and take actions to increase the healthcare capacity, particularly by employing internationally graduated health professionals. CONCLUSIONS: Access to primary care is essential for the health of immigrant populations in Canada. Individuals, community organizations, health service providers, and governments need to work both individually and collaboratively to improve immigrants' primary care access.

Prevalence of Loss of Smell and Loss of Taste in COVID-19 Infected Patients.

BACKGROUND: The clinical presentations of COVID-19 have been variable, with atypical presentations being reported worldwide. Different studies have shown that olfactory and gustatory symptoms are present in confirmed COVID-19 cases, who may not have had other nasal complaints earlier. The high prevalence of these symptoms, exhibiting olfactory dysfunction before the appearance of others, is a relevant finding to aid for early detection of COVID-19. In this study, we aim to find out about the prevalence of anosmia and ageusia in COVID-19 and its correlation with age, sex, and severity of disease in the Nepalese population. METHODS: Patients with laboratory-confirmed COVID-19 infection by reverse transcription-polymerase chain reaction (RT-PCR) done at Shukraraaj Tropical and Infectious Disease Hospital, Kathmandu were recruited. Questionnaires based on loss of taste and loss of smell components including age, sex, ethnicity, comorbidities were prepared, and the patients were interviewed retrospectively by phone contact. RESULTS: A total of 300 patients were enrolled in our study. The mean age of the patients was 38.36±14.24 years. Prevalence of loss of smell was 54%(N=162) and loss of taste was 53% (N=159). Both of the symptoms were present in 45% of patients. The severity of the disease has a statistically significant effect on the loss of smell and taste whereas gender and smoking history has no significant difference over it. CONCLUSIONS: More than half of the COVID-19 positive patients in our cohort had either loss of taste or loss of smell with the severity of disease having a significant effect on it.

The Morphological Variation of the Soft Palate in Hospital Visiting Patients.

BACKGROUND: The soft palate anatomy of individuals can have a range of morphologies. Cephalometric analysis is a low-cost approach to analyze the soft palate in patients with or without developmental abnormalities. METHODS: The lateral cephalogram of the patients visiting Tribhuvan University Teaching Hospital, Institute of Medicine for various dental treatment purposes was evaluated. The soft palate was delineated on the radiographs by sketching the soft palate's contour along its radiolucent outline using the curve lines and connectors of Microsoft PowerPoint. The soft palate was then categorized according to the study by You M et al. Results: The different types of soft palate morphology observed in the study were rat tail (42.4%), leaf-like (40.8%), butt-like shape (8.9%), straight-line (4.7%), s-shaped (1.9%), and crooked (0.9%). The males had rat-tail (44.4%), leaf-like (41.1%), butt-like shape (8.4%), straight-line (3.9%), s-shaped (1.3%), and crooked (0.6%), whereas the females had rat-tail like (40.6%), leaf-like (40.6%), butt-like shape (9.5%), straight-line (5.6%), s-shaped (2.5%), and crooked (1.2%) types of soft palate. CONCLUSIONS: The rat-tail form of the soft palate was the most prevalent, followed by the leaf-like in both sexes. The least common type was the crooked form. This study found no evidence of sexual dimorphism.

A checklist of spiders of Nepal (Arachnida; Araneae).

Spiders (order Araneae) have a worldwide distribution. As of June 17, 2022, the World spider catalog, Version 23.0, enlists 50,188 species of spiders from throughout the world. Except for the open sea and air, spiders live in every ecological environment. They prefer densely vegetated environments and are the world's seventh most diverse group of creatures in terms of species diversity. The checklist of spiders of south Asia mentions 222 spider species from Nepal, grouped into 23 families. However, the official database of the Nepalese government only lists 175 species of Nepalese spiders. This checklist is a vital update to the diversity of the spider fauna of Nepal. The goal is to compile a thorough list of all the spiders found in Nepal. We have enlisted 386 different spider species from Nepal, belonging to 135 different genera and 34 different families, after reviewing previous scientific publications, computer databases of the Nepalese government, and the World spider catalog, Version 23.0. It adds a total of 211 new spiders to Nepal's biodiversity database. Linyphiidae and Salticidae spiders dominate accounting for 27.46 percent and 17.36 percent of total species, respectively, on the checklist. Corrections to previous misidentifications are also included in this checklist, as well as taxonomy revisions. Synonymous species are sorted out to avoid recurrence. The trends in Nepalese spider discovery and dispersion have also been studied.

How will hydro-energy generation of the Nepalese Himalaya vary in the future? A climate change perspective.

Despite being one of the proven clean-energy technologies, hydroelectricity is losing attention in global research. Hydroelectricity is extremely important for countries possessing the required water resources, already heavily reliant on it and those lacking the financial capacity to invest in other expensive energy technologies. This study assessed the possible impact of climate change (CC) on hydro-energy generation in the Nepalese Himalaya (possessing eight peaks out of 14 over 8000 m) with a tremendous hydropower potential (∼50,000 MW). A planned 1200 MW storage type Budhigandaki Hydroelectricity Project is taken as a case. We estimated the energy generation for the baseline as well as 10 CC scenarios considering RCPs 4.5 and 8.5 at monthly, seasonal, and annual temporal scales for the mid-century. Results show that energy generation is highly dependent on the reservoir operating rule. The average annual energy generation is expected to vary within -5 to +12% of the base case in the mid-century, with significant variations across the months. We also infer that designing hydro-projects based on ensembled climate values could lead to a "rosy" but less probable and risky picture of energy generation in the future. Therefore, assessment of a wide spectrum of plausible CC scenarios are recommended. Storage type projects with provision of flexible operating rules considering finer temporal resolution and allocation to competing users (in case of multipurpose projects) supported by appropriate policies are desirable for climate resiliency. Complementing the existing energy generation mix with other technologies in areas where hydroelectricity is expected to undergo adverse impacts of CC is warranted for attaining future energy security and environmental safeguarding. Possibility of additional energy due to CC is a strong motivation for this region to focus on hydroelectricity development in the future.

Development of a scale to evaluate negative menstrual attitudes among Nepalese women.

BACKGROUND: Menstrual attitudes include negative and positive perceptions of menstruation and are associated with reproductive health, underscoring the importance of its evaluation in women. Given that social and cultural factors affect menstrual attitudes, developing evaluation methods specific to distinct societal cultures is necessary. METHODS: We developed a scale based on the menstrual attitude questionnaire, which is the most widely used measure of menstrual attitudes, to evaluate negative menstrual attitudes among Nepalese women in consideration of Nepalese cultural backgrounds and literacy. In total, 352 Nepalese women aged 20-45 years living in urban or suburban areas in Nepal were enrolled in the study. Participants were randomly divided into two groups using the permuted block method. Using the prototype, Group 1 (n = 176) was evaluated with an exploratory factor analysis to develop a reliable scale, and Group 2 (n = 176) was evaluated with a confirmatory factor analysis to confirm the structure of negative menstrual attitudes. Further, we preliminarily examined the relationship of negative menstrual attitudes with the frequency of traditional menstrual practices and intensity of menstrual pain, which are significant reproductive health issues in Nepal, in Group 2. RESULTS: We developed a 15-item, 3-factor scale to evaluate negative menstrual attitudes among Nepalese women using exploratory factor analysis. The first, second, and third factors were "Natural event" (α = 0.82), "Debilitating event" (α = 0.76), and "Bothersome event" (α = 0.69), respectively. Confirmatory factor analysis revealed that negative menstrual attitudes comprised a 3-factor structure. Participants who performed three traditional menstrual practices ("stay in their own house", "go to public spaces", and "contact with others generally") demonstrated significantly higher scores for negative menstrual attitudes than did non-performers. Negative menstrual attitudes were positively correlated with the intensity of menstrual pain (r = 0.558). CONCLUSIONS: This study is the first to evaluate menstrual attitudes and analyse its factor structure among Nepalese women. In the future, the relationship between accurately evaluated negative menstrual attitudes and reproductive health issues should be examined more comprehensively.

For sexually mature women, menstruation may be considered burdensome, but its absence may also be a source of concern. Perceptions regarding menstruation are collectively referred to as menstrual attitudes. Previous studies have reported that negative menstrual attitudes are associated with various reproductive health issues in women and vary according to social and cultural backgrounds. To adequately evaluate negative menstrual attitudes among Nepalese women (20­45 years old), we developed a 15-item scale that considers their cultural background and literacy. We observed that attitudes toward menstruation among Nepalese women consisted of three emotions: one positive emotion, including "menstruation is a natural phenomenon", and two negative emotions, including "menstruation is debilitating" and "menstruation is bothersome". In several developing countries, menstruating women are considered unclean, and various restrictions are imposed on women during menstruation (traditional menstrual practices). Nepalese women with strong negative menstrual attitudes, as assessed by our scale, engaged in several traditional menstrual practices with higher frequency. We also observed that women with more negative menstrual attitudes presented with more severe menstrual pain. Our scale was developed to be compatible with the values and literacy of Nepalese women and was easy to answer. We believe that reducing negative emotions toward menstruation will contribute to reducing the frequency of traditional menstrual practices and menstrual pain, thereby facilitating school attendance and entry into the workforce among women in Nepal.

Understanding Medication Adherence in Bhutanese Refugees With Diabetes in a Midwestern City.

INTRODUCTION: Bhutanese refugees have a higher prevalence of type 2 diabetes but are less likely to achieve medication adherence and glycemic control. The purpose of this project was to understand factors affecting diabetes medication adherence in this population. METHODOLOGY: This was a qualitative project using focus groups of adult Bhutanese refugees with type 2 diabetes ≥18 years old and hemoglobin A1C ≥8% and their caregivers from a family medicine clinic at the University of Kansas. Data were analyzed using content analysis. RESULTS: A total of 23 individuals participated. Three themes emerged from data analysis: desire to engage in care but face multiple barriers, family and community support invaluable for health, and considerations for culturally contextual person-centered care. Participants provided specific recommendations to address the barriers, with emphasis on improving health literacy. DISCUSSION: Integrating the identified factors can foster person-centered, culturally congruent care to improve diabetes medication adherence in Bhutanese refugees.

Assessing the industrial readiness for adoption of industry 4.0 in Nepal: A structural equation model analysis.

Industry 4.0 (I4.0) mainly focuses on manufacturing technology and processes that comprise a cyber-physical system (CPS), Internet of things (IoT), Industrial Internet of things (IIOT), Cognitive Computing and Artificial intelligence as innovation towards the computerization and exchange of information. Though it has been an emerging issue in the industrial and business world, very few studies has been undertaken in the Nepalese case. In this context, the study accesses the industrial readiness for the adoption of I4.0 in Kathmandu valley, Nepal. Explanatory Exploratory research design was adopted to examine if variables chosen actually affect industrial readiness and data was collected through structured questionnaires using both descriptive and inferential statistics via Structural Equation Modeling (SEM). Adopting the census method to collect data, a total of 287 industries located in three industrial estates were taken as a population. Collected data were analyzed using SPSS and AMOS. The study found that the major problem while adopting I4.0 is the lack of skilled manpower in the industrial sector. In addition, we found people, customers, and culture, strategy and leadership, governance and operations have a significant effect on technology innovation decision making. Similarly, government intervention plays a significant mediation role between dependent and independent variables. Furthermore, this study found industries in Nepal are not ready for I4.0 as they are not implementing any enabling technology that enables industry 4.0. These results will support managers/policymakers in recognizing the strategic actions that can be embraced in order to improve the company's readiness level to seek the optimum benefits from the adoption of I4.0 paradigms.

Knowledge, attitude, practice and perceived barriers of natural disaster preparedness among Nepalese immigrants residing in Japan.

BACKGROUND: Natural disasters have increased during the last several decades all over the world. Due to its geographical and climate conditions, Japan has long been vulnerable to several natural disasters. Coping with disasters is a major challenge overall and even harder for foreigners residing in Japan. Thus, the objective of this study was to examine the perceived knowledge, attitude, practice and perceived barriers of disaster preparedness among Nepalese immigrants in Japan. METHODS: A cross-sectional study was conducted among Nepalese immigrants residing in Japan with an online survey questionnaire. The questionnaire was validated and then administered. The participants were recruited via Facebook for this survey. Bivariable and multivariable logistic regression analyses were conducted to examine the factors associated with the perceived knowledge, attitude and practice of Nepalese immigrants regarding disaster preparedness. RESULTS: A total of 404 respondents were analyzed in this study and among them two-third were male. We found that the mean score of disaster preparedness practice was lowest than the knowledge and attitude (mean [Formula: see text] = 15.86 [Formula: see text] 5.52) as evidenced by the majority of the participants not being prepared for disaster situations and a limited proportion had ever taken necessary natural disaster preparedness measures. Japanese language was identified as the major barrier in assessing the knowledge, attitude and practice regarding disaster preparedness and was significantly associated with the knowledge level of disaster preparedness after adjusting for some socio-demographic covariates. (aOR: 1.84, 95% CI: (1.04 - 3.25)). CONCLUSIONS: This study observed that the perceived knowledge and practices regarding natural disasters are very poor while barriers to access these are substantial among Nepalese immigrants in Japan. As Japanese language was identified as a major barrier, the availability of language translation services in every health care sector also in the government offices of Japan might encourage people to learn more about disaster preparedness.

A non-traditional dietary pattern increases risk of coronary artery disease in the Nepalese population.

OBJECTIVES: Several dietary patterns are associated with cardiovascular diseases. Traditional, Western, Mediterranean, and vegetarian are common dietary patterns, derived from principal component analysis (PCA) of dietary food intakes associated with cardiovascular diseases; however, these patterns were derived mostly from the diet habits of people in Western and European countries. Therefore, the present study aimed to determine dietary patterns linked with coronary artery disease (CAD) in the Nepalese population. METHODS: Food frequency questionnaires were used to estimate dietary intakes in 306 people with CAD and 306 people in a control group matched for age and sex. PCA was performed to deduce the dietary patterns, and conditional logistic regression was executed to determine the association of the dietary patterns with CAD. RESULTS: The component of PCA with higher loadings of refined grain, sugar, and meat and lower loadings of milk, whole grain, and fruit was named the non-traditional dietary pattern in the present study. We found a 34% increased risk of CAD (odds ratio, 1.34; 95% confidence interval, 1.14-1.58; P < 0.001) associated with this dietary pattern after adjusting for smoking, physical activity, and cardiometabolic risk factors. Dietary-pattern scores were further categorized into tertiles, and the third tertile was observed with significanly higher odds of CAD than the first tertile (odds ratio, 2.32; 95% confidence interval, 1.3-4.14; P for trend = 0.004). CONCLUSIONS: PCA-derived non-traditional dietary patterns can be a risk for developing CAD in Nepalese people. However, further cohort studies or randomized community trials are suggested to confirm our findings.

Diversity and Distribution of Forest Ants (Hymenoptera: Formicidae) in Nepal: Implications for Sustainable Forest Management.

The information available on the diversity of ant species and their distribution and interaction with forest health in Nepal remains limited. As part of a nationwide project on forest health, we conducted inventories to assess the diversity and distribution of forest ants and their role in forest management in Nepal. Ants were collected from 187 plots of 10 m × 10 m size along the north-south belt transects in eastern, central, and western Nepal. We used vegetation beating, sweeping, and hand collection methods in selected forest types. In each transect, we designed six plots in each major forest type (Sal, Schima-Castanopsis, and broadleaf mixed forests) and three plots each in deodar, Alnus, riverine, and Cryptomeria forests. We recorded 70 ant species from 36 genera and six subfamilies. This includes five genera and nine species new for the country, as well as eight tramp species, four of which are major ecological, agricultural, and/or household pests. Our study indicates that forest ant species richness is high in western Nepal and the Siwaliks, and it decreases as elevation increases. The high diversity of ant species in the forests of Nepal needs to be assessed with further exploration using multiple sampling methods covering all seasons and forest types. Ants can be useful indicators for ecosystem management and human impacts on forests. Reports of invasive ants in Nepalese forests indicate the relevance of urgent interventions through sustainable forest management initiatives to prevent future incursions.

Pathways to mental health care in Nepal: a 14-center nationwide study.

BACKGROUND: Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes. METHODS: This was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed. RESULTS: Most of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt. CONCLUSIONS: Faith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.