Opportunities and challenges for circular economy in the Maldives: A stakeholder analysis of informal E-waste management in the Greater Malé Region.

In the Maldives, the contribution of the informal sector to e-waste management is significant as a formal e-waste management system is not yet established. The opportunities for advancing the circular economy in the Maldives' e-waste sector rely on the possibility of its formalization. This study aimed to examine the current and anticipated situations of e-waste management in the Greater Malé Region of the Maldives, with a specific focus on formalizing the informal sector. Interviews and questionnaire-based surveys were conducted followed by statistical analysis of the data. The t-test performed for the consumer survey data (n = 202) suggests that formalization encourages consumers to engage with the informal sector, resulting in increased resource recovery. Thematic analysis of interviews conducted with both formal and informal sector stakeholders (n = 17) revealed that the informal sector plays a substantial role in managing e-waste. It also underscored the need for government assistance to enhance safety and productivity in this sector. Various opportunities and challenges for establishing a circular economy in the country were identified, such as the rise in e-waste generation, the presence of an active informal workforce, the lack of sufficient government support, and prevailing stereotypes among consumers regarding informal workers. These findings provide a fresh perspective on the solutions for waste management in the Maldives and open the door to further explore the significance of the informal sector and feasible formalization initiatives. This study could contribute to the literature on the role of the informal sector in waste management in the Maldives and other small island developing states.

Foraging and the importance of knowledge in Pemba, Tanzania: implications for childhood evolution.

Childhood is a period of life unique to humans. Childhood may have evolved through the need to acquire knowledge and subsistence skills. In an effort to understand the functional significance of childhood, previous research examined increases with age in returns to foraging across food resources. Such increases could be due to changes in knowledge, or other factors such as body size or strength. Here, we attempt to unpack these age-related changes. First, we estimate age-specific foraging returns for two resources. We then develop nonlinear structural equation models to evaluate the relative importance of ecological knowledge, grip strength and height in a population of part-time children foragers on Pemba island, Tanzania. We use anthropometric measures (height, strength, n = 250), estimates of ecological knowledge (n = 93) and behavioural observations for 63 individuals across 370 foraging trips. We find slower increases in foraging returns with age for trap hunting than for shellfish collection. We do not detect any effect of individual knowledge on foraging returns, potentially linked to information sharing within foraging parties. Producing accurate estimates of the distinct contribution of specific traits to an individual's foraging performance constitutes a key step in evaluating different hypotheses for the emergence of childhood.

Independent evolution of intermediate bill widths in a seabird clade.

Interspecific introgression can occur between species that evolve rapidly within an adaptive radiation. Pachyptila petrels differ in bill size and are characterised by incomplete reproductive isolation, leading to interspecific gene flow. Salvin's prion (Pachyptila salvini), whose bill width is intermediate between broad-billed (P. vittata) and Antarctic (P. desolata) prions, evolved through homoploid hybrid speciation. MacGillivray's prion (P. macgillivrayi), known from a single population on St Paul (Indian Ocean), has a bill width intermediate between salvini and vittata and could also be the product of interspecies introgression or hybrid speciation. Recently, another prion population phenotypically similar to macgillivrayi was discovered on Gough (Atlantic Ocean), where it breeds 3 months later than vittata. The similarity in bill width between the medium-billed birds on Gough and macgillivrayi suggest that they could be closely related. In this study, we used genetic and morphological data to infer the phylogenetic position and evolutionary history of P. macgillivrayi and the Gough medium-billed prion relative other Pachyptila taxa, to determine whether species with medium bill widths evolved through common ancestry or convergence. We found that Gough medium-billed prions belong to the same evolutionary lineage as macgillivrayi, representing a new population of MacGillivray's prion that originated through a colonisation event from St Paul. We show that macgillivrayi's medium bill width evolved through divergence (genetic drift) and independently from that of salvini, which evolved through hybridisation (gene flow). This represents the independent convergence towards a similarly medium-billed phenotype. The newly discovered MacGillivray's prion population on Gough is of utmost conservation relevance, as the relict macgillivrayi population in the Indian Ocean is very small.

Enhancing pre-school teachers' competence in managing pediatric injuries in Pemba Island, Zanzibar.

BACKGROUND: Safe and healthy learning environment in pre-schools has received increased attention in promoting the well-being of pre-school children. However, pediatric injuries have remained one of the leading causes of childhood morbidity and mortality around the globe. Empowering pre-school teachers with first aid competencies have been identified as being of potential strategy against pediatric health burdens of problem. This study tested the effect of established pediatric first aid training on pre-school teachers' knowledge, attitude, and intention to practice first aid management to pre-school children in Zanzibar.  METHODS: Uncontrolled quasi-experimental design with a quantitative research approach was conducted in Teachers' Resource Centers among 120 preschool teachers at Pemba Island, Zanzibar. First aid training was facilitated based on the prescribed guidelines and standards of materials adapted from the American Academy of Pediatrics and implemented. The intervention was preceded by a baseline assessment using structured questionnaires adopted from previous studies that served as the main data collection tool. RESULTS: Participants' mean age was 32 years ± 6.2 with 84.2% of the sample being females. Given the training, post-test findings demonstrated a significant increase (p < 0.01) in participants' first aid management scores with mean differences of M = 15.08 ± 5.34 (Knowledge), M = 26.99 ± 6.587 (Attitude), and (M = 4.76 ± 0.648 (Intentional practice). CONCLUSION: The established pediatric first aid training can enhance the spectrum of managing pediatric injuries among preschool teachers in Zanzibar. Ongoing public health services opportunities should be structured within teachers' continuous learning against pediatric injuries in Zanzibar-Tanzania.

Pharmacological management of South Asians with type 2 diabetes: Consensus recommendations from the South Asian Health Foundation.

South Asians constitute approximately 1.6 billion people from the Indian subcontinent, comprising Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka; and make up the largest diaspora globally. Compared to the White European population, this group is at a higher risk of developing type 2 diabetes along with cardiovascular, renal and eye complications. Over the recent years, a number of new therapies for type 2 diabetes have become available for which cardiovascular outcome trials (CVOTs) have been published. The recent ADA/EASD consensus guidelines on diabetes, pre-diabetes and cardiovascular diseases' offer a transitional shift in type 2 diabetes management. The new consensus recommendations are based on recent CVOTs, many of which had a representation of South Asian cohorts. In light of this new evidence, there is urgent need for an integrated, evidence-based, cost-effective and individualised approach specific for South Asians. This review takes into consideration the evidence from these CVOTs and provides best practice recommendations for optimal management of South Asian people with type 2 diabetes, alongside the previously published consensus report from South Asian Health Foundation in 2014 [1].

Lethal Cenani Lenz syndrome in two consecutive pregnancies: Further extension of phenotype from Maldives.

Cenani Lenz syndrome is a rare autosomal recessive disorder associated with variable degree of limb malformations, dysmorphism, and renal agenesis. It is caused due to pathogenic variants in the LRP4 gene, which plays an important role in limb and renal development. Mutations in the APC gene have also been occasionally associated with CLS. The phenotypic spectrum ranges from mild to very severe perinatal lethal type depending on the type of variant. We report a pathogenic variant, c.2710 del T (p.Trp904GlyfsTer5) in theLRP4 gene, in a fetus with lethal Cenani Lenz syndrome with antenatal presentation of tetraphocomelia and symmetrical involvement of hands and feet.

Parasites in a hotspot: diversity and specificity patterns of apicomplexans infecting reptiles from the Socotra Archipelago.

Although parasites represent a major component of biodiversity, they remain poorly assessed, especially in remote regions. In this study, we screened 461 reptiles from Socotra, the largest and most biologically diverse archipelago in Arabia. Using 18S rRNA primers, we detected various apicomplexan parasites, namely haemogregarines, sarcocystids and eimeriids. Haemogregarines were the most common and genetically diverse, followed by sarcocystids (genus Sarcocystis) and eimeriids (genera Isospora and Lankesterella). All were related to parasites of other reptiles, including species from Arabia, Northern Africa and Asia. Like their 29 endemic reptile hosts, almost all Socotran parasites presented high genetic divergence and ecological differences from those found elsewhere, and probably represent undescribed endemic species. Among hosts, skinks were the most parasitized, which contrasted with similar studies from other areas, probably due to their more generalist diet and habitat use. As expected due to its high species richness, geckos harboured the highest parasite diversity in the archipelago. Parasite diversity also seemed to be correlated to island size, as the largest island harboured most haplotypes. This study emphasizes the importance of screening parasites in wild hosts from remote regions and of considering host ecology to understand disease transmission across taxa.

Evolution of Darwin's finches and their beaks revealed by genome sequencing.

Darwin's finches, inhabiting the Galápagos archipelago and Cocos Island, constitute an iconic model for studies of speciation and adaptive evolution. Here we report the results of whole-genome re-sequencing of 120 individuals representing all of the Darwin's finch species and two close relatives. Phylogenetic analysis reveals important discrepancies with the phenotype-based taxonomy. We find extensive evidence for interspecific gene flow throughout the radiation. Hybridization has given rise to species of mixed ancestry. A 240 kilobase haplotype encompassing the ALX1 gene that encodes a transcription factor affecting craniofacial development is strongly associated with beak shape diversity across Darwin's finch species as well as within the medium ground finch (Geospiza fortis), a species that has undergone rapid evolution of beak shape in response to environmental changes. The ALX1 haplotype has contributed to diversification of beak shapes among the Darwin's finches and, thereby, to an expanded utilization of food resources.

Navigating the health system in responding to health workforce challenges of the COVID-19 pandemic: the case of Maldives (short case).

Being a small island and low-middle income country (LMIC) heavily dependent on global markets for sustaining its basic needs and health system, Maldives faced specific challenges during the COVID-19 pandemic. This was reinforced through tensions between the heavily centralized healthcare delivery and a partially decentralized public health system. Using the pillars of pandemic response proposed by the World Health Organisation, this article explores the planning assumptions, resource estimations and strategies adopted to equip the health system with resources for the pandemic response. The resource need estimates based on projections for COVID-19 identified a shortfall of medical professionals to care for patients while maintaining 55% of the workforce for regular healthcare across the atolls. The findings show that while the policy of lockdown bought time to increase hospital beds and devices, the country was unable to increase the healthcare workforce. Furthermore, as the lockdown eased, the exponential increase of cases took Maldives to the global one per capita incidence. Despite this, with cautious planning and use of resources, the country has so far managed to maintain low mortality from COVID-19. The lessons from this experience are paramount in future pandemic response planning, not only for Maldives, but other small island LMICs.

Knowledge, attitudes and practices of South Asian immigrants in developed countries regarding oral cancer: an integrative review.

BACKGROUND: Oral cancer is a growing problem worldwide, with high incidence rates in South Asian countries. With increasing numbers of South Asian immigrants in developed countries, a possible rise in oral cancer cases is expected given the high prevalence in their source countries and the continued oral cancer risk behaviours of immigrants. The aim of this review is to synthesise existing evidence regarding knowledge, attitudes and practices of South Asian immigrants in developed countries regarding oral cancer. METHODS: Five electronic databases were systematically searched to identify original, English language articles focussing on oral cancer risk knowledge, attitudes and practices of South Asian immigrants in developed countries. All studies that met the following inclusion criteria were included: conducted among South Asian immigrants in developed countries; explored at least one study outcome (knowledge or attitudes or practices); used either qualitative, quantitative or mixed methods. No restrictions were placed on the publication date, quality and setting of the study. RESULTS: A total of 16 studies involving 4772 participants were reviewed. These studies were mainly conducted in the USA, UK, Italy and New Zealand between 1994 and 2018. Findings were categorised into themes of oral cancer knowledge, attitudes and practices. General lack of oral cancer risk knowledge (43-76%) among participants was reported. More than 50% people were found engaging in one or more oral cancer risk practices like smoking, betel quid/pan/gutka chewing. Some of the participants perceived betel quid/pan/gutka chewing habit good for their health (12-43.6%). CONCLUSION: This review has shown that oral cancer risk practices are prevalent among South Asian immigrants who possess limited knowledge and unfavourable attitude in this area. Culturally appropriate targeted interventions and strategies are needed to raise oral cancer awareness among South Asian communities in developed countries.

Zygosaccharomyces seidelii sp. nov. a new yeast species from the Maldives, and a revisit of the single-strain species debate.

Zygosaccharomyces seidelii, a new species in the genus Zygosaccharomyces is described. The description of the species is based on a single strain that was isolated from flowers collected on the Maldives. On this occasion, the description of yeast species from single strains was revisited. Sequence analysis of the D1/D2 domain of the nuclear large subunit rRNA gene revealed that Z. seidelii is closely related to Z. gambellarensis. Both species differ by 2.6% (one indel of 7 bp and 9 substitutions) in the D1/D2 domain, 71 substitutions and 23 indels in the ITS1-5.8S-ITS2 (ITS) region and by several physiological tests. Two divergent copies of the ITS region were detected in Z. seidelii. Asexual and sexual reproduction as well as the physiological properties of Z. seidelii fit well in the genus Zygosaccharomyces. (Holotype strain: CBS 16021, Isotype strain: CLIB 3343; MycoBank no.: MB830900).

Incidence, prevalence and mortality of diabetes in children and adolescents aged under 20 years in the Republic of Maldives.

AIM: There is little published data on diabetes in youth in the Maldives. This study aimed to determine incidence, prevalence and mortality of diabetes in children and adolescents <20 years. METHODS: Data on all known existing cases in 2009 and all new cases from 2009 to 2018 was collected from the Diabetes Society of the Maldives registry. RESULTS: Thirty-nine subjects <20 years were known to have diabetes at the start of 2009 and 92 new cases were diagnosed from 2009 to 2018. Of the 92 new cases, 76 had type 1 diabetes (T1D), 15 type 2 diabetes (T2D) and one secondary diabetes. Of the 76 new T1D cases, 64 were diagnosed <15 years. Mean age of onset for T1D <20 years was 10 ± 4.6 years, with 42 (55.3%) female. Ten (13.2%) were diagnosed 0-4 years, 27 (35.5%) 5-9 years, 27 (35.5%) 10-14 years and 12 (15.8%) 15-19 years. Annual T1D mean incidence rates/per 100 000 subjects for <15/<20 years, respectively, increased from 3.6/2.7 in 2009 to 11.0/9.1 in 2018, representing 12.0%/13.0% annualised increases (P = 0.01 for both). T1D prevalence in 2018 for <15 and <20 years was 47.1/100 000 and 52.0/100 000, respectively. No young person with T1D died during this period, with a total of 262 patient-years of follow-up for T1D cases. The child with secondary diabetes died of other causes. CONCLUSION: T1D incidence in Maldives is higher than that reported from other South Asian countries, and an increasing trend was observed. T2D also occurs relatively frequently. A zero mortality rate was observed for children and young adults with T1D and T2D from 2009 to 2018.

Movement and habitat use of striped marlin Kajikia audax in the Western Indian Ocean.

Striped marlin Kajikia audax are globally Near Threatened and their stock in the Indian Ocean was last assessed as "overfished and subject to overfishing". Significant gaps in our understanding of their ecology remain, hampering the efforts of fisheries managers to ensure stock sustainability. There is a particular lack of fisheries-independent data. Here we present the results from the first large-scale satellite tracking study of K. audax in the Indian Ocean. We tagged 49 K. audax with pop-up archival satellite-linked tags off the Kenyan coast from 2015 to 2019. Individuals were highly mobile, covering horizontal distances of up to 9187 km over periods ranging up to 183 days, with a mean daily distance of ~48 km. Long-distance movements were recorded to the east and north of East Africa, with the most distant tracks extending north to the Arabian Sea and east to near the Maldives. None of the K. audax swam south of East Africa. Kernel utilization distributions of fish locations demonstrated their shifting seasonal activity hotspots. Over the sport-fishing season (and tagging period) in Kenya, from December to March, K. audax typically stayed off the East African coast. After March, the activity hotspot shifted north to a region close to the Horn of Africa and Socotra Island. Remotely sensed sea surface temperature and chlorophyll-a maps indicated that this seasonal movement could be driven by a shift in prey availability. Our results show the high mobility of K. audax in the Western Indian Ocean, and that individuals seasonally range between two major fishing areas.

Identification of abuse experiences of South Asian women in the US and women in Mumbai, India.

The authors describe the experiences of abuse drawn from in-depth interviews conducted with 20 South Asian women in the United States and a sample of 21 abused women in Mumbai, India. We describe five major themes that identify the nature of domestic violence experienced in these two contexts, barriers to help-seeking and exiting abuse, and the process of ending the abusive relationship. The research sheds light on the similarities and differences in the two contexts. We outlined the similarities in the following themes (a) type of abuse, (b) treatment of children (c) abandonment. We found differences in the following themes (d) joint meeting, (e) back and forth between natal and marital home.

Modelling Agriculture, Forestry and Other Land Use (AFOLU) in response to climate change scenarios for the SAARC nations.

Agriculture and forestry are the two major land use classes providing sustenance to the human population. With the pace of development, these two land use classes continue to change over time. Land use change is a dynamic process under the influence of multiple drivers including climate change. Therefore, tracing the trajectory of the changes is challenging. The artificial neural network (ANN) has successfully been applied for tracing such a dynamic process to capture nonlinear responses. We test the application of the multilayer perceptron neural network (MLP-NN) to project the future Agriculture, Forestry and Other Land Use (AFOLU) for the year 2050 for the South Asian Association for Regional Cooperation (SAARC) nations which is a geopolitical union of Afghanistan, Bangladesh, Bhutan, India, Nepal, Maldives, Pakistan and Sri Lanka. The Intergovernmental Panel on Climate Change (IPCC) and Food and Agriculture Organization (FAO) use much frequently the term 'AFOLU' in their policy documents. Hence, we restricted our land use classification scheme as AFOLU for assessing the influence of climate change scenarios of the IPCC fifth assessment report (RCP 2.6, RCP 4.5, RCP 6.0 and RCP 8.5). Agricultural land would increase in all the SAARC nations, with the highest increase in Pakistan and Maldives; moderate increase in Afghanistan, India and Nepal; and the least increase in Bangladesh, Bhutan and Sri Lanka. The forestry land use will witness a decreasing trend under all scenarios in all of the SAARC nations with varying levels of changes. The study is expected to assist planners and policymakers to develop nations' specific strategy to proportionate land use classes to meet various needs on a sustainable basis.

Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments: A Scientific Statement From the American Heart Association.

South Asians (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) make up one quarter of the world's population and are one of the fastest-growing ethnic groups in the United States. Although native South Asians share genetic and cultural risk factors with South Asians abroad, South Asians in the United States can differ in socioeconomic status, education, healthcare behaviors, attitudes, and health insurance, which can affect their risk and the treatment and outcomes of atherosclerotic cardiovascular disease (ASCVD). South Asians have higher proportional mortality rates from ASCVD compared with other Asian groups and non-Hispanic whites, in contrast to the finding that Asian Americans (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) aggregated as a group are at lower risk of ASCVD, largely because of the lower risk observed in East Asian populations. Literature relevant to South Asian populations regarding demographics and risk factors, health behaviors, and interventions, including physical activity, diet, medications, and community strategies, is summarized. The evidence to date is that the biology of ASCVD is complex but is no different in South Asians than in any other racial/ethnic group. A majority of the risk in South Asians can be explained by the increased prevalence of known risk factors, especially those related to insulin resistance, and no unique risk factors in this population have been found. This scientific statement focuses on how ASCVD risk factors affect the South Asian population in order to make recommendations for clinical strategies to reduce disease and for directions for future research to reduce ASCVD in this population.

Phenotypic plasticity in locomotor performance of a monophyletic group of weevils accords with the 'warmer is better' hypothesis.

Ectotherms may respond to variable environmental conditions by altering their phenotypes. Phenotypic plasticity was initially thought to be beneficial to an organism's physiological fitness but several alternative hypotheses have been proposed with growing empirical support. In this study, we tested the full suite of hypotheses by investigating acclimation responses of locomotor performance for nine populations of five species of sub-Antarctic weevils, using static and fluctuating temperatures. Species showed typical locomotion thermal performance curves with temperature of the maximum speed (Topt) ranging between 22.3±1.7°C (mean±s.e.m.) and 31.1±0.7°C. For most species, Topt was not affected by acclimation. For maximum speed (Umax), significant, positive effects of acclimation were found for all species except a supralittoral one. Individuals acclimated to 0°C showed much lower values than the other two acclimation treatments (15°C and fluctuating 0-15°C). Performance breadth (the index of the breadth of the curve, Tbr) typically showed little response to acclimation. None of the traits of the supralittoral species was affected by acclimation treatment. Responses to stable and fluctuating temperature treatments were similar. Our findings also revealed that the mean estimated activation energy 0.40±0.015 eV (mean±s.e.m.) was lower than for other herbivores, the category to which these weevils belong, suggesting that some form of compensation in the rate-temperature relationship may be evident. Thus, we typically found support for the 'warmer is better' hypothesis for acclimation of locomotor performance, although some compensation was evident.

Acetoin is a key odor for resource location in the giant robber crab Birgus latro.

The terrestrial and omnivorous robber crab Birgus latro inhabits islands of the Indian Ocean and the Pacific Ocean. The animals live solitarily but occasionally gather at freshly opened coconuts or fructiferous arenga palms. By analyzing volatiles of coconuts and arenga fruit, we identified five compounds, including acetoin, which are present in both food sources. In a behavioral screen performed in the crabs' habitat, a beach on Christmas Island, we found that of 15 tested fruit compounds, acetoin was the only volatile eliciting significant attraction. Hence, acetoin might play a key role in governing the crabs' aggregation behavior at both food sources.

Prevalence of pelagic dependence among coral reef predators across an atoll seascape.

Coral reef food webs are complex, vary spatially and remain poorly understood. Certain large predators, notably sharks, are subsidized by pelagic production on outer reef slopes, but how widespread this dependence is across all teleost fishery target species and within atolls is unclear. North Malé Atoll (Maldives) includes oceanic barrier as well as lagoonal reefs. Nine fishery target predators constituting ca. 55% of the local fishery target species biomass at assumed trophic levels 3-5 were selected for analysis. Data were derived from carbon (δ13 C), nitrogen (δ15 N) and sulphur (δ34 S) stable isotopes from predator white dorsal muscle samples, and primary consumer species representing production source end-members. Three-source Bayesian stable isotope mixing models showed that uptake of pelagic production extends throughout the atoll, with predatory fishes showing equal planktonic reliance between inner and outer edge reefs. Median plankton contribution was 65%-80% for all groupers and 68%-88% for an emperor, a jack and snappers. Lagoonal and atoll edge predators are equally at risk from anthropogenic and climate-induced changes, which may impact the linkages they construct, highlighting the need for management plans that transcend the boundaries of this threatened ecosystem.