Search results for: cross wall
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5098

Search results for: cross wall

1558 Need of Medicines Information OPD in Tertiary Health Care Settings: A Cross Sectional Study

Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

Abstract:

Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

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1557 Author Profiling: Prediction of Learners’ Gender on a MOOC Platform Based on Learners’ Comments

Authors: Tahani Aljohani, Jialin Yu, Alexandra. I. Cristea

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The more an educational system knows about a learner, the more personalised interaction it can provide, which leads to better learning. However, asking a learner directly is potentially disruptive, and often ignored by learners. Especially in the booming realm of MOOC Massive Online Learning platforms, only a very low percentage of users disclose demographic information about themselves. Thus, in this paper, we aim to predict learners’ demographic characteristics, by proposing an approach using linguistically motivated Deep Learning Architectures for Learner Profiling, particularly targeting gender prediction on a FutureLearn MOOC platform. Additionally, we tackle here the difficult problem of predicting the gender of learners based on their comments only – which are often available across MOOCs. The most common current approaches to text classification use the Long Short-Term Memory (LSTM) model, considering sentences as sequences. However, human language also has structures. In this research, rather than considering sentences as plain sequences, we hypothesise that higher semantic - and syntactic level sentence processing based on linguistics will render a richer representation. We thus evaluate, the traditional LSTM versus other bleeding edge models, which take into account syntactic structure, such as tree-structured LSTM, Stack-augmented Parser-Interpreter Neural Network (SPINN) and the Structure-Aware Tag Augmented model (SATA). Additionally, we explore using different word-level encoding functions. We have implemented these methods on Our MOOC dataset, which is the most performant one comparing with a public dataset on sentiment analysis that is further used as a cross-examining for the models' results.

Keywords: deep learning, data mining, gender predication, MOOCs

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1556 Composite 'C' Springs for Anti-Seismic Building Suspension: Positioning 'Virtual Center of Pendulation above Gravity Center'

Authors: Max Sardou, Patricia Sardou

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Now that weight saving is mandatory, to author best knowledge composite springs, that we have invented, are best choice for automotive suspensions, against steel. So, we have created a Joint Ventures called S.ARA, in order to mass produce composite coils springs. Start of Production of composite coils springs was in 2014 for AUDI. As we have demonstrated, on the road, that composite springs are not a sweet dream. The present paper describes all the benefits of ‘C’ springs and ‘S’ springs for high performance vehicles suspension, for rocket stage separation, and for satellite injection into orbit. Developing rocket stage separation, we have developed for CNES (Centre National d’Etudes Spatiales) the following concept. If we call ‘line of action’ a line going from one end of a spring to the other. Our concept is to use for instance two springs inclined. In such a way that their line of action cross together and create at this crossing point a virtual center well above the springs. This virtual center, is pulling from above the top stage and is offering a guidance, perfectly stable and straight. About buildings, our solution is to transfer this rocket technology, creating a ‘virtual center’ of pendulation positioned above the building center of gravity. This is achieved by using tilted composite springs benches oriented in such a way that their line of action converges creating the ‘virtual center’. Thanks to the ‘virtual center’ position, the building behaves as a pendulum, hanged from above. When earthquake happen then the building will oscillate around its ‘virtual center’ and will go back safely to equilibrium after the tremor. ‘C’ springs, offering anti-rust, anti-settlement, fail-safe suspension, plus virtual center solution is the must for long-lasting, perfect protection of buildings against earthquakes.

Keywords: virtual center of tilt, composite springs, fail safe springs, antiseismic suspention

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1555 Effect of CYP2B6 c.516G>T and c.983T>C Single Nucleotide Polymorphisms on Plasma Nevirapine Levels in Zimbabwean HIV/AIDS Patients

Authors: Doreen Duri, Danai Zhou, Babil Stray-Pedersen, Collet Dandara

Abstract:

Given the high prevalence of HIV/AIDS in sub-Saharan Africa, and the elusive search for a cure, understanding the pharmacogenetics of currently used drugs is critical in populations from the most affected regions. Compared to Asian and Caucasian populations, African population groups are more genetically diverse, making it difficult to extrapolate findings from one ethnic group to another. This study aimed to investigate the role of genetic variation in CYP2B6 (c.516G>T and c.983T>C) single nucleotide polymorphisms on plasma nevirapine levels among HIV-infected adult Zimbabwean patients. Using a cross-sectional study, patients on nevirapine-containing HAART, having reached steady state (more than six weeks on treatment) were recruited to participate. Blood samples were collected after patients provided consent and samples were used to extract DNA for genetic analysis or to measure plasma nevirapine levels. Genetic analysis was carried out using PCR and RFLP or Snapshot for the two single nucleotide polymorphisms; CYP2B6 c.516G>T and c.983T>C, while LC-MS/MS was used in analyzing nevirapine concentration. CYP2B6 c.516G>T and c.983T>C significantly predicted plasma nevirapine concentration with the c.516T and c.983T being associated with elevated plasma nevirapine concentrations. Comparisons of the variant allele frequencies observed in this group to those reported in some African, Caucasian and Asian populations showed significant differences. We conclude that pharmacogenetics of nevirapine can be creatively used to determine patients who are likely to develop nevirapine-associated side effects as well as too low plasma concentrations for viral suppression.

Keywords: allele frequencies, genetically diverse, nevirapine, single nucleotide polymorphism

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1554 Exploring Critical Thinking Skill Development in the 21st Century College Classroom: A Multi-Case Study

Authors: Kimberlyn Greene

Abstract:

Employers today expect college graduates to not only develop and demonstrate content-specific knowledge but also 21st century skillsets such as critical thinking. International assessments suggest students enrolled in United States (U.S.) educational institutions are underperforming in comparison to their global peers in areas such as critical thinking and technology. This multi-case study examined how undergraduate digital literacy courses at a four-year university in the U.S., as implemented by instructors, fostered students’ development of critical thinking skills. The conceptual framework for this study presumed that as students engaged in complex thinking within the context of a digital literacy course, their ability to deploy critical thinking was contingent upon whether the course was designed with the expectation for students to use critical thinking skills as well as the instructor’s approach to implementing the course. Qualitative data collected from instructor interviews, classroom observations, and course documents were analyzed with an emphasis on exploring the course design and instructional methods that provided opportunities to foster critical thinking skill development. Findings from the cross-case analysis revealed that although the digital literacy courses were designed and implemented with the expectation students would deploy critical thinking; there was no explicit support for students to develop these skills. The absence of intentional skill development resulted in inequitable opportunities for all students to engage in complex thinking. The implications of this study suggest that if critical thinking is to remain a priority, then universities must expand their support of pedagogical and instructional training for faculty regarding how to support students’ critical thinking skill development.

Keywords: critical thinking skill development, curriculum design, digital literacy, pedagogy

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1553 The Impact of Culture on Tourists’ Evaluation of Hotel Service Experiences

Authors: Eid Alotaibi

Abstract:

The purpose of this study is to investigate the impact of tourists’ culture on perception and evaluation of hotel service experience and behavioral intentions. Drawing on Hofested’s cultural dimensions, this study seeks to further contribute towards understanding the effect of culture on perception and evaluation of hotels’ services, and whether there are differences between Saudi and European tourists’ perceptions of hotel services evaluation. A descriptive cross-sectional design was used in this study. Data were collected from tourists staying in five-star hotels in Saudi Arabia using the self-completion technique. The findings show that evaluations of hotel services differ from one culture to another. T-test results reveal that Saudis were more tolerant and reported significantly higher levels of satisfaction, were more likely to return and recommend the hotel, and perceived the price for the hotel stay as being good value for money as compared to their European counterparts. The sample was relatively small and specific to only five-star hotel evaluations. As a result, findings cannot be generalized to the wider tourist population. The results of this research have important implications for management within the Saudi hospitality industry. The study contributes to the tourist cultural theory by emphasizing the relative importance of cultural dimensions in-service evaluation. The author argues that no studies could be identified that compare Saudis and Europeans in their evaluations of their experiences staying at hotels. Therefore, the current study would enhance understanding of the effects of cultural factors on service evaluations and provide valuable input for international market segmentation and resource allocation in the Saudi hotel industry.

Keywords: culture, tourist, service experience, hotel industry, Hofested’s cultural dimensions

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1552 Transient Heat Transfer: Experimental Investigation near the Critical Point

Authors: Andreas Kohlhepp, Gerrit Schatte, Wieland Christoph, Spliethoff Hartmut

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In recent years the research of heat transfer phenomena of water and other working fluids near the critical point experiences a growing interest for power engineering applications. To match the highly volatile characteristics of renewable energies, conventional power plants need to shift towards flexible operation. This requires speeding up the load change dynamics of steam generators and their heating surfaces near the critical point. In dynamic load transients, both a high heat flux with an unfavorable ratio to the mass flux and a high difference in fluid and wall temperatures, may cause problems. It may lead to deteriorated heat transfer (at supercritical pressures), dry-out or departure from nucleate boiling (at subcritical pressures), all cases leading to an extensive rise of temperatures. For relevant technical applications, the heat transfer coefficients need to be predicted correctly in case of transient scenarios to prevent damage to the heated surfaces (membrane walls, tube bundles or fuel rods). In transient processes, the state of the art method of calculating the heat transfer coefficients is using a multitude of different steady-state correlations for the momentarily existing local parameters for each time step. This approach does not necessarily reflect the different cases that may lead to a significant variation of the heat transfer coefficients and shows gaps in the individual ranges of validity. An algorithm was implemented to calculate the transient behavior of steam generators during load changes. It is used to assess existing correlations for transient heat transfer calculations. It is also desirable to validate the calculation using experimental data. By the use of a new full-scale supercritical thermo-hydraulic test rig, experimental data is obtained to describe the transient phenomena under dynamic boundary conditions as mentioned above and to serve for validation of transient steam generator calculations. Aiming to improve correlations for the prediction of the onset of deteriorated heat transfer in both, stationary and transient cases the test rig was specially designed for this task. It is a closed loop design with a directly electrically heated evaporation tube, the total heating power of the evaporator tube and the preheater is 1MW. To allow a big range of parameters, including supercritical pressures, the maximum pressure rating is 380 bar. The measurements contain the most important extrinsic thermo-hydraulic parameters. Moreover, a high geometric resolution allows to accurately predict the local heat transfer coefficients and fluid enthalpies.

Keywords: departure from nucleate boiling, deteriorated heat transfer, dryout, supercritical working fluid, transient operation of steam generators

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1551 Screening for Internet Addiction among Medical Students in a Saudi Community

Authors: Nawaf A. Alqahtani, Ali M. Alqahtani, Khalid A. Alqahtani, Huda S. Abdullfattah, Ebtehal A. Alessa, Khalid S. Al Gelban, Ossama A. Mostafa

Abstract:

Background: The internet is an exciting medium that is becoming an essential part of everyday life. Although the internet is fully observed in Saudi Arabia, young people may be vulnerable to problematic internet use, possibly leading to addiction. Aim of study: To explore the magnitude of internet addiction (IA) among medical students associated risk factors and its impact on students' academic achievement. Subjects and Methods: A cross sectional study was conducted in 2014 on 571 medical students (293 males and 278 females) at the College of Medicine, King Khalid University, Abha, Saudi Arabia. Data Collection was done through using the Arabic version of the Compulsive Internet Use Scale and a checklist of demographic characteristics. Results: Age of participants ranged from 19 to 26 years (Mean+SD: 21.9+1.5 years). Internet access was available to 97.4% of students at home and to 80.2% of students at their mobile phones. The most frequently accessed websites by medical students were the social media (90.7%), scientific website (50.4%) and the news websites (31.3%). IA was mild in 47.8% of medical students while 5.8% had moderate IA. None of the students had severe IA. Prevalence of IA was significantly higher among female medical students (p=0.002), availability of internet at home (p=0.022), and availability of internet at the students' mobile phone (p=0.041). The mean General Point Average (GPA) was highest among students with mild IA (4.0+0.6), compared with 3.6+0.6 among those with moderate addiction, and 3.9+0.6 among those who did not show IA. Differences in mean GPA according to grade of IA were statistically significant ((P=0.001). Conclusions: Prevalence of IA is high among medical students in Saudi Arabia. Risk factors for IA include female gender, availability of internet at home or at the mobile phone. IA has a significant impact on students' GPA. Periodic screening of medical students for IA and raising their awareness toward the possible risk of IA are recommended.

Keywords: internet addiction, medical students, risk factors, Saudi Arabia

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1550 Seroprevalence and Associated Factors of Hepatitis B and Hepatitis C Viral Infections among Prisoners in Tigrai, Northern Ethiopia

Authors: Belaynesh Tsegay Beyene, Teklay Gebrecherkos, Atsebaha Gebrekidan Kahsay, Mahmud Abdulkader

Abstract:

Background: Hepatitis B and C viruses are of important health and socioeconomic problem of the globe with remarkable diseases and deaths in Sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigrai. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners of Tigrai, Ethiopia. Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigrai. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliter of blood was collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using enzyme-linked immunosorbent assay (ELISA) (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20 and p < 0.05 was considered statistically significant. Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1(0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18-25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell [AOR =3.95, 95% CI= (1.15, 13.6, p =0.029)] and having history of alcohol consumption [AOR =3.01, 95% CI= (1.17, 7.74, p =0.022)] were significantly associated with HBV infections. Conclusions: The seroprevalence of HBV among prisoners was nearly high or borderline (7.9%) with a very low HCV prevalence (0.3%). HBV was most prevalent among young adults, large number of prisoners per cell and those who had history of alcohol consumption. This study recommends that there should be prison-focused intervention including regular health education by emphasis on the mode of transmission and introducing HBV screening policy for prisoners especially when they enter to the prison.

Keywords: seroprevalence, HBV, HCV, prisoners, Tigrai

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1549 Structural Characterization of TIR Domains Interaction

Authors: Sara Przetocka, Krzysztof Żak, Grzegorz Dubin, Tadeusz Holak

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Toll-like receptors (TLRs) play central role in the innate immune response and inflammation by recognizing pathogen-associated molecular patterns (PAMPs). A fundamental basis of TLR signalling is dependent upon the recruitment and association of adaptor molecules that contain the structurally conserved Toll/interleukin-1 receptor (TIR) domain. MyD88 (myeloid differentiation primary response gene 88) is the universal adaptor for TLRs and cooperates with Mal (MyD88 adapter-like protein, also known as TIRAP) in TLR4 response which is predominantly used in inflammation, host defence and carcinogenesis. Up to date two possible models of MyD88, Mal and TLR4 interactions have been proposed. The aim of our studies is to confirm or abolish presented models and accomplish the full structural characterisation of TIR domains interaction. Using molecular cloning methods we obtained several construct of MyD88 and Mal TIR domain with GST or 6xHis tag. Gel filtration method as well as pull-down analysis confirmed that recombinant TIR domains from MyD88 and Mal are binding in complexes. To examine whether obtained complexes are homo- or heterodimers we carried out cross-linking reaction of TIR domains with BS3 compound combined with mass spectrometry. To investigate which amino acid residues are involved in this interaction the NMR titration experiments were performed. 15N MyD88-TIR solution was complemented with non-labelled Mal-TIR. The results undoubtedly indicate that MyD88-TIR interact with Mal-TIR. Moreover 2D spectra demonstrated that simultaneously Mal-TIR self-dimerization occurs which is necessary to create proper scaffold for Mal-TIR and MyD88-TIR interaction. Final step of this study will be crystallization of MyD88 and Mal TIR domains complex. This crystal structure and characterisation of its interface will have an impact in understanding the TLR signalling pathway and possibly will be used in development of new anti-cancer treatment.

Keywords: cancer, MyD88, TIR domains, Toll-like receptors

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1548 Software Architecture Implications on Development Productivity: A Case of Malawi Point of Care Electronic Medical Records

Authors: Emmanuel Mkambankhani, Tiwonge Manda

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Software platform architecture includes system components, their relationships, and design, as well as evolution principles. Software architecture and documentation affect a platform's customizability and openness to external innovators, thus affecting developer productivity. Malawi Point of Care (POC) Electronic Medical Records System (EMRS) follows some architectural design standards, but it lacks third-party innovators and is difficult to customize as compared to CommCare and District Health Information System 2 (DHIS2). Improving software architecture and documentation for the Malawi POC will increase productivity and third-party contributions. A conceptual framework based on Generativity and Boundary Resource Model (BRM) was used to compare the three platforms. Interviews, observations, and document analysis were used to collect primary and secondary data. Themes were found by analyzing qualitative and quantitative data, which led to the following results. Configurable, flexible, and cross-platform software platforms and the availability of interfaces (Boundary Resources) that let internal and external developers interact with the platform's core functionality, hence boosting developer productivity. Furthermore, documentation increases developer productivity, while its absence inhibits the use of resources. The study suggests that the architecture and openness of the Malawi POC EMR software platform will be improved by standardizing web application program interfaces (APIs) and making interfaces that can be changed by the user. In addition, increasing the availability of documentation and training will improve the use of boundary resources, thus improving internal and third-party development productivity.

Keywords: health systems, configurable platforms, software architecture, software documentation, software development productivity

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1547 The Two Layers of Food Safety and GMOs in the Hungarian Agricultural Law

Authors: Gergely Horváth

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The study presents the complexity of food safety dividing it into two layers. Beyond the basic layer of requirements, there is a more demanding higher level linked with quality and purity aspects. It would be important to give special prominence to both layers, given that massive illnesses are caused by foods even though officially licensed. Then the study discusses an exciting safety challenge stemming from the risks of genetically modified organisms (GMOs). Furthermore, it features legal case examples that illustrate how certain liability questions are solved or not yet decided in connection with the production of genetically modified crops. In addition, a special kind of land grabbing, more precisely land grabbing from non-GMO farming systems can also be noticed as well as a new phenomenon eroding food sovereignty. Coexistence, the state where organic, conventional, and GM farming systems are standing alongside each other is an unsuitable experiment that cannot be successful, because of biophysical reasons (such as cross-pollination). Agricultural and environmental lawyers both try to find the optimal solution. Agri-environmental measures are introduced as a special subfield of law maintaining also food safety. The important steps of agri-environmental legislation are aiming at the protection of natural values, the environmental media and strengthening food safety as well, practically the quality of agricultural products intended for human consumption. The major findings of the study focus on searching for the appropriate approach capable of solving the security and safety problems of food production. The most interesting concepts of the Hungarian national and EU food law legislation are analyzed in more detail with descriptive, analytic and comparative methods.

Keywords: food law, food safety, food security, GMO, Genetically Modified Organisms, agri-environmental measures

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1546 Prevalence and Risk Factors of Musculoskeletal Disorders among Physical Therapist's Seniors versus Internship Students

Authors: A. H. Bekhet, N. Helmy

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Background: Physical therapists are knowledgeable in treatment and prevention of musculoskeletal injuries; however, they have occupational musculoskeletal injuries because Physical therapy profession requires effort that may lead to work-related musculoskeletal disorders. No previous studies among physical therapists have been reported in Egypt. We aim to assess the prevalence and risk factors of musculoskeletal disorders among physical therapist’s seniors versus internship students. Method: We conducted a cross-sectional study in faculty of physical therapy Cairo university Prevalence and risk factors of musculoskeletal injuries were assessed using self-administered questionnaire with closed-ended questions. Seniors therapist was defined as a physical therapist with more than 5 years of work experience. Data were analyzed using SPSS 22.0 for Windows. Results: The study included 106 physical therapists (Junior = 72; senior = 34), the mean age of senior therapists was 30.1 (SD 6.3) years and junior therapists were 22.8 (SD 2.4). Female subjects constituted 83.9% of the studied sample. The mean hours of contact with patients was higher among junior therapists 6.4 (SD 2.6) vs. 5.7 (SD 2.1) among senior therapists. The prevalence of a musculoskeletal injury, once or more in their lifetime, was significantly higher among senior therapists (86% vs. 66.7%; p = 0.04). The highest risk factor in increasing the symptoms of the injury among junior therapists was maintaining a position for a prolonged period of time at 28% while performing manual therapy techniques was the highest risk factor among senior therapists at 32%. 53% of senior therapists have limited their patient contact time as a result of their injury in comparison to 25% of junior therapists (p = 0.09). Conclusion: the presented study shows that the prevalence of musculoskeletal injuries, once or more in their lifetime, is significantly higher among senior therapists.

Keywords: musculoskeletal injuries, occupational injuries, physical therapists, work related disorders

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1545 FT-NIR Method to Determine Moisture in Gluten Free Rice-Based Pasta during Drying

Authors: Navneet Singh Deora, Aastha Deswal, H. N. Mishra

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Pasta is one of the most widely consumed food products around the world. Rapid determination of the moisture content in pasta will assist food processors to provide online quality control of pasta during large scale production. Rapid Fourier transform near-infrared method (FT-NIR) was developed for determining moisture content in pasta. A calibration set of 150 samples, a validation set of 30 samples and a prediction set of 25 samples of pasta were used. The diffuse reflection spectra of different types of pastas were measured by FT-NIR analyzer in the 4,000-12,000 cm-1 spectral range. Calibration and validation sets were designed for the conception and evaluation of the method adequacy in the range of moisture content 10 to 15 percent (w.b) of the pasta. The prediction models based on partial least squares (PLS) regression, were developed in the near-infrared. Conventional criteria such as the R2, the root mean square errors of cross validation (RMSECV), root mean square errors of estimation (RMSEE) as well as the number of PLS factors were considered for the selection of three pre-processing (vector normalization, minimum-maximum normalization and multiplicative scatter correction) methods. Spectra of pasta sample were treated with different mathematic pre-treatments before being used to build models between the spectral information and moisture content. The moisture content in pasta predicted by FT-NIR methods had very good correlation with their values determined via traditional methods (R2 = 0.983), which clearly indicated that FT-NIR methods could be used as an effective tool for rapid determination of moisture content in pasta. The best calibration model was developed with min-max normalization (MMN) spectral pre-processing (R2 = 0.9775). The MMN pre-processing method was found most suitable and the maximum coefficient of determination (R2) value of 0.9875 was obtained for the calibration model developed.

Keywords: FT-NIR, pasta, moisture determination, food engineering

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1544 Institutional Capacity of Health Care Institutes for Diagnosis and Management of Common Genetic Diseases-a Study from a North Coastal District of Andhra Pradesh, India

Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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1543 The Effect of Nano-Silver Packaging on Quality Maintenance of Fresh Strawberry

Authors: Naser Valipour Motlagh, Majid Aliabadi, Elnaz Rahmani, Samira Ghorbanpour

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Strawberry is one of the most favored fruits all along the world. But due to its vulnerability to microbial contamination and short life storage, there are lots of problems in industrial production and transportation of this fruit. Therefore, lots of ideas have tried to increase the storage life of strawberries especially through proper packaging. This paper works on efficient packaging as well. The primary material used is produced through simple mixing of low-density polyethylene (LDPE) and silver nanoparticles in different weight fractions of 0.5 and 1% in presence of dicumyl peroxide as a cross-linking agent. Final packages were made in a twin-screw extruder. Then, their effect on the quality maintenance of strawberry is evaluated. The SEM images of nano-silver packages show the distribution of silver nanoparticles in the packages. Total bacteria count, mold, yeast and E. coli are measured for microbial evaluation of all samples. Texture, color, appearance, odor, taste and total acceptance of various samples are evaluated by trained panelists and based on 9-point hedonic scale method. The results show a decrease in total bacteria count and mold in nano-silver packages compared to the samples packed in polyethylene packages for the same storage time. The optimum concentration of silver nanoparticles for the lowest bacteria count and mold is predicted to be around 0.5% which has attained the most acceptance from the panelist as well. Moreover, organoleptic properties of strawberry are preserved for a longer period in nano-silver packages. It can be concluded that using nano-silver particles in strawberry packages has improved the storage life and quality maintenance of the fruit.

Keywords: antimicrobial properties, polyethylene, silver nanoparticles, strawberry

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1542 A Systematic Review for the Association between Active Smoking and Latent Tuberculosis Infection

Authors: Pui Hong Chung, Wing Chi Ho, Jun Li, Cyrus Leung, Ek Yeoh

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Background: Cigarette smoking is associated with poor tuberculosis (TB) outcomes in terms of progression of active TB, relapse of TB and TB-related mortality, but the association with latent tuberculosis infection (LTBI) is unclear. The systematic review conducted aimed at studying the association between active smoking and LTBI, and likelihood of dose-response relationship. Methods: Two independent reviewers searched three electronic databases comprising PudMed, Medline by EBSCOHOST, ExcerptaMedica Database (EMBASE), from inception up to 31st Dec 2015 for studies reporting data on current smoking and the LTBI with tuberculin skin test (TST) or interferon-γ release assays (IGRAs) results, comparing the odds ratios (ORs) of outcome measure of TST or IGRAs among current smokers with 95% confidence intervals (CI). Results: Seven studies were identified, including six cross-sectional studies and one longitudinal cohort study. The outcome measures from three studies were in TST, three studies in IGRAs and one for both tests. For TST, OR ranging from 1.39 to 3.40 (95% CI) with all studies shown positive association between cigarette smoking and LTBI. For IGRAs, OR ranging from 0.47 to 1.89 (95% CI) with one study shown the negative association that might be related to impaired interferon-gamma production in immunosuppressive persons. One identified study demonstrated positive dose-response relationship in TST result. Conclusions: Cigarette smoking is likely to be a risk factor of LTBI. There is the important implication for TB and tobacco control program to halt TB by empowering public health policy. Further study is also needed to provide more evidence of the dose-response model/relationship.

Keywords: latent tuberculosis infection, systematic review, active smoking, model

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1541 Openness to Linguistic and Value Diversity as a Key Factor in the Development of a Learning Community

Authors: Caterina Calicchio, Talia Sbardella

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The ability to move through geographical and symbolic spaces is key for building new nodes and social relationships. Especially in the framework of language learning, accepting and valuing diversity can help to create a constructive atmosphere of cooperation, innovation, and creativity. Thus, it is important to outline the stages of forming a learning community, focusing on the characteristics that can favor its development. It is known that elements like curiosity and motivation are significant for individual language learning; hence, the study attempts to investigate how factors like openness to diversity and cultural immersion could improve Italian learning and teaching. This paper aims to indicate the factors that could be significant for the development of a Learning Community by presenting a case study on a course on Italian as a second language for beginners: first, the theoretical matrices underlying social learning will be outlined. Secondly, a quantitative study will be described based on an adaptation of the openness to diversity and some insights psychometric scale questionnaire developed at the Umbra Institute. The questionnaire was delivered to 52 American college students with open-ended and closed-ended questions. Students were asked to specify their level of agreement to a set of statements on a six-point Likert scale ranging from (1) Strongly disagree to (6) Strongly agree. The data has been analyzed with a quantitative and qualitative method and has been represented in a pie chart and in a histogram. Moreover, mean and frequency have been calculated. The research findings demonstrate that openness to diversity and challenge enhances cross-cutting skills such as intercultural and communicative competence: through cultural immersion and the facility of speaking with locals, the participants have been able to develop their own Italian L2 language community. The goal is to share with the scientific community some insights to trace possible future lines of research.

Keywords: Italian as second language, language learning, learning community, openness to diversity

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1540 Functional Ingredients from Potato By-Products: Innovative Biocatalytic Processes

Authors: Salwa Karboune, Amanda Waglay

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Recent studies indicate that health-promoting functional ingredients and nutraceuticals can help support and improve the overall public health, which is timely given the aging of the population and the increasing cost of health care. The development of novel ‘natural’ functional ingredients is increasingly challenging. Biocatalysis offers powerful approaches to achieve this goal. Our recent research has been focusing on the development of innovative biocatalytic approaches towards the isolation of protein isolates from potato by-products and the generation of peptides. Potato is a vegetable whose high-quality proteins are underestimated. In addition to their high proportion in the essential amino acids, potato proteins possess angiotensin-converting enzyme-inhibitory potency, an ability to reduce plasma triglycerides associated with a reduced risk of atherosclerosis, and stimulate the release of the appetite regulating hormone CCK. Potato proteins have long been considered not economically feasible due to the low protein content (27% dry matter) found in tuber (Solanum tuberosum). However, potatoes rank the second largest protein supplying crop grown per hectare following wheat. Potato proteins include patatin (40-45 kDa), protease inhibitors (5-25 kDa), and various high MW proteins. Non-destructive techniques for the extraction of proteins from potato pulp and for the generation of peptides are needed in order to minimize functional losses and enhance quality. A promising approach for isolating the potato proteins was developed, which involves the use of multi-enzymatic systems containing selected glycosyl hydrolase enzymes that synergistically work to open the plant cell wall network. This enzymatic approach is advantageous due to: (1) the use of milder reaction conditions, (2) the high selectivity and specificity of enzymes, (3) the low cost and (4) the ability to market natural ingredients. Another major benefit to this enzymatic approach is the elimination of a costly purification step; indeed, these multi-enzymatic systems have the ability to isolate proteins, while fractionating them due to their specificity and selectivity with minimal proteolytic activities. The isolated proteins were used for the enzymatic generation of active peptides. In addition, they were applied into a reduced gluten cookie formulation as consumers are putting a high demand for easy ready to eat snack foods, with high nutritional quality and limited to no gluten incorporation. The addition of potato protein significantly improved the textural hardness of reduced gluten cookies, more comparable to wheat flour alone. The presentation will focus on our recent ‘proof-of principle’ results illustrating the feasibility and the efficiency of new biocatalytic processes for the production of innovative functional food ingredients, from potato by-products, whose potential health benefits are increasingly being recognized.

Keywords: biocatalytic approaches, functional ingredients, potato proteins, peptides

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1539 Fast Bayesian Inference of Multivariate Block-Nearest Neighbor Gaussian Process (NNGP) Models for Large Data

Authors: Carlos Gonzales, Zaida Quiroz, Marcos Prates

Abstract:

Several spatial variables collected at the same location that share a common spatial distribution can be modeled simultaneously through a multivariate geostatistical model that takes into account the correlation between these variables and the spatial autocorrelation. The main goal of this model is to perform spatial prediction of these variables in the region of study. Here we focus on a geostatistical multivariate formulation that relies on sharing common spatial random effect terms. In particular, the first response variable can be modeled by a mean that incorporates a shared random spatial effect, while the other response variables depend on this shared spatial term, in addition to specific random spatial effects. Each spatial random effect is defined through a Gaussian process with a valid covariance function, but in order to improve the computational efficiency when the data are large, each Gaussian process is approximated to a Gaussian random Markov field (GRMF), specifically to the block nearest neighbor Gaussian process (Block-NNGP). This approach involves dividing the spatial domain into several dependent blocks under certain constraints, where the cross blocks allow capturing the spatial dependence on a large scale, while each individual block captures the spatial dependence on a smaller scale. The multivariate geostatistical model belongs to the class of Latent Gaussian Models; thus, to achieve fast Bayesian inference, it is used the integrated nested Laplace approximation (INLA) method. The good performance of the proposed model is shown through simulations and applications for massive data.

Keywords: Block-NNGP, geostatistics, gaussian process, GRMF, INLA, multivariate models.

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1538 Long-Term Cohort of Patients with Beta Thalassemia; Prevailing Role of Serum Ferritin Levels in Hypocalcemia and Growth Retardation

Authors: Shervin Rashidinia, Sara Shahmoradi, Seyyed Shahin Eftekhari, Mohsen Talebizadeh, Mohammad Saleh Sadeghi

Abstract:

Background: Beta-thalassemia Major (BTM) is a kind of hereditary hemolytic anemia which depended on regular monthly blood transfusion. However, iron deposition into the organs leads to multi-organ damage. The present study is the first study which aimed to evaluate the average of five-years serum ferritin level and compared by the prevalence of short stature and hypocalcemia. Materials/Methods: A cross-sectional retrospective study which a total of 140 patients with beta-thalassemia who were referred to Qom Thalassemia Clinic between February 2011 and July 2016 were enrolled to be reviewed. The exclusion criteria were consisting of incomplete medical records, diagnosis less than 2-years-ago and the blood transfusion less than every 4 weeks. The data including age, gender, weight, height, age of initial blood transfusion, age of initial chelation therapy, ferritin, and calcium were collected and analysis by SPSS version 24. Results: A total of 140 patients were enrolled. Of them, 75 (53.4%) were female. The mean age of the patients was 13.4±4.6 years.The mean age of initial diagnosis was 20.2±7.4 months. Hypocalcemia and short stature were occurred in 41 (29.3%) and 37 (26.4%) patients, respectively. The mean five-years serum ferritin level was significantly higher in the patients with short stature and hypocalcemia (P<0.0001). However, rise in serum ferritin level significantly increases the risk of short-stature and hypocalcemia (1.0004- and 1.0029 fold, respectively). Conclusion: We demonstrated that prevalence of short stature and hypocalcemia were significantly higher in the BTM.However, ferritin significantly increases the risk of short stature and hypocalcemia.

Keywords: beta-thalassemia, ferritin, growth retardation, hypocalcemia

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1537 Effects of Ascophyllum nodosum in Tomato in the Tropical Caribbean Climate: Effects and Molecular Insights into Mechanisms

Authors: Omar Ali, Adesh Ramsubhag, Jayaraj Jayaraman

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Seaweed extracts have been reported as plant biostimulants which could be a safer, organic alternative to harsh pesticides. The incentive to use seaweed-based biostimulants is becoming paramount in sustainable agriculture. The current study, therefore, screened a commercial extract of A. nodosum in tomatoes, cultivated in Trinidad to showcase the multiple beneficial effects. Foliar treatment with an A. nodosum commercial extract led to significant increases in fruit yield and a significant reduction of incidence of bacterial spots and early blight diseases under both greenhouse and field conditions. Investigations were carried out to reveal the possible mechanisms of action of this biostimulant through defense enzyme assays and transcriptome profiling via RNA sequencing of tomato. Studies into disease control mechanisms by A. nodosum showed that the extract stimulated the activity of enzymes such as peroxidase, phenylalanine ammonia-lyase, chitinase, polyphenol oxidase, and β-1,3-glucanase. Additionally, the transcriptome survey revealed the upregulation and enrichment of genes responsible for the biosynthesis of growth hormones, defense enzymes, PR proteins and defense-related secondary metabolites, as well as genes involved in the nutrient mobilization, photosynthesis and primary and secondary metabolic pathways. The results of the transcriptome study also demonstrated the cross-talks between growth and defense responses, confirming the bioelicitor and biostimulant value of seaweed extracts in plants. These effects could potentially implicate the benefits of seaweed extract and validate its usage in sustainable crop production.

Keywords: A. nodosum, biostimulants, elicitor, enzymes, growth responses, seaweeds, tomato, transcriptome analysis

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1536 Assessment of the Work-Related Stress and Associated Factors among Sanitation Workers in Public Hospitals during COVID-19, Addis Ababa, Ethiopia

Authors: Zerubabel Mihret

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Background: Work-related stress is a pattern of reactions to work demands unmatched by worker’s knowledge, skills, or abilities. Healthcare institutions are considered high-risk and intensive work areas for work-related stress. However, there is the nonexistence of clear and strong data about the magnitude of work-related stress on sanitation workers in hospitals in Ethiopia. The aim of this study was to determine the magnitude of work-related stress among sanitation workers in public hospitals during COVID-19 in Addis Ababa, Ethiopia. Methods: Institution-based cross-sectional study was conducted from October 2021 to February 2022 among 494 sanitation workers who were selected from 4 hospitals. HSE (Health and Safety Executive of UK) standard data collection tool was used, and an interviewer-administered questionnaire was used to collect the data using KOBO collect application. The collected data were cleaned and analyzed using SPSS version 20.0. Both binary and multivariable logistic regression analyses were done to identify important factors having an association with work-related stress. Variables with p-value ≤ 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. A statistically significant level was declared at a p-value ≤ 0.05. Results: This study revealed that the magnitude of work-related stress among sanitation workers was 49.2% (95% CI 45-54). Significant proportions (72.7%) of sanitation workers were dissatisfied with their current job. Sex, age, experience, and chewing khat were significantly associated with work-related stress. Conclusion: Work-related stress is significantly high among sanitation workers. Sex, age, experience, and chewing khat were identified as factors associated with work-related stress. Intervention program focusing on the prevention and control of stress is desired by hospitals.

Keywords: work-related stress, sanitation workers, Likert scale, public hospitals, Ethiopia

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1535 Epstein-Barr Virus-associated Diseases and TCM Syndromes Types: In Search for Correlation

Authors: Xu Yifei, Le Yining, Yang Qingluan, Tu Yanjie

Abstract:

Objective: This study aims to investigate the distribution features of Traditional Chinese Medicine (TCM) syndromes and syndrome elements in Epstein-Barr virus-associated diseases and then explores the relations between TCM syndromes or syndrome elements and laboratory indicators of Epstein-Barr virus-associated diseases. Methods: A cross-sectional study of 70 patients with EBV infection was described. We assessed the diagnostic information and laboratory indicators of these patients from Huashan Hospital Affiliated to Fudan University between November 2017 and July 2019. The disease diagnosis and syndrome differentiation were based on the diagnostic criteria of EBV-associated diseases and the theory of TCM respectively. Confidence correlation analysis, logistic regression analysis, cluster analysis, and the Sankey diagram were used to analyze the correlation between the data. Results: The differentiation of the 4 primary TCM syndromes in the collected patients was correlated with the indexes of immune function, liver function, inflammation, and anemia, especially the relationship between Qifen syndrome and high lactic acid dehydrogenase level. The common 11 TCM syndrome elements were associated with the increased CD3+ T cell rate, low hemoglobin level, high procalcitonin level, high lactic acid dehydrogenase level, and low albumin level. Conclusion: The changes in immune function indexes, procalcitonin, and liver function-related indexes in patients with EBV-associated diseases were consistent with the evolution law of TCM syndromes. This study provides a reference for judging the pathological stages of these kinds of diseases, predicting their prognosis, and guiding subsequent treatment strategies based on TCM syndrome type.

Keywords: EBV-associated diseases, traditional Chinese medicine syndrome, syndrome element, diagnostics

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1534 Expanding the Therapeutic Utility of Curcumin

Authors: Azza H. El-Medany, Hanan H. Hagar, Omnia A. Nayel, Jamila H. El-Medany

Abstract:

In search for drugs that can target cancer cell micro-environment in as much as being able to halt malignant cellular transformation, the natural dietary phytochemical curcumin was currently assessed in DMH-induced colorectal cancer rat model. The study enrolled 50 animals divided into a control group (n=10) and DMH-induced colorectal cancer control group (n=20) (20mg/kg-body weight for 28 weeks) versus curcumin-treated group (n=20) (160 mg/kg suspension daily oral for further 8 weeks). Treatment by curcumin succeeded to significantly decrease the percent of ACF and tended to normalize back the histological changes retrieved in adenomatous and stromal cells induced by DMH. The drug also significantly elevated GSH and significantly reduced most of the accompanying biochemical elevations (namely MDA, TNF-α, TGF-β and COX2) observed in colonic carcinomatous tissue, induced by DMH, thus succeeding to revert that of MDA, COX2 and TGF-β back to near normal as justified by being non-significantly altered as compared to normal controls. The only exception was PAF that was insignificantly altered by the drug. When taken together, it could be concluded that curcumin possess the potentiality to halt some of the orchestrated cross-talk between cancerous transformation and its micro-environmental niche that contributes to cancer initiation, progression and metastasis in this experimental cancer colon model. Envisioning these merits to a drug with already known safety preferentiality, awaits final results of current ongoing clinical trials, before curcumin can be added to the new therapeutic armamentarium of anticancer therapy.

Keywords: curcumin, dimethyl hydralazine, aberrant crypt foci, malondialdehyde, reduced glutathione, cyclooxygenase-2, tumour necrosis factor-alpha, transforming growth factor-beta, platelet activating factor

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1533 A Five-Year Follow-up Survey Using Regression Analysis Finds Only Maternal Age to Be a Significant Medical Predictor for Infertility Treatment

Authors: Lea Stein, Sabine Rösner, Alessandra Lo Giudice, Beate Ditzen, Tewes Wischmann

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For many couples bearing children is a consistent life goal; however, it cannot always be fulfilled. Undergoing infertility treatment does not guarantee pregnancies and live births. Couples have to deal with miscarriages and sometimes even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified. To further our understanding, a cross-sectional five-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women’s Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). During infertility treatment, 72.6% of couples became pregnant and 69.5% were able to give birth. Suffering from miscarriages 27.5% of couples and 20.5% decided to discontinue an unsuccessful fertility treatment. The binary logistic regression models for clinical pregnancies, live births and dropouts were statistically significant for the maternal age, whereas the paternal age in addition to maternal and paternal BMI, smoking, infertility diagnoses and infections, showed no significant predicting effect on any of the outcome variables. The results confirm an effect of maternal age on infertility treatment, whereas the relevance of other medical predictors remains unclear. Further investigations should be considered to increase our knowledge of medical predictors.

Keywords: advanced maternal age, assisted reproductive technology, female factor, male factor, medical predictors, infertility treatment, reproductive medicine

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1532 Advanced Phosphorus-Containing Polymer Materials towards Eco-Friendly Flame Retardant Epoxy Thermosets

Authors: Ionela-Daniela Carja, Diana Serbezeanu, Tachita Vlad-Bubulac, Corneliu Hamciuc

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Nowadays, epoxy materials are extensively used in ever more areas and under ever more demanding environmental conditions due to their remarkable combination of properties, light weight and ease of processing. However, these materials greatly increase the fire risk due to their flammability and possible release of toxic by-products as a result of their chemical composition which consists mainly from carbon and hydrogen atoms. Therefore, improving the fire retardant behaviour to prevent the loss of life and property is of particular concern among government regulatory bodies, consumers and manufacturers alike. Modification of epoxy resins with organophosphorus compounds, as reactive flame retardants or additives, is the key to achieving non-flammable advanced epoxy materials. Herein, a detailed characterization of fire behaviour for a series of phosphorus-containing epoxy thermosets is reported. A carefully designed phosphorus flame retardant additive was simply blended with a bifunctional bisphenol-A based epoxy resin. Further thermal cross-linking in the presence of various aminic hardeners led to eco-friendly flame retardant epoxy resins. The type of hardener, concentration of flame retardant additive, compatibility between the components of the mixture, char formation and morphology, thermal stability, flame retardant mechanisms were investigated. It was found that even a very low content of phosphorus introduced into the epoxy matrix increased the limiting oxygen index value to about 30%. In addition, the peak of the heat release rate value decreased up to 45% as compared to the one of the neat epoxy system. The main flame retardant mechanism was the condensed-phase one as revealed by SEM and XPS measurements.

Keywords: condensed-phase mechanism, eco-friendly phosphorus flame retardant, epoxy resin, thermal stability

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1531 Violence and Challenges in the Pamir Hindu Kush: A Study of the Impact of Change on a Central but Unknown Region

Authors: Skander Ben Mami

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Despite its particular patterns and historical importance, the remote region of the Pamir Hindu Kush still lacks public recognition, as well as scientific substance, because of the abundance of classical state-centred geopolitical studies, the resilience of (inter)national narratives, and the political utility of the concepts of 'Central Asia' and 'South Asia'. However, this specific region of about 100 million inhabitants and located at the criss-cross of four geopolitical areas (Indian, Iranian, Chinese and Russian) over a territory of half a million square kilometres features a string of patterns that set it apart from the neighbouring areas of the Fergana, the Gansu and Punjab. Moreover, the Pamir Hindu Kush undergoes a series of parallel social and economic transformations that deserve scrutiny for their strong effect on the people’s lifestyle, particularly in three major urban centres (Aksu in China, Bukhara in Uzbekistan and Islamabad in Pakistan) and their immediate rural surroundings. While the involvement of various public and private stakeholders (States, NGOs, civil movements, private firms…) has undeniably resulted in positive elements (economic growth, connectivity, higher school attendance), it has in the same time generated a collection of negative effects (radicalizing, inequalities, pollution, territorial divide) that need to be addressed to strengthen regional and international security. This paper underscores the region’s strategical importance as the major hotbed and engine of insecurity and violence in Asia, notably in the context of Afghanistan’s enduring violence. It introduces the inner structures of the region, the different sources of violence as well as the governments’ responses to address it.

Keywords: geography, security, terrorism, urbanisation

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1530 Fodder Production and Livestock Rearing in Relation to Climate Change and Possible Adaptation Measures in Manaslu Conservation Area, Nepal

Authors: Bhojan Dhakal, Naba Raj Devkota, Chet Raj Upreti, Maheshwar Sapkota

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A study was conducted to find out the production potential, nutrient composition, and the variability of the most commonly available fodder trees along with the varying altitude to help optimize the dry matter requirement during winter lean period. The study was carried out from March to June, 2012 in Lho and Prok Village Development Committee of Manaslu Conservation Area (MCA), located in Gorkha district of Nepal. The other objective of the research was to learn the impact of climate change on livestock production linking it with feed availability. The study was conducted in two parts: social and biological. Accordingly, a households (HHs) survey was conducted to collect primary data from 70 HHs, focusing on the perception of respondents on impacts of climatic variability on the feeding management. The next part consisted of understanding yield potential and nutrient composition of the four most commonly available fodder trees (M. azedirach, M. alba, F. roxburghii, F. nemoralis), within two altitudes range: (1500-2000 masl and 2000-2500 masl) by using a RCB design in 2*4 factorial combination of treatments, each replicated four times. Results revealed that majority of the farmers perceived the change in climatic phenomenon more severely within the past five years. Farmers were using different adaptation technologies such as collection of forage from jungle, reducing unproductive animals, fodder trees utilization, and crop by product feeding at feed scarcity period. Ranking of the different fodder trees on the basis of indigenous knowledge and experiences revealed that F. roxburghii was the best-preferred fodder tree species (index value 0.72) in terms overall preferability whereas M. azedirach had highest growth and productivity (index value 0.77), F. roxburghii had highest adoptability (index value 0.69) and palatability (index value 0.69) as well. Similarly, fresh yield and dry matter yield of the each fodder trees was significant (P < 0.01) between the altitude and within species. Fodder trees yield analysis revealed that the highest dry matter (DM) yield (28 kg/tree) was obtained for F. roxburghii but that remained statistically similar (P > 0.05) to the other treatment. On the other hand, most of the parameters: ether extract (EE), acid detergent lignin (ADL), acid detergent fibre (ADF), cell wall digestibility (CWD), relative digestibility (RD), digestible nutrient (TDN), and Calcium (Ca) among the treatments were highly significant (P < 0.01). This indicates the scope of introducing productive and nutritive fodder trees species even at the high altitude to help reduce fodder scarcity problem during winter. The finding also revealed the scope of promoting all available local fodder trees species as crude protein content of these species were similar.

Keywords: fodder trees, yield potential, climate change, nutrient composition

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1529 Influenza Vaccine Uptake Among Tunisian Physicians in the 2018-2019 Influenza Season

Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

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