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Ongoing measles outbreak in Romania: Clinical investigation and molecular epidemiology performed on whole genome sequences
Aim Romania is currently facing a prolonged measles outbreak. The aim of the study was to analyse the circulating human measles virus (HMV) strains by combining whole genome sequencing (WGS) with phylogenetic analysis, with a focus on the haemagglutinin gene. Methods We conducted an observational study in the first five months of 2024, in which 168 patients diagnosed with measles were randomly included. We have evaluated the clinical and epidemiological differences between children and adults. Screening for samples to be sequenced was performed with a commercial kit (PrimerDesign). WGS was done on Illumina MiSeq platform and phylogenetic analysis was performed with ML FastTree. Results No significant epidemiological and clinical differences between patients in the two age groups were identified. WGS was successfully performed for a number of 124 HMV strains. Genotype analysis indicated all the sequences as D8, except one that was B3. Phylogenetic analysis identified two well supported clusters, suggestive for at least two local transmission networks in Romania. One large transmission network (n = 108) consisted of sequences both from adults and children. Only one sequence from outside Romania (reported in Russia in 2023) clustered within this group. Another small transmission cluster was identified (14 sequences of which 11 from patients infected in the spring of 2024 and three in 2022). A few differences between the two co-circulating viral variants/clusters were observed. The median duration of hospitalisation was 2 days longer for patients in smaller cluster compared to those in the larger one (p = 0.019). Furthermore, these two clusters presented different mutation profiles in the hemagglutinin (HA) and neuraminidase (N) genes with implications for molecular surveillance. Conclusion The current measles epidemic in Romania is driven mainly by two D8 genotype variants with different mutation profiles and slightly different severity of the disease, highlighting the usefulness of sustained molecular surveillance.
Correction: Association between nutritional level, menstrual-related symptoms, and mental health in female medical students
Are men’s gender equality beliefs associated with self-reported intimate partner violence perpetration? A state-level analysis of California men
Objectives To assess the association between gender equality beliefs and self-reported intimate partner violence (IPV) perpetration among California men. Methods We analyzed men’s data (N = 3609) from three waves (2021, 2022, and 2023) of cross-sectional data from a statewide sample of California adults. We assessed gender equality beliefs using a three-item measure adapted from the World Values Survey, with higher scores representing more gender unequal beliefs (e.g., ‘On a whole, men make better political leaders than women’). We assessed IPV perpetration in the last year by asking a) whether men committed any form of violence in the last year (physical violence, use or threat of violence with a weapon, sexual violence) and b) among those who reported committing violence, who they committed violence against. Those reporting violence against “a spouse or romantic partner” were categorized as perpetrating past-year IPV. Analyses were weighted to yield population estimates. Crude and adjusted logistic regression models evaluated the association between gender equality beliefs and past-year IPV perpetration. Results Almost 2% of men–equivalent to more than 280,000 men in California—reported IPV perpetration in the past year [1.9% (95%CI = 1.4–2.5)], and every one-point increase in their gender equality belief scale score [indicative of less gender equitable beliefs] was associated with 2.1 times greater odds of perpetrating past-year IPV (AOR: 2.14, 95%CI 1.61–2.86). Conclusions Findings support prior research indicating that patriarchal beliefs reinforce men’s violence against women in relationships and signal a need for violence prevention efforts focused on boys and men to that can include normative belief shifts related to women’s capacities.
Partially unraveling mechanistic underpinning and weight loss effects of time-restricted eating across diverse adult populations: A systematic review and meta-analyses of prospective studies
Time-restricted eating (TRE) is a promising and cost-effective dietary approach for weight management. This study aimed to evaluate the effects of TRE on weight loss in three adult populations using pre- and post-intervention analyses while also investigating its underlying mechanism. A systematic search was conducted across four databases (PubMed, Web of Science, Scopus, and the CENTRAL) up until January 28, 2024, specifically focusing on prospective studies that examined the efficacy of TRE in achieving weight loss. A random effects model was employed to conduct meta-analyses, while heterogeneity was assessed using the I2 statistic (PROSPERO: CRD42023439317). The study encompassed 36 selected studies involving 44 effect sizes and 914 participants. The effectiveness of the TRE was found to vary across health conditions, with modest weight loss observed in healthy individuals (pooled effect size -1.04 Kg, 95% CI: -1.42 to -0.65) and more significant weight reduction seen in participants with chronic diseases (pooled effect size -3.33 Kg, 95% CI: -5.05 to -1.62) and overweight/obesity (pooled effect size -4.21 Kg, 95% CI: -5.23 to -3.10). The observed decrease in body weight could be partially attributed to factors influencing energy balance, as evidenced by the significantly lower mean calorie intake at the end of the intervention (1694.71 kcal/day, 95% CI: 1498.57–1890.85) compared to the baseline intake (2000.64 kcal/day, 95% CI: 1830–2172.98), despite the absence of intentional efforts to restrict energy intake by the participants. These findings support the efficacy of this lifestyle intervention for weight loss maintenance and guide the development of its clinical guidelines.
Trait and plasticity evolution under competition and mutualism in evolving pairwise yeast communities
Although we have a good understanding of how phenotypic plasticity evolves in response to abiotic environments, we know comparatively less about responses to biotic interactions. We experimentally tested how competition and mutualism affected trait and plasticity evolution of pairwise communities of genetically modified brewer’s yeast. We quantified evolutionary changes in growth rate, resource use efficiency (RUE), and their plasticity in strains evolving alone, with a competitor, and with a mutualist. Compared to their ancestors, strains evolving alone had lower RUE and RUE plasticity. There was also an evolutionary tradeoff between changes in growth rate and RUE in strains evolving alone, suggesting selection for increased growth rate at the cost of efficiency. Strains evolving with a competitive partner had higher growth rates, slightly lower RUE, and a stronger tradeoff between growth rate and efficiency. In contrast, mutualism had opposite effects on trait evolution. Strains evolving with a mutualist had slightly lower growth rates, higher RUE, and a weak evolutionary tradeoff between growth rate and RUE. Despite their different effects on trait evolution, competition and mutualism had little effect on plasticity evolution for either trait, suggesting that abiotic factors could be more important than biotic factors in generating selection for plasticity.
Unveiling high solifuge diversity: Review of the genus Pseudocleobis Pocock, 1900 (Ammotrechidae) in Chile with the description of nine new species
The Pseudocleobis from Chile are revised. Pseudocleobis morsicans (Gervais, 1849) and P. chilensis Roewer, 1934 are considered species inquerenda. Pseudocleobis andinus (Pocock, 1899) is removed from the Chilean fauna, and its previous records are considered misidentifications. Pseudocleobis alticola Pocock, 1900 is recorded from Chile for the first time. Nine new species are described, Pseudocleobis elongatus n. sp., P. atacamensis n. sp., P. puna n. sp., P. krausi n. sp., P. choros n. sp., P. lalackama n. sp., P. mumai n. sp., P. cekalovici n. sp. and P. escuadra n. sp. The species can be distinguished by the male chelicera morphology. We discuss the relationship of Chilean Pseudocleobis with other species of the genus, based on morphology. This work increases the number of known Chilean solifuge species by almost 70%, revealing the high degree of diversification of this group in Chile.
Nearby armed conflict affects girls’ education in Africa
Female education is a crucial input to women’s agency and empowerment, and has wide-ranging impacts, from improved labor market outcomes to reducing child mortality. Existing gender-specific evidence on the effect of armed conflict on education is conflict-specific and mixed. We link granular data on conflict events to georeferenced survey data on educational attainment from 28 countries in Africa, and use a regression-based approach to estimate the local effect of conflict exposure on female years of schooling. We find that conflict events occurring within 25 kilometers during a female child’s primary school years reduces years of schooling by 0.4 years by adolescence. We do not find the same effect for males. Exposure to only low intensity conflict events with at most two casualties has persistent negative and significant effects. Consecutive years of conflict, however, can have positive effects in later years, which offset earlier negative effects, suggesting a habituation to violence. In the past two decades, we estimate excess child mortality in Africa associated with the indirect channel of women’s education to be similar in magnitude to the number of direct child casualties due to conflict.
Correction: In search of autophagy biomarkers in breast cancer: Receptor status and drug agnostic transcriptional changes during autophagy flux in cell lines
Knowledge of and perception towards eclampsia among women and men in Unguja Island, Zanzibar: A qualitative study
Background Eclampsia is among the primary causes of maternal and perinatal morbidity and mortality in Zanzibar. Many women and men are not aware of the signs, symptoms and causes of eclampsia and may have different explanatory models. Therefore, this study aimed to describe the community understanding of pre-eclampsia, as a key stage to improve maternal and perinatal health in Unguja Island, Zanzibar. Methods A qualitative study design of six focus group discussions (FDGs) was performed using a focus group interview guide; 51 male and female respondents at three selected wards of Unguja Island, Zanzibar participated. Thematic analysis was applied using Qualitative data analysis (QDA Miner Lite software version 2.0.9). Results Overall participants demonstrated a lack of understanding regarding eclampsia. The majority of participants perceived that there are certain things related to eclampsia: Mjusi or Mdudu (devil/satanic), superstitious issues, tension/stress from partners, food consumption, eating slaughtered meat like chicken, cow and goat during pregnancy, nice smelling lotion, soap and perfumes have been stated to be the causes of eclampsia. Spiritual and traditional remedies were mentioned as a treatment for eclampsia, including herbs, makombe (written verses of the Qur’an) and steaming (smoked dry leaves). Local names of eclampsia used by the communities, in urban and rural areas are mjusi (lizard) or mdudu (bug), which means the devil enters a woman’s body, especially during pregnancy or within 42 days post-delivery. Conclusion Most participants had a lack of understanding of eclampsia and perceived that there are traditional and spiritual issues related to its causes, attributed risks and clinical presentation, which makes them rely more on traditional and spiritual treatments. Therefore, health educational programs in the community setting and at the antenatal clinics, aiming at improving knowledge and dismissing myths and misperceptions regarding eclampsia, are recommended in rural and urban areas of Unguja Zanzibar.
Prevalence and determinants of unhealthy feeding practices among young children aged 6–23 months in five sub-Saharan African countries
Introduction Despite the World Health Organization’s advice against unhealthy feeding, many low- and middle-income countries, including sub-Saharan Africa (SSA) countries, are experiencing a nutritional transition to high in sugar, unhealthy fats, salts, and processed carbohydrates for younger children. However, there is a scarcity of recently updated multicounty information on unhealthy feeding practices and determinants in SSA countries. Therefore, this study aimed to assess the pooled prevalence of unhealthy feeding practices and determinants among children aged 6–23 months in five SSA countries. Method A cross-sectional study design was employed with the most recent demographic and health survey secondary data (DHS) from five SSA countries. This secondary data was accessed from the DHS portal through an online request. The DHS is the global data collection initiative that provides detailed and high-quality data on population demographics, health, and nutrition in low- and middle-income countries. We used a weighted sample of 14,064 children aged 6–23 months. A multilevel mixed-effect binary logistic regression model was fitted to identify significant factors associated with unhealthy feeding practices. The level of statistical significance was declared with p-value < 0.05. Result This study found that overall, 62.4% (95% CI: 61.62–63.17) of children aged 6–23 months in five SSA countries had unhealthy feeding practices. Rural residents, lower-middle-income SSA countries, and children aged above 12 months had lower odds of unhealthy feeding practices. On the other hand, richer households and women who had not had an optimal antenatal care visit had higher odds of unhealthy feeding practices. Conclusion According to this study, nearly two out of three young children in five SSA countries had unhealthy feeding practices. Both individual and community-level factors are significantly associated with unhealthy feeding practices. As a result, responsible bodies shall make all efforts to reduce unhealthy feeding practices among young children in SSA countries.
Design and fabrication of novel microfluidic-based droplets for drug screening on a chronic myeloid leukemia cell line
Background The challenges associated with traditional drug screening, such as high costs and long screening times, have led to an increase in the use of single-cell isolation technologies. Small sample volumes are required for high-throughput, cell-based assays to reduce assay costs and enable rapid sample processing. Using microfluidic chips, single-cell analysis can be conducted more effectively, requiring fewer reagents and maintaining biocompatibility. Due to the chip’s ability to manipulate small volumes of fluid, high-throughput screening assays can be developed that are both miniaturized and automated. In the present study, we employ microfluidic chips for drug screening in chronic myeloid leukemia. This study aimed to establish a robust methodology integrating diverse assays, providing a holistic understanding of drug response. Material and methods Herein, we have used a chronic myeloid leukemia derived cell line (K562) for drug screening with an innovative microfluidic-based drug screening approach to investigate the efficacy of imatinib in K562 cells. Cell viability was assessed using MTT assay. Apoptosis was measured using Annexin/PI staining by flow cytometry. Results Significant increased apoptosis was seen in K562 cells treated with imatinib in the microfluidic device compared to cells treated with imatinib in 24- and 96-well plates. Moreover, in the microfluidic chip, drug screening time was reduced from 48 hours to 24 hours. Conclusion Compared to traditional approaches, microfluidic-based drug screening efficiently evaluates the efficacy of imatinib in K562 cells. This approach is promising for drug discovery and treatment optimization, as it increases sensitivity and streamlines the screening process.
Hear it here: Built environments predict ratings and descriptions of ambiguous sounds
The built environments we move through are a filter for the stimuli we experience. If we are in a darker or a lighter room or space, a neutrally valenced sound could be perceived as more unpleasant or more pleasant. Past research suggests a role for the layout and lighting of a space in impacting how stimuli are rated, especially on bipolar valence scales. However, we do not know how affective experiences and descriptions of everyday auditory stimuli are impacted by built environments. In this study, we examine whether listening to a series of ambiguously valenced sounds in an older, darker building leads these sounds to be rated as less pleasant—and described using more negatively valenced language—compared to listening to these sounds in a newer building with more natural light. In a between-subjects design, undergraduate participants at an older building or a newer building (nOld = 46, nNew = 46; nFemale = 71, nMale = 18, MAge = 21.18, RangeAge = 17-38) listened to ten sounds that had previously been rated as ambiguous in valence, then rated these sounds on a bipolar valence scale before being asked to describe, in writing, how they felt about each sound. Participants rated sounds as being more pleasant at the New site compared to the Old site, but the sentiment of their descriptions only differed between sites when controlling for collinearity. However, bipolar scale ratings and description sentiment were highly correlated. Our findings suggest a role for the features of built environments in impacting how we appraise the valence of everyday sounds.
N-acetyl-L-cysteine and lauric acid; effective antioxidant and antimicrobial feed additives for juvenile Pacific white shrimp (Litopenaeus vannamei) cultured at high stocking density
Present study aimed at improving the immune and antioxidant response of Pacific white shrimp (Litopenaeus vannamei) cultured at high stocking density fed with 0.2% supplementation of lauric acid (LA) and N-acetyl-L-cysteine (NAC). Shrimp (initial average weight = 0.65 g; n = 270) were grown at low stocking density (LSD) (n = 10/0.80 ft3 per replicate) and high stocking density (HSD) (n = 20/0.80 ft3 per replicate). They were randomly distributed into five groups (T1: negative control at LSD, T2: positive control at HSD, T3: at HSD and fed with LA supplement diet, T4: at HSD and fed with NAC supplemented diet, T5: at HSD and fed with combination of LA and NAC). All these five treatments were studied in triplicates and study continued for eight weeks. Better growth and higher levels of glucose, total protein, total hemocyte count and phagocytic index were observed in shrimp fed with NAC and LA supplemented diets. Observed survival rate and feed conversion ratio in all treatments was 75–89% and < 0.82, respectively. All parameters indicating stress were observed to be higher in T1 as compared to T2. Improved expression of superoxide dismutase and glutathione peroxidase and lower levels of malondialdehyde genes in T3, T4 and T5 showed that supplementation with these nutraceuticals can improve antioxidant response at high stocking density. A parallel increase was observed in the profiles of prophenoloxidase and lysozyme, underscoring the immune-boosting effects of both NAC and LA. This finding was further supported by higher expression of innate immune signaling pathway-related gene, toll like receptor-2 in T3, T4 and T5. In conclusion, NAC and LA, can possibly improve the resistance of white pacific shrimp against oxidative stress and pathogens when cultured in intensive production system.
Nucleosome repositioning in cardiac reprogramming
Early events in the reprogramming of fibroblasts to cardiac muscle cells are unclear. While various histone undergo modification and re-positioning, and these correlate with the activity of certain genes, it is unknown if these events are causal or happen in response to reprogramming. Histone modification and re-positioning would be expected to open up chromatin on lineage-specific genes and this can be ascertained by studying nucleosome architecture. We have recently developed a set of tools to identify significant changes in nucleosome architecture which we used to study skeletal muscle differentiation. In this report, we have applied these tools to understand nucleosome architectural changes during fibroblast to cardiac muscle reprogramming. We found that nucleosomes surrounding the transcription start sites of cardiac muscle genes induced during reprogramming were insensitive to reprogramming factors as well as to agents which enhance reprogramming efficacy. In contrast, significant changes in nucleosome architecture were observed distal to the transcription start site. These regions were associated with nucleosome build-up. In summary, investigations into nucleosome structure do not support the notion that fibroblasts to cardiac muscle cell reprogramming involves chromatin opening and suggests instead long-range effects such as breaking closed-loop inhibition.
Spatiotemporal evolution of hedging effects in Asia-Pacific countries amid Sino-US competition: Insights from massive event data
Facing the pressure of Sino-US strategic competition, countries in the Asia-Pacific region often adopt hedging strategies to minimize risk and protect their interests. If implemented, these strategies could impact relationships between countries and lead to political instability. Owing to a lack of theoretical evaluation frameworks and methods, few studies have examined the implementation effects of hedging strategies adopted by Asia-Pacific countries amid Sino-US competition. This study proposes a novel four-quadrant evaluation theoretical framework, and constructs a Geopolitical Relation Index and a Comparative Relation Index based on the Global Database of Events, Language, and Tone massive event data. Since 2000, the effects of hedging strategies in 19 Asia-Pacific countries against China and the US have been dynamically quantified. The research reveals that Asia-Pacific countries’ dynamic performances over 24 years can be categorized into three groups: significantly closer to China, significantly closer to the US, and swinging. Since implementing the Belt and Road Initiative, countries close to China have deepened their ties, while those aligned with the US have strengthened their ties. Asia-Pacific countries have demonstrated similar characteristics from Obama’s presidency to Biden’s presidency. The results contribute to the dynamic assessment and ongoing monitoring of the execution effects of Asia-Pacific countries’ diplomatic strategies towards China and the US, offering valuable insights for timely refinement of their foreign policies.
A novel multi-user collaborative cognitive radio spectrum sensing model: Based on a CNN-LSTM model
Cognitive Radio (CR) technology enables wireless devices to learn about their surrounding spectrum environment through sensing capabilities, thereby facilitating efficient spectrum utilization without interfering with the normal operation of licensed users. This study aims to enhance spectrum sensing in multi-user cooperative cognitive radio systems by leveraging a hybrid model that combines Convolutional Neural Networks (CNN) and Long Short-Term Memory (LSTM) networks. A novel multi-user cooperative spectrum sensing model is developed, utilizing CNN’s local feature extraction capability and LSTM’s advantage in handling sequential data to optimize sensing accuracy and efficiency. Furthermore, a multi-head self-attention mechanism is incorporated to improve information flow, enhancing the model’s adaptability and robustness in dynamic and complex environments. Simulation experiments were conducted to quantitatively evaluate the performance of the proposed model. The results demonstrate that the CNN-LSTM model achieves low sensing error rates across various numbers of secondary users (16, 24, 32, 40, 48), with a particularly low sensing error of 9.9658% under the 32-user configuration. Additionally, when comparing the sensing errors of different deep learning models, the proposed model consistently outperformed others, showing a 12% lower sensing error under low-power conditions (100 mW). This study successfully develops a CNN-LSTM-based cooperative spectrum sensing model for multi-user cognitive radio systems, significantly improving sensing accuracy and efficiency. By integrating CNN and LSTM technologies, the model not only enhances sensing performance but also improves the handling of long-term dependencies in time-series data, offering a novel technical approach and theoretical support for cognitive radio research. Moreover, the introduction of the multi-head self-attention mechanism further optimizes the model’s adaptability to complex environments, demonstrating significant potential for practical applications.
Relationship between nocturnal blood pressure dip and β-parapapillary atrophy zone choroidal vessel density in normal-tension glaucoma patients
Purpose To investigate the relationship between nocturnal blood pressure (BP) dip and parapapillary choroidal vessel density (pCVD) in patients with normal-tension glaucoma (NTG) Methods This study analyzed 267 eyes of 267 untreated NTG patients who underwent 24-hour (h) intraocular pressure (IOP) and ambulatory BP monitoring in the habitual position. Patients were classified into 3 groups [non-dippers (nocturnal BP dip < 10%), dippers (nocturnal BP dip between 10% and 20%, and over-dippers (nocturnal BP dip > 20%)], and pCVDs were measured by using optical coherence tomography angiography (OCTA) images. Logistic regression analyses were performed to identify clinical factors associated with “over-dipper” cases. Linear regression analyses were conducted to determine the correlation between various clinical variables and pCVD. Results In clinical characteristics, over-dippers exhibited lower pCVD values compared to non-dippers or dippers (P = 0.004). High diurnal intraocular pressure (IOP) fluctuation (P = 0.031), high diurnal mean arterial pressure (MAP) fluctuation (P = 0.001), and low pCVD (P = 0.002) were identified as predictors of being “over-dipper” in multivariable logistic regression analyses. Moreover, peripapillary retinal vessel density (P = 0.040), presence of choroidal microvasculature dropout (P = 0.039), and nocturnal MAP dip % (P = 0.002) showed significant correlations with pCVD according to multivariable linear regression analyses. Conclusion Over-dippers presented with lower pCVD than non-dippers or dippers as measured by OCTA choroidal images. Low pCVD was a predictor of “over-dipper” cases and associated with a greater percentage of nocturnal MAP dip in NTG patients. 24-h ambulatory BP monitoring may provide further information for detecting low pCVD in NTG patients with nocturnal BP dip.
Dental caries and related factors in the elderly of the Azar cohort population: A cross-sectional study
Objective Oral health is often overlooked among the elderly due to the numerous comorbidities prevalent in this population. However, oral health significantly influences quality of life by affecting both general health and psychological well-being. The present study aimed to assess dental caries in elderly individuals using the DMFT index (decayed, missing, and filled teeth) and to explore its relationship with various factors based on data from the Azar cohort study in Iran. Materials and methods In this cross-sectional study, data from the initial phase of the Azar cohort study, which involved 2629 elderly individuals (aged 60 years and older), were statistically analyzed. The Azar cohort study evaluated demographic factors, the history of chronic diseases, and behavioral habits using a well-designed questionnaire administered through face- to -face interviews. The DMFT index was evaluated through oral examination. A negative binomial regression analysis with a log link function was employed to investigate the relationship between the DMFT and related variables, including gender, age, marital status, level of education, socioeconomic status, chronic diseases, smoking, alcohol consumption, and body mass index. Results The mean (SD) age of elderly individuals was 64.15±2.91 years. The mean (SD) DMFT was 28.42±6, and the mean (SD) number of missing teeth was 26.58±8.36. Approximately 70.8% of elderly individuals were edentulous. Women exhibited a higher mean DMFT score and a greater number of missing teeth compared to men. The mean DMFT score and its components significantly differed based on the level of education and socioeconomic status. However, no significant relationship was found between the DMFT index and the variables in the multiple regression analysis. Conclusion The high prevalence of edentulism and the elevated DMFT scores in the elderly population of the Azar cohort indicate a poor oral health status among older individuals. Providing the dental services within the primary health care system for the adults, can be beneficial in improving oral health in old age.
Soil quality indicator-based land productivity modelling for agricultural sustainability
Rapid population expansion has made food security a global concern for humanity, necessitating a sustainable assessment of natural resources. Well evaluated and managed soil is one of the most significant resources that can assist close the gap between supply and demand for food to attain food security. A precise assessment of land productivity (LP) is essential for sustainable land use management. The primary aim of this research is to predict the land productivity index (LPI) for certain locations on Egypt’s northwest coast under current conditions using soil quality indicators (SQIs). Additionally, the study proposed relevant management actions to boost land productivity in the future. To achieve this aim, a spatial model was created to assess LPI for some areas in the north western coast of Egypt. LP equation was used to estimate current land productivity index (CLPI) and potential land productivity index (PLPI). Results found that the study area mainly located under two classes of CLPI, e.g., average (class ⅡⅠ) represents an area of 13322.63 ha (67.55%) and good grade (class Ⅱ) covers an area of 4339.78 ha (22%). PLPI grades were good (II) and average (III) with an area of 16192.54 ha (82.10%) and 1903.23 ha (9.65%), respectively. The finding showed that more than 60% of the studied area was converted from poor and average class to good class after applying the proposed solutions of soil improvement. The methodology presented here can easily be replicated under similar circumstances in arid zones, allowing local governments and decision-makers to utilize the quantitative results obtained to ensure sustainable development.