Search results for: pneumonia vaccine uptake
Commenced in January 2007
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Edition: International
Paper Count: 1020

Search results for: pneumonia vaccine uptake

120 Performance Evaluation of the CSAN Pronto Point-of-Care Whole Blood Analyzer for Regular Hematological Monitoring During Clozapine Treatment

Authors: Farzana Esmailkassam, Usakorn Kunanuvat, Zahraa Mohammed Ali

Abstract:

Objective: The key barrier in Clozapine treatment of treatment-resistant schizophrenia (TRS) includes frequent bloods draws to monitor neutropenia, the main drug side effect. WBC and ANC monitoring must occur throughout treatment. Accurate WBC and ANC counts are necessary for clinical decisions to halt, modify or continue clozapine treatment. The CSAN Pronto point-of-care (POC) analyzer generates white blood cells (WBC) and absolute neutrophils (ANC) through image analysis of capillary blood. POC monitoring offers significant advantages over central laboratory testing. This study evaluated the performance of the CSAN Pronto against the Beckman DxH900 Hematology laboratory analyzer. Methods: Forty venous samples (EDTA whole blood) with varying concentrations of WBC and ANC as established on the DxH900 analyzer were tested in duplicates on three CSAN Pronto analyzers. Additionally, both venous and capillary samples were concomitantly collected from 20 volunteers and assessed on the CSAN Pronto and the DxH900 analyzer. The analytical performance including precision using liquid quality controls (QCs) as well as patient samples near the medical decision points, and linearity using a mix of high and low patient samples to create five concentrations was also evaluated. Results: In the precision study for QCs and whole blood, WBC and ANC showed CV inside the limits established according to manufacturer and laboratory acceptability standards. WBC and ANC were found to be linear across the measurement range with a correlation of 0.99. WBC and ANC from all analyzers correlated well in venous samples on the DxH900 across the tested sample ranges with a correlation of > 0.95. Mean bias in ANC obtained on the CSAN pronto versus the DxH900 was 0.07× 109 cells/L (95% L.O.A -0.25 to 0.49) for concentrations <4.0 × 109 cells/L, which includes decision-making cut-offs for continuing clozapine treatment. Mean bias in WBC obtained on the CSAN pronto versus the DxH900 was 0.34× 109 cells/L (95% L.O.A -0.13 to 0.72) for concentrations <5.0 × 109 cells/L. The mean bias was higher (-11% for ANC, 5% for WBC) at higher concentrations. The correlations between capillary and venous samples showed more variability with mean bias of 0.20 × 109 cells/L for the ANC. Conclusions: The CSAN pronto showed acceptable performance in WBC and ANC measurements from venous and capillary samples and was approved for clinical use. This testing will facilitate treatment decisions and improve clozapine uptake and compliance.

Keywords: absolute neutrophil counts, clozapine, point of care, white blood cells

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119 The Anesthesia Considerations in Robotic Mastectomies

Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev

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Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.

Keywords: anesthesia, mastectomies, robotic, hypercarbia

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118 Applying Organic Natural Fertilizer to 'Orange Rubis' and 'Farbaly' Apricot Growth, Yield and Fruit Quality

Authors: A. Tarantino, F. Lops, G. Lopriore, G. Disciglio

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Biostimulants are known as the organic fertilizers that can be applied in agriculture in order to increase nutrient uptake, growth and development of plants and improve quality, productivity and the environmental positive impacts. The aim of this study was to test the effects of some commercial biostimulants products (Bion® 50 WG, Hendophyt ® PS, Ergostim® XL and Radicon®) on vegeto-productive behavior and qualitative characteristics of fruits of two emerging apricot cultivars (Orange Rubis® and Farbaly®). The study was conducted during the spring-summer season 2015, in a commercial orchard located in the agricultural area of Cerignola (Foggia district, Apulian region, Southern Italy). Eight years old apricot trees, cv ‘Orange Rubis’ and ‘Farbaly®’, were used. The experimental data recorded during the experimental trial were: shoot length, total number of flower buds, flower buds drop and time of flowering and fruit set. Total yield of fruits per tree and quality parameters were determined. Experimental data showed some specific differences among the biostimulant treatments. Concerning the yield of ‘Orange Rubis’, except for the Bion treatment, the other three biostimulant treatments showed a tendentially lower values than the control. The yield of ‘Farbaly’ was lower for the Bion and Hendophyt treatments, higher for the Ergostim treatment, when compared with the yield of the control untreated. Concerning the soluble solids content, the juice of ‘Farbaly’ fruits had always higher content than that of ‘Orange Rubis’. Particularly, the Bion and the Hendophyt treatments showed in both harvest values tendentially higher than the control. Differently, the four biostimulant treatments did not affect significantly this parameter in ‘Orange Rubis’. With regard to the fruit firmness, some differences were observed between the two harvest dates and among the four biostimulant treatments. At the first harvest date, ‘Orange Rubis’ treated with Bion and Hendophyt biostimulants showed texture values tendentially lower than the control. Instead, ‘Farbaly’ for all the biostimulant treatments showed fruit firmness values significantly lower than the control. At the second harvest, almost all the biostimulants treatments in both ‘Orange Rubis’ and ‘Farbaly’ cultivar showed values lower than the control. Only ‘Farbaly’ treated with Radicon showed higher value in comparison to the control.

Keywords: apricot, fruit quality, growth, organic natural fertilizer

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117 Treatment of Papillary Thyroid Carcinoma Metastasis to the Sternum: A Case Report

Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

Abstract:

Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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116 Validation of an Impedance-Based Flow Cytometry Technique for High-Throughput Nanotoxicity Screening

Authors: Melanie Ostermann, Eivind Birkeland, Ying Xue, Alexander Sauter, Mihaela R. Cimpan

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Background: New reliable and robust techniques to assess biological effects of nanomaterials (NMs) in vitro are needed to speed up safety analysis and to identify key physicochemical parameters of NMs, which are responsible for their acute cytotoxicity. The central aim of this study was to validate and evaluate the applicability and reliability of an impedance-based flow cytometry (IFC) technique for the high-throughput screening of NMs. Methods: Eight inorganic NMs from the European Commission Joint Research Centre Repository were used: NM-302 and NM-300k (Ag: 200 nm rods and 16.7 nm spheres, respectively), NM-200 and NM- 203 (SiO₂: 18.3 nm and 24.7 nm amorphous, respectively), NM-100 and NM-101 (TiO₂: 100 nm and 6 nm anatase, respectively), and NM-110 and NM-111 (ZnO: 147 nm and 141 nm, respectively). The aim was to assess the biological effects of these materials on human monoblastoid (U937) cells. Dispersions of NMs were prepared as described in the NANOGENOTOX dispersion protocol and cells were exposed to NMs at relevant concentrations (2, 10, 20, 50, and 100 µg/mL) for 24 hrs. The change in electrical impedance was measured at 0.5, 2, 6, and 12 MHz using the IFC AmphaZ30 (Amphasys AG, Switzerland). A traditional toxicity assay, Trypan Blue Dye Exclusion assay, and dark-field microscopy were used to validate the IFC method. Results: Spherical Ag particles (NM-300K) showed the highest toxic effect on U937 cells followed by ZnO (NM-111 ≥ NM-110) particles. Silica particles were moderate to non-toxic at all used concentrations under these conditions. A higher toxic effect was seen with smaller sized TiO2 particles (NM-101) compared to their larger analogues (NM-100). No interferences between the IFC and the used NMs were seen. Uptake and internalization of NMs were observed after 24 hours exposure, confirming actual NM-cell interactions. Conclusion: Results collected with the IFC demonstrate the applicability of this method for rapid nanotoxicity assessment, which proved to be less prone to nano-related interference issues compared to some traditional toxicity assays. Furthermore, this label-free and novel technique shows good potential for up-scaling in directions of an automated high-throughput screening and for future NM toxicity assessment. This work was supported by the EC FP7 NANoREG (Grant Agreement NMP4-LA-2013-310584), the Research Council of Norway, project NorNANoREG (239199/O70), the EuroNanoMed II 'GEMN' project (246672), and the UH-Nett Vest project.

Keywords: cytotoxicity, high-throughput, impedance, nanomaterials

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115 Ecophysiological Features of Acanthosicyos horridus (!Nara) to Survive the Namib Desert

Authors: Jacques M. Berner, Monja Gerber, Gillian L. Maggs-Kolling, Stuart J. Piketh

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The enigmatic melon species, Acanthosicyos horridus Welw. ex Hook. f., locally known as !nara, is endemic to the hyper-arid Namib Desert, where it thrives in sandy dune areas and dry river banks. The Namib Desert is characterized by extreme weather conditions which include high temperatures, very low rainfall, and extremely dry air. Plant and animals that have made the Namib Dessert their home are dependent on non-rainfall water inputs, like fog, dew and water vapor, for survival. Fog is believed to be the most important non-rainfall water input for most of the coastal Namib Desert and is a life line to many Namib plants and animals. It is commonly assumed that the !nara plant is adapted and dependent upon coastal fog events. The !nara plant shares many comparable adaptive features with other organisms that are known to exploit fog as a source of moisture. These include groove-like structures on the stems and the cone-like structures of thorns. These structures are believed to be the driving forces behind directional water flow that allow plants to take advantage of fog events. The !nara-fog interaction was investigated in this study to determine the dependence of !nara on these fog events, as it would illustrate strategies to benefit from non-rainfall water inputs. The direct water uptake capacity of !nara shoots was investigated through absorption tests. Furthermore, the movement and behavior of fluorescent water droplets on a !nara stem were investigated through time-lapse macrophotography. The shoot water potential was measured to investigate the effect of fog on the water status of !nara stems. These tests were used to determine whether the morphology of !nara has evolved to exploit fog as a non-rainfall water input and whether the !nara plant has adapted physiologically in response to fog. Chlorophyll a fluorescence was used to compare the photochemical efficiency of !nara plants on days with fog events to that on non-foggy days. The results indicate that !nara plants do have the ability to take advantage of fog events as commonly believed. However, the !nara plant did not exhibit visible signs of drought stress and this, together with the strong shoot water potential, indicates that these plants are reliant on permanent underground water sources. Chlorophyll a fluorescence data indicated that temperature stress and wind were some of the main abiotic factors influencing the plants’ overall vitality.

Keywords: Acanthosicyos horridus, chlorophyll a fluorescence, fog, foliar absorption, !nara

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114 Health Equity in Hard-to-Reach Rural Communities in Abia State, Nigeria: An Asset-Based Community Development Intervention to Influence Community Norms and Address the Social Determinants of Health in Hard-to-Reach Rural Communities

Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

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Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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113 Targeted Photodynamic Therapy for Intraperitoneal Ovarian Cancer, A Way to Stimulate Anti-Tumoral Immune Response

Authors: Lea Boidin, Martha Baydoun, Bertrand Leroux, Olivier Morales, Samir Acherar, Celine Frochot, Nadira Delhem

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Ovarian cancer (OC) is one of the most defying diseases in gynecologic oncology. Even though surgery remains crucial in the therapy of patients with primary ovarian cancer, recurrent recidivism calls for the development of new therapy protocols to propose for patients dealing with this cancer. FRα is described as a tumor‐associated antigen in OC, where FRα expression is usually linked with more poorly differentiated, aggressive tumors. The Photodynamic treatment (PDT) available data have shown improvements in the uptake of small tumors and in the induction of a proper anti-tumoral immune response. In order to target specifically peritoneal metastatis, which overexpress FRα, a new-patented PS coupled with folic acid has been developed in our team. Herein we propose PDT using this new patented PS for PDT applied in an in vivo mice model. The efficacy of the treatment was evaluated in mice without and with PBMC reconstitution. Mice were divided into four groups: Non-Treated, PS, Light Only, and PDT Treated and subjected to illumination by laser set at 668nm with a duration of illumination of 45 minutes (or 1 min of illumination followed by 2 minutes of pause repeated 45 times). When mice were not reconstituted and after fractionized PDT protocol, a significant decrease in the tumor volume was noticed. An induction in the anti-tumoral cytokine IFNγ chaperoned this decrease while a subsequent inhibition in the cytokine TGFβ. Even more crucial, when mice were reconstituted and upon PDT, the fold of tumor decrease was even higher. An immune response was activated decoded with an increase in NK, CD3 +, LT helper and Cytotoxic T cells. Thereafter, an increase in the expression of the cytokines IFNγ and TNFα were noticed while an inhibition in TGFβ, IL8 and IL10 accompanied this immune response activation. Therefore, our work has shown for the first time that a fractionized PDT protocol using a folate-targeted PDT is effective for treatment of ovarian cancer. The interest in using PDT in this case, goes beyond the local induction of tumor apoptosis only, but can promote subsequent anti-tumor response. Most of the therapies currently used to treat ovarian cancer, have an uncooperative outcomes on the host immune response. The readiness of a tumor adjuvant treatment like PDT adequate in eliminating the tumor and in concert stimulating anti-tumor immunity would be weighty.

Keywords: folate receptor, ovarian cancer, photodynamic therapy, humanized mice model

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112 Feasibility of Online Health Coaching for Canadian Armed Forces Personnel Receiving Treatment for Depression, Anxiety and PTSD

Authors: Noah Wayne, Andrea Tuka, Adrian Norbash, Bryan Garber, Paul Ritvo

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Program/Intervention Description: The Canadian Armed Forces(CAF) Mental Health Clinicstreat a full spectrum of mental disorder, addictions, and psychosocial issues that include Major Depressive Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, and other diagnoses. We evaluated the feasibility of an online health coach interventiondelivering mindfulness based cognitive behavioral therapy (M-CBT) and behaviour changesupport for individuals receiving treatment at CAF Clinics. Participants were provided accounts on NexJ Connected Wellness, a digital health platform, and 16 weeks of phone-based health coaching,emphasizingmild to moderate aerobic exercise, a healthy diet, and M-CBT content. The primary objective was to assess the feasibility of the online deliverywith CAF members. Evaluation Methods: Feasibility was evaluated in terms of recruitment, engagement, and program satisfaction. Weadditionallyevaluatedhealth behavior change, program completion, and mental health symptoms (i.e. PHQ-9, GAD-7, PCL-5) at three time points. Results: Service members were referred from Vancouver, Esquimalt, and Edmonton CAF bases between August 2020 and January 2021. N=106 CAF personnel were referred, and n=77 consented.N=66 participated, and n=44 completed 4-month and follow-up measures. The platform received a mean rating of76.5 on the System Usability Scale, and health coaching was judged the most helpful program feature (95.2% endorsement), while reminders (53.7%), secure messaging (51.2%), and notifications (51.2%) were also identified. Improvements in mental health status during active interventions were observed on the PHQ-9 (-5.4, p<0.001), GAD-7 (-4.0, p<0.001), and PCL-5 (-4.1, p<0.05). Conclusion: Online health coaching was well-received amidst the COVID-19 pandemic and related lockdowns. Uptake and engagement were positively reported. Participants valuedcontacts and reported strong therapeutic alliances with coaches. Healthy diet, regular exercise, and mindfulness practice are important for physical and mental health. Engagements in these behaviors are associated with reduced symptoms. An online health coach program appears feasible for assisting Canadian Armed Forces personnel.

Keywords: coaching, CBT, military, depression, mental health, digital

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111 Sustainability Impact Assessment of Construction Ecology to Engineering Systems and Climate Change

Authors: Moustafa Osman Mohammed

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Construction industry, as one of the main contributor in depletion of natural resources, influences climate change. This paper discusses incremental and evolutionary development of the proposed models for optimization of a life-cycle analysis to explicit strategy for evaluation systems. The main categories are virtually irresistible for introducing uncertainties, uptake composite structure model (CSM) as environmental management systems (EMSs) in a practice science of evaluation small and medium-sized enterprises (SMEs). The model simplified complex systems to reflect nature systems’ input, output and outcomes mode influence “framework measures” and give a maximum likelihood estimation of how elements are simulated over the composite structure. The traditional knowledge of modeling is based on physical dynamic and static patterns regarding parameters influence environment. It unified methods to demonstrate how construction systems ecology interrelated from management prospective in procedure reflects the effect of the effects of engineering systems to ecology as ultimately unified technologies in extensive range beyond constructions impact so as, - energy systems. Sustainability broadens socioeconomic parameters to practice science that meets recovery performance, engineering reflects the generic control of protective systems. When the environmental model employed properly, management decision process in governments or corporations could address policy for accomplishment strategic plans precisely. The management and engineering limitation focuses on autocatalytic control as a close cellular system to naturally balance anthropogenic insertions or aggregation structure systems to pound equilibrium as steady stable conditions. Thereby, construction systems ecology incorporates engineering and management scheme, as a midpoint stage between biotic and abiotic components to predict constructions impact. The later outcomes’ theory of environmental obligation suggests either a procedures of method or technique that is achieved in sustainability impact of construction system ecology (SICSE), as a relative mitigation measure of deviation control, ultimately.

Keywords: sustainability, environmental impact assessment, environemtal management, construction ecology

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110 Equilibrium, Kinetic and Thermodynamic Studies of the Biosorption of Textile Dye (Yellow Bemacid) onto Brahea edulis

Authors: G. Henini, Y. Laidani, F. Souahi, A. Labbaci, S. Hanini

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Environmental contamination is a major problem being faced by the society today. Industrial, agricultural, and domestic wastes, due to the rapid development in the technology, are discharged in the several receivers. Generally, this discharge is directed to the nearest water sources such as rivers, lakes, and seas. While the rates of development and waste production are not likely to diminish, efforts to control and dispose of wastes are appropriately rising. Wastewaters from textile industries represent a serious problem all over the world. They contain different types of synthetic dyes which are known to be a major source of environmental pollution in terms of both the volume of dye discharged and the effluent composition. From an environmental point of view, the removal of synthetic dyes is of great concern. Among several chemical and physical methods, adsorption is a promising technique due to the ease of use and low cost compared to other applications in the process of discoloration, especially if the adsorbent is inexpensive and readily available. The focus of the present study was to assess the potentiality of Brahea edulis (BE) for the removal of synthetic dye Yellow bemacid (YB) from aqueous solutions. The results obtained here may transfer to other dyes with a similar chemical structure. Biosorption studies were carried out under various parameters such as mass adsorbent particle, pH, contact time, initial dye concentration, and temperature. The biosorption kinetic data of the material (BE) was tested by the pseudo first-order and the pseudo-second-order kinetic models. Thermodynamic parameters including the Gibbs free energy ΔG, enthalpy ΔH, and entropy ΔS have revealed that the adsorption of YB on the BE is feasible, spontaneous, and endothermic. The equilibrium data were analyzed by using Langmuir, Freundlich, Elovich, and Temkin isotherm models. The experimental results show that the percentage of biosorption increases with an increase in the biosorbent mass (0.25 g: 12 mg/g; 1.5 g: 47.44 mg/g). The maximum biosorption occurred at around pH value of 2 for the YB. The equilibrium uptake was increased with an increase in the initial dye concentration in solution (Co = 120 mg/l; q = 35.97 mg/g). Biosorption kinetic data were properly fitted with the pseudo-second-order kinetic model. The best fit was obtained by the Langmuir model with high correlation coefficient (R2 > 0.998) and a maximum monolayer adsorption capacity of 35.97 mg/g for YB.

Keywords: adsorption, Brahea edulis, isotherm, yellow Bemacid

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109 Noncovalent Antibody-Nanomaterial Conjugates: A Simple Approach to Produce Targeted Nanomedicines

Authors: Nicholas Fletcher, Zachary Houston, Yongmei Zhao, Christopher Howard, Kristofer Thurecht

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One promising approach to enhance nanomedicine therapeutic efficacy is to include a targeting agent, such as an antibody, to increase accumulation at the tumor site. However, the application of such targeted nanomedicines remains limited, in part due to difficulties involved with biomolecule conjugation to synthetic nanomaterials. One approach recently developed to overcome this has been to engineer bispecific antibodies (BsAbs) with dual specificity, whereby one portion binds to methoxy polyethyleneglycol (mPEG) epitopes present on synthetic nanomedicines, while the other binds to molecular disease markers of interest. In this way, noncovalent complexes of nanomedicine core, comprising a hyperbranched polymer (HBP) of primarily mPEG, decorated with targeting ligands are able to be produced by simple mixing. Further work in this area has now demonstrated such complexes targeting the breast cancer marker epidermal growth factor receptor (EGFR) to show enhanced binding to tumor cells both in vitro and in vivo. Indeed the enhanced accumulation at the tumor site resulted in improved therapeutic outcomes compared to untargeted nanomedicines and free chemotherapeutics. The current work on these BsAb-HBP conjugates focuses on further probing antibody-nanomaterial interactions and demonstrating broad applicability to a range of cancer types. Herein are reported BsAb-HBP materials targeted towards prostate-specific membrane antigen (PSMA) and study of their behavior in vivo using ⁸⁹Zr positron emission tomography (PET) in a dual-tumor prostate cancer xenograft model. In this model mice bearing both PSMA+ and PSMA- tumors allow for PET imaging to discriminate between nonspecific and targeted uptake in tumors, and better quantify the increased accumulation following BsAb conjugation. Also examined is the potential for formation of these targeted complexes in situ following injection of individual components? The aim of this approach being to avoid undesirable clearance of proteinaceous complexes upon injection limiting available therapeutic. Ultimately these results demonstrate BsAb functionalized nanomaterials as a powerful and versatile approach for producing targeted nanomedicines for a variety of cancers.

Keywords: bioengineering, cancer, nanomedicine, polymer chemistry

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108 Safe Disposal of Processed Industrial Biomass as Alternative Organic Manure in Agriculture

Authors: V. P. Ramani, K. P. Patel, S. B. Patel

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It is necessary to dispose of generated industrial wastes in the proper way to overcome the further pollution for a safe environment. Waste can be used in agriculture for good quality higher food production. In order to evaluate the effect and rate of processed industrial biomass on yield, contents, uptake and soil status in maize, a field experiment was conducted during 2009 - 2011 at Anand on loamy sand soil for two years. The treatments of different levels of NPK i.e. 100% RD, 75% RD and 50% RD were kept to study the possibility of reduction in fertilizer application with the use of processed biomass (BM) in different proportion with FYM. (Where, RD= Recommended dose, FYM= Farm Yard Manure, BM= Processed Biomass.) The significantly highest grain yield of maize was recorded under the treatment of 75% NPK + BM application @ 10t ha-1. The higher (10t ha-1) and lower (5t ha-1) application rate of BM with full dose of NPK was found beneficial being at par with the treatment 75% NPK along with BM application @ 10t ha-1. There is saving of 25% recommended dose of NPK when combined with BM application @ 10.0t ha-1 or 50% saving of organics when applied with full dose (100%) of NPK. The highest straw yield (7734 kg ha-1) of maize on pooled basis was observed under the treatment of recommended dose of NPK along with FYM application at 7.5t ha-1 coupled with BM application at 2.5t ha-1. It was also observed that highest straw yield was at par under all the treatments except control and application of 100% recommended dose of NPK coupled with BM application at 7.5t ha-1. The Fe content of maize straw were found altered significantly due to different treatments on pooled basis and it was noticed that biomass application at 7.5t ha-1 along with recommended dose of NPK showed significant enhancement in Fe content of straw over other treatments. Among heavy metals, Co, Pb and Cr contents of grain were found significantly altered due to application of different treatments variably during the pooled. While, Ni content of maize grain was not altered significantly due to application of different organics. However, at higher rate of BM application i.e. of 10t ha-1, there was slight increase in heavy metal content of grain/ straw as well as DTPA heavy metals in soil; although the increase was not alarming Thus, the overall results indicated that the application of BM at 5t ha-1 along with full dose of NPK is beneficial to get higher yield of maize without affecting soil / plant health adversely. It also indicated that the 5t BM ha-1 could be utilized in place of 10t FYM ha-1 where FYM availability is scarce. The 10t BM ha-1 helps to reduce a load of chemical fertilizer up to 25 percent in agriculture. The lower use of agro-chemicals always favors safe environment. However, the continuous use of biomass needs periodical monitoring to check any buildup of heavy metals in soil/ plant over the years.

Keywords: alternate use of industrial waste, heavy metals, maize, processed industrial biomass

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107 In vitro and in vivo Effects of 'Sonneratia alba' Extract against the Fish Pathogen 'Aphanomyces invadans'

Authors: S. F. Afzali, W. L. Wong

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The epizootic ulcerative syndrome (EUS) causes by the oomycete fungus, Aphanomyces invadans; known to be one of the infectious fish diseases for farmed and wild fishes in fresh and brackish-water from the Asia-pacific region, America and Africa. Although, EUS had been documented by the Office International des Epizooties (OIE) since 1995, hitherto, there is neither standard chemical agents that can be used for successful treatment of this destructive infection in the time of outbreak; nor available vaccine for prevention. Plant-based remedies in controlling fish diseases are gaining much attention recently as an alternative to chemical treatments, which possess negative effects to the environment and human. In present study, Sonneratia alba, a mangrove plant belongs to the Sonneratiaceae family, was screened in vitro and in vivo for its antifungal activity against A. invadans mycelium growth and its effects on fish innate immune system and disease resistant. The in vitro tests was performed using the disc diffusion methods with measurements of minimum inhibitory concentration (MIC) and inhibition zone. For in vivo study, the S. alba extract supplemented diets were administrated at 0.0, 1.0%, 3.0%, and 5.0% on healthy goldfish, Carassius auratus, which challenged with A. invadans zoospores (100 spores/ml). To compare the significant differences in the hematological and immunological parameters obtained from the experiments, the data were analysed using the SPSS. The methanol extract of S. alba effectively inhibited the mycelial growth of A. invadans at a minimum concentration of 1000 ppm for agar and filter paper diffusion experiments. In the agar diffusion test, 500 ppm of the extract inhibited the fungus mycelial growth up to 96 hours after exposure. The mycelial growth from the edge of the pre-inoculated A. invadans agar discs treated with S. alba extracts at concentrations of 100, 500 and 1000 ppm were 15, 8 and 0 mm respectively. The results of the filter paper disc test showed that the S. alba extract at its minimal inhibitory concentration (1000 ppm) has similar qualitative inhibitory effect as malachite green at 1 ppm and formalin at 250 ppm. According to the in vivo tests findings, in the infected fish fed with 3.0% and 5.0% supplementation diet, the numbers of white blood cell and myeloperoxidase activity significantly increased after the second week of treatment. Whilst the numbers of red blood cell significantly decreased in the infected fish fed with 0.0 and 1.0% supplementation diet. After the third week of feeding, significant increases in the total protein, albumin level, lysozyme activity were recorded in the infected fish fed with 3.0% and 5.0% supplementation diet. Also, the enriched diets increased the survival rate as compared to the untreated group that suffered from 90% mortality. The present study indicated that S. alba extract may inhibit the mycelial growth of A. invadans effectively, suggesting an alternative to other chemotherapeutic agents, which brought much environmental and health concerns to the public, for EUS treatment.

Keywords: fungal pathogen, goldfish, organic extract, treatment

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106 Preparation of IPNs and Effect of Swift Heavy Ions Irradiation on their Physico-Chemical Properties

Authors: B. S Kaith, K. Sharma, V. Kumar, S. Kalia

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Superabsorbent are three-dimensional networks of linear or branched polymeric chains which can uptake large volume of biological fluids. The ability is due to the presence of functional groups like –NH2, -COOH and –OH. Such cross-linked products based on natural materials, such as cellulose, starch, dextran, gum and chitosan, because of their easy availability, low production cost, non-toxicity and biodegradability have attracted the attention of Scientists and Technologists all over the world. Since natural polymers have better biocompatibility and are non-toxic than most synthetic one, therefore, such materials can be applied in the preparation of controlled drug delivery devices, biosensors, tissue engineering, contact lenses, soil conditioning, removal of heavy metal ions and dyes. Gums are natural potential antioxidants and are used as food additives. They have excellent properties like high solubility, pH stability, non-toxicity and gelling characteristics. Till date lot of methods have been applied for the synthesis and modifications of cross-linked materials with improved properties suitable for different applications. It is well known that ion beam irradiation can play a crucial role to synthesize, modify, crosslink or degrade polymeric materials. High energetic heavy ions irradiation on polymer film induces significant changes like chain scission, cross-linking, structural changes, amorphization and degradation in bulk. Various researchers reported the effects of low and heavy ion irradiation on the properties of polymeric materials and observed significant improvement in optical, electrical, chemical, thermal and dielectric properties. Moreover, modifications induced in the materials mainly depend on the structure, the ion beam parameters like energy, linear energy transfer, fluence, mass, charge and the nature of the target material. Ion-beam irradiation is a useful technique for improving the surface properties of biodegradable polymers without missing the bulk properties. Therefore, a considerable interest has been grown to study the effects of SHIs irradiation on the properties of synthesized semi-IPNs and IPNs. The present work deals with the preparation of semi-IPNs and IPNs and impact of SHI like O7+ and Ni9+ irradiation on optical, chemical, structural, morphological and thermal properties along with impact on different applications. The results have been discussed on the basis of Linear Energy Transfer (LET) of the ions.

Keywords: adsorbent, gel, IPNs, semi-IPNs

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105 Influence of CO₂ on the Curing of Permeable Concrete

Authors: A. M. Merino-Lechuga, A. González-Caro, D. Suescum-Morales, E. Fernández-Ledesma, J. R. Jiménez, J. M. Fernández-Rodriguez

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Since the mid-19th century, the boom in the economy and industry has grown exponentially. This has led to an increase in pollution due to rising Greenhouse Gas (GHG) emissions and the accumulation of waste, leading to an increasingly imminent future scarcity of raw materials and natural resources. Carbon dioxide (CO₂) is one of the primary greenhouse gases, accounting for up to 55% of Greenhouse Gas (GHG) emissions. The manufacturing of construction materials generates approximately 73% of CO₂ emissions, with Portland cement production contributing to 41% of this figure. Hence, there is scientific and social alarm regarding the carbon footprint of construction materials and their influence on climate change. Carbonation of concrete is a natural process whereby CO₂ from the environment penetrates the material, primarily through pores and microcracks. Once inside, carbon dioxide reacts with calcium hydroxide (Ca(OH)2) and/or CSH, yielding calcium carbonates (CaCO3) and silica gel. Consequently, construction materials act as carbon sinks. This research investigated the effect of accelerated carbonation on the physical, mechanical, and chemical properties of two types of non-structural vibrated concrete pavers (conventional and draining) made from natural aggregates and two types of recycled aggregates from construction and demolition waste (CDW). Natural aggregates were replaced by recycled aggregates using a volumetric substitution method, and the CO₂ capture capacity was calculated. Two curing environments were utilized: a carbonation chamber with 5% CO₂ and a standard climatic chamber with atmospheric CO₂ concentration. Additionally, the effect of curing times of 1, 3, 7, 14, and 28 days on concrete properties was analyzed. Accelerated carbonation in-creased the apparent dry density, reduced water-accessible porosity, improved compressive strength, and decreased setting time to achieve greater mechanical strength. The maximum CO₂ capture ratio was achieved with the use of recycled concrete aggregate (52.52 kg/t) in the draining paver. Accelerated carbonation conditions led to a 525% increase in carbon capture compared to curing under atmospheric conditions. Accelerated carbonation of cement-based products containing recycled aggregates from construction and demolition waste is a promising technology for CO₂ capture and utilization, offering a means to mitigate the effects of climate change and promote the new paradigm of circular economy.

Keywords: accelerated carbonation, CO₂ curing, CO₂ uptake and construction and demolition waste., circular economy

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104 Repurposing Dairy Manure Solids as a Non- Polluting Fertilizer and the Effects on Nutrient Recovery in Tomatoes (Solanum Lycopersicum)

Authors: Devon Simpson

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Recycled Manure Solids (RMS), attained via centrifugation from Canadian dairy farms, were synthesized into a non-polluting fertilizer by bonding micronutrients (Fe, Zn, and Mn) to cellulose fibers and then assessed for the effectiveness of nutrient recovery in tomatoes. Manure management technology is critical for improving the sustainability of agroecosystems and has the capacity to offer a truly circular economy. The ability to add value to manure byproducts offers an opportunity for economic benefits while generating tenable solutions to livestock waste. The dairy industry is under increasing pressure from new environmental protections such as government restrictions on manure applications, limitations on herd size as well as increased product demand from a growing population. Current systems use RMS as bedding, so there is a lack of data pertaining to RMS use as a fertilizer. This is because of nutrient distribution, where most nutrients are retained in the liquid effluent of the solid-liquid separation. A literature review on the physical and chemical properties of dairy manure further revealed more data for raw manure than centrifuged solids. This research offers an innovative perspective and a new avenue of exploration in the use of RMS. Manure solids in this study were obtained directly from dairy farms in Salmon Arm and Abbotsford, British Columbia, and underwent physical, chemical, and biological characterizations pre- and post-synthesis processing. Samples were sent to A&L labs Canada for analysis. Once characterized and bonded to micronutrients, the effect of synthesized RMS on nutrient recovery in tomatoes was studied in a greenhouse environment. The agricultural research package ‘agricolae’ for R was used for experimental design and data analysis. The growth trials consisted of a randomized complete block design (RCBD) that allowed for analysis of variance (ANOVA). The primary outcome was to measure nutrient uptake, and this was done using an Inductively Coupled Plasma Mass Spectrometer (IC-PMS) to analyze the micronutrient content of both the tissue and fruit of the tomatoes. It was found that treatments containing bonded dairy manure solids had an increased micronutrient concentration. Treatments with bonded dairy manure solids also saw an increase in yield, and a brix analysis showed higher sugar content than the untreated control and a grower standard.

Keywords: aoecosystems, dairy manure, micronutrient fertilizer, manure management, nutrient recovery, nutrient recycling, recycled manure solids, regenerative agricugrlture, sustainable farming

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103 Development of a Stable RNAi-Based Biological Control for Sheep Blowfly Using Bentonite Polymer Technology

Authors: Yunjia Yang, Peng Li, Gordon Xu, Timothy Mahony, Bing Zhang, Neena Mitter, Karishma Mody

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Sheep flystrike is one of the most economically important diseases affecting the Australian sheep and wool industry (>356M/annually). Currently, control of Lucillia cuprina relies almost exclusively on chemicals controls and the parasite has developed resistance to nearly all control chemicals used in the past. It is therefore critical to develop an alternative solution for the sustainable control and management of flystrike. RNA interference (RNAi) technologies have been successfully explored in multiple animal industries for developing parasites controls. This research project aims to develop a RNAi based biological control for sheep blowfly. Double-stranded RNA (dsRNA) has already proven successful against viruses, fungi and insects. However, the environmental instability of dsRNA is a major bottleneck for successful RNAi. Bentonite polymer (BenPol) technology can overcome this problem, as it can be tuned for the controlled release of dsRNA in the gut challenging pH environment of the blowfly larvae, prolonging its exposure time to and uptake by target cells. To investigate the potential of BenPol technology for dsRNA delivery, four different BenPol carriers were tested for their dsRNA loading capabilities, and three of them were found to be capable of affording dsRNA stability under multiple temperatures (4°C, 22°C, 40°C, 55°C) in sheep serum. Based on stability results, dsRNA from potential targeted genes was loaded onto BenPol carriers and tested in larvae feeding assays, three genes resulting in knockdowns. Meanwhile, a primary blowfly embryo cell line (BFEC) derived from L. cuprina embryos was successfully established, aim for an effective insect cell model for testing RNAi efficacy for preliminary assessments and screening. The results of this study establish that the dsRNA is stable when loaded on BenPol particles, unlike naked dsRNA rapidly degraded in sheep serum. The stable nanoparticle delivery system offered by BenPol technology can protect and increase the inherent stability of dsRNA molecules at higher temperatures in a complex biological fluid like serum, providing promise for its future use in enhancing animal protection.

Keywords: flystrike, RNA interference, bentonite polymer technology, Lucillia cuprina

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102 Effects of Lime and N100 on the Growth and Phytoextraction Capability of a Willow Variety (S. Viminalis × S. Schwerinii × S. Dasyclados) Grown in Contaminated Soils

Authors: Mir Md. Abdus Salam, Muhammad Mohsin, Pertti Pulkkinen, Paavo Pelkonen, Ari Pappinen

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Soil and water pollution caused by extensive mining practices can adversely affect environmental components, such as humans, animals, and plants. Despite a generally positive contribution to society, mining practices have become a serious threat to biological systems. As metals do not degrade completely, they require immobilization, toxicity reduction, or removal. A greenhouse experiment was conducted to evaluate the effects of lime and N100 (11-amino-1-hydroxyundecylidene) chelate amendment on the growth and phytoextraction potential of the willow variety Klara (S. viminalis × S. schwerinii × S. dasyclados) grown in soils heavily contaminated with copper (Cu). The plants were irrigated with tap or processed water (mine wastewater). The sequential extraction technique and inductively coupled plasma-mass spectrometry (ICP-MS) tool were used to determine the extractable metals and evaluate the fraction of metals in the soil that could be potentially available for plant uptake. The results suggest that the combined effects of the contaminated soil and processed water inhibited growth parameter values. In contrast, the accumulation of Cu in the plant tissues was increased compared to the control. When the soil was supplemented with lime and N100; growth parameter and resistance capacity were significantly higher compared to unamended soil treatments, especially in the contaminated soil treatments. The combined lime- and N100-amended soil treatment produced higher growth rate of biomass, resistance capacity and phytoextraction efficiency levels relative to either the lime-amended or the N100-amended soil treatments. This study provides practical evidence of the efficient chelate-assisted phytoextraction capability of Klara and highlights its potential as a viable and inexpensive novel approach for in-situ remediation of Cu-contaminated soils and mine wastewaters. Abandoned agricultural, industrial and mining sites can also be utilized by a Salix afforestation program without conflict with the production of food crops. This kind of program may create opportunities for bioenergy production and economic development, but contamination levels should be examined before bioenergy products are used.

Keywords: copper, Klara, lime, N100, phytoextraction

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101 Bioleaching of Metals Contained in Spent Catalysts by Acidithiobacillus thiooxidans DSM 26636

Authors: Andrea M. Rivas-Castillo, Marlenne Gómez-Ramirez, Isela Rodríguez-Pozos, Norma G. Rojas-Avelizapa

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Spent catalysts are considered as hazardous residues of major concern, mainly due to the simultaneous presence of several metals in elevated concentrations. Although hydrometallurgical, pyrometallurgical and chelating agent methods are available to remove and recover some metals contained in spent catalysts; these procedures generate potentially hazardous wastes and the emission of harmful gases. Thus, biotechnological treatments are currently gaining importance to avoid the negative impacts of chemical technologies. To this end, diverse microorganisms have been used to assess the removal of metals from spent catalysts, comprising bacteria, archaea and fungi, whose resistance and metal uptake capabilities differ depending on the microorganism tested. Acidophilic sulfur oxidizing bacteria have been used to investigate the biotreatment and extraction of valuable metals from spent catalysts, namely Acidithiobacillus thiooxidans and Acidithiobacillus ferroxidans, as they present the ability to produce leaching agents such as sulfuric acid and sulfur oxidation intermediates. In the present work, the ability of A. thiooxidans DSM 26636 for the bioleaching of metals contained in five different spent catalysts was assessed by growing the culture in modified Starkey mineral medium (with elemental sulfur at 1%, w/v), and 1% (w/v) pulp density of each residue for up to 21 days at 30 °C and 150 rpm. Sulfur-oxidizing activity was periodically evaluated by determining sulfate concentration in the supernatants according to the NMX-k-436-1977 method. The production of sulfuric acid was assessed in the supernatants as well, by a titration procedure using NaOH 0.5 M with bromothymol blue as acid-base indicator, and by measuring pH using a digital potentiometer. On the other hand, Inductively Coupled Plasma - Optical Emission Spectrometry was used to analyze metal removal from the five different spent catalysts by A. thiooxidans DSM 26636. Results obtained show that, as could be expected, sulfuric acid production is directly related to the diminish of pH, and also to highest metal removal efficiencies. It was observed that Al and Fe are recurrently removed from refinery spent catalysts regardless of their origin and previous usage, although these removals may vary from 9.5 ± 2.2 to 439 ± 3.9 mg/kg for Al, and from 7.13 ± 0.31 to 368.4 ± 47.8 mg/kg for Fe, depending on the spent catalyst proven. Besides, bioleaching of metals like Mg, Ni, and Si was also obtained from automotive spent catalysts, which removals were of up to 66 ± 2.2, 6.2±0.07, and 100±2.4, respectively. Hence, the data presented here exhibit the potential of A. thiooxidans DSM 26636 for the simultaneous bioleaching of metals contained in spent catalysts from diverse provenance.

Keywords: bioleaching, metal removal, spent catalysts, Acidithiobacillus thiooxidans

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100 Medical Decision-Making in Advanced Dementia from the Family Caregiver Perspective: A Qualitative Study

Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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99 Immunoliposome-Mediated Drug Delivery to Plasmodium-Infected and Non-Infected Red Blood Cells as a Dual Therapeutic/Prophylactic Antimalarial Strategy

Authors: Ernest Moles, Patricia Urbán, María Belén Jiménez-Díaz, Sara Viera-Morilla, Iñigo Angulo-Barturen, Maria Antònia Busquets, Xavier Fernàndez-Busquets

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Bearing in mind the absence of an effective vaccine against malaria and its severe clinical manifestations causing nearly half a million deaths every year, this disease represents nowadays a major threat to life. Besides, the basic rationale followed by currently marketed antimalarial approaches is based on the administration of drugs on their own, promoting the emergence of drug-resistant parasites owing to the limitation in delivering drug payloads into the parasitized erythrocyte high enough to kill the intracellular pathogen while minimizing the risk of causing toxic side effects to the patient. Such dichotomy has been successfully addressed through the specific delivery of immunoliposome (iLP)-encapsulated antimalarials to Plasmodium falciparum-infected red blood cells (pRBCs). Unfortunately, this strategy has not progressed towards clinical applications, whereas in vitro assays rarely reach drug efficacy improvements above 10-fold. Here, we show that encapsulation efficiencies reaching >96% can be achieved for the weakly basic drugs chloroquine (CQ) and primaquine using the pH gradient active loading method in liposomes composed of neutrally charged, saturated phospholipids. Targeting antibodies are best conjugated through their primary amino groups, adjusting chemical crosslinker concentration to retain significant antigen recognition. Antigens from non-parasitized RBCs have also been considered as targets for the intracellular delivery of drugs not affecting the erythrocytic metabolism. Using this strategy, we have obtained unprecedented nanocarrier targeting to early intraerythrocytic stages of the malaria parasite for which there is a lack of specific extracellular molecular tags. Polyethylene glycol-coated liposomes conjugated with monoclonal antibodies specific for the erythrocyte surface protein glycophorin A (anti-GPA iLP) were capable of targeting 100% RBCs and pRBCs at the low concentration of 0.5 μM total lipid in the culture, with >95% of added iLPs retained into the cells. When exposed for only 15 min to P. falciparum in vitro cultures synchronized at early stages, free CQ had no significant effect over parasite viability up to 200 nM drug, whereas iLP-encapsulated 50 nM CQ completely arrested its growth. Furthermore, when assayed in vivo in P. falciparum-infected humanized mice, anti-GPA iLPs cleared the pathogen below detectable levels at a CQ dose of 0.5 mg/kg. In comparison, free CQ administered at 1.75 mg/kg was, at most, 40-fold less efficient. Our data suggest that this significant improvement in drug antimalarial efficacy is in part due to a prophylactic effect of CQ found by the pathogen in its host cell right at the very moment of invasion.

Keywords: immunoliposomal nanoparticles, malaria, prophylactic-therapeutic polyvalent activity, targeted drug delivery

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98 Facilitating Primary Care Practitioners to Improve Outcomes for People With Oropharyngeal Dysphagia Living in the Community: An Ongoing Realist Review

Authors: Caroline Smith, Professor Debi Bhattacharya, Sion Scott

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Introduction: Oropharyngeal Dysphagia (OD) effects around 15% of older people, however it is often unrecognised and under diagnosed until they are hospitalised. There is a need for primary care healthcare practitioners (HCPs) to assume a proactive role in identifying and managing OD to prevent adverse outcomes such as aspiration pneumonia. Understanding the determinants of primary care HCPs undertaking this new behaviour provides the intervention targets for addressing. This realist review, underpinned by the Theoretical Domains Framework (TDF), aims to synthesise relevant literature and develop programme theories to understand what interventions work, how they work and under what circumstances to facilitate HCPs to prevent harm from OD. Combining realist methodology with behavioural science will permit conceptualisation of intervention components as theoretical behavioural constructs, thus informing the design of a future behaviour change intervention. Furthermore, through the TDF’s linkage to a taxonomy of behaviour change techniques, we will identify corresponding behaviour change techniques to include in this intervention. Methods & analysis: We are following the five steps for undertaking a realist review: 1) clarify the scope 2) Literature search 3) appraise and extract data 4) evidence synthesis 5) evaluation. We have searched Medline, Google scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We are obtaining additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature is being screened, evaluated and synthesised in Excel and Nvivo. We will appraise evidence in relation to its relevance and rigour. Data will be extracted and synthesised according to its relation to Initial programme theories (IPTs). IPTs were constructed after the preliminary literature search, informed by the TDF and with input from a stakeholder group of patient and public involvement advisors, general practitioners, speech and language therapists, geriatricians and pharmacists. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication standards to report study results. Results: In this ongoing review our search has identified 1417 manuscripts with approximately 20% progressing to full text screening. We inductively generated 10 IPTs that hypothesise practitioners require: the knowledge to spot the signs and symptoms of OD; the skills to provide initial advice and support; and access to resources in their working environment to support them conducting these new behaviours. We mapped the 10 IPTs to 8 TDF domains and then generated a further 12 IPTs deductively using domain definitions to fulfil the remaining 6 TDF domains. Deductively generated IPTs broadened our thinking to consider domains such as ‘Emotion,’ ‘Optimism’ and ‘Social Influence’, e.g. If practitioners perceive that patients, carers and relatives expect initial advice and support, then they will be more likely to provide this, because they will feel obligated to do so. After prioritisation with stakeholders using a modified nominal group technique approach, a maximum of 10 IPTs will progress to test against the literature.

Keywords: behaviour change, deglutition disorders, primary healthcare, realist review

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97 Access and Utilization of Family Planning Services among Women in a Rural Community of Enugu state Nigeria, using a Descriptive Cross-sectional Design

Authors: Chidiebere Joy Nwankwo, Benjamin S. C. Uzochukwu, Florence T. Sibeudu

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Background: Family planning is one of the most cost-effective ways to prevent maternal, infant, and child mortality. It can decrease maternal mortality by reducing the number of unintended pregnancies, the number of abortions, and the proportion of births at high risk. It has been seen to improve the health and economic well-being of families and communities and ensures women’s planned childbearing in order to achieve education and career goals which could raise family income thereby reducing poverty. The choice and use of a particular family planning method and their sources vary globally. Rural Communities often face significant challenges in accessing and utilizing family planning services. Aim: This study set out to assess Access and Utilization of Family Planning Services among Women of Reproductive Age in a Rural Community of Enugu state, Nigeria. Rural communities were chosen for this study because past demographic surveys have shown that women in urban areas are more likely to accept and practice family planning compared to those in rural areas. Method: A Descriptive Cross-sectional Research design was employed to achieve the aim and objectives of the study. Data collected from 177 consenting participants using interviewer-administered questionnaires was analysed using Descriptive statistics to summarize the Socio-demographic characteristics of the participants and Access and Utilization of Family Planning Services among the participants including Reasons for using different Family Planning Methods and Barriers encountered in Access and Utilization of these services. A Cross-tabulation between Socio-demographic Characteristics of respondents and the use of Family Planning services was carried out. Result: The findings of this study revealed that majority of the participants (72.9%) have not utilized any family planning service. Out of those (27.1%) that have used any family planning service, majority of them are still currently using a form of family planning service and have access to them in health facilities, patent medicine vendors and others based on multiple responses. Male condoms were the most utilized modern family planning service. Based on multiple responses, inaccessibility, personal beliefs and partner’s objection were the most identified barriers encountered in accessing family planning services. Conclusion: Access and uptake of family planning services in rural communities is lower than the national average. Increasing access to family planning is an urgent priority for rural areas Interventions that will scale up Access and Utilization of family planning services in rural communities should be intensified.

Keywords: access, family planning, rural community, utilization

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96 Glutamine Supplementation and Resistance Traning on Anthropometric Indices, Immunoglobulins, and Cortisol Levels

Authors: Alireza Barari, Saeed Shirali, Ahmad Abdi

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Introduction: Exercise has contradictory effects on the immune system. Glutamine supplementation may increase the resistance of the immune system in athletes. The Glutamine is one of the most recognized immune nutrients that as a fuel source, substrate in the synthesis of nucleotides and amino acids and is also known to be part of the antioxidant defense. Several studies have shown that improving glutamine levels in plasma and tissues can have beneficial effects on the function of immune cells such as lymphocytes and neutrophils. This study aimed to investigate the effects of resistance training and training combined with glutamine supplementation to improve the levels of cortisol and immunoglobulin in untrained young men. The research shows that physical training can increase the cytokines in the athlete’s body of course; glutamine can counteract the negative effects of resistance training on immune function and stability of the mast cell membrane. Materials and methods: This semi-experimental study was conducted on 30 male non-athletes. They were randomly divided into three groups: control (no exercise), resistance training, resistance training and glutamine supplementation, respectively. Resistance training for 4 weeks and glutamine supplementation in 0.3 gr/kg/day after practice was applied. The resistance-training program consisted of eight exercises (leg press, lat pull, chest press, squat, seatedrow, abdominal crunch, shoulder press, biceps curl and triceps press down) four times per week. Participants performed 3 sets of 10 repetitions at 60–75% 1-RM. Anthropometry indexes (weight, body mass index, and body fat percentage), oxygen uptake (VO2max) Maximal, cortisol levels of immunoglobulins (IgA, IgG, IgM) were evaluated Pre- and post-test. Results: Results showed four week resistance training with and without glutamine cause significant increase in body weight, BMI and significantly decreased (P < 0/001) in BF. Vo2max also increased in both groups of exercise (P < 0/05) and exercise with glutamine (P < 0/001), such as in both groups significant reduction in IgG (P < 0/05) was observed. But no significant difference observed in levels of cortisol, IgA, IgM in any of the groups. No significant change observed in either parameter in the control group. No significant difference observed between the groups. Discussion: The alterations in the hormonal and immunological parameters can be used in order to assess the effect overload on the body, whether acute or chronically. The plasmatic concentration of glutamine has been associated to the functionality of the immunological system in individuals sub-mitted to intense physical training. resistance training has destructive effects on the immune system and glutamine supplementation cannot neutralize the damaging effects of power exercise on the immune system.

Keywords: glutamine, resistance traning, immuglobulins, cortisol

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95 Kinetic, Equilibrium and Thermodynamic Studies of the Adsorption of Crystal Violet Dye Using Groundnut Hulls

Authors: Olumuyiwa Ayoola Kokapi, Olugbenga Solomon Bello

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Dyes are organic compounds with complex aromatic molecular structure that resulted in fast colour on a substance. Dye effluent found in wastewater generated from the dyeing industries is one of the greatest contributors to water pollution. Groundnut hull (GH) is an agricultural material that constitutes waste in the environment. Environmental contamination by hazardous organic chemicals is an urgent problem, which is partially solved through adsorption technologies. The choice of groundnut hull was promised on the understanding that some materials of agricultural origin have shown potentials to act as Adsorbate for hazardous organic chemicals. The aim of this research is to evaluate the potential of groundnut hull to adsorb Crystal violet dye through kinetic, isotherm and thermodynamic studies. The prepared groundnut hulls was characterized using Brunauer, Emmett and Teller (BET), Fourier transform infrared (FTIR) and scanning electron microscopy (SEM). Operational parameters such as contact time, initial dye concentration, pH, and effect of temperature were studied. Equilibrium time for the adsorption process was attained in 80 minutes. Adsorption isotherms used to test the adsorption data were Langmuir and Freundlich isotherms model. Thermodynamic parameters such as ∆G°, ∆H°, and ∆S° of the adsorption processes were determined. The results showed that the uptake of dye by groundnut hulls occurred at a faster rate, corresponding to an increase in adsorption capacity at equilibrium time of 80 min from 0.78 to 4.45 mg/g and 0.77 to 4.45mg/g with an increase in the initial dye concentration from 10 to 50 mg/L for pH 3.0 and 8.0 respectively. High regression values obtained for pseudo-second-order kinetic model, sum of square error (SSE%) values along with strong agreement between experimental and calculated values of qe proved that pseudo second-order kinetic model fitted more than pseudo first-order kinetic model. The result of Langmuir and Freundlich model showed that the adsorption data fit the Langmuir model more than the Freundlich model. Thermodynamic study demonstrated the feasibility, spontaneous and endothermic nature of the adsorption process due to negative values of free energy change (∆G) at all temperatures and positive value of enthalpy change (∆H) respectively. The positive values of ∆S showed that there was increased disorderliness and randomness at the solid/solution interface of crystal violet dye and groundnut hulls. The present investigation showed that, groundnut hulls (GH) is a good low-cost alternative adsorbent for the removal of Crystal Violet (CV) dye from aqueous solution.

Keywords: adsorption, crystal violet dye, groundnut halls, kinetics

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94 Isolation of Nitrosoguanidine Induced NaCl Tolerant Mutant of Spirulina platensis with Improved Growth and Phycocyanin Production

Authors: Apurva Gupta, Surendra Singh

Abstract:

Spirulina spp., as a promising source of many commercially valuable products, is grown photo autotrophically in open ponds and raceways on a large scale. However, the economic exploitation in an open system seems to have been limited because of lack of multiple stress-tolerant strains. The present study aims to isolate a stable stress tolerant mutant of Spirulina platensis with improved growth rate and enhanced potential to produce its commercially valuable bioactive compounds. N-methyl-n'-nitro-n-nitrosoguanidine (NTG) at 250 μg/mL (concentration permitted 1% survival) was employed for chemical mutagenesis to generate random mutants and screened against NaCl. In a preliminary experiment, wild type S. platensis was treated with NaCl concentrations from 0.5-1.5 M to calculate its LC₅₀. Mutagenized colonies were then screened for tolerance at 0.8 M NaCl (LC₅₀), and the surviving colonies were designated as NaCl tolerant mutants of S. platensis. The mutant cells exhibited 1.5 times improved growth against NaCl stress as compared to the wild type strain in control conditions. This might be due to the ability of the mutant cells to protect its metabolic machinery against inhibitory effects of salt stress. Salt stress is known to adversely affect the rate of photosynthesis in cyanobacteria by causing degradation of the pigments. Interestingly, the mutant cells were able to protect its photosynthetic machinery and exhibited 4.23 and 1.72 times enhanced accumulation of Chl a and phycobiliproteins, respectively, which resulted in enhanced rate of photosynthesis (2.43 times) and respiration (1.38 times) against salt stress. Phycocyanin production in mutant cells was observed to enhance by 1.63 fold. Nitrogen metabolism plays a vital role in conferring halotolerance to cyanobacterial cells by influx of nitrate and efflux of Na+ ions from the cell. The NaCl tolerant mutant cells took up 2.29 times more nitrate as compared to the wild type and efficiently reduce it. Nitrate reductase and nitrite reductase activity in the mutant cells also improved by 2.45 and 2.31 times, respectively against salt stress. From these preliminary results, it could be deduced that enhanced nitrogen uptake and its efficient reduction might be a reason for adaptive and halotolerant behavior of the S. platensis mutant cells. Also, the NaCl tolerant mutant of S. platensis with significant improved growth and phycocyanin accumulation compared to the wild type can be commercially promising.

Keywords: chemical mutagenesis, NaCl tolerant mutant, nitrogen metabolism, photosynthetic machinery, phycocyanin

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93 Complete Genome Sequence Analysis of Pasteurella multocida Subspecies multocida Serotype A Strain PMTB2.1

Authors: Shagufta Jabeen, Faez J. Firdaus Abdullah, Zunita Zakaria, Nurulfiza M. Isa, Yung C. Tan, Wai Y. Yee, Abdul R. Omar

Abstract:

Pasteurella multocida (PM) is an important veterinary opportunistic pathogen particularly associated with septicemic pasteurellosis, pneumonic pasteurellosis and hemorrhagic septicemia in cattle and buffaloes. P. multocida serotype A has been reported to cause fatal pneumonia and septicemia. Pasteurella multocida subspecies multocida of serotype A Malaysian isolate PMTB2.1 was first isolated from buffaloes died of septicemia. In this study, the genome of P. multocida strain PMTB2.1 was sequenced using third-generation sequencing technology, PacBio RS2 system and analyzed bioinformatically via de novo analysis followed by in-depth analysis based on comparative genomics. Bioinformatics analysis based on de novo assembly of PacBio raw reads generated 3 contigs followed by gap filling of aligned contigs with PCR sequencing, generated a single contiguous circular chromosome with a genomic size of 2,315,138 bp and a GC content of approximately 40.32% (Accession number CP007205). The PMTB2.1 genome comprised of 2,176 protein-coding sequences, 6 rRNA operons and 56 tRNA and 4 ncRNAs sequences. The comparative genome sequence analysis of PMTB2.1 with nine complete genomes which include Actinobacillus pleuropneumoniae, Haemophilus parasuis, Escherichia coli and five P. multocida complete genome sequences including, PM70, PM36950, PMHN06, PM3480, PMHB01 and PMTB2.1 was carried out based on OrthoMCL analysis and Venn diagram. The analysis showed that 282 CDs (13%) are unique to PMTB2.1and 1,125 CDs with orthologs in all. This reflects overall close relationship of these bacteria and supports the classification in the Gamma subdivision of the Proteobacteria. In addition, genomic distance analysis among all nine genomes indicated that PMTB2.1 is closely related with other five Pasteurella species with genomic distance less than 0.13. Synteny analysis shows subtle differences in genetic structures among different P.multocida indicating the dynamics of frequent gene transfer events among different P. multocida strains. However, PM3480 and PM70 exhibited exceptionally large structural variation since they were swine and chicken isolates. Furthermore, genomic structure of PMTB2.1 is more resembling that of PM36950 with a genomic size difference of approximately 34,380 kb (smaller than PM36950) and strain-specific Integrative and Conjugative Elements (ICE) which was found only in PM36950 is absent in PMTB2.1. Meanwhile, two intact prophages sequences of approximately 62 kb were found to be present only in PMTB2.1. One of phage is similar to transposable phage SfMu. The phylogenomic tree was constructed and rooted with E. coli, A. pleuropneumoniae and H. parasuis based on OrthoMCL analysis. The genomes of P. multocida strain PMTB2.1 were clustered with bovine isolates of P. multocida strain PM36950 and PMHB01 and were separated from avian isolate PM70 and swine isolates PM3480 and PMHN06 and are distant from Actinobacillus and Haemophilus. Previous studies based on Single Nucleotide Polymorphism (SNPs) and Multilocus Sequence Typing (MLST) unable to show a clear phylogenetic relatedness between Pasteurella multocida and the different host. In conclusion, this study has provided insight on the genomic structure of PMTB2.1 in terms of potential genes that can function as virulence factors for future study in elucidating the mechanisms behind the ability of the bacteria in causing diseases in susceptible animals.

Keywords: comparative genomics, DNA sequencing, phage, phylogenomics

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92 Genetically Engineered Crops: Solution for Biotic and Abiotic Stresses in Crop Production

Authors: Deepak Loura

Abstract:

Production and productivity of several crops in the country continue to be adversely affected by biotic (e.g., Insect-pests and diseases) and abiotic (e.g., water temperature and salinity) stresses. Over-dependence on pesticides and other chemicals is economically non-viable for the resource-poor farmers of our country. Further, pesticides can potentially affect human and environmental safety. While traditional breeding techniques and proper- management strategies continue to play a vital role in crop improvement, we need to judiciously use biotechnology approaches for the development of genetically modified crops addressing critical problems in the improvement of crop plants for sustainable agriculture. Modern biotechnology can help to increase crop production, reduce farming costs, and improve food quality and the safety of the environment. Genetic engineering is a new technology which allows plant breeders to produce plants with new gene combinations by genetic transformation of crop plants for improvement of agronomic traits. Advances in recombinant DNA technology have made it possible to have genes between widely divergent species to develop genetically modified or genetically engineered plants. Plant genetic engineering provides the strength to harness useful genes and alleles from indigenous microorganisms to enrich the gene pool for developing genetically modified (GM) crops that will have inbuilt (inherent) resistance to insect pests, diseases, and abiotic stresses. Plant biotechnology has made significant contributions in the past 20 years in the development of genetically engineered or genetically modified crops with multiple benefits. A variety of traits have been introduced in genetically engineered crops which include (i) herbicide resistance. (ii) pest resistance, (iii) viral resistance, (iv) slow ripening of fruits and vegetables, (v) fungal and bacterial resistance, (vi) abiotic stress tolerance (drought, salinity, temperature, flooding, etc.). (vii) quality improvement (starch, protein, and oil), (viii) value addition (vitamins, micro, and macro elements), (ix) pharmaceutical and therapeutic proteins, and (x) edible vaccines, etc. Multiple genes in transgenic crops can be useful in developing durable disease resistance and a broad insect-control spectrum and could lead to potential cost-saving advantages for farmers. The development of transgenic to produce high-value pharmaceuticals and the edible vaccine is also under progress, which requires much more research and development work before commercially viable products will be available. In addition, molecular-aided selection (MAS) is now routinely used to enhance the speed and precision of plant breeding. Newer technologies need to be developed and deployed for enhancing and sustaining agricultural productivity. There is a need to optimize the use of biotechnology in conjunction with conventional technologies to achieve higher productivity with fewer resources. Therefore, genetic modification/ engineering of crop plants assumes greater importance, which demands the development and adoption of newer technology for the genetic improvement of crops for increasing crop productivity.

Keywords: biotechnology, plant genetic engineering, genetically modified, biotic, abiotic, disease resistance

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91 Genetic Diversity of Norovirus Strains in Outpatient Children from Rural Communities of Vhembe District, South Africa, 2014-2015

Authors: Jean Pierre Kabue, Emma Meader, Afsatou Ndama Traore, Paul R. Hunter, Natasha Potgieter

Abstract:

Norovirus is now considered the most common cause of outbreaks of nonbacterial gastroenteritis. Limited data are available for Norovirus strains in Africa, especially in rural and peri-urban areas. Despite the excessive burden of diarrhea disease in developing countries, Norovirus infections have been to date mostly reported in developed countries. There is a need to investigate intensively the role of viral agents associated with diarrhea in different settings in Africa continent. To determine the prevalence and genetic diversity of Norovirus strains circulating in the rural communities in the Limpopo Province, South Africa and investigate the genetic relationship between Norovirus strains, a cross-sectional study was performed on human stools collected from rural communities. Between July 2014 and April 2015, outpatient children under 5 years of age from rural communities of Vhembe District, South Africa, were recorded for the study. A total of 303 stool specimens were collected from those with diarrhea (n=253) and without (n=50) diarrhea. NoVs were identified using real-time one-step RT-PCR. Partial Sequence analyses were performed to genotype the strains. Phylogenetic analyses were performed to compare identified NoVs genotypes to the worldwide circulating strains. Norovirus detection rate was 41.1% (104/253) in children with diarrhea. There was no significant difference (OR=1.24; 95% CI 0.66-2.33) in Norovirus detection between symptomatic and asymptomatic children. Comparison of the median CT values for NoV in children with diarrhea and without diarrhea revealed significant statistical difference of estimated GII viral load from both groups, with a much higher viral burden in children with diarrhea. To our knowledge, this is the first study reporting on the differences in estimated viral load of GII and GI NoV positive cases and controls. GII.Pe (n=9) were the predominant genotypes followed by GII.Pe/GII.4 Sydney 2012 (n=8) suspected recombinant and GII.4 Sydney 2012 variants(n=7). Two unassigned GII.4 variants and an unusual RdRp genotype GII.P15 were found. With note, the rare GIIP15 identified in this study has a common ancestor with GIIP15 strain from Japan previously reported as GII/untypeable recombinant strain implicated in a gastroenteritis outbreak. To our knowledge, this is the first report of this unusual genotype in the African continent. Though not confirmed predictive of diarrhea disease in this study, the high detection rate of NoV is an indication of subsequent exposure of children from rural communities to enteric pathogens due to poor sanitation and hygiene practices. The results reveal that the difference between asymptomatic and symptomatic children with NoV may possibly be related to the NoV genogroups involved. The findings emphasize NoV genetic diversity and predominance of GII.Pe/GII.4 Sydney 2012, indicative of increased NoV activity. An uncommon GII.P15 and two unassigned GII.4 variants were also identified from rural settings of the Vhembe District/South Africa. NoV surveillance is required to help to inform investigations into NoV evolution, and to support vaccine development programmes in Africa.

Keywords: asymptomatic, common, outpatients, norovirus genetic diversity, sporadic gastroenteritis, South African rural communities, symptomatic

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