Search results for: service area analysis

Authors: Zaida Perez-Bassart, Berta Polanco-Estibalez, Maria Jose Fabra, Amparo Lopez-Rubio, Antonio Martinez-Abad

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Mushroom production has enormously increased in recent years, not only as food products but also for applications in pharmaceuticals, nutraceuticals, and cosmetics. Consequently, interest in its chemical composition, nutritional value, and therapeutic properties has also increased. Fungi are rich in bioactive compounds such as polysaccharides, polyphenols, glycopeptides, and ergosterol, of great medicinal value, but within polysaccharides, β-glucans are the most prominent molecules. They are formed by D-glucose monomers, linked by β-glucosidic bonds β-(1,3) with side chains linked by β-(1,6) bonds. The number and position of the β-(1,6) branches strongly influence the arrangement of the tertiary structure, which, together with the molecular weight, determine the different attributed bioactivities (immunostimulating, anticancer, antimicrobial, prebiotic, etc.) and physico-chemical properties (solubility, bioaccessibility, viscosity or emulsifying). On the other hand, there is a growing interest in the study of fungi as an alternative source of chitin obtained from the by-products of the fungal industry. In this work, a cascade extraction process using aqueous neutral and alkaline treatments was carried out for Grifola frondosa and Lentinula edodes, and the compositional analysis and functional properties of each fraction were characterized. Interestingly, the first fraction obtained by using aqueous treatment at room temperature was the richest in polysaccharides, proteins, and polyphenols, thus obtaining a greater antioxidant capacity than in the other fractions. In contrast, the fractions obtained by alkaline treatments showed a higher degree of β-glucans purification compared to aqueous extractions but a lower extraction yield. Results revealed the different structural recalcitrance of β-glucans, preferentially linked to proteins or chitin depending on the fungus type, which had a direct impact on the functionalities and bioactivities of each fraction.

Keywords: fungi, mushroom, β-glucans, chitin

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Hamed Nafar, Sajad Rezaei, Hamid Behbahani

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Safety analysis of the roads through the accident rates which is one of the widely used tools has been resulted from the direct exposure method which is based on the ratio of the vehicle-kilometers traveled and vehicle-travel time. However, due to some fundamental flaws in its theories and difficulties in gaining access to the data required such as traffic volume, distance and duration of the trip, and various problems in determining the exposure in a specific time, place, and individual categories, there is a need for an algorithm for prioritizing the road safety so that with a new exposure method, the problems of the previous approaches would be resolved. In this way, an efficient application may lead to have more realistic comparisons and the new method would be applicable to a wider range of time, place, and individual categories. Therefore, an algorithm was introduced to prioritize the safety of roads using the quasi-induced exposure method and utilizing the analytical hierarchy process. For this research, 11 provinces of Iran were chosen as case study locations. A rural accidents database was created for these provinces, the validity of quasi-induced exposure method for Iran’s accidents database was explored, and the involvement ratio for different characteristics of the drivers and the vehicles was measured. Results showed that the quasi-induced exposure method was valid in determining the real exposure in the provinces under study. Results also showed a significant difference in the prioritization based on the new and traditional approaches. This difference mostly would stem from the perspective of the quasi-induced exposure method in determining the exposure, opinion of experts, and the quantity of accidents data. Overall, the results for this research showed that prioritization based on the new approach is more comprehensive and reliable compared to the prioritization in the traditional approach which is dependent on various parameters including the driver-vehicle characteristics.

Keywords: road safety, prioritizing, Quasi-induced exposure, Analytical Hierarchy Process

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Authors: Pibool Waijittragum

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The purpose of this research is to analyze the marketing strategies of Thai Halal products which related to the way of life for Thai Muslims. The expected benefit is the marketing strategy for brand building process for Halal products in Thailand. 4 elements of marketing strategies which necessary for the brand identity creation is the research framework: Consists of Attributes, Benefits, Values and Personality. The research methodology was applied using qualitative and quantitative; 19 marketing experts with dynamic roles in Thai consumer products were interviewed. In addition, a field survey of 122 Thai Muslims selected from 175 Muslim communities in Bangkok was studied. Data analysis will be according to 5 categories of Thai Halal product: 1) Meat 2) Vegetable and Fruits 3) Instant foods and Garnishing ingredient 4) Beverages, desserts and snacks 5) Hygienic daily products; such as soap, shampoo and body lotion. The results will explain some suitable representation in the marketing strategies of Thai Halal products as are: 1) Benefit; the characteristics of the product with its benefit. Consumers will purchase this product with the reason of; it is beneficial nutrients product, there are no toxic or chemical residues. Fresh and clean materials 2) Attribute; the exterior images that attract to consumer. Consumers will purchase this product with the reason of; there is a standard proof mark, food and drug secure proof mark and Halal products mark. Packaging and its materials should be draw attention. Use an attractive graphic. Use outstanding images of product, material or ingredients. 3) Value; the value of products that affect to consumers perception; it is healthy products. Accumulate quality of life. It is a product of expertise, manufacturing of research result. Consumers are important. It’s sincere, honest and reliable to all. 4) Personality; reflection of consumers thought. The personality feedback to them after they were consumes this product; they are health care persons. They are the rational person, moral person, justice person and thoughtful person like a progressive thinking.

Keywords: marketing strategies, product identity, branding, Thai Halal products

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Authors: Beatrice Fenu, Francesco Niosi, Giovanni Bracco, Giuliana Mattiazzo

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In recent years, Europe has seen a great development of renewable energy, in a perspective of reducing polluting emissions and transitioning to cleaner forms of energy, as established by the European Green New Deal. Wind energy has come to cover almost 15% of European electricity needs andis constantly growing. In particular, far-offshore wind turbines are attractive from the point of view of exploiting high-speed winds and high wind availability. Considering offshore wind turbine siting that combines the resources analysis, the bathymetry, environmental regulations, and maritime traffic and considering the waves influence in the stability of the platform, the hydrodynamic characteristics of the platform become fundamental for the evaluation of the performances of the turbine, especially for the pitch motion. Many platform's geometries have been studied and used in the last few years. Their concept is based upon different considerations as hydrostatic stability, material, cost and mooring system. A new method to reach a high-performances substructure for different kinds of wind turbines is proposed. The system that considers substructure, mooring, and wind turbine is implemented in Orcaflex, and the simulations are performed considering several sea states and wind speeds. An external dynamic library is implemented for the turbine control system. The study shows the comparison among different substructures and the new concepts developed. In order to validate the model, CFD simulations will be performed by mean of STAR CCM+, and a comparison between rigid and elastic body for what concerns blades and tower will be carried out. A global model will be built to predict the productivity of the floating turbine according to siting, resources, substructure, and mooring. The Levelized Cost of Electricity (LCOE) of the system is estimated, giving a complete overview about the advantages of floating offshore wind turbine plants. Different case studies will be presented.

Keywords: aero-hydrodynamic model, computational fluid dynamics, floating offshore wind, siting, verification, and validation

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Authors: Masbubul Ishtiaque Ahmed

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Food chain contamination by heavy metals has become a critical issue in recent years because of their potential accumulation in bio systems through contaminated water, soil and irrigation water. Industrial discharge, fertilizers, contaminated irrigation water, fossil fuels, sewage sludge and municipality wastes are the major sources of heavy metal contamination in soils and subsequent uptake by crops. The main objectives of this project were to determine the levels of minerals, trace elements and heavy metals in major foods and beverages consumed by the poor and non-poor households of Dhaka city and assess the dietary risk exposure to heavy metal and trace metal contamination and potential health implications as well as recommendations for action. Heavy metals are naturally occurring elements that have a high atomic weight and a density of at least 5 times greater than that of water. Their multiple industrial, domestic, agricultural, medical and technological applications have led to their wide distribution in the environment; raising concerns over their potential effects on human health and the environment. Their toxicity depends on several factors including the dose, route of exposure, and chemical species, as well as the age, gender, genetics, and nutritional status of exposed individuals. Because of their high degree of toxicity, arsenic, cadmium, chromium, lead, and mercury rank among the priority metals that are of public health significance. These metallic elements are considered systemic toxicants that are known to induce multiple organ damage, even at lower levels of exposure. This review provides an analysis of their environmental occurrence, production and use, potential for human exposure, and molecular mechanisms of toxicity, and carcinogenicity.

Keywords: food chain, determine the levels of minerals, trace elements, heavy metals, production and use, human exposure, toxicity, carcinogenicity

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Authors: Sameer Masood, Lucas Chartier

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Head injuries are a commonly encountered presentation in emergency departments (ED) and the Choosing Wisely Canada (CWC) campaign was released in June 2015 in an attempt to decrease imaging utilization for patients with minor head injuries. The impact of the CWC campaign on imaging utilization for head injuries has not been explored in the ED setting. In our study, we describe the characteristics of patients with head injuries presenting to a tertiary care academic ED and the impact of the CWC campaign on CT head utilization. This retrospective cohort study used linked databases from the province of Ontario, Canada to assess emergency department visits with a primary diagnosis of head injury made between June 1, 2014 and Aug 31, 2016 at the University Health Network in Toronto, Canada. We examined the number of visits during the study period, the proportion of patients that had a CT head performed before and after the release of the CWC campaign, as well as mode of arrival, and disposition. There were 4,322 qualifying visits at our site during the study period. The median presenting age was 44.12 years (IQR 27.83,67.45), the median GCS was 15 (IQR 15,15) and the majority of patients presenting had intermediate acuity (CTAS 3). Overall, 43.17% of patients arrived via ambulance, 49.24 % of patients received a CT head and 10.46% of patients were admitted. Compared to patients presenting before the CWC campaign release, there was no significant difference in the rate of CT heads after the CWC (50.41% vs 47.68%, P = 0.07). There were also no significant differences between the two groups in mode of arrival (ambulance vs ambulatory) (42.94% vs 43.48%, P = 0.72) or admission rates (9.85% vs 11.26%, P = 0.15). However, more patients belonged to the high acuity groups (CTAS 1 or 2) in the post CWC campaign release group (12.98% vs 8.11% P <0.001). Visits for head injuries make up a significant proportion of total ED visits and approximately half of these patients receive CT imaging in the ED. The CWC campaign did not seem to impact imaging utilization for head injuries in the 14 months following its launch. Further efforts, including local quality improvement initiatives, are likely needed to increase adherence to its recommendation and reduce imaging utilization for head injuries.

Keywords: choosing wisely, emergency department, head injury, quality improvement

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Authors: Oluwabukola Oluwaseyi Oduntan

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The English Language plays a central and strategic role in the school system because almost all the school subjects are taught using the English language. However, students’ achievement in this subject at senior secondary school is not encouraging. Therefore, this study examined the effects of oral-written mode of assessment on senior secondary school students’ achievement in a descriptive essay. It also examined the moderating effects of students’ gender and class on students’ achievement in a descriptive essay. The study adopted a pretest-posttest, control group, quasi-experimental design with a 2x2x3 factorial matrix. The participant consisted of 140 Senior Secondary II students drawn from four intact classes from four schools randomly selected from four Local Government Areas randomly selected from Oyo town in Oyo State. Two schools were assigned each to the treatment group and the control group. The following instruments were used for the study: Descriptive Essay Achievement Test (r = 0.78); Descriptive Achievement Test Marking Scheme; Check List of Oral-Written Assessment and Teachers’ Instructional Guide on Descriptive Essay (r = 0.81). Seven null hypotheses guided the study and tested at 0.05 level of significance. Data were analyzed using Analysis of Covariance, Estimated Marginal Means and Scheffe post-hoc test. The result revealed that treatment had a significant main effect on students’ achievement in descriptive essay (F(1,127) = 25.407, P < .05, η2 = .167). Students exposed to oral-written assessment had a higher achievement scores ((x ) ̅= 36.15) than those exposed to written assessment ((x ) ̅= 28.55). There was no significant main effect of gender on students’ achievement in descriptive essay (F₍₁, ₁₂₇₎ = .349, P > .05, η2 = .003). The result also revealed that the effects of class was not significant on students’ students’ achievement in descriptive essay (F₍₁, ₁₂₇₎ = .679, P > .05, η2 = .006). Oral-written mode of assessment enhanced students’ achievement in a descriptive essay. It is, therefore, recommended that teachers and curriculum developers should adopt the use of oral-written assessment for better improvement of students’ achievement in a descriptive essay.

Keywords: class, gender, oral-written assessment, written assessment

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Authors: Yulia Eka Putrie, Widjaja Martokusumo

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The development of architecture today indicates that an architectural object often does not represent one single identity only. One architectural object could represents layers of multiple identities of an increasingly complex society. Mosque architecture for example, is mainly associated with one religious identity; that mosque architecture serves as the representation of Islamic identity. However, on many occasions, mosque architecture also serves as the representation of other motives, such as political, social, even individual identity. In normal circumstances, these layers of identities are not always seen or realized by common people outside the community. They are only represented implicitly in some symbolic forms, activities, and events. On the other hand, in specific circumstances, these kinds of identities were represented explicitly in mosque architecture. This paper is a part of an initial research on the representation of socio-political identities in Nahdliyyin mosques in East Java, Indonesia. Nahdliyyin mosques were chosen as the object of research because of its significance in Indonesian socio-political context, because majority of Indonesian muslims are culturally associated with Nahdlatul Ulama (NU) with its aswaja doctrine. Some frictions in mosque ownership and management between Nahdliyyin and other islamic school of thoughts, has resulted in preventive efforts, where some of the efforts are related to the representation of their identity in their mosque architecture. The research is a field research that took place in Malang, East Java. Malang is one of main cities in East Java; a cultural and regional basis of NU and Nahdliyyin people. Formal analysis were conducted in ten large Nahdliyyin mosques in Malang. Some structured and in-depth interviews were also held to explore the motives of identity representation in some architectural aspects of the mosques. The result of this initial study indicates that there are layers of identities which were manifested in the studied mosques. These layers of identities in Nahdliyyin mosques were based on the same main values, but represented through various formal expressions. Furthermore, the study also brings the deeper understanding on socio-political context of mosques in Nahdliyyin culture.

Keywords: Nahdliyyin mosque architecture, layers of identities, representation, Nahdlatul Ulama

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Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

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Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.

Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.

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Authors: Yin Ma, Xun Wang, Kelsey Austin

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Purpose – Building upon career construction theory and the conservation of resources theory, we developed a moderated mediation model to examine how the perceived university support impact students’ career adapting responses, namely, crystallization, exploration, decision and preparation, via the mediator career adaptability and moderator perceived parental support. Design/methodology/approach – The multi-stage sampling strategy was employed and survey data were collected. Structural equation modeling was used to perform the analysis. Findings – Perceived university support could directly promote students’ career adaptability, and promote three career adapting responses, namely, exploration, decision and preparation. It could also impact four career adapting responses via mediation effect of career adaptability. Its impact on students’ career adaptability can greatly increase when students’ receive parental related career support. Research limitations/implications – The cross-sectional design limits causal inference. Conducted in China, our findings should be cautiously interpreted in other countries due to cultural differences. Practical implications – University support is vital to students’ career adaptability and supports from parents can enhance this process. University-home collaboration is necessary to promote students’ career adapting responses. For students, seeking and utilizing as much supporting resources as possible is vital for their human resources development. On an organizational level, universities could benefit from our findings by introducing the practices which ask students to rate the career-related courses and encourage them to chat with parents regularly. Originality/ value – Using recently developed scale, current work contributes to the literature by investigating the impact of multiple contextual factors on students’ career adapting response. It also provide the empirical support for the role of human intervention in fostering career adapting responses.

Keywords: career adapability, university and parental support, China studies, sociology of education

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Authors: Kurias George, Ildefonso Cuesta Romeo, Clara Salueña Pérez, Jordi Sole Olle

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With the growing prevalence of wind energy there is a need, for modeling techniques to evaluate the impact of wind farms on meteorology and oceanography. This study presents an approach that utilizes the WRF (Weather Research and Forecasting )with that include a Wind Farm Parametrization model to simulate the dynamics around Parc Tramuntana project, a offshore wind farm to be located near the Gulf of Roses off the coast of Barcelona, Catalonia. The model incorporates parameterizations for wind turbines enabling a representation of the wind field and how it interacts with the infrastructure of the wind farm. Current results demonstrate that the model effectively captures variations in temeperature, pressure and in both wind speed and direction over time along with their resulting effects on power output from the wind farm. These findings are crucial for optimizing turbine placement and operation thus improving efficiency and sustainability of the wind farm. In addition to focusing on atmospheric interactions, this study delves into the wake effects within the turbines in the farm. A range of meteorological parameters were also considered to offer a comprehensive understanding of the farm's microclimate. The model was tested under different horizontal resolutions and farm layouts to scrutinize the wind farm's effects more closely. These experimental configurations allow for a nuanced understanding of how turbine wakes interact with each other and with the broader atmospheric and oceanic conditions. This modified approach serves as a potent tool for stakeholders in renewable energy, environmental protection, and marine spatial planning. environmental protection and marine spatial planning. It provides a range of information regarding the environmental and socio economic impacts of offshore wind energy projects.

Keywords: weather research and forecasting, wind turbine wake effects, environmental impact, wind farm parametrization, sustainability analysis

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Authors: Ramanish Ravishankar, Azar Hussain, Mahmoud Loubani, Mubarak Chaudhry

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Background and Aims: Currently, there are no strict guidelines in cardiopulmonary bypass temperature management in cardiac surgery not involving the aortic arch. This study aims to compare patient outcomes undergoing mild hypothermia and normothermia. The aim of this study was to compare patient outcomes between mild hypothermia and normothermia undergoing on-pump cardiac surgery not involving the aortic arch. Methods: This was a retrospective cohort study from January 2015 until May 2023. Patients who underwent cardiac surgery with cardiopulmonary bypass temperatures ≥32oC were included and stratified into mild hypothermia (32oC – 35oC) and normothermia (>35oC) cohorts. Propensity matching was applied through the nearest neighbour method (1:1) using the risk factors detailed in the EuroScore using RStudio. The primary outcome was mortality. Secondary outcomes included post-op stay, intensive care unit readmission, re-admission, stroke, and renal complications. Patients who had major aortic surgery and off-pump operations were excluded. Results: Each cohort had 1675 patients. There was a significant increase in overall mortality with the mild hypothermia cohort (3.59% vs. 2.32%; p=0.04912). There was also a greater stroke incidence (2.09% vs. 1.13%; p=0.0396) and transient ischaemic attack (TIA) risk (3.1% vs. 1.49%; p=0.0027). There was no significant difference in renal complications (9.13% vs. 7.88%; p=0.2155). Conclusions: Patient’s who underwent mild hypothermia during cardiopulmonary bypass have a significantly greater mortality, stroke, and transient ischaemic attack incidence. Mild hypothermia does not appear to provide any benefit over normothermia and does not appear to provide any neuroprotective benefits. This shows different results to that of other major studies; further trials and studies need to be conducted to reach a consensus.

Keywords: cardiac surgery, therapeutic hypothermia, neuroprotection, cardiopulmonary bypass

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Authors: Danielle Katrina Santos, Koji Shimada

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Environmentally-friendly agriculture has been promoted for over two decades as a response to the environmental challenges brought by climate change and biological loss. Located above the equator, it is possible that Japan may benefit from future climate change, yet Japan is also a rarely developed country located in the Asian Monsoon climate region, making it vulnerable to the impacts of climate change. In this regard, the Japanese government has initiated policies to adapt to the adverse effects of climate change through the promotion and popularization of environmentally-friendly farming practices. This study aims to determine profit efficiency among environmentally-friendly rice farmers in Shiga Prefecture using the Stochastic Frontier Approach. A cross-sectional survey was conducted among 66 farmers from top rice-producing cities through a structured questionnaire. Results showed that the gross farm income of environmentally-friendly rice farmers was higher by JPY 316,223.00/ha. Production costs were also found to be higher among environmentally-friendly rice farmers, especially on labor costs, which accounted for 32% of the total rice production cost. The resulting net farm income of environmentally-friendly rice farmers was only higher by JPY 18,044/ha. Results from the stochastic frontier analysis further showed that the profit efficiency of conventional farmers was only 69% as compared to environmentally-friendly rice farmers who had a profit efficiency of 76%. Furthermore, environmentally-friendly agriculture participation, other types of subsidy, educational level, and farm size were significant factors positively influencing profit efficiency. The study concluded that substitution of environmentally-friendly agriculture for conventional rice farming would result in an increased profit efficiency due to the direct payment subsidy and price premium received. The direct government policies that would strengthen the popularization of environmentally-friendly agriculture to increase the production of environmentally-friendly products and reduce pollution load to the Lake Biwa ecosystem.

Keywords: profit efficiency, environmentally-friendly agriculture, rice farmers, direct payment subsidies

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Authors: Chairun Wiedyaningsih, Sri Suryawati, Yati Soenarto, Muhammad Hakimi

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Background: Many drugs used in paediatrics are not commercially available in suitable dosage forms. Therefore, the drugs often prescribed in extemporaneous compounding dosage form. Compounding can pose health risks include poor quality and unsafe products. Studies of compounding dosage form have primarily focused on prescription profiles, reasons of prescribing never be explored. Objectives: The study was conducted to identify factors influencing physicians’ decision to prescribe extemporaneous compounding dosage form for paediatric outpatients. Setting: Daerah Istimewa Yogyakarta (DIY) province, Indonesia. Method: Qualitative semi-structured interviews were conducted with 15 general physicians and 7 paediatricians to identify the reason of prescribing extemporaneous compounding dosage form. The interviews were transcribed and analysed using thematic analysis. Results: Factors underlying prescribing of compounding could be categorized to therapy, healthcare system, patient and past experience. The primary reasons of therapy factors were limited availability of drug compositions, dosages or formulas specific for children. Beliefs in efficacy of the compounding forms were higher when the drugs used primarily to overcome complex cases. Physicians did not concern about compounding form containing several active substances because manufactured syrups may also contain several active substances. Although medicines were available in manufactured syrups, limited institutional budget was healthcare system factor of compounding prescribing. The prescribing factors related to patients include easy to use, efficient and lower price. The prescribing factors related to past experience were physicians’ beliefs to the progress of patient's health status. Conclusions: Compounding was prescribed based on therapy-related factors, healthcare system factors, patient factors and past experience.

Keywords: compounding dosage form, interview, physician, prescription

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Authors: S. C. Lin, W. F. Hung, W. W. Cheng

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Teacher empowerment was regarded as investing teachers with the right to participate in the determination of school goals and policies and to exercise professional judgment about what and how to teach. Professional commitment was considered as a person’s belief in and acceptance of the values of his or her chosen occupation or line of work, and a willingness to maintain membership in that occupation. An effective school has been defined as one in which students’ progress further than might be expected from consideration of its intake. An effective school thus adds extra value to its students' outcomes, in comparison with other schools serving similar intakes. A number of literature from various countries explored that teacher empowerment and professional commitment significantly influenced school effectiveness. However, there lacked more empirical studies to examine the relationships among them. Hence, this study was to explore the relationships among teacher empowerment, professional commitment and school effectiveness in junior high schools in Taiwan. Samples were seven hundred and five junior high school teachers selected from Taichung City, Changhua County and Nantou County. Questionnaire was applied to collect data. Data were analyzed by using descriptive statistics, t-test, one-way ANOVA, Pearson’s product-moment correlation, and multiple regression analysis. The findings of this study were as follows: First, the overall performances of teachers’ perceptions of teacher empowerment, teacher professional commitment and school effectiveness were above average. Second, the teachers’ perceptions of teacher empowerment were significant different in gender, designated duty, and school size. Third, the teachers’ perceptions of teacher professional commitment were significant different in gender, designated duty, and school size. Fourth, the teachers’ perceptions of school effectiveness were significant different in designated duty. Fifth, teacher empowerment was mid-positively correlation by teacher professional commitment. Sixth, there was mid-positively correlation between teacher empowerment and school effectiveness. Seventh, there was mid-positively correlation between teacher professional commitment and school effectiveness. Eighth, Teacher empowerment and professional commitment could significantly predict school effectiveness. Based on the findings of this study, the study proposed some suggestions for educational authorities, schools, teachers, and future studies as well.

Keywords: junior high school teacher, teacher empowerment, teacher professional commitment, school effectiveness

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Authors: Trianasari, Gede Adi Yuniarta

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The tourism industry has been widely recognized as one of the world’s largest industries and is expected to have continuous growth. While it has positive impacts especially on the job markets and economic aspect, this industry also brings serious environmental impacts that may not be neglected. As such, the tourism industry is faced with increasing demands and challenges to deal with the environmental issues. Corporate Social Responsibility (CSR) is a way to show the firms’ concern on the societal and environmental aspects. In line with the increasing pressure on such responsibilities, a growing number of firms have involved in CSR activities. In Bali, the majority of both chained and locally owned hotels have shown their efforts on CSR practices. However, little is known about what and how they perform or implement such program especially within the environmental aspect. The importance of understanding what they focus on lays in the identification of areas that have received sufficient treatment and those that require more attention. Furthermore, also, it is especially essential considering that Bali is one of the worldly known destinations that have been facing numerous crucial issues on environment that may threaten the sustainability of the island and its people. This paper reports on the results of a study exploring the practices of CSR in hotels in Bali. Data were collected from 49 hotel managers and human resource managers in Bali across four major tourist areas, using semi structured interview method. The analysis was conducted qualitatively. The results showed that all hotels under study have implemented CSR activities in which environment was found to be the second key aspect, following the activities directly related to community aspect. Moreover, there were five major types of environmental action identified: beach cleaning, replantation, marine conservation, turtle conservation, mangrove, and garbage management. These findings suggest that hotels in Bali under study have shown their concern on the environment, however, less attention was given on attempt to reduce the environmental impacts of their operations. Mapping the types of environmental related CSR activities enhances the knowledge of and gives lights into the CSR literature especially from the perspective of Eastern practice.

Keywords: CSR, exploratory study, sustainable tourism, tourist object

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Authors: Tugce Caliskan

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The gentrification literature in Turkey provided important insights regarding the analysis of the socio-spatial change in İstanbul mostly through the existing gentrification theories which were produced in Anglo-American literature. Yet early researches focused on the classical gentrification while failing to notice other place-specific forms of the phenomena. It was only after the mid-2000s that scholarly attention shifted to the recent discussions in the mainstream such as the neoliberal urban policies, government involvement, and resistance. Although these studies have considerable potential to contribute to the geography of gentrification, it seems that copying the linear timeline of Anglo-American conceptualization limited the space to introduce contextually nuanced way of process in Turkey. More specifically, the gentrification literature in Turkey acknowledged the linear timeline of the process drawing on the mainstream studies, and, made the spontaneous classical gentrification as the starting point in İstanbul at the expense of contextually specific forms of the phenomenon that took place in the same years. This paper is an attempt to understand place-specific forms of gentrification through the abandonment of the linear understanding of time. In this vein, this paper approaches the process as moving both linear and cyclical rather than the waves succeeded each other. Maintaining a dialectical relationship between the cyclical and the linear time, this paper investigates how the components of gentrification have been taken place in the cyclical timeline while becoming bolder in the linear timeline. This paper argues that taking the (re)investment in the secondary circuit of capital and class transformation as the core characteristics of gentrification, and accordingly, searching for these components beyond the linear timeline provide strategic value to decenter the perspectives, not merely for Turkish studies. In this vein, this strategy revealed that Western experience of gentrification did not travel, adopted or copied in Turkey but gentrification -as an abstract and general concept- has emerged as a product of different contextual, historical and temporal forces which must be considered within the framework of state-led urbanization as early as 1980 differing from the Global North trajectories.

Keywords: comparative urbanism, geography of gentrification, linear and cyclical timeline, state-led gentrification

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Authors: Laid Fekih

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Background: The purpose of this paper is to examine the psychological stressors caused by urbanization, a field study conducted on a sample range of youth who live in urban areas. Some of them reside in areas with green surroundings while others reside in lack of green areas, which saw the terrible expansion of urban. The study included the impact of urbanization on the mental health of youths; select the psychological problems most commonly caused by urbanization, and the impact of green spaces in alleviating stress. Method: The method used in this research is descriptive, as the data collected from a sample of 160 young men were analyzed. The tool used is the psychological distress test. We proceeded with some statistical techniques, which provided percentages, analysis of variance, and t-tests. Results: The findings of this research were: (i) The psychological stressors caused by urban expansion are mainly in the intensity of stress, incompetence, emotional, and psychosomatic problems. (ii) There was a statistically significant difference at the level of significance 0.02 among young people who live in places in green spaces and without green space in terms of psychological stressors, in favor of young people who live in places free of greenery. (iii) The quality of this primary variable effect of housing (rental or ownership) is statistically significant in favor of young people living in rented accommodation. Conclusion: The green spaces provided by Tlemcen city are inadequate and insufficient to fulfill the population's requirements for contact with nature, leading to such effects that may negatively affect mental health, which makes it a prominent process that should not be neglected. Incorporating green spaces into the design of buildings, homes, and communities to create shared spaces, which facilitate interaction and foster well-being, becomes the main purpose. We think this approach can support the reconstruction of the built environment with green spaces by facilitating the link between psychological stress perception studies and technologies.

Keywords: psychological stressors, urbanization, psychological problems, green spaces

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Authors: Mingaile Jurkute, Vilnius University

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The memory of the Lithuanian partisan war (1944-1953) underwent extremely dramatic transformations. During this war, the image of the resistance and a partisan was one of the key elements of Lithuanian identity. Its importance is evidenced by the extremely large legacy of songs about partisans, no other topic has collected so much folklore in Lithuania. In the Soviet years, this resistance was practically forced to be forgotten. Terror and Soviet laws have forced people to stop talking about the events, even in the family circle. In addition, the Soviets created their own propaganda story, reinterpreting the Lithuanian partisan war, presenting partisans as bandits who brutally tortured and murdered locals. But even in the Soviet years, the memory could neither be completely suppressed, nor completely transformed into wishful shape. The analysis of fiction and cinema shows that the traumatic memory of real events rushed to the surface, thus transforming the very propagandistic narrative. After the restoration of the Republic of Lithuania in 1990, the Lithuanian partisan war was gradually returned to the central place of Lithuanian history. After 2014 the nationalist heroic narrative about Lithuanian partisans became the central narrative of modern Lithuanian history. Nevertheless, interviews I conducted in Lithuanian villages reveal that the memory of local communities and families preserves quite different experiences that do not fit into neither the Soviet narrative nor the heroic one. Such experiences include, for example, partisan violence against local families. This paper is about the efforts of two political ideologies (the Soviet and the Lithuanian patriotic) to use the history of the Lithuanian partisans for their own needs, and the attempts of small communities (mostly families) to resist these efforts. The research reveals that family memory, even when opposed to aggressive state memory policies, can preserve counter-narratives by exploiting unexpected objects beyond the control of the state, such as nature and wildlife. Basically, the paper analyses the limits of the instrumentalization of memory, even by extremely aggressive political regimes.

Keywords: collective memory, post-memory, violence, military conflict, family memory

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Authors: Ugur Choban, Aruzhan Zhaksylyk, Assylbek Nurgabdeshov

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In recent years, there has been an increasing understanding of the value of encouraging entrepreneurial attitudes in university students. This is motivated by the belief that stimulating entrepreneurship not only promotes economic growth but also fosters innovation. This study looks at the complex link and addresses critical gaps between psychological capital and entrepreneurial intention among university students, with a specific emphasis on how contextual factors like academic support and past business experience impact this dynamic. Using a quantitative research method, data were gathered from a broad sample of 300 university students drawn from several faculties. The study used a questionnaire that included the Psychological Capital Questionnaire (PCQ) to assess psychological capital and a validated scale for entrepreneurial intention, as well as binary measures of academic support and prior entrepreneurial experience. Statistical investigations, including multigroup analyses performed with SmartPLS software, provided interesting insights into the effect of contextual factors on the relationship between psychological capital and entrepreneurial intention. The findings highlight that psychological capital had a strong favorable influence on university students' entrepreneurial inclinations. Furthermore, the study found that academic support enhances the influence of psychological capital on entrepreneurial intentions, emphasizing the significance of institutional backing in fostering entrepreneurial mindsets. Furthermore, students with prior entrepreneurial experience had a stronger propensity for entrepreneurship, showing a synergistic link between psychological capital and entrepreneurial background. These findings have both theoretical and practical implications. By explaining the mechanisms by which psychological capital promotes entrepreneurial intentions, the study contributes to the establishment of focused entrepreneurship education programs and support activities that are suited to student requirements. Policymakers may use these findings to create policies that encourage student entrepreneurship, ultimately encouraging economic development and innovation.

Keywords: academic support, entrepreneurial intentions, higher education institutions, psychological capital, prior entrepreneurial experience

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Authors: Kayode O. Afolabi, Benson C. Iweriebor, Anthony I. Okoh, Larry C. Obi

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Porcine circovirus type 2 (PCV2) is the major etiological viral agent of porcine multisystemic wasting syndrome (PWMS) and other porcine circovirus-associated diseases (PCVAD) of great economic importance in pig industry globally. In an effort to determine the status of swine herds in the Province as regarding the ‘small but powerful’ viral pathogen; a total of 375 blood, faecal and nasal swab samples were obtained from seven pig farms (commercial and communal) in Amathole, O.R. Tambo and Chris-Hani District Municipalities of Eastern Cape Province between the year 2015 and 2016. Three hundred and thirty nine (339) samples out of the total sample were subjected to molecular screening using PCV2 specific primers by conventional polymerase chain reaction (PCR). Selected sequences were further analyzed and confirmed through genome sequencing and phylogenetic analyses. The data obtained revealed that 15.93% of the screened samples (54/339) from the swine herds of the studied areas were positive for PCV2; while the severity of occurrence of the viral pathogen as observed at farm level ranges from approximately 5.6% to 60% in the studied farms. The Majority, precisely 15 out of 17 (88%) analyzed sequences were found clustering with other PCV2b reference strains in the phylogenetic analysis. More interestingly, two other sequences obtained were also found clustering within PCV2d genogroup, which is presently another fast-spreading genotype with observable higher virulence in global swine herds. This finding confirmed the presence of this all-important viral pathogen in pigs of the region; which could result in a serious outbreak of PCVAD and huge economic loss at the instances of triggering factors if no appropriate measures are taken to curb its spread effectively.

Keywords: pigs, polymerase chain reaction, porcine circovirus type 2, South Africa

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Authors: Kamila Weissova, Jitka Skrabalova, Katerina Skalova, Jana Koprivova, Zdenka Bendova

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Any Arctic visitor has to deal with extreme conditions, including constant light during the summer season or constant darkness during winter time. Light/dark cycle is the most powerful synchronizing signal for biological clock and the absence of daily dark period during the polar day can significantly alter the functional state of the internal clock. However, the inner clock can be synchronized by other zeitgebers such as physical activity, food intake or social interactions. Here, we investigated the effect of polar day on circadian clock of 10 researchers attending the polar base station in the Svalbard region during July. The data obtained on Svalbard were compared with the data obtained before the researchers left for the expedition (in the Czech Republic). To determine the state of circadian clock we used wrist actigraphy followed by sleep diaries, saliva, and buccal mucosa samples, both collected every 4 hours during 24h-interval to detect melatonin by radioimmunoassay and clock gene (PER1, BMAL1, NR1D1, DBP) mRNA levels by RT-qPCR. The clock gene expression was analyzed using cosinor analysis. From our results, it is apparent that the constant sunlight delayed melatonin onset and postponed the physical activity in the same order. Nevertheless, the clock gene expression displayed higher amplitude on Svalbard compared to the amplitude detected in the Czech Republic. These results have suggested that the common daily schedule at the Svalbard expedition can strengthen circadian rhythm in the environment that is lacking light/dark cycle. In conclusion, the constant sunlight delays melatonin onset, but it still maintains its rhythmic secretion. The effect of constant sunlight on circadian clock can be minimalized by common daily scheduled activity.

Keywords: actighraph, clock genes, human, melatonin, polar day

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Authors: Reza Tirsadi Librawan, Tara Vergita Rakhma

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The increasing demand for energy and concern of global warming are intertwined issues of critical importance. With the pressing needs of clean, efficient and cost-effective energy conversion processes, an alternative clean energy source is needed. Biomass is one of the preferable options because it is clean and renewable. The efficiency for biomass conversion is constrained by the relatively low energy density and high moisture content from biomass. This study based on bio-based resources presents the Biomass Direct Chemical Looping Combustion Process (BDCLC), an alternative process that has a potential to convert biomass in thermal cracking to produce electricity and CO2. The BDCLC process using iron-based oxygen carriers has been developed as a biomass conversion process with in-situ CO2 capture. The BDCLC system cycles oxygen carriers between two reactor, a reducer reactor and combustor reactor in order to convert coal for electric power generation. The reducer reactor features a unique design: a gas-solid counter-current moving bed configuration to achieve the reduction of Fe2O3 particles to a mixture of Fe and FeO while converting the coal into CO2 and steam. The combustor reactor is a fluidized bed that oxidizes the reduced particles back to Fe2O3 with air. The oxidation of iron is an exothermic reaction and the heat can be recovered for electricity generation. The plant design’s objective is to obtain 5 MW of electricity with the design of the reactor in 900 °C, 2 ATM for the reducer and 1200 °C, 16 ATM for the combustor. We conduct process simulation and analysis to illustrate the individual reactor performance and the overall mass and energy management scheme of BDCLC process that developed by Aspen Plus software. Process simulation is then performed based on the reactor performance data obtained in multistage model.

Keywords: biomass, CO2 capture, direct chemical looping combustion, power generation

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Authors: Florian Vincent Haase, Adrian Dierl, Anna Henke, Ralf Woll, Ennes Sarradj

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Structured sheet metals and structured sandwich sheet metals are three-dimensional, lightweight structures with increased stiffness which are used in the automotive industry. The impedance, a figure of resistance of a structure to vibrations, will be determined regarding plain sheets, structured sheets, and structured sandwich sheets. The aim of this paper is generating an experimental design in order to minimize costs and duration of experiments. The design of experiments will be used to reduce the large number of single tests required for the determination of correlation between the impedance and its influencing factors. Full and fractional factorials are applied in order to systematize and plan the experiments. Their major advantages are high quality results given the relatively small number of trials and their ability to determine the most important influencing factors including their specific interactions. The developed full factorial experimental design for the study of plain sheets includes three factor levels. In contrast to the study of plain sheets, the respective impedance analysis used on structured sheets and structured sandwich sheets should be split into three phases. The first phase consists of preliminary tests which identify relevant factor levels. These factor levels are subsequently employed in main tests, which have the objective of identifying complex relationships between the parameters and the reference variable. Possible post-tests can follow up in case additional study of factor levels or other factors are necessary. By using full and fractional factorial experimental designs, the required number of tests is reduced by half. In the context of this paper, the benefits from the application of design for experiments are presented. Furthermore, a multistage approach is shown to take into account unrealizable factor combinations and minimize experiments.

Keywords: structured sheet metals, structured sandwich sheet metals, impedance measurement, design of experiment

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Authors: Koko Iwan Agus Kurniawan, Dwi Purnomo, Anas Bunyamin, Arif Rahman Jaya

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Fruters model is a concept of technopreneurship-based on empowerment, in which technology research results were designed to create high value-added products and implemented as a locomotive of collaborative empowerment; thereby, the impact was widely spread. This model still needs to be inventoried and validated concerning the influenced variables in the business growth process. Model validation accompanied by mapping was required to be applicable to Small Medium Enterprises (SMEs) agro-industry based on sustainable social business and existing real cases. This research explained the empowerment model of Yourgood, an SME, which emphasized on empowering the farmers/ breeders in farmers in rural areas, Cipageran, Cimahi, to housewives in urban areas, Bandung, West Java, Indonesia. This research reviewed some works of literature discussing the agro-industrial development associated with the empowerment and social business process and gained a unique business model picture with the social business platform as well. Through the mapped business model, there were several advantages such as technology acquisition, independence, capital generation, good investment growth, strengthening of collaboration, and improvement of social impacts that can be replicated on other businesses. This research used analytical-descriptive research method consisting of qualitative analysis with design thinking approach and that of quantitative with the AHP (Analytical Hierarchy Process). Based on the results, the development of the enterprise’s process was highly affected by supplying farmers with the score of 0.248 out of 1, being the most valuable for the existence of the enterprise. It was followed by university (0.178), supplying farmers (0.153), business actors (0.128), government (0.100), distributor (0.092), techno-preneurship laboratory (0.069), banking (0.033), and Non-Government Organization (NGO) (0.031).

Keywords: agro-industry, small medium enterprises, empowerment, design thinking, AHP, business model canvas, social business

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Authors: Ángel de J. López-Pérez, Sonia E. Ruiz, Vanessa A. Segovia

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Buildings vulnerability due to seismic activity has been highly studied since the middle of last century. As a solution to the structural and non-structural damage caused by intense ground motions, several seismic energy dissipating devices, such as buckling-restrained braces (BRB), have been proposed. BRB have shown to be effective in concentrating a large portion of the energy transmitted to the structure by the seismic ground motion. A design approach for buildings with BRB elements, which is based on a seismic Displacement-Based formulation, has recently been proposed by the coauthors in this paper. It is a practical and easy design method which simplifies the work of structural engineers. The method is used here for the design of the structure-BRB damper system. The objective of the present study is to extend and apply a methodology to find the best combination of design parameters on multiple-degree-of-freedom (MDOF) structural frame – BRB systems, taking into account simultaneously: 1) initial costs and 2) an adequate engineering demand parameter. The design parameters considered here are: the stiffness ratio (α = K_frame/K_total), and the strength ratio (γ = V_damper/V_total); where K represents structural stiffness and V structural strength; and the subscripts "frame", "damper" and "total" represent: the structure without dampers, the BRB dampers and the total frame-damper system, respectively. The selection of the best combination of design parameters α and γ is based on an initial costs analysis and on the structural dynamic response of the structural frame-damper system. The methodology is applied to a 12-story 5-bay steel building with BRB, which is located on the intermediate soil of Mexico City. It is found the best combination of design parameters α and γ for the building with BRB under study.

Keywords: best combination of design parameters, BRB, buildings with energy dissipating devices, buckling-restrained braces, initial costs

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Authors: Aurora Gitto, Philipp Proksch

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The presence of various microorganisms (bacteria, fungi) in surface water and groundwater represents an important issue for human health worldwide. The matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS) has emerged as a promising and reliable tool for bacteria identification in clinical diagnostic microbiology and environmental strains thanks to an ionization technique that uses a laser energy absorbing matrix to create ions from large molecules with minimal fragmentation. The study aims first to conceptualise and set up library information and create a comprehensive database of MALDI-TOF-MS spectra from environmental water samples. The samples were analysed over a year (2021-2022) using membrane filtration methodology (0.45 μm and 0.22 μm) and then isolated on R2A agar for a period of 5 days and Yeast extract agar growing at 22 °C up to 4 days and 37 °C for 48 hours. The undetected organisms by MALDI-TOF-MS were analysed by PCR and then sequenced. The information obtained by the sequencing was further implemented in the MALDI-TOF-MS library. Among the culturable bacteria, the results show how the incubator temperature affects the growth of some genera instead of others, as demonstrated by Pseudomonas sp., which grows at 22 °C, compared to Bacillus sp., which is abundant at 37 °C. The bacteria community shows a variation in composition also between the media used, as demonstrated with R2A agar which has been defined by a higher presence of organisms not detected compared to YEA. Interesting is the variability of the Genus over one year of sampling and how the seasonality impacts the bacteria community; in fact, in some sampling locations, we observed how the composition changed, moving from winter to spring and summer. In conclusion, the bacteria community in groundwater and river bank filtration represents important information that needs to be added to the library to simplify future water quality analysis but mainly to prevent potential risks to human health.

Keywords: water quality, MALDI-TOF-MS, sequencing, library

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Authors: Yen-Hao Su, Wan-Chun Tang, Ya-Wen Cheng, Peik Sia, Chi-Chen Huang, Yi-Chao Lee, Hsin-Yi Jiang, Ming-Heng Wu, I-Lu Lai, Jun-Wei Lee, Kuen-Haur Lee

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There is a wide range of drugs and combinations under investigation and/or approved over the last decade to treat colorectal cancer (CRC), but the 5-year survival rate remains poor at stages II–IV. Therefore, new, more efficient drugs still need to be developed that will hopefully be included in first-line therapy or overcome resistance when it appears, as part of second- or third-line treatments in the near future. In this study, we revealed that heat shock protein 90 (Hsp90) inhibitors have high therapeutic potential in CRC according to combinative analysis of NCBI's Gene Expression Omnibus (GEO) repository and chemical genomic database of Connectivity Map (CMap). We found that second generation Hsp90 inhibitor, NVP-AUY922, significantly down regulated the activities of a broad spectrum of kinases involved in regulating cell growth arrest and death of NVPAUY922-sensitive CRC cells. To overcome NVP-AUY922-induced upregulation of survivin expression which causes drug insensitivity, we found that combining berberine (BBR), a herbal medicine with potency in inhibiting survivin expression, with NVP-AUY922 resulted in synergistic antiproliferative effects for NVP-AUY922-sensitive and -insensitive CRC cells. Furthermore, we demonstrated that treatment of NVP-AUY922-insensitive CRC cells with the combination of NVP-AUY922 and BBR caused cell growth arrest through inhibiting CDK4 expression and induction of microRNA-296-5p (miR-296-5p)-mediated suppression of Pin1–β-catenin–cyclin D1 signaling pathway. Finally, we found that the expression level of Hsp90 in tumor tissues of CRC was positively correlated with CDK4 and Pin1 expression levels. Taken together, these results indicate that combination of NVP-AUY922 and BBR therapy can inhibit multiple oncogenic signaling pathways of CRC.

Keywords: berberine, colorectal cancer, connectivity map, heat shock protein 90 inhibitor

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Authors: Syed Beenish Rufai, Sarman Singh

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Background: Performance of Genotype MTBDRsl (Hain Life science GmbH Germany) for detection of mutations associated with second-line drug resistance is well known. However, less evidence regarding the association of mutations and genetic background of strains is known which, in the future, is essential for clinical management of anti-tuberculosis drugs in those settings where the probability of particular genotype is predominant. Material and Methods: During this retrospective study, a total of 259 MDR-TB isolates obtained from pulmonary TB patients were tested for second-line drug susceptibility testing (DST) using Genotype MTBDRsl VER 1.0 and compared with BACTEC MGIT-960 as a reference standard. All isolates were further characterized using spoligotyping. The spoligo patterns obtained were compared and analyzed using SITVIT_WEB. Results: Of total 259 MDR-TB isolates which were screened for second-line DST by Genotype MTBDRsl, mutations were found to be associated with gyrA, rrs and emb genes in 82 (31.6%), 2 (0.8%) and 90 (34.7%) isolates respectively. 16 (6.1%) isolates detected mutations associated with both FQ as well as to AG/CP drugs (XDR-TB). No mutations were detected in 159 (61.4%) isolates for corresponding gyrA and rrs genes. Genotype MTBDRsl showed a concordance of 96.4% for detection of sensitive isolates in comparison with second-line DST by BACTEC MGIT-960 and 94.1%, 93.5%, 60.5% and 50% for detection of XDR-TB, FQ, EMB, and AMK/CAP respectively. D94G was the most prevalent mutation found among (38 (46.4%)) OFXR isolates (37 FQ mono-resistant and 1 XDR-TB) followed by A90V (23 (28.1%)) (17 FQ mono-resistant and 6 XDR-TB). Among AG/CP resistant isolates A1401G was the most frequent mutation observed among (11 (61.1%)) isolates (2 AG/CP mono-resistant isolates and 9 XDR-TB isolates) followed by WT+A1401G (6 (33.3%)) and G1484T (1 (5.5%)) respectively. On spoligotyping analysis, Beijing strain (46%) was found to be the most predominant strain among pre-XDR and XDR TB isolates followed by CAS (30%), X (6%), Unique (5%), EAI and T each of 4%, Manu (3%) and Ural (2%) respectively. Beijing strain was found to be strongly associated with D94G (47.3%) and A90V mutations by (47.3%) and 34.8% followed by CAS strain by (31.6%) and 30.4% respectively. However, among AG/CP resistant isolates, only Beijing strain was found to be strongly associated with A1401G and WT+A1401G mutations by 54.5% and 50% respectively. Conclusion: Beijing strain was found to be strongly associated with the most prevalent mutations among pre-XDR and XDR TB isolates. Acknowledgments: Study was supported with Grant by All India Institute of Medical Sciences, New Delhi reference No. P-2012/12452.

Keywords: tuberculosis, line probe assay, XDR TB, drug susceptibility

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