Search results for: male population
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7832

Search results for: male population

7502 Sublethal Effects of Thiamethoxam-Lambda Cyhalothrin on the Life Table Parameters and Population Projection of Trialeurodes vaporariorum (Hemiptera: Aleyrodidae) and Its Parasitoid, Encarsia formosa (Hymenoptera: Aphelinidae)

Authors: Sevda Ddras, Fariba Mehrkhou, Remzi Atlihan, Maryam Fourouzan

Abstract:

The greenhouse whitefly, Trialeurodes vaporariorum Westwood (Hemiptera: Aleyrodidae), is one of the most important pest on vegetables and ornamental host plants. In this research, the sub-lethal concentration (LC30) of thiamethoxam-lambda cyhalothrin (TLC) on the biological properties, life table parameters and population projection of T. vaporarium and its parasitoid, Encarsia formosa Gahan, were studied at controlled condition (25 ±5 ℃, R.H. 60 ±10 % and a photoperiod of 16:8 h (L:D). Bioassays were conducted by dipping tomato leaves containing third instar nymphs of the whitefly T. vaporariorum, in the obtained LC30 concentration of eforia. The life table data were analyzed using the computer program TWOSEX–MSChart based on the age-stage, two-sex life table theory. The results showed that, usage of sublethal concentration of TLC effected the biological properties and population growth parameters of greenhouse whitefly by shortening the developmentl time, adult longevity, decreasing the fecundity and population growth paramters. Also, the LC30 concentration of TLC had negative effects on life history and life table parameters of E.formosa. The obtained results illustrated that the sublethal concentration of TLC resulted in prolonging of developmental time, decreasing of adult longevity, survival rate and population growth parameters of E.formosa. Additionally, the population projection results were accordance with the population growth rate of either greenhouse whitefly or E.formosa. We conclude that, TLC should not be used in integrated pest management programs where E. formosa exists.

Keywords: greenhouse whitefly, Encarsia formosa, thiamethoxam-lambda cyhalothrin, population projection, life table parameters

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7501 Singular Stochastic Control Model with Carrying Capacity of Population Management Policy for Squirrels in Durian Orchards

Authors: Sasiwimol Auepong, Raywat Tanadkithirun

Abstract:

In this work, the problem that squirrels ruin durian, which is an economical fruit in Thailand, is considered. We seek the strategy for the durian farmers to eliminate the squirrels under the consideration that squirrels also provide ecosystem service. The population dynamics of squirrels are constructed to have carrying capacity since we consider the population in a confined area. A performance index indicating the total benefit of a given elimination strategy is provided. It comprises the cost of countermeasures, the loss of resources, and the ecosystem service provided by squirrels. The optimal performance index is numerically solved through the variational inequality using the finite difference method. The optimal strategy to control the squirrel population is also given numerically.

Keywords: controlled stochastic differential equation, durian, finite difference method, performance index, singular stochastic control model, squirrel

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7500 Causes of Blindness and Low Vision among Visually Impaired Population Supported by Welfare Organization in Ardabil Province in Iran

Authors: Mohammad Maeiyat, Ali Maeiyat Ivatlou, Rasul Fani Khiavi, Abouzar Maeiyat Ivatlou, Parya Maeiyat

Abstract:

Purpose: Considering the fact that visual impairment is still one of the countries health problem, this study was conducted to determine the causes of blindness and low vision in visually impaired membership of Ardabil Province welfare organization. Methods: The present study which was based on descriptive and national-census, that carried out in visually impaired population supported by welfare organization in all urban and rural areas of Ardabil Province in 2013 and Collection of samples lasted for 7 months. The subjects were inspected by optometrist to determine their visual status (blindness or low vision) and then referred to ophthalmologist in order to discover the main causes of visual impairment based on the international classification of diseases version 10. Statistical analysis of collected data was performed using SPSS software version 18. Results: Overall, 403 subjects with mean age of years participated in this study. 73.2% were blind, 26.8 % were low vision and according gender grouping 60.50 % of them were male, 39.50 % were female that divided into three groups with the age level of lower than 15 (11.2%) 15 to 49 (76.7%), and 50 and higher (12.1%). The age range was 1 to 78 years. The causes of blindness and low vision were in descending order: optic atrophy (18.4%), retinitis pigmentosa (16.8%), corneal diseases (12.4%), chorioretinal diseases (9.4%), cataract (8.9%), glaucoma (8.2%), phthisis bulbi (7.2%), degenerative myopia (6.9%), microphtalmos ( 4%), amblyopia (3.2%), albinism (2.5%) and nistagmus (2%). Conclusion: in this study the main causes of visual impairments were optic atrophy and retinitis pigmentosa, thus specific prevention plans can be effective in reducing the incidence of visual disabilities.

Keywords: blindness, low vision, welfare, ardabil

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7499 Population Ecology of the House Rat (Rattus rattus) in Rural Human Dwelling of Pothwar Plateau, Pakistan

Authors: Surrya Khanam

Abstract:

Understanding the population characteristics of pest species is crucial to develop suitable management plans. The present study was aimed to determine the population ecology of House rat (Rattus rattus) in rural human dwellings of Pothwar, Pakistan. Seasonal rodent trapping was conducted in four villages of Pothwar area from March 2012 to February 2014. A total of 217 individuals of R.rattus were captured from houses, shops, and farm houses. There was no significant difference in the abundance of species across different trapping seasons. The species sex ratio was unbiased and did not differ significantly from 1:1 at all the sites and across all the trapping seasons. The population of R. Rattus had individuals of different age groups, viz., juvenile, sub adults and adults. Overall, more adult individuals were captured in spring and summer season. Breeding activity was continuous throughout the year and reproductively active individuals relatively outnumbered inactive individuals. The results showed that village indoor habitats provided a suitable habitat for rat populations all the year round. The information obtained from this study will be helpful in the development of control strategies for R. rattus populations in commensal habitats.

Keywords: ecology, indoor pests, Rattus rattus, population characteristics

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7498 Social Receptiveness of Tourists in the Batumi Population

Authors: Megi Surmanidze

Abstract:

The relations between tourists and the population is essentially important to develop tourism. This global branch is an incoming stream and plays the huge economy role in the country is development. This branch is important for adjarian region as well as for Batumi as a touristic city. When lots of tourists visit our city, the relationship and attitudes between tourists and the local population is too important and play the determinant role whether they will visit the country again or not. Receptivness is on actual accompanying process typical for tourism as a growing incoming business direction, and its necessary to be studied the problems and touristic relationships. The aim of the article is to show the importance of receptibility in the business touristic industry also, the topic was to show the dimension scale of receptibility revearing in Batumi population. The topic itself is of hight importance as the touristic business is growing day by day, though the helpful and disturbing social couses were left out of focus were dencely connected to the relations between tourists and the local population. The value is real and directly proportional to the relationship between tourists and the population. The qualitative social research was fulfield. The method to get information was deepened interview. the method gave us the opportunity to get acquented to the actors points of view, also it was suitable points of view, also it was suitable to create favourable conditions to respodents be sincere during interviev and don’t hide their real emotions and the opinions.

Keywords: tourism industry, receptiveness, cultural identity, xenophobia

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7497 Assessment of Acquired Language Disorders in Bilingual French-English Adults in Ontario: Current Practice and Challenges

Authors: Sophie Laurence, Catherine Rivard

Abstract:

The assessment of acquired language disorders in the adult population, whether for a bilingual or monolingual adult, is a complex process that requires the speech-language pathologist (SLP) to make a judicious choice when selecting the assessment method and tools. However, this task is even more complex with Ontario's bilingual population due to the lack of linguistically and culturally appropriate tools for this population. Numerous researches examined language assessment of the pediatric bilingual population; however, few studies have focused on assessing acquired language disorders in bilingual adults. This study's main objective is to identify the challenges that SLPs encounter when assessing language in the bilingual English-French adult population in Ontario to ultimately be able to serve this population in the future better. An online questionnaire was made available to 1325 members of the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) who work with the adult population. The answers to this questionnaire (n = 71) allowed us to identify the tools and strategies most commonly used by SLPs in current practice, identify the assessment challenges faced by SLPs, and determine the causes of these challenges as well as potential solutions. In an English and French assessment, the Western Aphasia Battery, the Boston Diagnostic Aphasia Examination, and the Boston Naming Test were the three tools that respondents deemed to be the most relevant for the assessment. Besides, the results revealed that limited access to SLPs and interpreters who speak the client's language and the lack of standardized and normalized assessment tools for Ontario's French-speaking and bilingual English-French clientele are at the heart of the challenges of current SLP practice. Consistent with these findings, respondents highlighted two potential solutions to address these challenges: SLPs have access to standardized/normalized tools for the population under study and better access to SLPs and interpreters who speak the client's language.

Keywords: assessment, acquired language disorders, bilingualism, speech-Language pathology, adult population

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7496 Clustering for Detection of the Population at Risk of Anticholinergic Medication

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

Abstract:

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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7495 A Game-Based Methodology to Discriminate Executive Function – a Pilot Study With Institutionalized Elderly People

Authors: Marlene Rosa, Susana Lopes

Abstract:

There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.

Keywords: board game, aging, executive function, evaluation

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7494 Hospital Beds: Figuring and Forecasting Patient Population Arriving at Health Care Research Institute, Illustrating Roemer's Law

Authors: Karthikeyan Srinivasan, Ranjana Singh, Yatin Talwar, Karthikeyan Srinivasan

Abstract:

Healthcare services play a vital role in the life of human being. The Setup of Hospital varies in wide spectrum of cost, technology, and access. Hospital’s of Public sector satisfies need of a common man to poorer, which can differ at private owned hospitals on cost and treatment. Patient assessing hospital frequently assumes spending time at the hospital is miserable and not aware of what is happening around them. Mostly they are queued up round the clock waiting to be admitted on hospital beds. The idea here is to highlight the role in admitting patient population of Outdoor as well as Emergency entering the Post Graduate Institute of Medical Education and Research, Chandigarh with available hospital beds. This study emphasizes the trend forecasting and acquiring beds needed. The conception “if patient population increases’ likewise increasing hospital beds advertently perceived. If tend to increase the hospital beds, thereby exploring budget, Manpower, space, and infrastructure make compulsion. This survey ideally draws out planning and forecasting beds to cater patient population in and around neighboring state of Chandigarh for admission at territory healthcare and research institute on available hospital beds. Executing healthcare services for growing population needs to know Roemer’s law indicating "in an insured population, a hospital bed built is a filled bed".

Keywords: admissions, average length of stay, bed days, hospital beds, occupancy rates

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7493 Small and Medium Enterprises Owner-Managers/Entrepreneurs and Their Risk Perception in Songkhla Province, Thailand

Authors: Patraporn Kaewkhanitarak, Weerawan Marangkun

Abstract:

The objective of this study was to explore the establishment and to investigate the relationship between the gender (male or female) of SME owner-managers/ entrepreneurs and their risk perception in business activity. The study examines the data by interviewing 76 SME owner-managers/entrepreneurs’ responses (37 males, 39 females) in manufacturing, finance, human resources and marketing sector in the economic regions of Songkhla province, Thailand. This study found that four tools which were operation, cash flow, staff, and new market were perceived by the SME owner-managers/entrepreneurs at high level. However, male and female SME owner-managers/entrepreneurs perceived some factors such as the age of SME owner-managers/entrepreneurs, the duration of firm operation, type of firm, and type of business without significant differences. In contrast, the gender affected the risk perception about increasing cost, fierce competition, leapfrog development of firm, substandard staff, namely that male and female perceived these factors with significant differences. According to the research, SME owner-managers/entrepreneurs should develop their risk management competency to deal with the risk efficiently. Secondly, SME firms should gather into groups. Furthermore, it was shown that the five key tools used to manage these risky situations were the use of managerial competencies and clustering.

Keywords: risk perception, owner-managers/entrepreneurs, SME, Songkhla, Thailand

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7492 Assessment of Population Trends of Birds at Taunsa Barrage Wildlife Sanctuary, Pakistan

Authors: Fehmeada Bibi, Shafqat Nawaz Qaisrani, Masood Akhtar, Zulfiqar Ali

Abstract:

Population trends learning is an important tool for conservation programs in rare as well as in common species of birds. A study was conducted to assess annual decline in species of birds and to identify the causes of this decline at Taunsa Barrage wildlife Sanctuary, Punjab, Pakistan. Data were collected by direct census method during wintering and breeding periods (2001 to 2002 and 2008 to 2011). The results indicated an increasing trend in 157, whereas a decreasing trend in 14 species of birds. Among the species with declining trend, there was a 92% decrease in White-backed Vulture (Gyps bengalensis), 60% in Greater Painted Snipe (Rostratula benghalensis), 57% in Garganey (Anas querquedula), Pallas’s Fish Eagle and Long-legged Buzzard (Buteo rufinus) 50% each, 41% in Grey Heron (Ardea cinerea), 39% in Little Cormorant (Phalacrocorax niger), 37% in Gadwall (Anas strepera), 33% in Marsh Harrier (Circus aeruginosus), 30% in Black Drongo (Dicrurus macrocercus) and 26% in Red-crested Pochard (Netta rufina) population. Habitat exploitation, hunting and grazing were found the main causes of this decline. In conclusion, conservation and management of the study area is foremost to interests of declining bird population. It is suggested, therefore, to take immediate steps for the protection of the sanctuary to conserve the declining population of birds.

Keywords: population trends, wildlife sanctuary, bird, habitat exploitation

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7491 The Impact of Australia's Skilled Migrant Selection System: A Case Study of Japanese Skilled Migrants and Their Families

Authors: Iori Hamada

Abstract:

Australia's skilled migrant selection system is constantly changing its target skills and criteria according to the labour market demands. The government's intention to employ this highly selective market-driven selection system is to better target the skills needed in the economy, enable skilled migrants to be employed in industries that have the highest need, and consequently boost the economy and population. However, migration scholars have called this intention into question, arguing that the system is not making the best use of skilled migrants. This paper investigates the impact of recent reforms in Australian skilled migration system on skilled migrants' employment and related life conditions. Drawing on semi-structured qualitative interviews with Japanese skilled migrants in Australia, it argues that Australia’s skilled migrant selection system guarantees neither skilled migrants' employment nor successful transfer of their skills to the labour market. The findings show that Japanese skilled migrants are often unemployed or under-employed, although they intend to achieve upward occupational mobility. The interview data also reveal that male unemployment or under-employment status prompts some Japanese men to leave Australia and find a job that better matches their skills and qualifications in a new destination. Further, it finds that Japanese male skilled migrants who experience downward occupational mobility tend to continue to take a primary breadwinner role, which affects the distribution of paid and unpaid work within their families. There is a growing body of research investigating skilled migrants’ downward career mobility. However, little has been written on skilled Japanese migrants. Further, the work-family intersection is a 'hot public policy topic' in Australia and elsewhere. Yet, the existing studies focus almost exclusively on non-migrant families. This calls attention to the urgency of assessing the work-family lives of skilled migrants. This study fills these gaps, presenting additional insight into Japanese skilled migrants’ work and family in and beyond Australia.

Keywords: Australia, employment, family, Japanese skilled migrants

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7490 Admission C-Reactive Protein Serum Levels and In-Hospital Mortality in the Elderly Admitted to the Acute Geriatrics Department

Authors: Anjelika Kremer, Irina Nachimov, Dan Justo

Abstract:

Background: C-reactive protein (CRP) serum levels are commonly measured in hospitalized patients. Elevated admission CRP serum levels and in-hospital mortality has been seldom studied in the general population of elderly patients admitted to the acute Geriatrics department. Methods: A retrospective cross-sectional study was conducted at a tertiary medical center. Included were all elderly patients (age 65 years or more) admitted to a single acute Geriatrics department from the emergency room between April 2014 and January 2015. CRP serum levels were measured routinely in all patients upon the first 24 hours of admission. A logistic regression analysis was used to study if admission CRP serum levels were associated with in-hospital mortality independent of age, gender, functional status, and co-morbidities. Results: Overall, 498 elderly patients were included in the analysis: 306 (61.4%) female patients and 192 (38.6%) male patients. The mean age was 84.8±7.0 years (median: 85 years; IQR: 80-90 years). The mean admission CRP serum levels was 43.2±67.1 mg/l (median: 13.1 mg/l; IQR: 2.8-51.7 mg/l). Overall, 33 (6.6%) elderly patients died during the hospitalization. A logistic regression analysis showed that in-hospital mortality was independently associated with history of stroke (p < 0.0001), heart failure (p < 0.0001), and admission CRP serum levels (p < 0.0001) – and to a lesser extent with age (p = 0.042), collagen vascular disease (p=0.011), and recent venous thromboembolism (p=0.037). Receiver operating characteristic (ROC) curve showed that admission CRP serum levels predict in-hospital mortality fairly with an area under the curve (AUC) of 0.694 (p < 0.0001). Cut-off value with maximal sensitivity and specificity was 19.7 mg/L. Conclusions: Admission CRP serum levels may be used to predict in-hospital mortality in the general population of elderly patients admitted to the acute Geriatrics department.

Keywords: c-reactive protein, elderly, mortality, prediction

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7489 Alpha Lipoic Acid: An Antioxidant for Infertility

Authors: Chiara Di Tucci, Giulia Galati, Giulia Mattei, Valentina Bonanni, Oriana Capri, Renzo D'Amelio, Ludovico Muzii, Pierluigi Benedetti Panici

Abstract:

Objective: Infertility is an increasingly frequent health condition, which may depend on female or male factors. Oxidative stress (OS), resulting from a disrupted balance between reactive oxygen species (ROS) and protective antioxidants, affects the reproductive lifespan of men and women. In this review, we examine if alpha lipoic acid (ALA), among the oral supplements currently in use, has an evidence-based beneficial role in the context of female and male infertility. Methods: We performed a search from English literature using the PubMed database with the following keywords: 'female infertility', 'male infertility', 'semen', 'sperm', 'sub-fertile man', 'alpha-lipoic acid', ' alpha lipoic acid', 'lipoid acid', 'endometriosis', 'chronic pelvic pain', 'follicular fluid' and 'oocytes'. We included clinical trials, multicentric studies, and reviews. The total number of references found after automatically and manually excluding duplicates was 180. After the primary and secondary screening, 28 articles were selected. Results: The available literature demonstrates the positive effects of ALA in multiple processes, from oocyte maturation (0.87 ± 0.9% of oocyte in MII vs 0.81 ± 3.9%; p < .05) to fertilization, embryo development (57.7% vs 75.7% grade 1 embryo; p < .05) and reproductive outcomes. Its regular administration both in sub-fertile women and men has been shown to reduce pelvic pain in endometriosis (p < .05), regularize menstrual flow and metabolic disorders (p < .01), and improve sperm quality (p < .001). Conclusions: ALA represents a promising new molecule in the field of couple infertility. More clinical studies are needed in order to enhance its use in clinical practice.

Keywords: alpha lipoic acid, endometriosis, infertility, male factor, polycystic ovary syndrome

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7488 The Effect of Tribulus Terresteris on Histomorphometrical Changes of Testis Induced by Ethanol Administration in Male Wistar Rats

Authors: Arash Esfandiari, Ebrahim Parsaei

Abstract:

The purpose of this research was to survey the effect of tribulus terresteris on histomorphometrical changes of testis induced by ethanol administration in male wistar rats. Fifteen male wistar rats divided into three groups: 1- control group (n=5). 2- Experimental group I (IP received 1 mg/gr Alcohole 20% for 30 days) (n=5). 3- Experimental group II (IP received 1 mg/gr Alcohole 20% for 30 days and IP received 100 mg/kg tribulus terresteris 15 days before received Alcohole for 45 days) (n=5). All procedures and care of the animals were conducted following protocols approved by the ethical committee (Iranian Society for the Prevention of cruelty to animal, and Iranian Veterinary Organization). Results showed that the thickness of the wall of seminiferous tubule, the weight of testis, the number of spermatogenic cells were decreased in experimental group I. In addition, all of these parameters were increased in experimental group II compared with experimental group I. These decrement of all of parameters in experimental group I with significant difference in comparison control group (p≤ 0.05). But all of parameters had increment in experimental group II with no significant difference compared with control group (p≥ 0.05) and significant difference with experimental group I (p≤ 0.05).It is concluded that tribulus terresteris may prevent from reducing the number of spermatogenic cell that has been created by the consumption of alcohole.

Keywords: ethanol, histomorphometric, testis, teribulus terresteris

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7487 Antidiarrhea Effect of T-DABUTO from Madinella speciosa L. on Male Balb-C Mice Induced Oleum Ricini

Authors: Adhara Puspa Noorita, Azkiyatin Nailil M., Rita Aryanti, Sushanti Nuraini, Pujiati Abbas, Suparmi

Abstract:

T-Dabuto is a tea made from leaves and fruits of parijoto (Madinella speciosa L.), which flavonoid, saponin and tanin contained in that tea are reported have diarrhea-caused antibacterial activity. However, the in vivo antidiarrhea effect have not clear yet. This study was conducted to determine the effect of T-DABUTO to faecal characteristics in male Balb/C-mice induced oleum ricini. Experimental research with post-test only control group design was conducted using 35 young male mice strain Balb-C which was divided into 5 groups. All groups were induced by 0.7 ml/ head of oleum ricini and 3 hours later followed by aquadest for first group, while the 2nd, 3rd, 4th and 5th group were treated by T-DABUTO solution with 75 mg/kgBW, 150 mg/kgBW, 300 mg/kgBW, and 600 mg/kgBW respectively as 0.7 ml/ head/ 0.5 hous for 8 hours. Feces collected were used to identify the frequency, absorbtion diameter and fecal weight. T-DABUTO on dose 75 mg/kg BW has the highest antidiarrhea activity which the mean of frequency defecation, water feacal absorbsion and feacal weight were 1.71±0.95 times, 0.38±0.49 mm, 0.43±0.28 mg, respectively. The T-DABUTO treatment did not influence the body weight of diarrheal mice. The T-DABUTO is potential as one of natural diarrhea tratment, especially in children.

Keywords: diarrhea, flavonid, tannin, saponin

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7486 Prevalence of Cerebral Microbleeds in Apparently Healthy, Elderly Population: A Meta-Analysis

Authors: Vidishaa Jali, Amit Sinha, Kameshwar Prasad

Abstract:

Background and Objective: Cerebral microbleeds are frequently found in healthy elderly individuals. We performed a meta- analysis to determine the prevalence of cerebral microbleeds in apparently healthy, elderly population and to determine the effect of age, smoking and hypertension on the occurrence of cerebral microbleeds. Methods: Relevant literature was searched using electronic databases such as MEDLINE, EMBASE, PubMed, Cochrane database, Google scholar to identify studies on the prevalence of cerebral microbleeds in general elderly population till March 2016. STATA version 13 software was used for analysis. Fixed effect model was used if heterogeneity was less than 50%. Otherwise, random effect model was used. Meta- regression analysis was performed to check any effect of important variables such as age, smoking, hypertension. Selection Criteria: We included cross-sectional studies performed in apparently healthy elderly population, who had age more than 50 years. Results: The pooled proportion of cerebral microbleeds in healthy population is 12% (95% CI, 0.11 to 0.13). No significant effect of age was found on the prevalence of cerebral microbleeds (p= 0.99). A linear relationship between increase in hypertension and the prevalence of cerebral microbleeds was found, however, this linear relationship was not statistically significant (p=0.16). Similarly, A linear relationship between increase in smoking and the prevalence of cerebral microbleeds was found, however, this linear relationship was also not statistically significant (p=0.21). Conclusion: Presence of cerebral microbleeds is evident in apparently healthy, elderly population, in more than 10% of individuals.

Keywords: apparently healthy, elderly, prevalence, cerebral microbleeds

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7485 Comparative Study of Estimators of Population Means in Two Phase Sampling in the Presence of Non-Response

Authors: Syed Ali Taqi, Muhammad Ismail

Abstract:

A comparative study of estimators of population means in two phase sampling in the presence of non-response when Unknown population means of the auxiliary variable(s) and incomplete information of study variable y as well as of auxiliary variable(s) is made. Three real data sets of University students, hospital and unemployment are used for comparison of all the available techniques in two phase sampling in the presence of non-response with the newly generalized ratio estimators.

Keywords: two-phase sampling, ratio estimator, product estimator, generalized estimators

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7484 Efficacy and Safety of Combination Therapy in Androgenetic Alopecia: Randomized Uncontrolled Evaluator, Blind Study

Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

Abstract:

Introduction: Early age of onset of baldness has marked psychological impact on personality. Combination therapies have better efficacy than monotherapy in androgenetic alopecia. Although medical, surgical treatment and cosmetic aids are available for treatment of pattern baldness, medical is first preferred the line of treatment. Although only 5% topical minoxidil is USFDA approved, 10% is available in India since 2007. Efficacy of tablet finasteride is well established in male pattern baldness. 5% topical minoxidil is effective and safe in female pattern baldness. There is a role of saw palmetto in regrowth of scalp hair. With this background research was undertaken to study efficacy and safety of topical minoxidil 10% + tab. Finesteride (1mg) + dermaroller in male pattern baldness and topical minoxidil 5% + cap. Saw palmetto (320 mg) + dermaroller in female pattern baldness. Methods and Materials: It was a randomized uncontrolled evaluator blind study consisting of total 21 patients, 15 of male pattern baldness and 6 of female pattern baldness within 20-35 yrs of age were enrolled. Male patients had Hamilton grade 2-4 MPB and females had Ludwig grade 2 FPB. Male patients were treated with Tab Finesteride 1mg once daily + 10% topical Minoxidil 1ml twice daily for 6 months. Female patients were treated with Cap. Saw palmetto 320 mg once daily + 5% topical Minoxidil twice daily for 6 months. In both male & female patients dermaroller therapy was used once in 10 days for 4 sittings followed by once in 15 days for next 5 months. Blood pressure and possible side effects were monitored in every follow up visits. Pre and post treatment photographs were taken. Assessment of hair growth was done at baseline and at the end of 6 months. Patients satisfactory grading scale and Physician assessment of hair growth scale were used to assessing the results. Trichoscan was done for assessment of hair-shaft diameter and density. Pre and post treatment photographs and Trichoscan hair growth analysis (by diameter and density) was done by physician (dermatologist) not directly involved in this study (evaluator blind). Result: This combination therapy showed moderate response in female pattern alopecia and good to excellent results in male pattern alopecia at the end of 6 months. During therapy none of the patients showed side effects like hypotension, headache and loss of libido, hirsuitism. Mild irritation due to crystal deposition was noted by 3 patients. Conclusion: Effective and early treatment using combination therapy with higher percent of Minoxidil for rapid hair growth is necessary in initial period since it will boost up the self-confidence in patients leading to better treatment compliance. Subsequent maintenance of hair growth can be done with lower concentration. No significant side effects with treatment are observed in both group of patients.

Keywords: androgenetic alopecia, dermaroller, finasteride, minoxidil, saw palmetto

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7483 Testicular Dose and Associated Risk from Common Pelvis Radiation Therapy in Iran

Authors: Ahmad Shanei, Milad Baradaran-Ghahfarokhi

Abstract:

This study aimed to investigate testicular dose (TD) and the associated risk of heritable disease from common pelvis radiotherapy of male patients in Iran. In this work, the relation between TD and changes in beam energy, pelvis size, source to skin distance (SSD) and beam directions (anterior or posterior) were also evaluated. The values of TDs were measured on 67 randomly selected male patients during common pelvis radiotherapy using 1.17 and 1.33 MeV, Theratron Cobalt-60 unit at SSD of 80 cm and 9 MV, Neptun 10 PC and 18 MV, GE Saturne 20 at SSD of 100 cm at Seyed-Al Shohada Hospital, Isfahan, Iran. Results showed that the maximum TD was up to 12% of the tumor dose. Considering the risk factor for radiation-induced heritable disorders of 0.1% per Sv, an excess risk of hereditary disorders of 72 per 10000 births was conservatively calculated. There was a significant difference in the measured TD using different treatment machines and energies (P < 0.001). The TD at 100 cm SSD were much less than that for 80 cm SSD (P <0.001). The Pearson Correlation test showed that, as expected, there was a strong correlation between TD and patient’s pelvis size (r = 0.275, P <0.001). Using the student’s t-tests, it was found that, there was not a significant difference between TD and beam direction (P = 0.231). Iranian male patients undergoing pelvic radiotherapy have the potential of receiving a TD of more than 1 Gy which might result in temporary azoospermia. The risk for induction of hereditary disorders in future generations should be considered as low but not negligible in comparison with the correspondent nominal risk.

Keywords: pelvis radiotherapy, testicular dose, infertility, hereditary effects

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7482 Estimating Age In Deceased Persons From The North Indian Population Using Ossification Of The Sternoclavicular Joint

Authors: Balaji Devanathan, Gokul G, Raveena Divya, Abhishek Yadav, Sudhir K.Gupta

Abstract:

Background: Age estimation is a common problem in administrative settings, medico legal cases, and among athletes competing in different sports. Age estimation is a problem in medico legal problems that arise in hospitals when there has been a criminal abortion, when consenting to surgery or a general physical examination, when there has been infanticide, impotence, sterility, etc. Medical imaging progress has benefited forensic anthropology in various ways, most notably in the area of determining bone age. An efficient method for researching the epiphyseal union and other differences in the body's bones and joints is multi-slice computed tomography. There isn't a significant database on Indians available. So to obtain an Indian based database author has performed this original study. Methodologies: The appearance and fusion of ossification centre of sternoclavicular joint is evaluated, and grades were assigned accordingly. Using MSCT scans, we examined the relationship between the age of the deceased and alterations in the sternoclavicular joint during the appearance and union in 500 instances, 327 men and 173 females, in the age range of 0 to 25 years. Results: According to our research in both the male and female groups, the ossification centre for the medial end of the clavicle first appeared between the ages of 18.5 and 17.1 respectively. The age range of the partial union was 20.4 and 20.2 years old. The earliest age of complete fusion was 23 years for males and 22 years for females. For fusion of their sternebrae into one, age range is 11–24 years for females and 17–24 years. The fusion of the third and fourth sternebrae was completed by 11 years. The fusions of the first and second and second and third sternebrae occur by the age of 17 years. Furthermore, correlation and reliability were carried out which yielded significant results. Conclusion: With numerous exceptions, the projected values are consistent with a large number of the previously developed age charts. These variations may be caused by the ethnic or regional heterogeneity in the ossification pattern among the population under study. The pattern of bone maturation did not significantly differ between the sexes, according to the study. The study's age range was 0 to 25 years, and for obvious reasons, the majority of the occurrences occurred in the last five years, or between 20 and 25 years of age. This resulted in a comparatively smaller study population for the 12–18 age group, where age estimate is crucial because of current legal requirements. It will require specialized PMCT research in this age range to produce population standard charts for age estimate. The medial end of the clavicle is one of several ossification foci that are being thoroughly investigated since they are challenging to assess with a traditional X-ray examination. Combining the two has been shown to be a valid result when it comes to raising the age beyond eighteen.

Keywords: age estimation, sternoclavicular joint, medial clavicle, computed tomography

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7481 An Appraisal of the Knowledge Attitude and Practice (Kap) on Plastic Waste Pollution as a Resilience Pathway for Mitigating Climate Change Case of Durumi 1 Urban Slum Area of Abuja Nigeria

Authors: Pascal U. Onu, Doris A. Ogbang, Emmanuel Okechukwu.

Abstract:

Background: Plastics in their various forms have become ubiquitous in a very short space of time. This ubiquitous nature has plagued and daunted nations globally, overwhelming their ability to manage the environmental impact, especially its linkages to climate change. This has mobilized nations globally and triggered debates on the best approaches to ensure sustainability in terms of its production and utilization, as total elimination seems unrealistic. Objective: This study undertook to understand the pattern of plastic waste management, and its pollution awareness levels by the residents of the study area. Methods: Data were obtained through questionnaires designed specifically for plastic waste and qualitatively via journals and articles. Simple descriptive survey techniques with a survey population size of 300 respondents using kobo collect were employed. Results: Analysis based on disaggregated data indicated a proportionate distribution among male and female respondents (53% male and 47% female, respectively). Overall awareness levels on plastic waste's contribution to climate change, compared to its environmental impact, are reflective of a dire need for increased efforts in strengthening awareness creation, especially across gender populations and religious backgrounds. Drainage blockage topped the ranks among common problems caused by plastic waste within the area. Various plastic waste disposal methods were ranked, while pro-environmental measures for reducing the waste menace showed more willingness from males at 52%. Conclusion: These outcomes are instructive and suggest the need for renewed and increased awareness/education on the nexus of plastic pollution to climate change and also appropriate synergies/collaboration between government, private sector, and local communities, especially in the area of recycling to improve sustainability in plastic waste management.

Keywords: plastic waste, KAP, climate change, Nigeria

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7480 Assessment of Cytotoxic and Genotoxic Effect of Tartrazine in Both Male and Female Albino Rats

Authors: Alaa F. A. Bakr, Sherein S. Abdelgayed, Osama. S. EL-Tawil, Adel M. Bakeer

Abstract:

Objective: This study was carried out to evaluate the cytotoxic and genotoxic effect of tartrazine in both male and female albino rats. Methodology: Forty adult male (20) and female (20) Sprague Dawley albino rats (120 - 150g) were obtained and distributed into four experimental groups; Group I; 10 untreated males, Group II; 10 untreated females, Group III; 10 treated males, and Group IV; 10 treated females. Body weight was recorded weekly, reduced glutathione (RGH), lipid peroxidation (SOD), and superoxide dismutase activity (MDA) in liver tissue were carried out, histopathological studies of brain, liver, and kidneys were performed, COMET assay was performed, all values were statistically analyzed. Results: Decrease in the activity of RGH and SOD in the treated groups were reported, but there was a more significant decrease in the female treated group. MDA was increased in treated groups with tartrazine, moreover, it was more significant in the female treated group. Multiple histological lesions were developed in brain, liver, and kidneys. COMET showed positive results. Conclusion: Our study concluded that Tartrazine has a cytotoxic and genotoxic effect on albino rats and it was more significant in females than males.

Keywords: tartrazine, cytotoxicity, genotoxicity, histopathology, albino rats

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7479 Acoustic Characteristics of Ultrasonic Vocalizations in Rat Pups Prenatally Exposed to Ethanol

Authors: Mohd. Ashik Shahrier, Hiromi Wada

Abstract:

Prenatal ethanol exposure has potential to induce difficulties in the social behavior of rats and can alter pup-dam communication suggesting that deficits in pups could result in altered dam behavior, which in turn could result in more aberrant behavior in the pup. Ultrasonic vocalization (USV) is a sensitive tool for investigating social behavior between rat pups and their dam. Rat pups produce USVs on separation from their dam. This signals the dam to locate her pups and retrieve them back to the nest. In this study, it was predicted that prenatal ethanol exposure cause alterations on the acoustic characteristics of USVs in rat pups. Thirteen pregnant rats were purchased and randomly assigned into three groups: high-ethanol (n = 4), low-ethanol (n = 5), and control (n = 4) groups. Laboratory ethanol (purity = 99.5%) was dissolved in tap water and administered to the high- and low-ethanol groups as drinking water from gestational days (GD) 8-20. Ethanol-containing water was administered to the animals in three stages by gradually increasing the concentration between GDs 8–20. From GDs 8–10, 10% and 5%, from GDs 11–13, 20% and 10%, and from GDs 14–20, 30% and 15% ethanol-containing water (v/v) was administered to the high- and low-ethanol groups, respectively. Tap water without ethanol was given to the control group throughout the experiment. The day of birth of the pups was designated as postnatal day (PND) 0. On PND 4, each litter was culled to four male and four female pups. For the present study, two male and two female pups were randomly sampled from each litter as subjects. Thus, eight male and eight female pups from the high-ethanol and control groups and another 10 male and 10 female pups from the low-ethanol group, were sampled. An ultrasonic microphone and the Sonotrack system version 2.4.0 (Metris, Hoofddorp, The Netherlands) were used to record and analyze USVs of the pups. On postnatal days 4, 8, 12 and 16, the resultant pups were individually isolated from their dams and littermates, and USVs were recorded for 5 min in a sound-proof box. Pups in the high-ethanol group produced greater number of USVs compared with that in both low-ethanol and control groups on PND 12. Rat pups in the high-ethanol group also produced higher mean, minimum, and maximum fundamental frequencies of USVs compared with that in both low-ethanol and control groups. Male pups in the high-ethanol group had higher USV amplitudes than in those in low-ethanol and control groups on PND 12. These results suggest that pups in the high-ethanol group relatively experienced more negative emotionality due to the ethanol-induced neuronal activation in the core limbic system and tegmental structures and accordingly, produced altered USVs as distress calls.

Keywords: emotionality, ethanol, maternal separation, ultrasonic vocalization

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7478 Demographic Profile, Risk Factors and In-hospital Outcomes of Acute Coronary Syndrome (ACS) in Young Population, in Pakistan-Single Center Real World Experience

Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan

Abstract:

Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.

Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome

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7477 Reduction in Population Growth under Various Contraceptive Strategies in Uttar Pradesh, India

Authors: Prashant Verma, K. K. Singh, Anjali Singh, Ujjaval Srivastava

Abstract:

Contraceptive policies have been derived to achieve desired reductions in the growth rate and also, applied to the data of Uttar-Pradesh, India for illustration. Using the Lotka’s integral equation for the stable population, expressions for the proportion of contraceptive users at different ages have been obtained. At the age of 20 years, 42% of contraceptive users is imperative to reduce the present annual growth rate of 0.036 to 0.02, assuming that 40% of the contraceptive users discontinue at the age of 25 years and 30% again continue contraceptive use at age 30 years. Further, presuming that 75% of women start using contraceptives at the age of 23 years, and 50% of the remaining women start using contraceptives at the age of 28 years, while the rest of them start using it at the age of 32 years. If we set a minimum age of marriage as 20 years, a reduction of 0.019 in growth rate will be obtained. This study describes how the level of contraceptive use at different age groups of women reduces the growth rate in the state of Uttar Pradesh. The article also promotes delayed marriage in the region.

Keywords: child bearing, contraceptive devices, contraceptive policies, population growth, stable population

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7476 Synergetic Effect of Dietary Essential Amino Acids (Lysine and Methionine) on the Growth, Body Composition and Enzymes Activities of Genetically Male Tilapia

Authors: Noor Khan, Hira Waris

Abstract:

This study was conducted on genetically male tilapia (GMT) fry reared in glass aquarium for three months to examine the synergetic effect of essential amino acids (EAA) supplementation on growth, body composition, and enzyme activities. Fish having average body weight of 16.56 ± 0.42g were fed twice a day on artificial feed (20% crude protein) procured from Oryza Organics (commercial feed) supplemented with EAA; methionine (M) and lysine (L) designated as T1 (0.3%M and 2%L), T2 (0.6%M and 4%L), T3 (0.9%M and 6%L) and control without EAA. Significantly higher growth performance was observed in T1, followed by T2, T3, and control. The results revealed that whole-body dry matter and crude protein were significantly higher (p ≤ 0.05) in T3 (0.9% and 6%) feeding fish, while the crude fat was lower (p ≤ 0.05) in a similar group of fish. Additionally, protease, amylase, and lipase activities were also observed maximum (p ≤ 0.05) in response to T3 than other treatments and control. However, the EAA, especially lysine and methionine, were found significantly higher (p ≤ 0.05) in T1 compared to other treatments. Conclusively, the addition of EAA, methionine, and lysine in the feed not only enhanced the growth performance of GMT fry but also improved body proximate composition and essential amino acid profile.

Keywords: genetically male tilapia, body composition, digestive enzyme activities, amino acid profile

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7475 Genetic Polymorphisms of the Human Organic Cation Transporter 2 gene, SLC22A2, in the Zulu population

Authors: N. Hoosain, S. Nene, B. Pearce, C. Jacobs, M. Du Plessis, M. Benjeddou

Abstract:

Organic Cation Transporters play a vital role in the absorption, tissue distribution and elimination of various substrates. Numerous studies have suggested that variations in non-synonymous single nucleotide polymorphisms (SNPs) of SLC22A2 could influence an individual’s response to various treatments, including clinically important drugs. This study is the first to determine the baseline frequency distribution for twenty SNPs of SLC22A2in the Zulu population. DNA was collected from 101 unrelated “healthy” Zulu participants. Genotypes of all samples were determined using a multiplex PCR and SNaPshot assay followed by the generation of the haplotype structure. This is the first time that the baseline frequency distribution of SNPs is reported for the Zulu population. Data from this study could be used in in vitro and in vivo pharmacogenetic and pharmacokinetic studies to evaluate the potential role the studied SNPs play in the therapeutic efficacy of clinically important drugs.

Keywords: SLC22A2 gene, SNaPshot assay, PCR, Zulu population

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7474 The Impact of Water Resources on Economic and Social Development in Kuwait

Authors: Obaid Alotaibi

Abstract:

The geographical location of the State of Kuwait contributed significantly to the suffering of Kuwait in the past, due to the scarcity of natural water resources and the inability of the State's financial resources to provide other water resources to meet the needs of the population. The problem of water scarcity in Kuwait remained until the beginning of the second half of the twentieth century, as the country's economic conditions revived with the emergence and export of oil; which was clearly reflected in the steady growth of the population. To cope with this population, increase, it was necessary to expand the various development programs to include all sectors of the state. The process of development and urbanization could not start without finding solutions to the problem of water shortage in Kuwait. The only option for officials to meet the needs of the population and the different sectors of water development is the desalination of seawater. This process necessitated the establishment of six desalination plants along the coast of Kuwait and extended freshwater arteries to reach everywhere on the land. However, this does not mean that the problem of water shortage has been completely solved. The desalination plants are not meeting the country's future water needs, especially considering the increasing population growth. These stations are nearing completion and they need to be replaced, renovation and maintenance, require significant expenses. Therefore, it was necessary for scientific research to address the issue of water in Kuwait, whether in the field of development of existing resources or in the field of rationalization of consumption and protection of available resources. The study focused on how to address the increasing demand for water resulting from population increase, the impact of water on economic and social development, the prospects of water resources in Kuwait and its ability to meet the needs of the country by 2030.

Keywords: economic, development, Kuwait, social, water resources

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7473 A Vaccination Program to Control an Outbreak of Acute Hepatitis A among MSM in Taiwan, 2016

Authors: Ying-Jung Hsieh, Angela S. Huang, Chu-Ming Chiu, Yu-Min Chou, Chin-Hui Yang

Abstract:

Background and Objectives: Hepatitis A is primarily acquired by the fecal-oral route through person-to-person contact or ingestion of contaminated food or water. During 2010 to 2014, an average of 83 cases of locally-acquired disease was reported to Taiwan’s notifiable disease system. Taiwan Centers for Disease Control (TCDC) identified an outbreak of acute hepatitis A which began in June 2015. Of the 126 cases reported in 2015, 103 (82%) cases were reported during June–December and 95 cases (92%) of them were male. The average age of all male cases was 31 years (median, 29 years; range, 15–76 years). Among the 95 male cases, 49 (52%) were also infected with HIV, and all reported to have had sex with other men. To control this outbreak, TCDC launched a free hepatitis A vaccination program in January 2016 for close contacts of confirmed hepatitis A cases, including family members, sexual partners, and household contacts. Effect of the vaccination program was evaluated. Methods: All cases of hepatitis A reported to the National Notifiable Disease Surveillance System were included. A case of hepatitis A was defined as a locally-acquired disease in a person who had acute clinical symptoms include fever, malaise, loss of appetite, nausea or abdominal discomfort compatible with hepatitis, and tested positive for anti-HAV IgM during June 2015 to June 2016 in Taiwan. The rate of case accumulation was calculated using a simple regression model. Results: During January–June 2016, there were 466 cases of hepatitis A reported; of the 243 (52%) who were also infected with HIV, 232 (95%) had a history of having sex with men. Of the 346 cases that were followed up, 259 (75%) provided information on contacts but only 14 (5%) of them provided the name of their sexual partners. Among the 602 contacts reported, 349 (58%) were family members, 14 (2%) were sexual partners, and 239 (40%) were other household contacts. Among the 602 contacts eligible for free hepatitis A vaccination, 440 (73%) received the vaccine. There were 87 (25%) cases that refused to disclose their close contacts. The average case accumulation rate during January–June 2016 was 21.7 cases per month, which was 6.8 times compared to the average case accumulation rate during June–December 2015 of 3.2 cases per month. Conclusions: Despite vaccination program aimed to provide free hepatitis A vaccine to close contacts of hepatitis A patients, the outbreak continued and even gained momentum in transmission. Refusal by hepatitis A patients to provide names of their close contacts and rejection of contacts to take the hepatitis A vaccine may have contributed to the poor effect of the program. Targeted vaccination efforts of all MSM may be needed to control the outbreak among this population in the short term. In the long term, universal vaccination program is needed to prevent the infection of hepatitis A.

Keywords: hepatitis A, HIV, men who have sex with men, vaccination

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