Search results for: end stage kidney disease

Authors: Hossam Mohammed Abdelfattah

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In ancient Egypt, poverty, recognized as the foremost challenge, was extensively addressed in teachings, wisdom, and literary texts. These sources vividly depicted the suffering of a class deprived of life's pleasures. The ancient Egyptian language evolved to introduce terms reflecting poverty and hunger, underscoring the society's commitment to acknowledging and cautioning against this prevalent issue. Among the notable expressions, iwty.f emerged during the Middle Kingdom, symbolizing "the one without property" and signifying the destitute poor. iwty n.f traced back to the Pyramid Texts era, referred to "the one who has nothing" or simply, the poor. Another term, , iwty-sw emphasized the state of possessing nothing. rA-awy originating in the Middle Kingdom Period, initially meant "poverty and poor," expanding to signify poverty in various texts with the addition of the preposition "in," conveying strength given to the poor. During the First Intermediate Period, sny - mnt denoted going through a crisis or suffering, possibly referencing a widespread disease or plague. It encompassed meanings of sickness, pain, and anguish. The term .” sq-sn introduced in Middle Kingdom texts, conveyed the notion of becoming miserable. sp-Xsy . represented a temporal expression reflecting a period of misery or poverty, with Xsy ,indicating distress or misery. The term qsnt appearing in Middle Kingdom texts, held meanings of painful, difficult, harsh, miserable, emaciated, and in bad condition. Its feminine form, qsn denoted anxiety and turmoil. Finally, tp-qsn encapsulated the essence of misery and unhappiness. In essence, these expressions provide linguistic insights into the multifaceted experience of poverty in ancient Egypt, illustrating the society's keen awareness and efforts to address this pervasive challenge.

Keywords: poverty, poor, suffering, misery, painful, ancient Egypt

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Authors: N. Hachemi, I. Benmehdi, O. Hasnaoui

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The air like water is an essential element for living beings. Each day, a man breathes about 20m3 of air. It originally consists of a set of gas whose presence and concentrations correspond to the needs of life. This study focuses on air pollution by smoke and dust emitted from the chimney of the cement works of Beni Saf, pathological and their impact on the environment. Dust of the cement plant are harmless to permissible levels for living organisms, but the two combined phenomena namely the release of dust and aridity of the climate, which severely marked area of Beni Saf; have contributed adverse effects in on human health and the degradation of vegetation cover and species especially weakened by environmental stress. The most visible impact is certainly the deposition of dust on the surrounding areas of the cement factory, and seriously affecting the aesthetics of the landscape. Health problems are more important inside and outside the factory. Among the diseases notable caused by the cement works are: deafness, heart disease, asthma and mental. The dust of the cement works is mainly composed of fine particles of limestone, clay, free lime, silicates and also loaded of the gases such as carbon dioxide gas CO2. The accumulation of this gas in the atmosphere is directly involved in the phenomenon of increasing of greenhouse effect. Some gases, for example, are directly toxic. They can change the climate, changing precipitation types and become a greater source of stress by drought, etc. The environment also suffers from air pollution indirectly; it is more precisely the acid rain. They are produced by the combustion of non-metals in air. Acid rain has consequences for contaminating the soil, weakening the flora, fauna and acidifies lakes. Finally, the pollution problems are multiple and specific dust. It can worsen and change, it has reached epidemic proportions quantitatively and qualitatively disturbing and unpredictable.

Keywords: atmospheric pollution, cement, dust, environment

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Authors: Aidan Jacobsen, Morgan Motia, David Sam, Jonathan Mudge

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Background: The Centers for Disease Control (CDC) lists vaccine requirements for children under two years old to correlate with development markers. CDC lists the coverage by age 24 months to be at least 90% nationally and 84% for Rhode Island Blackstone Valley Community Health Center (BVCHC) in Central Falls, Rhode Island, currently has a completed vaccination rate of 51% for children by the age of 24 months. Current barriers to care for up to date well child vaccinations include lack of transportation, parental work, childcare, and other social stressors. Objective: Increase the vaccination rate of children under the age of 24 months at BVCHC. Conduct a literature review to identify the common barriers preventing children under 24 months from receiving vaccinations. Reduce the barriers to expand access to vaccination care for infants Methods: Setting: Blackstone Valley Community Health Center, Pawtucket, RI Participants: (n=41), Patients between the age of 20-24 months, not up to date with the CDC vaccination recommendations and without a future appointment. QI Intervention: Patients were contacted via phone and offered an appointment during extra Saturday clinic hours in order to receive up to date vaccine care. A Saturday vaccine clinic was established specifically for patients in need of vaccines and having identified barriers to care. Conclusions: Expanding clinic hours and targeting non vaccine up –to-date patients can increase the current standard of childhood immunizations at BVCHC. Overcoming barriers preventing childhood immunization can improve access to providing up to date vaccinations. Other barriers still deter from reaching the national standard of immunizations rates.

Keywords: vaccinations, well child care, barriers to care, social determinants of health

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Authors: Leonard Chimaobi Agim, Charles Arinzechukwu Igwe, Emmanuel Uzoma Onweremadu, Gabreil Osuji

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Soil erosion has been linked to stream sedimentation, ecosystem degradation, and loss of soil nutrients. A study was conducted to evaluate the effect of some organic amendment on sediment yield, splash loss, and runoff of soils of selected parent materials in southeastern Nigeria. A total of 20 locations, five from each of four parent materials namely: Asu River Group (ARG), Bende Ameki Group (BAG), Coastal Plain Sand (CPS) and Falsebedded Sandstone (FBS) were used for the study. Collected soil samples were analyzed with standard methods for the initial soil properties. Rainfall simulation at an intensity of 190 mm hr-1was conducted for 30 minutes on the soil samples at both the initial stage and after amendment to obtain erosion parameters. The influence of parent material on sediment yield, splash loss and runoff based on rainfall simulation was tested for using one way analyses of variance, while the influence of organic material and their combinations were a factorially fitted in a randomized complete block design. The organic amendments include; goat dropping (GD), poultry dropping (PD), municipal solid waste (MSW) and their combinations (COA) applied at four rates of 0, 10, 20 and 30 t ha-1 respectively. Data were analyzed using analyses of variance suitable for a factorial experiment. Significant means were separated using LSD at 5 % probability levels. Result showed significant (p ≤ 0.05) lower values of sediment yield, splash loss and runoff following amendment. For instance, organic amendment reduced sediment yield under wet and dry runs by 12.91 % and 26.16% in Ishiagu, 40.76% and 45.67%, in Bende, 16.17% and 50% in Obinze and 22.80% and 42.35% in Umulolo respectively. Goat dropping and combination of amendment gave the best results in reducing sediment yield.

Keywords: organic amendment, parent material, rainfall simulation, soil erosion

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Authors: Shannon Richards-Green, Suzanne Gough, Sharon Mickan

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Background: Healthcare leaders work in highly complex and rapidly changing environments. Consequently, they need both flexibility and the capacity to hold multiple perspectives simultaneously. My research explored how healthcare leaders understand and make sense (meaning) of their leadership experiences and how this understanding was manifested in their leadership behaviours. Methods: This grounded theory study was conducted via 2 x 1-hour interviews with healthcare leaders within acute care hospitals. A total of 33 hours of interviews were conducted with 17 participants. Participants were recruited using a combination of purposive and snowball sampling. Interviews were recorded, transcribed, and coded to explore emergent patterns and relationships within the data, utilising constant comparative analysis. Adult developmental stage was defined through a subject-object interview with each participant, in alignment with the tenets of constructive development theory. Findings: Participants from acute care hospitals within Australia have participated in the study, with the majority representing the executive leadership level. Broad categories emerging from the data include; Broadening perspectives and abilities as a leader, Dealing with and experiencing conflict within the workplace, Experiencing rewarding times as a leader, and Leading in alignment with a strong personal values system. Discussion: Successfully dealing with complex challenges requires an ability to engage with nuanced perspectives and responses, an integral part of adult developmental growth. In dealing with conflict, for example, leaders at various levels of adult development approached the situation quite differently. Understanding how healthcare leaders make sense of their experiences can assist in providing insights into the value of supporting adult developmental growth in healthcare leadership.

Keywords: leadership, adult development, complexity, growth

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Authors: Shang-Yu Chiang, Yu-Shan Tsai, Shih-Hsien Sung, Chung-Ming Lo

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Mitral regurgitation (MR) is a heart disorder which the mitral valve does not close properly when the heart pumps out blood. MR is the most common form of valvular heart disease in the adult population. The diagnostic echocardiographic finding of MR is straightforward due to the well-known clinical evidence. In the determination of MR severity, quantification of sonographic findings would be useful for clinical decision making. Clinically, the vena contracta is a standard for MR evaluation. Vena contracta is the point in a blood stream where the diameter of the stream is the least, and the velocity is the maximum. The quantification of vena contracta, i.e. the vena contracta width (VCW) at mitral valve, can be a numeric measurement for severity assessment. However, manually delineating the VCW may not accurate enough. The result highly depends on the operator experience. Therefore, this study proposed an automatic method to quantify VCW to evaluate MR severity. Based on color Doppler ultrasound, VCW can be observed from the blood flows to the probe as the appearance of red or yellow area. The corresponding brightness represents the value of the flow rate. In the experiment, colors were firstly transformed into HSV (hue, saturation and value) to be closely align with the way human vision perceives red and yellow. Using ellipse to fit the high flow rate area in left atrium, the angle between the mitral valve and the ultrasound probe was calculated to get the vertical shortest diameter as the VCW. Taking the manual measurement as the standard, the method achieved only 0.02 (0.38 vs. 0.36) to 0.03 (0.42 vs. 0.45) cm differences. The result showed that the proposed automatic VCW extraction can be efficient and accurate for clinical use. The process also has the potential to reduce intra- or inter-observer variability at measuring subtle distances.

Keywords: mitral regurgitation, vena contracta, color doppler, image processing

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Authors: Athicha Cherdpunt, Patompong Satapornpong

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The medical cannabis is made up of components also known as cannabinoids, which consists of two ingredients which are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Interestingly, the Cannabinoid can be used for many treatments such as chemotherapy, including nausea and vomiting, cachexia, anorexia nervosa, spinal cord injury and disease, epilepsy, pain, and many others. However, the adverse drug reactions (ADRs) of THC can cause sedation, anxiety, dizziness, appetite stimulation and impairments in driving and cognitive function. Furthermore, genetic polymorphisms of CYP2C9, CYP2C19 and CYP3A4 influenced the THC metabolism and might be a cause of ADRs. Particularly, CYP2C19*17 allele increases gene transcription and therefore results in ultra-rapid metabolizer phenotype (UM). The aim of this study, is to investigate the frequency of CYP2C19*17 alleles in Thai patients who have been treated with medical cannabis. We prospectively enrolled 60 Thai patients who were treated with medical cannabis and clinical data from College of Pharmacy, Rangsit University. DNA of each patient was isolated from EDTA blood, using the Genomic DNA Mini Kit. CYP2C19*17 genotyping was conducted using the real time-PCR ViiA7 (ABI, Foster City, CA, USA). 30 patients with medical cannabis-induced ADRs group, 20 (67%) were female, and 10 (33%) were male, with an age range of 30-69 years. On the other hand, 30 patients without medical cannabis-induced ADRs (control group) consist of 17 (57%) female and 13 (43%) male. The most ADRs for medical cannabis treatment in the case group were dry mouth and dry throat (77%), tachycardia (70%), nausea (30%) and arrhythmia(10%). Accordingly, the case group carried CYP2C19*1/*1 (normal metabolizer) approximately 93%, while 7% patients carrying CYP2C19*1/*17 (ultra rapid metabolizers) exhibited in this group. Meanwhile, we found 90% of CYP2C19*1/*1 and 10% of CYP2C19*1/*17 in control group. In this study, we identified the frequency of CYP2C19*17 allele in Thai population which will support the pharmacogenetics biomarkers for screening and avoid ADRs of medical cannabis treatment.

Keywords: CYP2C19, allele frequency, ultra rapid metabolizer, medical cannabis

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Authors: Deborah Nicholson, Fiona McCormack, Pete Seaman, Karen Bell

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This paper explores alcohol consumption amongst retirees in the West of Scotland in the context of active and healthy ageing discourses. The public health consequences of alcohol use are well documented and of growing concern to policy makers in Scotland and elsewhere. However, alcohol occupies a prominent position in a range of cultural and social practices and has associated meanings for users related to conviviality, leisure, sociability, and inclusion- features closely tied to active and healthy ageing. These perceived positive and negative meanings place alcohol in an ambiguous and contradictory position in relation to the Scottish Government’s key health policy initiatives aimed at healthy ageing and the reduction of alcohol-related ill-health. This paper explores these positive and negative associations through an examination of the meanings which retirees attach to alcohol and the routines and rituals they develop to navigate wider health concerns. Methods: participants were recruited from the West of Scotland area using a quota sampling design based around gender, age, and socioeconomic position. Forty participants were interviewed using a semi-structured interview schedule and qualitative techniques. The interviews were transcribed and thematic analysis of the data was conducted. Results: Alcohol use amongst retirees in Scotland was widely varied with marked differences noted in terms of gender and age group, but with less clear variance by socioeconomic position. A range of strategies was employed to limit alcohol use by time, context, location and/or volume and these strategies clearly drew on a perception of alcohol use in retirement as potentially more problematic than at earlier stage of life. Thus, the retirees in the sample used these limiting strategies to navigate the positive and negative meanings they attached to alcohol use.

Keywords: alcohol, health, retirement, routines

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Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis

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Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.

Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity

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Authors: E. Von Cheong, Carol Sinnott, Darren Dahly, Patricia M. Kearney

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Introduction and Aim: Adverse childhood experiences (ACEs) are all too common and have been linked to poorer health and wellbeing across the life course. While the prevention of ACEs is a worthy goal, it is important that we also try to lessen the impact of ACEs for those who do experience them. This study aims to investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these. Method: We analysed baseline data from the Mitchelstown (Ireland) 2010-11 cohort involving 2047 men and women aged 50–69 years. Self-reported assessments included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale), and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by the subtypes abuse, neglect, and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors that were selected using the Directed Acyclic Graph (DAG) approach. We also tested whether the estimated associations varied across levels of PSS (poor, moderate, and good). Results: 23.7% of participants reported at least one ACE (95% CI: 21.9% to 25.6%). ACE exposures (overall or subtype) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. For example, exposure to any ACE (vs. none) was associated with 3 times the odds of depressive symptoms (Adjusted OR 2.97; 95% CI 1.63 to 5.40) among individuals reporting poor PSS, while among those reporting moderate PSS, the adjusted OR was 1.18 (95% CI 0.72 to 1.94). Discussion: ACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms among those also reporting poor PSS. Interventions that enhance perception of social support following ACE exposure may help reduce the burden of depression in older populations.

Keywords: adverse childhood experiences, depression, later-life, perceived social support

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Authors: Adi Narayana S Sudhakar. I

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Energy conversion is one of the inevitable parts of any industries. It involves either conversion of mechanical energy in to electrical or vice versa. The later conversion of energy i.e. electrical to mechanical emphasizes the need of motor .Statistics reveals, about 8 % of industries’ annual turnover met on maintenance. Thus substantial numbers of efforts are required to minimize in incurring expenditure met towards break down maintenance. Condition monitoring is one of such techniques based on vibration widely used to recognize premature failures and paves a way to minimize cumbersome involved during breakdown of machinery. The present investigation involves a case study of squirrel cage induction motor (frequently in the electro machines) has been chosen for the conditional monitoring to predict its soundness on the basis of results of FFT analyser. Accelerometer which measures the acceleration converts in to impulses by FFT analyser generates vibration spectrum and time spectrum has been located at various positions on motor under different conditions. Results obtained from the FFT analyzer are compared to that of ISO standard vibration severity charts are taken to predict the preventative condition of considered machinery. Initial inspection of motor revealed that stator faults, broken end rings in rotor, eccentricity faults and misalignment between bearings are trouble shootings areas for present investigation. From the results of the shaft frequencies, it can be perceived that there is a misalignment between the bearings at both the ends. The higher order harmonics of FTF shows the presence of cracks on the race of the bearings at both the ends which are in the incipient stage. Replacement of the bearings at both the drive end (6306) and non-drive end (6206) and the alignment check between the bearings in the shaft are suggested as the constructive measures towards preventive maintenance of considered squirrel cage induction motor.

Keywords: FFT analyser, condition monitoring, vibration spectrum, time spectrum accelerometer

Procedia PDF Downloads 447

Authors: M. B. Mshelia, J. K Balogun, J. Auta, N. O. Bankole

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The current status and abundance of the genus Citharinus was carried out in Jebba Lake, Niger State, Nigeria from January to December, 2011. The aim was to determine the extent of exploitation of the genus Citharinus in Jebba Lake so as to advice the government of Nigeria on how to overcome difficulties in terms of the sustainability of the said fish in the Lake. Descriptive statistics were used to analyze the data obtained. A total of 2,389 of the genus Citharinus were caught during the sampling period. Only two species of the genus Citharinus were caught with 1,220 in number and 430.68kg total weight of Citharinus citharus and 1,169 in number and 418.56kg total weight of Citharinus latus). The current total yield estimated for the genus Citharinus in Jebba Lake in the six (6) sampling sites was calculated and pooled together to be 849.24kg. A day’s catch was calculated to be 35.38kg. The monthly and annual yields of the genus Citharinus were calculated to 1061.55 equivalents to 1 ton and 12 metric tonnes respectively. For the fecundity, June, July and August were discovered as the spawning period for the genus Citharinus and out of total experimental gillnet catch of 2, 389, only 244 (10.21%)of Citharinus citharus and 231 (9.67%) of Citharinus latus were in sexually mature stage. Out of these numbers, 113 (46.31%) were males and 121 (53.69%) were females of Citharinus citharus and 112 (48.48) were males and 119 (51.52) were females of Citharinus latus. The youngest mature males in either of the two had a standard length of 31.5 with a weight of 800.5gWhilethe youngest spawning females were having the standard length of 29.5 cm with a weight of 1,3oo.5g.It was also discovered that females started maturing earlier than the males at the standard length for females and males to be 18.0cm and 19.5cm respectively. Their fecundity ranged from 15,000 to 16, 500 eggs. The sex ratio of 1172 that were males and 1217 that were females was 1 male to 1.0383 females which was equivalent to 1:1 sex ratio of male to female. It was concluded that Jebba Lake had suffered seriously over exploitation of the genus Citharinus and proper management have to be enforced on the lake otherwise the threat of fish being extent may arise.

Keywords: Jebba Lake, Niger State, Nigeria, Citharinus citharus, Citharinus latus, fecundity, sex ratio

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Authors: S. Essa, H. Safar, R. Raghupathy

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Human cytomegalovirus (CMV) continues to be a source of severe complications to immunologically immature and immune-compromised hosts. Effective CMV vaccine that diminishes CMV disease in transplant patients and avoids congenital infection remains of high importance as no approved vaccines exist. Though the exact links of defense mechanisms are unidentified, viral-specific antibodies and Th1/Th2 cytokine responses have been involved in controlling viral infections. CMV envelope glycoprotein B (UL55/gB), the matrix proteins (UL83/pp65, UL99/pp28, UL32/pp150), and the assembly protein UL80a/pp38 are known to be targets of antiviral immune responses. In this study, mice were immunized with five HCMV antigens (UL32/pp150, UL80a/pp38, UL99/pp28, and UL83/pp65), and serum samples were collected and evaluated for eliciting viral-specific antibody responses. Moreover, Splenocytes were collected, stimulated, and assessed for cytokine responses. The results demonstrated a CMV-antigen-specific antibody response to pp38 and pp65 (E/C >2.0). The highest titers were detected with pp38 (average E/C 16.275) followed by pp65 (average E/C 7.72). Compared to control cells, splenocytes from PP38 antigen immunized mice gave a significantly higher concentration of GM-CSF, IFN-γ, IL-2 IL-4, IL-5, and IL-17A (P<0.05). Also, splenocytes from pp65 antigen immunized mice resulted in a significantly higher concentration of GM-CSF, IFN-γ, IL-2 IL-4, IL-10, IL-12, IL-17A, and TNF- α. The designation of target CMV peptides by identifying viral-specific antibodies and cytokine responses is vital for understanding the protective immune mechanisms during CMV infection and identifying appropriate viral antigens to develop novel vaccines.

Keywords: hepatitis C virus, peripheral blood mononuclear cells, neutrophils, cytokines

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Authors: Tarali Kalita, Karabi Dutta

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The North Eastern Region of India, with diverse climatic conditions and a wide range of ecological habitats, makes an ideal natural abode for a good number of silk-producing insects. Cocoon is the economically important life stage from where silk of economic importance is obtained. In recent years, silk-based biomaterials have gained considerable attention, which is dependent on the structure and properties of the silkworm cocoons as well as silk yarn. The present investigation deals with the morphological study of cocoons, including cocoon color, cocoon size, shell weight and shell ratio of eleven different species of silk insects collected from different regions of North East India. The Scanning Electron Microscopic study and X-ray photoelectron spectroscopy were performed to know the arrangement of silk threads in cocoons and the atomic elemental analysis, respectively. Further, collected cocoons were degummed and reeled/spun on a reeling machine or spinning wheel to know the filament length, linear density and tensile strength by using Universal Testing Machine. The study showed significant variation in terms of cocoon color, cocoon shape, cocoon weight and filament packaging. XPS analysis revealed the presence of elements (Mass %) C, N, O, Si and Ca in varying amounts. The wild cocoons showed the presence of Calcium oxalate crystals which makes the cocoons hard and needs further treatment to reel. In the present investigation, the highest percentage of strain (%) and toughness (g/den) were observed in Antheraea assamensis, which implies that the muga silk is a more compact packing of molecules. It is expected that this study will be the basis for further biomimetic studies to design and manufacture artificial fiber composites with novel morphologies and associated material properties.

Keywords: cocoon characterization, north-east India, prospects, silk characterization

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Authors: Tess Hartland, Moitree Banerjee, Sue Churchill, Antonina Pereira, Ian Tyndall, Ruth Lowry

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Background: Sexual health services and policies for middle-aged and older adults are underdeveloped, while global sexually transmitted infections in this age group are on the rise. The Interreg cross-Europe Sexual Health In Over 45s (SHIFT) project aims to increase participation in sexual health services and improve sexual health and wellbeing in people aged over 45, with an additional focus on disadvantaged groups. Methods: A two-pronged mixed-methodology is being used to develop a model for good service provision in sexual health for over 45s. (1) Following PRISMA-ScR guidelines, a scoping review is being conducted, using the databases PsychINFO, Web of Science, ERIC and PubMed. A key search strategy using terms around sexual health, good practice, over 45s and disadvantaged groups. The initial search for literature yielded 7914 results. (2) Surveys (n=1000) based on the Theory of Planned Behaviour are being administered across the UK, Belgium and Netherlands to explore current sexual health knowledge, awareness and attitudes. Expected results: It is expected that sexual health needs and potential gaps in service provision will be identified in order to inform good practice for sexual health services for the target population. Results of the scoping review are being analysed, while focus group and survey data is being gathered. Preliminary analysis of the survey data highlights barriers to access such as limited risk awareness and stigma. All data analysis will be completed by the time of the conference. Discussion: Findings will inform the development of a model to improve sexual health and wellbeing for among over 45s, a population which is often missed in sexual health policy improvement.

Keywords: adult health, disease prevention, health promotion, over 45s, sexual health

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Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin

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Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.

Keywords: Covid-19, health workforce, primary health care, health systems, depression

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Authors: Naveen Kumar Perumalla, Devadas Kuna, Mohammed Akhter Ali

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Satellite Navigation System such as the United States Global Positioning System (GPS) plays a significant role in determining the user position. Similar to that of GPS, Indian Regional Navigation Satellite System (IRNSS) is a Satellite Navigation System indigenously developed by Indian Space Research Organization (ISRO), India, to meet the country’s navigation applications. This system is also known as Navigation with Indian Constellation (NavIC). The NavIC system’s main objective, is to offer Positioning, Navigation and Timing (PNT) services to users in its two service areas i.e., covering the Indian landmass and the Indian Ocean. Six NavIC satellites are already deployed in the space and their receivers are in the performance evaluation stage. Four NavIC dual frequency receivers are installed in the ‘Advanced GNSS Research Laboratory’ (AGRL) in the Department of Electronics and Communication Engineering, University College of Engineering, Osmania University, India. The NavIC receivers can be operated in two positioning modes: Stand-alone IRNSS and Hybrid (IRNSS+GPS) modes. In this paper, analysis of various parameters such as Dilution of Precision (DoP), three Dimension (3D) Root Mean Square (RMS) Position Error and Horizontal Position Error with respect to Visibility of Satellites is being carried out using the real-time IRNSS data, obtained by operating the receiver in both positioning modes. Two typical days (6th July 2017 and 7th July 2017) are considered for Hyderabad (Latitude-17°24'28.07’N, Longitude-78°31'4.26’E) station are analyzed. It is found that with respect to the considered parameters, the Hybrid mode operation of NavIC receiver is giving better results than that of the standalone positioning mode. This work finds application in development of NavIC receivers for civilian navigation applications.

Keywords: DoP, GPS, IRNSS, GNSS, position error, satellite visibility

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Authors: Maria Albuquerque, Miguel Matias, Ângelo Sá, Juliana Sousa, Maria Manuel Mouzinho

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Obesity is a frequent disease in Portugal. The surgical treatment is very effective and has an indication when there is a failure of the medical treatment. Although massive weight loss is associated with considerable health gains, these patients are characterized by a variable degree of dermolipodistrophy. In some cases, there is even the development of physical symptoms such as intertriginous, and some degree of psychological distress is present. In almost all cases, a desire for a better body contour, which inhibits some aspects of social life, is a fact. A prospective study was made to access the impact of body contouring surgery in the quality of life of patients who underwent a massive weight lost correction surgical procedure at Centro Hospitalar de Lisboa Central between January 2020 and December 2021. The patients were submitted to the Body Q subjective questionnaire adapted for the Portuguese language and accessed for the following categories: Anguish with Appearance, Contempt with Body Image, Satisfaction with the Abdomen, and Overall Satisfaction with the Body. The questionnaire was repeated at the 6 months mark. A total of 80 patients were sampled. The sex distribution was 79 female and 1 male. The median BMI index before surgery was inferior to 28%. The pre operatory questionnaire showed high scores for Anguish with Appearance and low scores for the body image self-evaluation. Overall, there was an improvement of at least 50% in all the evaluated scores. Additionally, a correlation was found between abdominoplasty and the contempt with body image and satisfaction with the abdomen (p-value <0.05). Massive weight loss is associated with important body deformities that have a significant impact on the patient’s personal and social life. Body contouring surgery is then vital for these patients as it implicates major aesthetic and functional benefits.

Keywords: abdominoplasty, cruroplasty, obesity, massive weight loss

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Authors: Zaide Montes Ortiz, Jorge Alberto Molina, Alejandro Reyes

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Insects are extremely successful organisms. A sophisticated olfactory system is in part responsible for their survival and reproduction. The detection of volatile organic compounds can positively or negatively affect many behaviors in insects. Compounds such as carbon dioxide (CO2), ammonium, indol, and lactic acid are essential for many species of mosquitoes like Anopheles gambiae in order to locate vertebrate hosts. For instance, in A. gambiae, the olfactory receptor AgOR2 is strongly activated by indol, which accounts for almost 30% of human sweat. On the other hand, in some insects of agricultural importance, the detection and identification of pheromone receptors (PRs) in lepidopteran species has become a promising field for integrated pest management. For example, with the disruption of the pheromone receptor, BmOR1, mediated by transcription activator-like effector nucleases (TALENs), the sensitivity to bombykol was completely removed affecting the pheromone-source searching behavior in male moths. Then, the detection and identification of olfactory receptors in the genomes of insects is fundamental to improve our understanding of the ecological interactions, and to provide alternatives in the integrated pests and vectors management. Hence, the objective of this study is to propose a bioinformatic workflow to enhance the detection and identification of potential olfactory receptors in genomes of relevant insects. Applying Hidden Markov models (Hmms) and different computational tools, potential candidates for pheromone receptors in Tuta absoluta were obtained, as well as potential carbon dioxide receptors in Rhodnius prolixus, the main vector of Chagas disease. This study showed the validity of a bioinformatic workflow with a potential to improve the identification of certain olfactory receptors in different orders of insects.

Keywords: bioinformatic workflow, insects, olfactory receptors, protein prediction

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Authors: Emre Ipekci Cetin, Ebru Tarcan Icigen

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Personnel selection process is considered as one of the most important and most difficult issues in human resources management. At the stage of personnel selection, the applicants are handled according to certain criteria, the candidates are dealt with, and efforts are made to select the most appropriate candidate. However, this process can be more complicated in terms of the managers who will carry out the staff selection process. Candidates should be evaluated according to different criteria such as work experience, education, foreign language level etc. It is crucial that a rational selection process is carried out by considering all the criteria in an integrated structure. In this study, the problem of choosing the front office manager of a 5 star accommodation enterprise operating in Antalya is addressed by using multi-criteria decision-making methods. In this context, SWARA (Step-wise weight assessment ratio analysis) and MOORA (Multi-Objective Optimization on the basis of ratio analysis) methods, which have relatively few applications when compared with other methods, have been used together. Firstly SWARA method was used to calculate the weights of the criteria and subcriteria that were determined by the business. After the weights of the criteria were obtained, the MOORA method was used to rank the candidates using the ratio system and the reference point approach. Recruitment processes differ from sector to sector, from operation to operation. There are a number of criteria that must be taken into consideration by businesses in accordance with the structure of each sector. It is of utmost importance that all candidates are evaluated objectively in the framework of these criteria, after these criteria have been carefully selected in the selection of suitable candidates for employment. In the study, staff selection process was handled by using SWARA and MOORA methods together.

Keywords: accommodation establishments, human resource management, multi-objective optimization on the basis of ratio analysis, multi-criteria decision making, step-wise weight assessment ratio analysis

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Authors: Edward Holupka, John Rossman, Tye Morancy, Joseph Aronovitz, Irving Kaplan

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A common modality for the treatment of early stage prostate cancer is the implantation of radioactive seeds directly into the prostate. The radioactive seeds are positioned inside the prostate to achieve optimal radiation dose coverage to the prostate. These radioactive seeds are positioned inside the prostate using Transrectal ultrasound imaging. Once all of the planned seeds have been implanted, two dimensional transaxial transrectal ultrasound images separated by 2 mm are obtained through out the prostate, beginning at the base of the prostate up to and including the apex. A common deep neural network, called DetectNet was trained to automatically determine the position of the implanted radioactive seeds within the prostate under ultrasound imaging. The results of the training using 950 training ultrasound images and 90 validation ultrasound images. The commonly used metrics for successful training were used to evaluate the efficacy and accuracy of the trained deep neural network and resulted in an loss_bbox (train) = 0.00, loss_coverage (train) = 1.89e-8, loss_bbox (validation) = 11.84, loss_coverage (validation) = 9.70, mAP (validation) = 66.87%, precision (validation) = 81.07%, and a recall (validation) = 82.29%, where train and validation refers to the training image set and validation refers to the validation training set. On the hardware platform used, the training expended 12.8 seconds per epoch. The network was trained for over 10,000 epochs. In addition, the seed locations as determined by the Deep Neural Network were compared to the seed locations as determined by a commercial software based on a one to three months after implant CT. The Deep Learning approach was within \strikeout off\uuline off\uwave off2.29\uuline default\uwave default mm of the seed locations determined by the commercial software. The Deep Learning approach to the determination of radioactive seed locations is robust, accurate, and fast and well within spatial agreement with the gold standard of CT determined seed coordinates.

Keywords: prostate, deep neural network, seed implant, ultrasound

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Authors: Nuo Xu, Sijing Chen

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Background: Childbirth is considered a critical traumatic event throughout our lives, positively or negatively impacting the mother's physiology, psychology, and even the whole family. Adverse birth experiences, such as labor pain, anxiety, and fear can negatively impact the mother. Studies had shown that the immersive nature of VR can distract attention from pain and increase focus on interventions for pain relief. However, the existing studies that applied VR to maternal delivery were still in their infancy and showed disparate results, and the small sample size is not representative, so this review analyzed the effects of VR in labor, such as on maternal pain and anxiety, with a view to providing a basis for future applications. Search strategy: We searched Pubmed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wan-Fang database from the building to November 17, 2021. Selection Criteria: Randomized controlled trials (RCTs) that intervened the pregnant women aged 18-35 years with gestational >34 weeks and without complications with VR technology were contained within this review. Data Collection and Analysis: Two researchers completed the study selection, data extraction, and assessment of study quality. For quantitative data we used MD or SMD, and RR (risk ratio) for qualitative data. Random-effects model and 95% confidence interval (95% CI) were used. Main Results: 12 studies were included. Using VR could relieve pain during labor (MD=-1.81, 95% CI (-2.04, -1.57), P< 0.00001) and active period (SMD=-0.41, 95% CI (-0.68, -0.14), P= 0.003), reduce anxiety (SMD=-1.39, 95% CI (-1.99, -0.78), P< 0.00001) and improve satisfaction (RR = 1.32; 95% CI (1.10, 1.59); P = 0.003), but the effect on the duration of first (SMD=-1.12, 95% CI (-2.38, 0.13), P=0.08) and second (SMD=-0.22, 95% CI (-0.67, 0.24), P=0.35) stage of labor was not statistically significant. Conclusions: Compared with conventional care, VR technology can relieve labor pain and anxiety and improve satisfaction. However, extensive experimental validation is still needed.

Keywords: virtual reality, delivery, labor pain, anxiety, meta-analysis, systematic review

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Authors: G. Wojcik, J. Gindlhuber, A. Syarif, K. Hoetzenecker, P. Bohm, P. Vesely, V. Biasin, G. Kwapiszewska

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Pulmonary fibrosis is a rare disease where uncontrolled wound healing processes damage the lung structure. Intensive changes within the extracellular matrix (ECM) and its interaction with fibroblasts have a major role in pulmonary fibrosis development. Among others, collagen is one of the main components of the ECM, and it is important for lung structure. In IPF, constant production of collagen by fibroblast, through TGFβ1-SMAD2/3 pathways, leads to an uncontrolled deposition of matrix and hence lung remodeling. Abnormal changes in lipid production, alterations in fatty acids (FAs) metabolism, enhanced oxidative stress, and lipid peroxidation in fibrotic lung and fibrotic fibroblasts have been reported; however, the interplay between the collagen and lipids is not yet established. One of the FAs influx regulators is Angiopoietin-like 4 (ANGPTL4), which inhibits lipoprotein lipase work, decreasing the availability of FAs. We hypothesized that altered lipid composition or availability could have the capability to influence the phenotype of different fibroblast populations in the lung and hence influence lung fibrosis. To prove our hypothesis, we aim to investigate lipids and their influence on human, animal, and in vitro levels. In the bleomycin model, treatment with the well-known metabolic drugs Rosiglitazone or Metformin significantly lower collagen production. Similar results were noticed in ANGPTL4 KO animals, where the KO of ANGPTL4 leads to an increase of FAs availability and lower collagen deposition after the bleomycin challenge. Currently, we study the treatment of different FAs on human lung para fibroblasts (hPF) isolated from donors. To understand the lipid composition, we are collecting human lung tissue from donors and pulmonary fibrosis patients for Liquid chromatography-mass spectrometry. In conclusion, our results suggest the lipid influence on collagen deposition during lung fibrosis, but further research needs to be conducted to understand the matter of this relationship.

Keywords: collagen, fibroblasts, lipidomics, lung, pulmonary fibrosis

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Authors: Destriyanti Sugiarti, Ririn A Wulandari

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Background: Malaria disease was widespread in many countries, both tropical and sub-tropical. Tasikmalaya is a region that experienced an increase in malaria cases over the last 5 years and highest in 2013, a total of 168 positive cases of malaria. Tasikmalaya region consists of coastal and mountain areas, it has a potential place for Anopheles mosquito breeding, i.e swamp, lagoon, andrice fields.The purpose of this study was to determine the correlation of environmental risk factors with the incidence of malaria in Tasikmalaya. Methods: The design of the study is case control study with 140 samples in 5 sub-district (Cineam, Cikatomas, Cipatujah, Salopa, and Jatiwaras). This study examines the environmental factors that influence the incidence of malaria in Tasikmalaya District in 2013. The research used 14 variables: individual characteristics (education, knowledge, occupation) and environmental risk factors (mobility to endemic areas, use mosquito nets, use of wire gauze at home, use mosquito repellent, repellent use, the presence of a large animal in a cage, breeding place, the presence of larvae, temperature and humidity chamber). Results: Results demonstrated an association between occupation (0.22; 0.10-0.47), the mobility of the population to the endemic areas (37.4; 14.29-98.18) ,the presence of larvae (5.26; 1.41-19.74), and the room temperature with optimum temperature for mosquito breeding is 25-30oC (3.25; 1.62- 6.50). Conclusion: The dominant factor affecting the spread of malaria in Tasikmalaya is the mobility of the population to endemic areas. The results of the study suggest migration survey conducted activity and health promotion for preventive efforts against malaria in malaria-endemic areas, and to encourage people to behave healthy life by freeing environment of mosquito larvae and protect themselves from mosquito bites.

Keywords: Environmental risk factors, malaria, correlation, Anopheles

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Authors: Jorge Iván Bañol-Betancur, Lina María Martínez-Sánchez, María de los Ángeles Rodríguez-Gázquez, Estefanía Bahamonde-Olaya, Ana María Gutiérrez-Tamayo, Laura Isabel Jaramillo-Jaramillo, Camilo Ruiz-Mejía, Natalia Morales-Quintero

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Acute chest pain is a distressing sensation between the diaphragm and the base of the neck and it represents a diagnostic challenge for any physician in the emergency department. Objective: To establish the main clinical and epidemiological characteristics of patients who present with chest pain to the emergency department in a private clinic from the city of Medellin, during 2014-2015. Methods: Cross-sectional retrospective observational study. Population and sample were patients who consulted for chest pain in the emergency department who met the eligibility criteria. The information was analyzed in SPSS program vr.21; qualitative variables were described through relative frequencies, and the quantitative through mean and standard deviation ‬or medians according to their distribution in the study population. Results: A total of 231 patients were evaluated, the mean age was 49.5 ± 19.9 years, 56.7% were females. The most frequent pathological antecedents were hypertension 35.5%, diabetes 10,8%, dyslipidemia 10.4% and coronary disease 5.2%. Regarding pain features, in 40.3% of the patients the pain began abruptly, in 38.2% it had a precordial location, for 20% of the cases physical activity acted as a trigger, and 60.6% was oppressive. Costochondritis was the most common cause of chest pain among patients with an established etiologic diagnosis, representing the 18.2%. Conclusions: Although the clinical features of pain reported coincide with the clinical presentation of an acute coronary syndrome, the most common cause of chest pain in study population was costochondritis instead, indicating that it is a differential diagnostic in the approach of patients with pain acute chest.

Keywords: acute coronary syndrome, chest pain, epidemiology, osteochondritis

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Authors: Min L. Stewart, Patrick Johnston

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Predictive coding has been proposed as a general explanatory framework for understanding the neural mechanisms of perception. As such, an underweighting of perceptual priors has been hypothesised to underpin a range of differences in inferential and sensory processing in autism spectrum disorders. However, empirical evidence to support this has not been well established. The present study uses an electroencephalography paradigm involving changes of facial identity and person category (actors etc.) to explore how levels of autistic traits (AT) affect predictive coding at multiple stages in the visual processing hierarchy. The study uses a rapid serial presentation of faces, with hierarchically structured sequences involving both periodic and aperiodic repetitions of different stimulus attributes (i.e., person identity and person category) in order to induce contextual expectations relating to these attributes. It investigates two main predictions: (1) significantly larger and late neural responses to change of expected visual sequences in high-relative to low-AT, and (2) significantly reduced neural responses to violations of contextually induced expectation in high- relative to low-AT. Preliminary frequency analysis data comparing high and low-AT show greater and later event-related-potentials (ERPs) in occipitotemporal areas and prefrontal areas in high-AT than in low-AT for periodic changes of facial identity and person category but smaller ERPs over the same areas in response to aperiodic changes of identity and category. The research advances our understanding of how abnormalities in predictive coding might underpin aberrant perceptual experience in autism spectrum. This is the first stage of a research project that will inform clinical practitioners in developing better diagnostic tests and interventions for people with autism.

Keywords: hierarchical visual processing, face processing, perceptual hierarchy, prediction error, predictive coding

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Authors: Juan A. Ferriz-Papi, Allan L. Nantel, Talib E. Butt

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Buildings are thought to consume about 50% of the total energy in the UK. The use stage in a building life cycle has the largest energy consumption, although different assessments are showing that the construction can equal several years of maintenance and operations. The selection of materials with lower embodied energy is very important to reduce this consumption. For this reason, timber is one adequate material due to its low embodied energy and the capacity to be used as carbon storage. The use of timber in the construction industry is very significant. Sawn wood, for example, is one of the top 5 construction materials consumed in the UK according to National Statistics. Embodied energy for building products considers the energy consumed in extraction and production stages. However, it is not the same consideration if this product is produced locally as when considering the resource produced further afield. Transport is a very relevant matter that profoundly influences in the results of embodied energy. The case of timber use in the UK is important because the balance between imports and exports is far negative, industry consuming more imported timber than produced. Nearly 80% of sawn softwood used in construction is imported. The imports-exports deficit for sawn wood accounted for more than 180 million pounds during the first four-month period of 2016. More than 85% of these imports come from Europe (83% from the EU). The aim of this study is to analyze climate change impact due to transport for timber products consumed in the UK. An approximate estimation of energy consumed and carbon emissions are calculated considering the timber product’s import origin. The results are compared to the total consumption of each product, estimating the impact of transport on the final embodied energy and carbon emissions. The analysis of these results can help deduce that one big challenge for climate change is the reduction of external dependency, with the associated improvement of internal production of timber products. A study of different types of timber products produced in the UK and abroad is developed to understand the possibilities for this country to improve sustainability and self-management. Reuse and recycle possibilities are also considered.

Keywords: embodied energy, climate change, CO2 emissions, timber, transport

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Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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Authors: Arezoo Fallahi, Fateme Aslibigi, Parvaneh Taymoori, Babak Nematshahrbabaki

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Background and Aims: Cancer of the cervix, one of cancer-related death, is the second most common cancer in women worldwide. It develops over time but it is one of the most preventable types of cancer and there is the available proper screening program for its preventing. Since Pap smear test is vital to prevent and control of disease but women do not accomplish it regularly. Therefore, this study was aimed to explore women's needs referring to health care centers for doing Pap smear test. Material and methods: In this study, an inductive qualitative method with content analysis approach was used. This survey was done in varamin city (is located capital of Iran) in year 2014. Through the purposive sampling 15 women's view of point referring to health care centers of for doing Pap smear test was surveyed. Inclusion criteria were: 20-50 years old married women, having experience Pap smear test and attendance to participate in the Study. Recorded semi- structured interviews were typed and analyzed through of content analysis method. To obtain trustworthiness and rigor of the data, the criteria of credibility, dependability, confirmability and transferability was used. Results: During the data analysis, four main categories of “role of health care team”, “role of organizations”, “social support” and “policies and administration system” were developed. The participants emphasized on making motivational rules and coordination among organizations to do behaviors related to women health. Conclusion: The findings of study showed that doing Pap smear test are attributed to appropriate and intimate interactions with health professionals, family support, encouraging legislation and policies and coordination and notification of organizations. Therefore, designers and stockholders of policies and health system should more consider to growth and involve other organizations toward women's health.

Keywords: qualitative approach, pap smear test, women, health care centers

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Authors: Degineh Belachew Andarge, Tariku Lambiyo Anticho, Getamesay Mulatu Jara, Musa Mohammed Ali

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Introduction: Tuberculosis (TB) is a communicable chronic disease causedby Mycobacterium tuberculosis (MTB). About one-third of the world’s population is latently infected with MTB. TB is among the top 10 causes of mortality throughout the globe from a single pathogen. Objective: The aim of this study was to determine the prevalence of tuberculosis,rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis, and associated factors among presumptive tuberculosis cases attending the tuberculosis clinic of Adare General Hospital located in Hawassa city. Methods: A hospital-based cross-sectional study was conducted among 321 tuberculosis suspected patients from April toJuly 2018. Socio-demographic, environmental, and behavioral data were collected using a structured questionnaire. Sputumspecimens were analyzed using GeneXpert. Data entry was made using Epi info version 7 and analyzed by SPSS version 20. Logistic regression models were used to determine the risk factors. A p-value less than 0.05 was taken as a cut point. Results: In this study, the prevalence of Mycobacterium tuberculosis was 98 (30.5%) with 95% confidence interval (25.5–35.8), and the prevalence of rifampicin-resistant/multidrug-resistantMycobacterium tuberculosis among the 98 Mycobacteriumtuberculosis confirmed cases was 4 (4.1%). The prevalence of rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosisamong the tuberculosis suspected patients was 1.24%. Participants who had a history of treatment with anti-tuberculosisdrugs were more likely to develop rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis. Conclusions: This study identified relatively high rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis amongtuberculosis suspected patients in the study area. Early detection of drug-resistant Mycobacterium tuberculosis should be givenenough attention to strengthen the management of tuberculosis cases and improve direct observation therapy short-course and eventually minimize the spread of rifampicin-resistant tuberculosis strain in the community.

Keywords: rifampicin resistance, mycobacterium tuberculosis, risk factors, prevalence of TB

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