Search results for: impact on human health
Commenced in January 2007
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Edition: International
Paper Count: 23935

Search results for: impact on human health

685 Gut Microbiota in Patients with Opioid Use Disorder: A 12-week Follow up Study

Authors: Sheng-Yu Lee

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Aim: Opioid use disorder is often characterized by repetitive drug-seeking and drug-taking behaviors with severe public health consequences. Animal model showed that opioid-induced perturbations in the gut microbiota causally relate to neuroinflammation, deficits in reward responding, and opioid tolerance, possibly due to changes in gut microbiota. Therefore, we propose that the dysbiosis of gut microbiota can be associated with pathogenesis of opioid dependence. In this current study, we explored the differences in gut microbiota between patients and normal controls and in patients before and after initiation of methadone treatment program for 12 weeks. Methods: Patients with opioid use disorder between 20 and 65 years were recruited from the methadone maintenance outpatient clinic in 2 medical centers in the Southern Taiwan. Healthy controls without any family history of major psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) were recruited from the community. After initial screening, 15 patients with opioid use disorder joined the study for initial evaluation (Week 0), 12 of them completed the 12-week follow-up while receiving methadone treatment and ceased heroin use (Week 12). Fecal samples were collected from the patients at baseline and the end of 12th week. A one-time fecal sample was collected from the healthy controls. The microbiota of fecal samples were investigated using 16S rRNA V3V4 amplicon sequencing, followed by bioinformatics and statistical analyses. Results: We found no significant differences in species diversity in opioid dependent patients between Week 0 and Week 12, nor compared between patients at both points and controls. For beta diversity, using principal component analysis, we found no significant differences between patients at Week 0 and Week 12, however, both patient groups showed significant differences compared to control (P=0.011). Furthermore, the linear discriminant analysis effect size (LEfSe) analysis was used to identify differentially enriched bacteria between opioid use patients and healthy controls. Compared to controls, the relative abundance of Lactobacillaceae Lactobacillus (L. Lactobacillus), Megasphaera Megasphaerahexanoica (M. Megasphaerahexanoica) and Caecibacter Caecibactermassiliensis (C Caecibactermassiliensis) were increased in patients at Week 0, while Coriobacteriales Atopobiaceae (C. Atopobiaceae), Acidaminococcus Acidaminococcusintestini (A. Acidaminococcusintestini) and Tractidigestivibacter Tractidigestivibacterscatoligenes (T. Tractidigestivibacterscatoligenes) were increased in patients at Week 12. Conclusion: In conclusion, we suggest that the gut microbiome community maybe linked to opioid use disorder, such differences may not be altered even after 12-week of cessation of opioid use.

Keywords: opioid use disorder, gut microbiota, methadone treatment, follow up study

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684 Carotenoid Bioaccessibility: Effects of Food Matrix and Excipient Foods

Authors: Birgul Hizlar, Sibel Karakaya

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Recently, increasing attention has been given to carotenoid bioaccessibility and bioavailability in the field of nutrition research. As a consequence of their lipophilic nature and their specific localization in plant-based tissues, carotenoid bioaccessibility and bioavailability is generally quite low in raw fruits and vegetables, since carotenoids need to be released from the cellular matrix and incorporated in the lipid fraction during digestion before being absorbed. Today’s approach related to improving the bioaccessibility is to design food matrix. Recently, the newest approach, excipient food, has been introduced to improve the bioavailability of orally administered bioactive compounds. The main idea is combining food and another food (the excipient food) whose composition and/or structure is specifically designed for improving health benefits. In this study, effects of food processing, food matrix and the addition of excipient foods on the carotenoid bioaccessibility of carrots were determined. Different excipient foods (olive oil, lemon juice and whey curd) and different food matrices (grating, boiling and mashing) were used. Total carotenoid contents of the grated, boiled and mashed carrots were 57.23, 51.11 and 62.10 μg/g respectively. No significant differences among these values indicated that these treatments had no effect on the release of carotenoids from the food matrix. Contrary to, changes in the food matrix, especially mashing caused significant increase in the carotenoid bioaccessibility. Although the carotenoid bioaccessibility was 10.76% in grated carrots, this value was 18.19% in mashed carrots (p<0.05). Addition of olive oil and lemon juice as excipients into the grated carrots caused 1.23 times and 1.67 times increase in the carotenoid content and the carotenoid bioaccessibility respectively. However, addition of the excipient foods in the boiled carrot samples did not influence the release of carotenoid from the food matrix. Whereas, up to 1.9 fold increase in the carotenoid bioaccessibility was determined by the addition of the excipient foods into the boiled carrots. The bioaccessibility increased from 14.20% to 27.12% by the addition of olive oil, lemon juice and whey curd. The highest carotenoid content among mashed carrots was found in the mashed carrots incorporated with olive oil and lemon juice. This combination also caused a significant increase in the carotenoid bioaccessibility from 18.19% to 29.94% (p<0.05). When compared the results related with the effect of the treatments on the carotenoid bioaccessibility, mashed carrots containing olive oil, lemon juice and whey curd had the highest carotenoid bioaccessibility. The increase in the bioaccessibility was approximately 81% when compared to grated and mashed samples containing olive oil, lemon juice and whey curd. In conclusion, these results demonstrated that the food matrix and addition of the excipient foods had a significant effect on the carotenoid content and the carotenoid bioaccessibility.

Keywords: carrot, carotenoids, excipient foods, food matrix

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683 Persistence of Ready Mix (Chlorpyriphos 50% + Cypermethrin 5%), Cypermethrin and Chlorpyriphos in Soil under Okra Fruits

Authors: Samriti Wadhwa, Beena Kumari

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Background and Significance: Residue levels of ready mix (chlorpyriphos 50% and cypermethrin 5%), cypermethrin and chlorpyriphos individually in sandy loam soil under okra fruits (Variety, Varsha Uphar) were determined; a field experiment was conducted at Research Farm of Department of Entomology of Chaudhary Charan Singh Haryana Agriculture University, Hisar, Haryana, India. Persistence behavior of cypermethrin and chlorpyriphos was studied following application of a pre-mix formulation of insecticides viz. Action-505EC, chlorpyriphos (Radar 20 EC) and cypermethrin (Cyperkill 10 EC) at the recommended dose and double the recommended dose along with control at fruiting stage. Pesticide application also leads to decline in soil acarine fauna which is instrumental in the breakdown of the litter because of which minerals are released into the soil. So, by this study, one can evaluate the safety of pesticides for the soil health. Methodology: Action-505EC (chlorpyriphos 50% and cypermethrin 5%) at 275 g a .i. ha⁻¹ (single dose) and 550 g a. i. ha⁻¹ (double dose), chlorpyriphos (Radar 20 EC) at 200 g a. i. ha⁻¹ (single dose) and 400 g a. i. ha⁻¹ (double dose) and cypermethrin (Cyperkill 10 EC) at 50 g a. i. ha⁻¹ (single dose) and 100 g a. i. ha⁻¹ (double dose) were applied at the fruiting stage on okra crop. Samples of soils from okra field were collected periodically at 0 (1h after spray), 1, 3, 5, 7, 10, 15 days and at harvest after application as well of control soil sample. After air drying, adsorbing through Florisil and activated charcoal and eluting with hexane: acetone (9:1) then residues in soils were estimated by a gas chromatograph equipped with a capillary column and electron capture detector. Results: No persistence of cypermethrin in ready-mix in soil under okra fruits at single and double dose was observed. In case of chlorpyriphos in ready-mix, average initial deposits on 0 (1 h after treatment) day was 0.015 mg kg⁻¹ and 0.036 mg kg⁻¹ which persisted up to 5 days and up to 7 days for single and double dose, respectively. After that residues reached below a detectable level of 0.010 mg kg⁻¹. Experimental studies on cypermethrin individually revealed that average initial deposits on 0 (1 h after treatment) were 0.008 mg kg⁻¹ and 0.012 mg kg⁻¹ which persisted up to 3 days and 5 days for single and double dose, respectively after that residues reached to below detectable level. The initial deposits of chlorpyriphos individually in soil were found to be 0.055 mg kg⁻¹ and 0.113 mg kg⁻¹ which persisted up to 7 days and 10 days at a lower dose and higher dose, respectively after that residues reached to below determination level. Conclusion: In soil under okra crop, only individual cypermethrin in both the doses persisted whereas no persistence of cypermethrin in ready-mix was observed. Persistence of chlorpyriphos individually is more as compared to chlorpyriphos in ready-mix in both the doses. Overall, the persistence of chlorpyriphos in soil under okra crop is more than cypermethrin.

Keywords: chlorpyriphos, cypermethrin, okra, ready mix, soil

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682 Economics of Precision Mechanization in Wine and Table Grape Production

Authors: Dean A. McCorkle, Ed W. Hellman, Rebekka M. Dudensing, Dan D. Hanselka

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The motivation for this study centers on the labor- and cost-intensive nature of wine and table grape production in the U.S., and the potential opportunities for precision mechanization using robotics to augment those production tasks that are labor-intensive. The objectives of this study are to evaluate the economic viability of grape production in five U.S. states under current operating conditions, identify common production challenges and tasks that could be augmented with new technology, and quantify a maximum price for new technology that growers would be able to pay. Wine and table grape production is primed for precision mechanization technology as it faces a variety of production and labor issues. Methodology: Using a grower panel process, this project includes the development of a representative wine grape vineyard in five states and a representative table grape vineyard in California. The panels provided production, budget, and financial-related information that are typical for vineyards in their area. Labor costs for various production tasks are of particular interest. Using the data from the representative budget, 10-year projected financial statements have been developed for the representative vineyard and evaluated using a stochastic simulation model approach. Labor costs for selected vineyard production tasks were evaluated for the potential of new precision mechanization technology being developed. These tasks were selected based on a variety of factors, including input from the panel members, and the extent to which the development of new technology was deemed to be feasible. The net present value (NPV) of the labor cost over seven years for each production task was derived. This allowed for the calculation of a maximum price for new technology whereby the NPV of labor costs would equal the NPV of purchasing, owning, and operating new technology. Expected Results: The results from the stochastic model will show the projected financial health of each representative vineyard over the 2015-2024 timeframe. Investigators have developed a preliminary list of production tasks that have the potential for precision mechanization. For each task, the labor requirements, labor costs, and the maximum price for new technology will be presented and discussed. Together, these results will allow technology developers to focus and prioritize their research and development efforts for wine and table grape vineyards, and suggest opportunities to strengthen vineyard profitability and long-term viability using precision mechanization.

Keywords: net present value, robotic technology, stochastic simulation, wine and table grapes

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681 Investigation of the EEG Signal Parameters during Epileptic Seizure Phases in Consequence to the Application of External Healing Therapy on Subjects

Authors: Karan Sharma, Ajay Kumar

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Epileptic seizure is a type of disease due to which electrical charge in the brain flows abruptly resulting in abnormal activity by the subject. One percent of total world population gets epileptic seizure attacks.Due to abrupt flow of charge, EEG (Electroencephalogram) waveforms change. On the display appear a lot of spikes and sharp waves in the EEG signals. Detection of epileptic seizure by using conventional methods is time-consuming. Many methods have been evolved that detect it automatically. The initial part of this paper provides the review of techniques used to detect epileptic seizure automatically. The automatic detection is based on the feature extraction and classification patterns. For better accuracy decomposition of the signal is required before feature extraction. A number of parameters are calculated by the researchers using different techniques e.g. approximate entropy, sample entropy, Fuzzy approximate entropy, intrinsic mode function, cross-correlation etc. to discriminate between a normal signal & an epileptic seizure signal.The main objective of this review paper is to present the variations in the EEG signals at both stages (i) Interictal (recording between the epileptic seizure attacks). (ii) Ictal (recording during the epileptic seizure), using most appropriate methods of analysis to provide better healthcare diagnosis. This research paper then investigates the effects of a noninvasive healing therapy on the subjects by studying the EEG signals using latest signal processing techniques. The study has been conducted with Reiki as a healing technique, beneficial for restoring balance in cases of body mind alterations associated with an epileptic seizure. Reiki is practiced around the world and is recommended for different health services as a treatment approach. Reiki is an energy medicine, specifically a biofield therapy developed in Japan in the early 20th century. It is a system involving the laying on of hands, to stimulate the body’s natural energetic system. Earlier studies have shown an apparent connection between Reiki and the autonomous nervous system. The Reiki sessions are applied by an experienced therapist. EEG signals are measured at baseline, during session and post intervention to bring about effective epileptic seizure control or its elimination altogether.

Keywords: EEG signal, Reiki, time consuming, epileptic seizure

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680 Investigation of the Role of Lipoprotein a rs10455872 Gene Polymorphism in Childhood Obesity

Authors: Mustafa M. Donma, Ayşen Haksayar, Bahadır Batar, Buse Tepe, Birol Topçu, Orkide Donma

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Childhood obesity is an ever-increasing health problem. The Association of obesity with severe chronic diseases such as diabetes and cardiovascular diseases makes the problem life-threatening. Aside from psychological, societal and metabolic factors, genetic polymorphisms have gained importance concerning etiology in recent years. The aim of this study was to evaluate the relationship between rs10455872 gene polymorphism in the Lipoprotein (a) locus and the development of childhood obesity. This was a prospective study carried out according to the Helsinki Declarations. The study protocol was approved by the Institutional Ethics Committee. This study was supported by Tekirdag Namik Kemal University Rectorate, Scientific Research Projects Coordination Unit. Project No: NKUBAP.02.TU.20.278. A total of 180 children (103 obese (OB) and 77 healthy), aged 6-18 years, without any acute or chronic disease, participated in the study. Two different groups were created: OB and healthy control. Each group was divided into two further groups depending on the nature of the polymorphism. Anthropometric measurements were taken during the detailed physical examination. Laboratory tests and TANITA measurements were performed. For the statistical evaluations, SPSS version 28.0 was used. A P-value smaller than 0.05 was the statistical significance degree. The distribution of lipoprotein (a) rs10455872 gene polymorphism did not differ between OB and healthy children. Children with AG genotype in both OB and control groups had lower body mass index (BMI), diagnostic obesity notation model assessment index (DONMA II), body fat ratio (BFR), C-reactive protein (CRP), and metabolic syndrome index (MetS index) values compared to children with normal AA genotype. In the OB group, serum iron, vitamin B12, hemoglobin, MCV, and MCH values were found to be higher in the AG genotype group than those of children with the normal AA genotype. A significant correlation was found between the MetS index and BFR among OB children with normal homozygous genotype. MetS index increased as BFR increased in this group. However, such a correlation was not observed in the OB group with heterozygous AG genotype. To the best of our knowledge, the association of lipoprotein (a) rs10455872 gene polymorphism with the etiology of childhood obesity has not been studied yet. Therefore, this study was the first report suggesting polymorphism with AG genotype as a good risk factor for obesity.

Keywords: child, gene polymorphism, lipoprotein (a), obesity, rs10455872

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679 Fabrication of Highly Stable Low-Density Self-Assembled Monolayers by Thiolyne Click Reaction

Authors: Leila Safazadeh, Brad Berron

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Self-assembled monolayers have tremendous impact in interfacial science, due to the unique opportunity they offer to tailor surface properties. Low-density self-assembled monolayers are an emerging class of monolayers where the environment-interfacing portion of the adsorbate has a greater level of conformational freedom when compared to traditional monolayer chemistries. This greater range of motion and increased spacing between surface-bound molecules offers new opportunities in tailoring adsorption phenomena in sensing systems. In particular, we expect low-density surfaces to offer a unique opportunity to intercalate surface bound ligands into the secondary structure of protiens and other macromolecules. Additionally, as many conventional sensing surfaces are built upon gold surfaces (SPR or QCM), these surfaces must be compatible with gold substrates. Here, we present the first stable method of generating low-density self assembled monolayer surfaces on gold for the analysis of their interactions with protein targets. Our approach is based on the 2:1 addition of thiol-yne chemistry to develop new classes of y-shaped adsorbates on gold, where the environment-interfacing group is spaced laterally from neighboring chemical groups. This technique involves an initial deposition of a crystalline monolayer of 1,10 decanedithiol on the gold substrate, followed by grafting of a low-packed monolayer on through a photoinitiated thiol-yne reaction in presence of light. Orthogonality of the thiol-yne chemistry (commonly referred to as a click chemistry) allows for preparation of low-density monolayers with variety of functional groups. To date, carboxyl, amine, alcohol, and alkyl terminated monolayers have been prepared using this core technology. Results from surface characterization techniques such as FTIR, contact angle goniometry and electrochemical impedance spectroscopy confirm the proposed low chain-chain interactions of the environment interfacing groups. Reductive desorption measurements suggest a higher stability for the click-LDMs compared to traditional SAMs, along with the equivalent packing density at the substrate interface, which confirms the proposed stability of the monolayer-gold interface. In addition, contact angle measurements change in the presence of an applied potential, supporting our description of a surface structure which allows the alkyl chains to freely orient themselves in response to different environments. We are studying the differences in protein adsorption phenomena between well packed and our loosely packed surfaces, and we expect this data will be ready to present at the GRC meeting. This work aims to contribute biotechnology science in the following manner: Molecularly imprinted polymers are a promising recognition mode with several advantages over natural antibodies in the recognition of small molecules. However, because of their bulk polymer structure, they are poorly suited for the rapid diffusion desired for recognition of proteins and other macromolecules. Molecularly imprinted monolayers are an emerging class of materials where the surface is imprinted, and there is not a bulk material to impede mass transfer. Further, the short distance between the binding site and the signal transduction material improves many modes of detection. My dissertation project is to develop a new chemistry for protein-imprinted self-assembled monolayers on gold, for incorporation into SPR sensors. Our unique contribution is the spatial imprinting of not only physical cues (seen in current imprinted monolayer techniques), but to also incorporate complementary chemical cues. This is accomplished through a photo-click grafting of preassembled ligands around a protein template. This conference is important for my development as a graduate student to broaden my appreciation of the sensor development beyond surface chemistry.

Keywords: low-density self-assembled monolayers, thiol-yne click reaction, molecular imprinting

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678 Cr (VI) Adsorption on Ce0.25Zr0.75O2.nH2O-Kinetics and Thermodynamics

Authors: Carlos Alberto Rivera-corredor, Angie Dayana Vargas-Ceballos, Edison Gilpavas, Izabela Dobrosz-Gómez, Miguel Ángel Gómez-García

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Hexavalent chromium, Cr (VI) is present in the effluents from different industries such as electroplating, mining, leather tanning, etc. This compound is of great academic and industrial concern because of its toxic and carcinogenic behavior. Its dumping to both environmental and public health for animals and humans causes serious problems in water sources. The amount of Cr (VI) in industrial wastewaters ranges from 0.5 to 270,000 mgL-1. According to the Colombian standard for water quality (NTC-813-2010), the maximum allowed concentration for the Cr (VI) in drinking water is 0.05 mg L-1. To comply with this limit, it is essential that industries treat their effluent to reduce the Cr (VI) to acceptable levels. Numerous methods have been reported for the treatment removing metal ions from aqueous solutions such as: reduction, ion exchange, electrodialysis, etc. Adsorption has become a promising method for the purification of metal ions in water, since its application corresponds with an economic and efficient technology. The absorbent selection and the kinetic and thermodynamic study of the adsorption conditions are key to the development of a suitable adsorption technology. The Ce0.25Zr0.75O2.nH2O presents higher adsorption capacity between a series of hydrated mixed oxides Ce1-xZrxO2 (x = 0, 0.25, 0.5, 0.75, 1). This work presents the kinetic and thermodynamic study of Cr (VI) adsorption on Ce0.25Zr0.75O2.nH2O. Experiments were performed under the following experimental conditions: initial Cr (VI) concentration = 25, 50 and 100 mgL-1, pH = 2, adsorbent charge = 4 gL-1, stirring time = 60 min, temperature=20, 28 and 40 °C. The Cr (VI) concentration was spectrophotometrically estimated by the method of difenilcarbazide with monitoring the absorbance at 540 nm. The Cr (VI) adsorption over hydrated Ce0.25Zr0.75O2.nH2O models was analyzed using pseudo-first and pseudo-second order kinetics. The Langmuir and Freundlich models were used to model the experimental data. The convergence between the experimental values and those predicted by the model, is expressed as a linear regression correlation coefficient (R2) and was employed as the model selection criterion. The adsorption process followed the pseudo-second order kinetic model and obeyed the Langmuir isotherm model. The thermodynamic parameters were calculated as: ΔH°=9.04 kJmol-1,ΔS°=0.03 kJmol-1 K-1, ΔG°=-0.35 kJmol-1 and indicated the endothermic and spontaneous nature of the adsorption process, governed by physisorption interactions.

Keywords: adsorption, hexavalent chromium, kinetics, thermodynamics

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677 Prescription of Maintenance Fluids in the Emergency Department

Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

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676 Attributable Mortality of Nosocomial Infection: A Nested Case Control Study in Tunisia

Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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675 Level of Caregiver Burden: A Study of Caregivers of Stroke Survivors at CRP in Bangladesh

Authors: Yeasir Arafat Alve, Nazmun Nahar, Salma BeguM

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Introduction / Rationale: Caregivers of stroke survivors have experienced financial, emotional, physical and mental anxiety and have influence of family bonding and social customs, where 80% of caregivers were women and majority of the patients were cared for by immediate family members for example a spouse, son/daughter, son-in-law, daughter-in-law, siblings and they are significantly feel burden as a caregiver. In Bangladeshi context, there has a limitation of knowledge about the level of caregiver burden. This study could be suggested the health professional to focus on the care giving stress to provide a better support to them and also it will be advisable to provide equivalent services for caregivers and their families. Objectives: The study finds out the socio-demographic image of caregivers of stroke survivors in Bangladesh as well as discovers the level of burden of caregiver of stroke survivor in relation to general strain, isolation, disappointment, emotional involvement and environment. The study will find out the association between level of burden among caregivers and onset of stroke of survivors & duration of care giving. As well as to determine the association between level of burden among caregivers and caregiver’s age, gender, occupation and caregiver’s relationship with stroke survivors. Method / Approach: The study is a non experimental cross-sectional study design where 151 participants were selected through purposive comprehensive sampling. Data were selected from occupational therapy outdoor and stroke rehab unit, CRP (Savar & Mirpur) where using the Caregiver Burden Scale (a structured questionnaire) with face to face interview. Results: Most of the caregivers (78.8%) of stroke survivors faced moderate level of burden in general strain (37.7%), isolation (27.2%) but in case of disappointment (60.3%) feel higher burden and lower burden in emotional involvement (9.9%) and environment (0.7%). Caregiver burden level was significantly associated with caregivers’ age (P=0.006), sex (P=0.002), occupation (p= 0.04), relationship with stroke survivors (P=0.02), care giving duration (P=0.000), care giving hours (P=0.009), and onset of stroke (P=0.000) of stroke survivors. Conclusion: The study findings revealed that most of the caregivers faced moderate burden where no environmental burden for them, this is possibly in case of Bangladeshi culture where people hospitable. Through this study, it was also found that there is a possibility to have the higher burden. Finally, it is being also suggested that appropriate advice and support may preserve care giving which eventually enables the survivors to live a longer and more fulfilling life in the community.

Keywords: caregiver, level of caregiver burden, stroke survivor, stroke rehab unit

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674 Biogas Production from Kitchen Waste for a Household Sustainability

Authors: Vuiswa Lucia Sethunya, Tonderayi Matambo, Diane Hildebrandt

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South African’s informal settlements produce tonnes of kitchen waste (KW) per year which is dumped into the landfill. These landfill sites are normally located in close proximity to the household of the poor communities; this is a problem in which the young children from those communities end up playing in these landfill sites which may result in some health hazards because of methane, carbon dioxide and sulphur gases which are produced. To reduce this large amount of organic materials being deposited into landfills and to provide a cleaner place for those within the community especially the children, an energy conversion process such as anaerobic digestion of the organic waste to produce biogas was implemented. In this study, the digestion of various kitchen waste was investigated in order to understand and develop a system that is suitable for household use to produce biogas for cooking. Three sets of waste of different nutritional compositions were digested as per acquired in the waste streams of a household at mesophilic temperature (35ᵒC). These sets of KW were co-digested with cow dung (CW) at different ratios to observe the microbial behaviour and the system’s stability in a laboratory scale system. The gas chromatography-flame ionization detector analyses have been performed to identify and quantify the presence of organic compounds in the liquid samples from co-digested and mono-digested food waste. Acetic acid, propionic acid, butyric acid and valeric acid are the fatty acids which were studied. Acetic acid (1.98 g/L), propionic acid (0.75 g/L) and butyric acid (2.16g/L) were the most prevailing fatty acids. The results obtained from organic acids analysis suggest that the KW can be an innovative substituent to animal manure for biogas production. The faster degradation period in which the microbes break down the organic compound to produce the fatty acids during the anaerobic process of KW also makes it a better feedstock during high energy demand periods. The C/N ratio analysis showed that from the three waste streams the first stream containing vegetables (55%), fruits (16%), meat (25%) and pap (4%) yielded more methane-based biogas of 317mL/g of volatile solids (VS) at C/N of 21.06. Generally, this shows that a household will require a heterogeneous composition of nutrient-based waste to be fed into the digester to acquire the best biogas yield to sustain a households cooking needs.

Keywords: anaerobic digestion, biogas, kitchen waste, household

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673 In vivo Antidiabetic and in vitro Antioxidant Activity of Myrica salicifolia Hochst. ex A. Rich. (Myricaceae) Root Extract in Streptozotocin-Induced Diabetic Mice

Authors: Yohannes Kelifa, Gomathi Periasamy, Aman Karim

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Introduction: Diabetes mellitus has become a major public health and economical problem across the globe. Modern antidiabetic drugs have a number of limitations, and scientific investigation of traditional herbal remedies used for diabetes may provide novel leads for the development of new antidiabetic drugs that can be used as alternative or complementary to available antidiabetic allopathic medications. Though Myrica salicifolia Hochst. ex A. Rich. is used for the management of diabetes in Ethiopian traditional medicine, there was no previous scientific evidence about its antidiabetic effect to the authors’ knowledge. This study was undertaken to evaluate the antidiabetic activity the root extracts of Myrica salicifolia in streptozotocin (STZ)-induced diabetic mice. Methods: Experimental diabetes was induced by intraperitoneal administration of STZ (150 mg/kg) in male mice. Diabetic mice were treated with oral doses of M. salicifolia root extracts at 200, 400 and 600 mg/kg, and its fractions (chloroform, ethyl acetate, n-butanol and aqueous) at a dose of 400 mg/kg daily for 15 days. Fasting blood glucose level (BGL) was measured at 0, 5th,10th, and 15th day. The free radical scavenging activity of the crude extract was determined using in vitro by DPPH assay. The statistical significance was assessed by one-way ANOVA, followed by Tukey’s multiple comparison tests. Results were considered significant when p < 0.05. Results: Daily administration of the M. salicifolia 80% methanol root extracts (at three different doses (200, 400 and 600 mg/kg) significantly (p < 0.05, p < 0.01 and p < 0.001) reduced fasting BGL compared with diabetic control. The aqueous and butanol fractions at a dose of 400 mg/kg resulted in maximum reduction of fasting BGL by 42.39%, and 52.13%, respectively at the 15th day in STZ-induced diabetic mice. Free radical scavenging activity of the 80% methanol extract of M. salicifolia was comparable to ascorbic acid. The IC50 values of the crude extract and ascorbic acid (a reference compound) were found to be 4.54 μg/ml and 4.39 μg/ml, respectively. Conclusion: These findings demonstrated that the methanolic extracts of M. salicifolia root and its fractions (n-butanol and aqueous) exhibit a significant antihyperglycemic activity in STZ-induced diabetic mice. Furthermore, the result of the present study indicates that M. salicifolia root extract is a potential source of natural antioxidants.

Keywords: antidiabetic, diabetes mellitus, DPPH, mice, Myrica salicifolia, streptozotocin

Procedia PDF Downloads 196
672 Development of an Integrated Reaction Design for the Enzymatic Production of Lactulose

Authors: Natan C. G. Silva, Carlos A. C. Girao Neto, Marcele M. S. Vasconcelos, Luciana R. B. Goncalves, Maria Valderez P. Rocha

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Galactooligosaccharides (GOS) are sugars with prebiotic function that can be synthesized chemically or enzymatically, and this last one can be promoted by the action of β-galactosidases. In addition to favoring the transgalactosylation reaction to form GOS, these enzymes can also catalyze the hydrolysis of lactose. A highly studied type of GOS is lactulose because it presents therapeutic properties and is a health promoter. Among the different raw materials that can be used to produce lactulose, whey stands out as the main by-product of cheese manufacturing, and its discarded is harmful to the environment due to the residual lactose present. Therefore, its use is a promising alternative to solve this environmental problem. Thus, lactose from whey is hydrolyzed into glucose and galactose by β-galactosidases. However, in order to favor the transgalactosylation reaction, the medium must contain fructose, due this sugar reacts with galactose to produce lactulose. Then, the glucose-isomerase enzyme can be used for this purpose, since it promotes the isomerization of glucose into fructose. In this scenario, the aim of the present work was first to develop β-galactosidase biocatalysts of Kluyveromyces lactis and to apply it in the integrated reactions of hydrolysis, isomerization (with the glucose-isomerase from Streptomyces murinus) and transgalactosylation reaction, using whey as a substrate. The immobilization of β-galactosidase in chitosan previously functionalized with 0.8% glutaraldehyde was evaluated using different enzymatic loads (2, 5, 7, 10, and 12 mg/g). Subsequently, the hydrolysis and transgalactosylation reactions were studied and conducted at 50°C, 120 RPM for 20 minutes. In parallel, the isomerization of glucose into fructose was evaluated under conditions of 70°C, 750 RPM for 90 min. After, the integration of the three processes for the production of lactulose was investigated. Among the evaluated loads, 7 mg/g was chosen because the best activity of the derivative (44.3 U/g) was obtained, being this parameter determinant for the reaction stages. The other parameters of immobilization yield (87.58%) and recovered activity (46.47%) were also satisfactory compared to the other conditions. Regarding the integrated process, 94.96% of lactose was converted, achieving 37.56 g/L and 37.97 g/L of glucose and galactose, respectively. In the isomerization step, conversion of 38.40% of glucose was observed, obtaining a concentration of 12.47 g/L fructose. In the transgalactosylation reaction was produced 13.15 g/L lactulose after 5 min. However, in the integrated process, there was no formation of lactulose, but it was produced other GOS at the same time. The high galactose concentration in the medium probably favored the reaction of synthesis of these other GOS. Therefore, the integrated process proved feasible for possible production of prebiotics. In addition, this process can be economically viable due to the use of an industrial residue as a substrate, but it is necessary a more detailed investigation of the transgalactosilation reaction.

Keywords: beta-galactosidase, glucose-isomerase, galactooligosaccharides, lactulose, whey

Procedia PDF Downloads 138
671 Women Right to Land Entitlement for Gender Equality: Critical Review

Authors: A. Yousuf, M. Iqbal, A. Mir, S. Aziz

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This study deals with the women’s right to land for gender equality. Economic Transformation Initiative, Gilgit-Baltistan (ETI-GB), an ambitious program supported by International Fund for Agricultural Development United Nation (IFAD, UN), aims to strengthen land reforms process in disputed area of Gilgit-Baltistan (GB) Pakistan, that is taking place first time in the history. This project is a brick to build the foundation of land reforms and land policies in GB. The ETI-GB provides substantive support to government of GB in developing policy measures and initiatives to promote women’s right to have and to own land is kind of unconventional step in a very traditional society. It would be interesting to have discussion and document the people’s response regarding this project. The study has used mixed method for data collection. For qualitative data, content analysis is used to have a thorough understanding of different types of land reforms across the globe particularly in South Asia. Theoretical understanding of the literature is essential which provides the basis why land reforms are important and how far it plays an important role when it comes to eliminating inequality. Focused group discussion was carried out for verification and triangulation of data. For quantitative, survey was conducted to take responses from the people of the region and analyzed. The program is implemented in Ghizer district of GB. 2340 households were identified as beneficiaries of newly developed land. Among them, 2285 were men households, and 55 were women households. There is a significant difference between men and women households. In spite of great difference, it is a great achievement of the donor that in history of GB, first time women are going to be entitled to land ownership. GB is a patriarchal society, many social factors like cultural, religious play role for gender inequality. In developing countries, such as Pakistan, the awareness of land property rights has not been given proper attention to gender equality development frameworks. It is argued that land property rights of women have not been taken into mainstream policymaking in the development of nation building process. Consequently, this has generated deprivation of women’s property rights, low income level, lack of education and poor health. This paper emphasises that there should have proper land property right of women in Gilgit-Baltistan Pakistan, provided that the gender empowerment could be increased in terms of women’s property rights.

Keywords: gender equality, women right to land ownership, property rights, women empowerment

Procedia PDF Downloads 150
670 Review of the Safety of Discharge on the First Postoperative Day Following Carotid Surgery: A Retrospective Analysis

Authors: John Yahng, Hansraj Riteesh Bookun

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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

Procedia PDF Downloads 165
669 Detection and Identification of Antibiotic Resistant Bacteria Using Infra-Red-Microscopy and Advanced Multivariate Analysis

Authors: Uraib Sharaha, Ahmad Salman, Eladio Rodriguez-Diaz, Elad Shufan, Klaris Riesenberg, Irving J. Bigio, Mahmoud Huleihel

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Antimicrobial drugs have an important role in controlling illness associated with infectious diseases in animals and humans. However, the increasing resistance of bacteria to a broad spectrum of commonly used antibiotics has become a global health-care problem. Rapid determination of antimicrobial susceptibility of a clinical isolate is often crucial for the optimal antimicrobial therapy of infected patients and in many cases can save lives. The conventional methods for susceptibility testing like disk diffusion are time-consuming and other method including E-test, genotyping are relatively expensive. Fourier transform infrared (FTIR) microscopy is rapid, safe, and low cost method that was widely and successfully used in different studies for the identification of various biological samples including bacteria. The new modern infrared (IR) spectrometers with high spectral resolution enable measuring unprecedented biochemical information from cells at the molecular level. Moreover, the development of new bioinformatics analyses combined with IR spectroscopy becomes a powerful technique, which enables the detection of structural changes associated with resistivity. The main goal of this study is to evaluate the potential of the FTIR microscopy in tandem with machine learning algorithms for rapid and reliable identification of bacterial susceptibility to antibiotics in time span of few minutes. The bacterial samples, which were identified at the species level by MALDI-TOF and examined for their susceptibility by the routine assay (micro-diffusion discs), are obtained from the bacteriology laboratories in Soroka University Medical Center (SUMC). These samples were examined by FTIR microscopy and analyzed by advanced statistical methods. Our results, based on 550 E.coli samples, were promising and showed that by using infrared spectroscopic technique together with multivariate analysis, it is possible to classify the tested bacteria into sensitive and resistant with success rate higher than 85% for eight different antibiotics. Based on these preliminary results, it is worthwhile to continue developing the FTIR microscopy technique as a rapid and reliable method for identification antibiotic susceptibility.

Keywords: antibiotics, E. coli, FTIR, multivariate analysis, susceptibility

Procedia PDF Downloads 264
668 Analyzing the Contamination of Some Food Crops Due to Mineral Deposits in Ondo State, Nigeria

Authors: Alexander Chinyere Nwankpa, Nneka Ngozi Nwankpa

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In Nigeria, the Federal government is trying to make sure that everyone has access to enough food that is nutritiously adequate and safe. But in the southwest of Nigeria, notably in Ondo State, the most valuable minerals such as oil and gas, bitumen, kaolin, limestone talc, columbite, tin, gold, coal, and phosphate are abundant. Therefore, some regions of Ondo State are now linked to large quantities of natural radioactivity as a result of the mineral presence. In this work, the baseline radioactivity levels in some of the most important food crops in Ondo State were analyzed, allowing for the prediction of probable radiological health impacts. To this effect, maize (Zea mays), yam (Dioscorea alata) and cassava (Manihot esculenta) tubers were collected from the farmlands in the State because they make up the majority of food's nutritional needs. Ondo State was divided into eight zones in order to provide comprehensive coverage of the research region. At room temperature, the maize (Zea mays), yam (Dioscorea alata), and cassava (Manihot esculenta) samples were dried until they reached a consistent weight. They were pulverized, homogenized, and 250 g packed in a 1-liter Marinelli beaker and kept for 28 days to achieve secular equilibrium. The activity concentrations of Radium-226 (Ra-226), Thorium-232 (Th-232), and Potassium-40 (K-40) were determined in the food samples using Gamma-ray spectrometry. Firstly, the Hyper Pure Germanium detector was calibrated using standard radioactive sources. The gamma counting, which lasted for 36000s for each sample, was carried out in the Centre for Energy Research and Development, Obafemi Awolowo University, Ile-Ife, Nigeria. The mean activity concentration of Ra-226, Th-232 and K-40 for yam were 1.91 ± 0.10 Bq/kg, 2.34 ± 0.21 Bq/kg and 48.84 ± 3.14 Bq/kg, respectively. The content of the radionuclides in maize gave a mean value of 2.83 ± 0.21 Bq/kg for Ra-226, 2.19 ± 0.07 Bq/kg for Th-232 and 41.11 ± 2.16 Bq/kg for K-40. The mean activity concentrations in cassava were 2.52 ± 0.31 Bq/kg for Ra-226, 1.94 ± 0.21 Bq/kg for Th-232 and 45.12 ± 3.31 Bq/kg for K-40. The average committed effective doses in zones 6-8 were 0.55 µSv/y for the consumption of yam, 0.39 µSv/y for maize, and 0.49 µSv/y for cassava. These values are higher than the annual dose guideline of 0.35 µSv/y for the general public. Therefore, the values obtained in this work show that there is radiological contamination of some foodstuffs consumed in some parts of Ondo State. However, we recommend that systematic and appropriate methods also need to be established for the measurement of gamma-emitting radionuclides since these constitute important contributors to the internal exposure of man through ingestion, inhalation, or wound on the body.

Keywords: contamination, environment, radioactivity, radionuclides

Procedia PDF Downloads 103
667 Teacher Collaboration Impact on Bilingual Students’ Oral Communication Skills in Inclusive Contexts

Authors: Diana González, Marta Gràcia, Ana Luisa Adam-Alcocer

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Incorporating digital tools into educational practices represents a valuable approach for enriching the quality of teachers' educational practices in oral competence and fostering improvements in student learning outcomes. This study aims to promote a collaborative and culturally sensitive approach to professional development between teachers and a speech therapist to enhance their self-awareness and reflection on high-quality educational practices that integrate school components to strengthen children’s oral communication and pragmatic skills. The study involved five bilingual teachers fluent in both English and Spanish, with three specializing in special education and two in general education. It focused on Spanish-English bilingual students, aged 3-6, who were experiencing speech delays or disorders in a New York City public school, with the collaboration of a speech therapist. Using EVALOE-DSS (Assessment Scale of Oral Language Teaching in the School Context - Decision Support System), teachers conducted self-assessments of their teaching practices, reflect and make-decisions throughout six classes from March to June, focusing on students' communicative competence across various activities. Concurrently, the speech therapist observed and evaluated six classes per teacher using EVALOE-DSS during the same period. Additionally, professional development meetings were held monthly between the speech therapist and teachers, centering on discussing classroom interactions, instructional strategies, and the progress of both teachers and students in their classes. Findings highlight the digital tool EVALOE-DSS's value in analyzing communication patterns and trends among bilingual children in inclusive settings. It helps in identifying improvement areas through teacher and speech therapist collaboration. After self-reflection meetings, teachers demonstrated increased awareness of student needs in oral language and pragmatic skills. They also exhibited enhanced utilization of strategies outlined in EVALOE-DSS, such as actively guiding and orienting students during oral language activities, promoting student-initiated communicative interactions, teaching students how to seek and provide information, and managing turn-taking to ensure inclusive participation. Teachers participating in the professional development program have shown positive progress in assessing their classes across all dimensions of the training tool, including instructional design, teacher conversation management, pupil conversation management, communicative functions, teacher strategies, and pupil communication functions. This includes aspects related to both teacher actions and child actions, particularly in child language development. This progress underscores the effectiveness of individual reflection (conducted weekly or biweekly using EVALOE-DSS) as well as collaborative reflection among teachers and the speech therapist during meetings. The EVALOE-SSD has proven effective in supporting teachers' self-reflection, decision-making, and classroom changes, leading to improved development of students' oral language and pragmatic skills. It has facilitated culturally sensitive evaluations of communication among bilingual children, cultivating collaboration between teachers and speech therapist to identify areas of growth. Participants in the professional development program demonstrated substantial progress across all dimensions assessed by EVALOE-DSS. This included improved management of pupil communication functions, implementation of effective teaching strategies, and better classroom dynamics. Regular reflection sessions using EVALOE-SSD supported continuous improvement in instructional practices, highlighting its role in fostering reflective teaching and enriching student learning experiences. Overall, EVALOE-DSS has proven invaluable for enhancing teaching effectiveness and promoting meaningful student interactions in diverse educational settings.

Keywords: bilingual students, collaboration, culturally sensitive, oral communication skills, self-reflection

Procedia PDF Downloads 34
666 Variability in Contraception Choices and Abortion Rates among Female Garment Factory Workers in Urban and Rural Cambodia

Authors: Olalekan Olaluwoye, Joanne Williams, Elizabeth Hoban

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Background: Modern contraceptives are effective in preventing unwanted pregnancies and therefore the potential to reduce abortion rates. There is a need for information about how rates of contraceptive use and abortion vary across Cambodia and the relationship between the prevalence of modern contraception use and abortion rates. This study compares the use of contraception and abortion among female garment factory workers in rural and urban areas of Cambodia. Method: Cross-sectional surveys were conducted with 1701 women working in eleven garment factories in rural and urban areas of Cambodia. Sexual and reproductive health data were collected using Audio-Assisted Survey Interviews and analysed using STATA 14 software. Findings: Over 70% of the respondents were less than 30 years of age across both rural and urban settings and over 50% have only primary education, thus the study population was largely young women with limited education. A significantly higher proportion of the rural women earned over $200 in the previous month compared with their urban counterparts. The majority of the urban women (51.5%) were married, while single women (46.9%) made up the largest group working in the rural factories. A significantly larger proportion of women in the rural areas (83.9%) were sexually active compared to the urban women (50.9%). More women from the rural areas (41.4%) had been pregnant at some time compared with the urban population (37.7%). The use of any contraceptive method among sexually active women was significantly higher in the rural areas (80.1%) compared to the urban areas (65.7%) with p-value=0.000. However, among those women who used contraception, the prevalence of modern contraception use was slightly higher in the urban population (68.8% urban, 63.4% rural, p-value=0.1). For women who had a history of pregnancy the abortion prevalence was higher among rural women (43.8%) compared to their urban counterparts (37.7%). Regression analysis showed that after adjustment for the demographic variables (age, relationship status, income, education) only age and relationship status had a significant influence on the use of modern contraception.Single females who were sexually active and older women, who had potentially completed their families, were more likely to choose modern contraception. Conclusion: Although overall the use of contraception was higher among rural women, the use of modern contraception was higher among urban women.This finding may partly explain the higher rates of abortion among women in the rural areas as traditional contraception methods have higher failure rates and are more likely to result in an unplanned pregnancy.Despite the regional variation, the high rates of abortion across the country suggest there is a need for improve education on family planning among female garment factory workers in Cambodia.

Keywords: abortion, Cambodia, contraception, garment factory

Procedia PDF Downloads 149
665 Gamification Beyond Competition: the Case of DPG Lab Collaborative Learning Program for High-School Girls by GameLab KBTU and UNICEF in Kazakhstan

Authors: Nazym Zhumabayeva, Aleksandr Mezin, Alexandra Knysheva

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Women's underrepresentation in STEM is critical, worsened by ineffective engagement in educational practices. UNICEF Kazakhstan and GameLab KBTU's collaborative initiatives aim to enhance female STEM participation by fostering an inclusive environment. Learning from LEVEL UP's 2023 program, which featured a hackathon, the 2024 strategy pivots towards non-competitive gamification. Although the data from last year's project showed higher than average student engagement, observations and in-depth interviews with participants showed that the format was stressful for the girls, making them focus on points rather than on other values. This study presents a gamified educational system, DPG Lab, aimed at incentivizing young women's participation in STEM through the development of digital public goods (DPGs). By prioritizing collaborative gamification elements, the project seeks to create an inclusive learning environment that increases engagement and interest in STEM among young women. The DPG Lab aims to find a solution to minimize competition and support collaboration. The project is designed to motivate female participants towards the development of digital solutions through an introduction to the concept of DPGs. It consists of a short online course, a simulation videogame, and a real-time online quest with an offline finale at the KBTU campus. The online course offers short video lectures on open-source development and DPG standards. The game facilitates the practical application of theoretical knowledge, enriching the learning experience. Learners can also participate in a quest that encourages participants to develop DPG ideas in teams by choosing missions throughout the quest path. At the offline quest finale, the participants will meet in person to exchange experiences and accomplishments without engaging in comparative assessments: the quest ensures that each team’s trajectory is distinct by design. This marks a shift from competitive hackathons to a collaborative format, recognizing the unique contributions and achievements of each participant. The pilot batch of students is scheduled to commence in April 2024, with the finale anticipated in June. It is projected that this group will comprise 50 female high-school students from various regions across Kazakhstan. Expected outcomes include increased engagement and interest in STEM fields among young female participants, positive emotional and psychological impact through an emphasis on collaborative learning environments, and improved understanding and skills in DPG development. GameLab KBTU intends to undertake a hypothesis evaluation, employing a methodology similar to that utilized in the preceding LEVEL UP project. This approach will encompass the compilation of quantitative metrics (conversion funnels, test results, and surveys) and qualitative data from in-depth interviews and observational studies. For comparative analysis, a select group of participants from the previous year's project will be recruited to engage in the DPG Lab. By developing and implementing a gamified framework that emphasizes inclusion, engagement, and collaboration, the study seeks to provide practical knowledge about effective gamification strategies for promoting gender diversity in STEM. The expected outcomes of this initiative can contribute to the broader discussion on gamification in education and gender equality in STEM by offering a replicable and scalable model for similar interventions around the world.

Keywords: collaborative learning, competitive learning, digital public goods, educational gamification, emerging regions, STEM, underprivileged groups

Procedia PDF Downloads 59
664 Breast Cancer Incidence Estimation in Castilla-La Mancha (CLM) from Mortality and Survival Data

Authors: C. Romero, R. Ortega, P. Sánchez-Camacho, P. Aguilar, V. Segur, J. Ruiz, G. Gutiérrez

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Introduction: Breast cancer is a leading cause of death in CLM. (2.8% of all deaths in women and 13,8% of deaths from tumors in womens). It is the most tumor incidence in CLM region with 26.1% from all tumours, except nonmelanoma skin (Cancer Incidence in Five Continents, Volume X, IARC). Cancer registries are a good information source to estimate cancer incidence, however the data are usually available with a lag which makes difficult their use for health managers. By contrast, mortality and survival statistics have less delay. In order to serve for resource planning and responding to this problem, a method is presented to estimate the incidence of mortality and survival data. Objectives: To estimate the incidence of breast cancer by age group in CLM in the period 1991-2013. Comparing the data obtained from the model with current incidence data. Sources: Annual number of women by single ages (National Statistics Institute). Annual number of deaths by all causes and breast cancer. (Mortality Registry CLM). The Breast cancer relative survival probability. (EUROCARE, Spanish registries data). Methods: A Weibull Parametric survival model from EUROCARE data is obtained. From the model of survival, the population and population data, Mortality and Incidence Analysis MODel (MIAMOD) regression model is obtained to estimate the incidence of cancer by age (1991-2013). Results: The resulting model is: Ix,t = Logit [const + age1*x + age2*x2 + coh1*(t – x) + coh2*(t-x)2] Where: Ix,t is the incidence at age x in the period (year) t; the value of the parameter estimates is: const (constant term in the model) = -7.03; age1 = 3.31; age2 = -1.10; coh1 = 0.61 and coh2 = -0.12. It is estimated that in 1991 were diagnosed in CLM 662 cases of breast cancer (81.51 per 100,000 women). An estimated 1,152 cases (112.41 per 100,000 women) were diagnosed in 2013, representing an increase of 40.7% in gross incidence rate (1.9% per year). The annual average increases in incidence by age were: 2.07% in women aged 25-44 years, 1.01% (45-54 years), 1.11% (55-64 years) and 1.24% (65-74 years). Cancer registries in Spain that send data to IARC declared 2003-2007 the average annual incidence rate of 98.6 cases per 100,000 women. Our model can obtain an incidence of 100.7 cases per 100,000 women. Conclusions: A sharp and steady increase in the incidence of breast cancer in the period 1991-2013 is observed. The increase was seen in all age groups considered, although it seems more pronounced in young women (25-44 years). With this method you can get a good estimation of the incidence.

Keywords: breast cancer, incidence, cancer registries, castilla-la mancha

Procedia PDF Downloads 310
663 Urban Compactness and Sustainability: Beijing Experience

Authors: Xilu Liu, Ameen Farooq

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Beijing has several compact residential housing settings in many of its urban districts. The study in this paper reveals that urban compactness, as predictor of density, may carry an altogether different meaning in the developing world when compared to the U.S for achieving objectives of urban sustainability. Recent urban design studies in the U.S are debating for compact and mixed-use higher density housing to achieve sustainable and energy efficient living environments. While the concept of urban compactness is widely accepted as an approach in modern architectural and urban design fields, this belief may not directly carry well into all areas within cities of developing countries. Beijing’s technology-driven economy, with its historic and rich cultural heritage and a highly speculated real-estate market, extends its urban boundaries into multiple compact urban settings of varying scales and densities. The accelerated pace of migration from the countryside for better opportunities has led to unsustainable and uncontrolled buildups in order to meet the growing population demand within and outside of the urban center. This unwarranted compactness in certain urban zones has produced an unhealthy physical density with serious environmental and ecological challenging basic living conditions. In addition, crowding, traffic congestion, pollution and limited housing surrounding this compactness is a threat to public health. Several residential blocks in close proximity to each other were found quite compacted, or ill-planned, with residential sites due to lack of proper planning in Beijing. Most of them at first sight appear to be compact and dense but further analytical studies revealed that what appear to be dense actually are not as dense as to make a good case that could serve as the corner stone of sustainability and energy efficiency. This study considered several factors including floor area ratio (FAR), ground coverage (GSI), open space ratio (OSR) as indicators in analyzing urban compactness as a predictor of density. The findings suggest that these measures, influencing the density of residential sites under study, were much smaller in density than expected given their compact adjacencies. Further analysis revealed that several residential housing appear to support the notion of density in its compact layout but are actually compacted due to unregulated planning marred by lack of proper urban design standards, policies and guidelines specific to their urban context and condition.

Keywords: Beijing, density, sustainability, urban compactness

Procedia PDF Downloads 422
662 Cancer Burden and Policy Needs in the Democratic Republic of the Congo: A Descriptive Study

Authors: Jean Paul Muambangu Milambo, Peter Nyasulu, John Akudugu, Leonidas Ndayisaba, Joyce Tsoka-Gwegweni, Lebwaze Massamba Bienvenu, Mitshindo Mwambangu Chiro

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In 2018, non-communicable diseases (NCDs) were responsible for 48% of deaths in the Democratic Republic of Congo (DRC), with cancer contributing to 5% of these deaths. There is a notable absence of cancer registries, capacity-building activities, budgets, and treatment roadmaps in the DRC. Current cancer estimates are primarily based on mathematical modeling with limited data from neighboring countries. This study aimed to assess cancer subtype prevalence in Kinshasa hospitals and compare these findings with WHO model estimates. Methods: A retrospective observational study was conducted from 2018 to 2020 at HJ Hospitals in Kinshasa. Data were collected using American Cancer Society (ACS) questionnaires and physician logs. Descriptive analysis was performed using STATA version 16 to estimate cancer burden and provide evidence-based recommendations. Results: The results from the chart review at HJ Hospitals in Kinshasa (2018-2020) indicate that out of 6,852 samples, approximately 11.16% were diagnosed with cancer. The distribution of cancer subtypes in this cohort was as follows: breast cancer (33.6%), prostate cancer (21.8%), colorectal cancer (9.6%), lymphoma (4.6%), and cervical cancer (4.4%). These figures are based on histopathological confirmation at the facility and may not fully represent the broader population due to potential selection biases related to geographic and financial accessibility to the hospital. In contrast, the World Health Organization (WHO) model estimates for cancer prevalence in the DRC show different proportions. According to WHO data, the distribution of cancer types is as follows: cervical cancer (15.9%), prostate cancer (15.3%), breast cancer (14.9%), liver cancer (6.8%), colorectal cancer (5.9%), and other cancers (41.2%) (WHO, 2020). Conclusion: The data indicate a rising cancer prevalence in DRC but highlight significant gaps in clinical, biomedical, and genetic cancer data. The establishment of a population-based cancer registry (PBCR) and a defined cancer management pathway is crucial. The current estimates are limited due to data scarcity and inconsistencies in clinical practices. There is an urgent need for multidisciplinary cancer management, integration of palliative care, and improvement in care quality based on evidence-based measures.

Keywords: cancer, risk factors, DRC, gene-environment interactions, survivors

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661 Climate Change Threats to UNESCO-Designated World Heritage Sites: Empirical Evidence from Konso Cultural Landscape, Ethiopia

Authors: Yimer Mohammed Assen, Abiyot Legesse Kura, Engida Esyas Dube, Asebe Regassa Debelo, Girma Kelboro Mensuro, Lete Bekele Gure

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Climate change has posed severe threats to many cultural landscapes of UNESCO world heritage sites recently. The UNESCO State of Conservation (SOC) reports categorized flooding, temperature increment, and drought as threats to cultural landscapes. This study aimed to examine variations and trends of rainfall and temperature extreme events and their threats to the UNESCO-designated Konso Cultural Landscape in southern Ethiopia. The study used dense merged satellite-gauge station rainfall data (1981-2020) with spatial resolution of 4km by 4km and observed maximum and minimum temperature data (1987-2020). Qualitative data were also gathered from cultural leaders, local administrators, and religious leaders using structured interview checklists. The spatial patterns, coefficient of variation, standardized anomalies, trends, and magnitude of change of rainfall and temperature extreme events both at annual and seasonal levels were computed using the Mann-Kendall trend test and Sen’s slope estimator under the CDT package. The standard precipitation index (SPI) was also used to calculate drought severity, frequency, and trend maps. The data gathered from key informant interviews and focus group discussions were coded and analyzed thematically to complement statistical findings. Thematic areas that explain the impacts of extreme events on the cultural landscape were chosen for coding. The thematic analysis was conducted using Nvivo software. The findings revealed that rainfall was highly variable and unpredictable, resulting in extreme drought and flood. There were significant (P<0.05) increasing trends of heavy rainfall (R10mm and R20mm) and the total amount of rain on wet days (PRCPTOT), which might have resulted in flooding. The study also confirmed that absolute temperature extreme indices (TXx, TXn, and TNx) and the percentile-based temperature extreme indices (TX90p, TN90p, TX10p, and TN10P) showed significant (P<0.05) increasing trends which are signals for warming of the study area. The results revealed that the frequency as well as the severity of drought at 3-months (katana/hageya seasons) was more pronounced than the 12-months (annual) time scale. The highest number of droughts in 100 years is projected at a 3-months timescale across the study area. The findings also showed that frequent drought has led to loss of grasses which are used for making traditional individual houses and multipurpose communal houses (pafta), food insecurity, migration, loss of biodiversity, and commodification of stones from terrace. On the other hand, the increasing trends of rainfall extreme indices resulted in destruction of terraces, soil erosion, loss of life and damage of properties. The study shows that a persistent decline in farmland productivity, due to erratic and extreme rainfall and frequent drought occurrences, forced the local people to participate in non-farm activities and retreat from daily preservation and management of their landscape. Overall, the increasing rainfall and temperature extremes coupled with prevalence of drought are thought to have an impact on the sustainability of cultural landscape through disrupting the ecosystem services and livelihood of the community. Therefore, more localized adaptation and mitigation strategies to the changing climate are needed to maintain the sustainability of Konso cultural landscapes as a global cultural treasure and to strengthen the resilience of smallholder farmers.

Keywords: adaptation, cultural landscape, drought, extremes indices

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660 Curcumin-Loaded Pickering Emulsion Stabilized by pH-Induced Self-Aggregated Chitosan Particles for Encapsulating Bioactive Compounds for Food, Flavor/Fragrance, Cosmetics, and Medicine

Authors: Rizwan Ahmed Bhutto, Noor ul ain Hira Bhutto, Mingwei Wang, Shahid Iqbal, Jiang Yi

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Curcumin, a natural polyphenolic compound, boasts numerous health benefits; however, its industrial applications are hindered by instabilities and poor solubility. Encapsulating curcumin in Pickering emulsion presents a promising strategy to enhance its bioavailability. Yet, the development of an efficient and straightforward method to fabricate a natural emulsifier for Pickering emulsion poses a significant challenge. Chitosan has garnered attention due to its non-toxicity and excellent emulsifying properties. This study aimed to prepare four distinct types of self-aggregated chitosan particles using a pH-responsive self-assembling approach. The properties of the aggregated particles were adjusted by pH, degree of deacetylation (DDA), and molecular weight (MW), thereby controlling surface charge, size (ranging from nano to micro and floc), and contact angle. Pickering emulsions were then formulated using these various aggregated particles. As MW and pH increased and DDA decreased, the networked structures of the aggregated particles formed, resulting in highly elastic gels that were more resistant to the breakdown of Pickering emulsion at ambient temperature. With elevated temperatures, the kinetic energy of the aggregated particles increased, disrupting hydrogen bonds and potentially transforming the systems from fluids to gels. The Pickering emulsion based on aggregated particles served as a carrier for curcumin encapsulation. It was observed that DDA and MW played crucial roles in regulating drug loading, encapsulation efficiency, and release profile. This research sheds light on selecting suitable chitosan for controlling the release of bioactive compounds in Pickering emulsions, considering factors such as adjustable rheological properties, microstructure, and macrostructure. Furthermore, this study introduces an environmentally friendly and cost-effective synthesis of pH-responsive aggregate particles without the need for high-pressure homogenizers. It underscores the potential of aggregate particles with various MWs and DDAs for encapsulating other bioactive compounds, offering valuable applications in industries including food, flavor/fragrance, cosmetics, and medicine.

Keywords: chitosan, molecular weight, rheological properties, curcumin encapsulation

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659 The Effect of Organizational Justice on Management by Values Perception and Intention to Leave: A Study among Nurses

Authors: Arzu K. Harmanci Seren, Burcu Alacam, Serap Altuntas, Ulku Baykal

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Organizational justice has been evaluated as a concept related to rules developed with regards to distributing gains and making decisions of distribution such as duty, goods, service, reward, punishment, fee, organizational position, opportunity or role among those working in that organization, and to social norms on which these rules are based. Studies of organizational justice are crucial for analyzing the organizational life. It is considered that organization justice will be positively influential upon organizational behaviours such as employees’ level of work satisfaction, their performance, and behaviours of organization citizenship, management by values perception, tendency towards cooperation, and towards quitting their jobs. However, when the literature related to health and nurse management is examined, authors could not reach enough findings related to the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values. For that reason, this study has been carried out with the purpose of determining the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values. The study has been carried out with 176 nurses working in a university hospital in Istanbul and a private hospital who accepted to take part in the study, and it is definitive and relation-seeking. Before the data has been collected, ethics committee approval and institutional permissions have been taken, Organizational Justice Scale, Management by Values, Intention to Leave Scale with a questionnaire including 8 questions that aims at defining the personal and professional characteristics of the nurses have been used as a means of data collection. The data collected between 1 May and 20 June 2016 have been evaluated by the researchers in a computer via definitive, relation-seeking and psychometric statistic. As a result of the study, it has been determined that most of the nurses are working in a university hospital (70.5%), that they are 30 and over (49.4%), women (91.5%), single (52.8%) and have a Bachelor’s Degree (48.3%), working in a surgery unit (17.6), have 5 year or less institutional experience (44.9%), 11 year or more professional experience. Cronbach alpha values of the scales used in this study are .94, .95 and .56. Nurses’ average scores of Organizational Justice Scale is M= 3.35±.96, Management by Values Scale is M=3.30±.74, Intention to Leave Scale is M=8.36±3.14. As a result of the analysis carried out in order to determine the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values, it has been pointed out that the Perception of Organizational Justice influenced the perception of Management by Values positively, Intention to Leave negatively.

Keywords: intention to leave, management by values, nursing, organizational justice

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658 Insufficient Sleep as a Risk Factor for Substance Use Among Adolescents: The Mediating Role of Depressive Symptoms

Authors: Aaron Kim, Nydia Hernandez

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Despite the known deficits in sleep duration among adolescents and the increasing prevalence of substance use behaviors among this group, relatively little is known about how insufficient sleep is related to various substance use behaviors and the underlying mechanisms. Informed by the literature suggesting the predictive role of insufficient sleep for substance use and depressive symptoms, we hypothesized that adolescents who lack sufficient sleep during school nights would report a higher level of depressive symptoms and substance use than their counterparts with sufficient sleep. We also hypothesized that depressive symptoms would explain the association of insufficient sleep with substance use, suggesting that mental health plays an important role as a mechanism between insufficient sleep and substance use. This study used the data drawn from the 2019 Youth Risk Behavior Surveillance System Data, which includes a nationally representative sample of U.S. high school students (N=13,677, 49.4% Female, 9th-12th graders). Self-report measures of insufficient sleep (sleeping<7 h on an average school night), depressive symptoms (yes/no), any past 30-day use of cigarette (yes/no), e-cigarette (yes/no), alcohol (yes/no), and marijuana (yes/no). Among the total sample, 47.9% of students reported that they did not have sufficient sleep on school nights, indicating sleeping less than 7 hours. Regarding depressive symptoms, 36.7% of students reported feeling sad or hopeless almost every day for two weeks or more in a row during the past 12 months. Also, the percentages of students who reported one or more times of cigarette use, e-cigarette use, alcohol use, and marijuana use in the past month were 5.32%, 30.11%, 26.83%, and 21.65%, respectively. For bivariate associations among these study variables, insufficient sleep was positively associated with other variables: depressive symptoms (r=.08, p<.001), cigarette use (r=.03, p<.001), e-cigarette use (r=.04, p<.001), alcohol use (r=.07, p<.001), and marijuana use (r=.08, p<.001). After controlling for students’ characteristics (i.e., age, gender, race/ethnicity, grades), sleeping less than 7 hours on school nights (vs. sleeping more than 7 hours) was significantly associated with the past 30-day use of alcohol and marijuana, whereas cigarette and e-cigarette uses were not. That is, the students who reported having an insufficient sleep on school nights had higher odds of alcohol (Odds Ratio [OR]=1.15, 95% Confidence Interval [CI]=1.014-1.301) and marijuana use (OR=1.36, 95% CI=1.132-1.543). In a subsequent analysis including depressive symptoms together with insufficient sleep, the association of insufficient sleep with alcohol use (OR=1.13, 95% CI=1.011-1.297) and marijuana use (OR=1.33, 95% CI=1.130-1.521) were attenuated and explained by depressive symptoms. Depressive symptoms significantly increased the odds of alcohol use by 32.2% (OR=1.32, 95% CI=1.131-1.557) and marijuana use by 202.1% (OR=2.02, 95% CI=1.672-2.502). These findings together suggest that insufficient sleep may contribute to increased risks of substance uses among adolescents. The current study also shows that psychological disorders of adolescents play important roles in understanding the association between insufficient sleep and substance use, suggesting insufficient sleep is related to substance use indirectly through depressive symptoms. This study indicates the importance of sleep deprivation among adolescents and screening for insufficient sleep in preventing/intervening in substance use.

Keywords: adolescents, depressive symptoms, sleep, substance use

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657 Albinism in the South African Workplace: Reasonable Accommodation of a Black Person Living in a White Skin

Authors: Laetitia Fourie

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Dangerous myths and stereotypes contribute to the fact that persons living with albinism are amongst the most vulnerable groups in society. The prevalence of albinism varies around the world and the World Health Organization estimates that around 1 in 5000 people in Sub-Saharan Africa are affected by this genetic disorder. Persons who are living with the condition usually experience a lack of melanin in their skin, eyes and hair that results in possible physical impairments such as poor eyesight and skin cancers. Being affected by such disorders and consequently classified as an albino, give way for unequal treatment which ultimately requires safeguarding these persons against unfair discrimination - not only on the basis of their race and color (or lack thereof), but also on the basis of their disability. The Constitution of the Republic of South Africa provides that everyone is equal before the law and prohibits unfair discrimination on the grounds of race, color and disability. This right is given effect to by the Employment Equity Act, which strives to eliminate unfair discrimination on similar grounds within any employment policy or practice. An essential non-discrimination measure that can be implemented in the labor market to achieve equality is the duty of reasonable accommodation that rests upon employers. However, reasonable accommodation is only introduced as an affirmative action measure in order to provide equal employment opportunities to the identified designated groups who include black people (defined to include Indians, Chinese and Colored), women and people with disabilities. Even though this duty exists, South African law does not elaborate on the scope of the duty, except for a Disability Code, which does not hold the force of law. Furthermore, in respect of applying affirmative action measures to people with disabilities, the law does not elaborate on the meaning of disability. Considering that persons living with albinism will find it difficult to show that they are black or disabled in order to be acknowledged as part of the designated groups, their access to reasonable accommodation will be limited to a great extent. This paper will aim to illustrate to which extent South African law currently fails to implement its international obligations as a State Party to the Conventions of the United Nations, and how these failures should be corrected in order to serve the needs of all South Africans, including albinos.

Keywords: albinism, disability, equality, South Africa, United Nations

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656 Drug Susceptibility and Genotypic Assessment of Mycobacterial Isolates from Pulmonary Tuberculosis Patients in North East Ethiopia

Authors: Minwuyelet Maru, Solomon Habtemariam, Endalamaw Gadissa, Abraham Aseffa

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Background: Tuberculosis is a major public health problem in Ethiopia. The burden of TB is aggravated by emergence and expansion of drug resistant tuberculosis and different lineages of Mycobacterium tuberculosis (M. tuberculosis) have been reported in many parts of the country. Describing strains of Mycobacterial isolates and drug susceptibility pattern is necessary. Method: Sputum samples were collected from smear positive pulmonary TB patients age >= 7 years between October 1, 2012 to September 30, 2013 and Mycobacterial strains isolated on Loweensten Jensen (LJ) media. Each strain was characterized by deletion typing and Spoligotyping. Drug sensitivity testing was determined with the indirect proportion method using Middle brook 7H10 media and association to determine possible risk factors to drug resistance was done. Result: A total of 144 smear positive pulmonary tuberculosis patients were enrolled. The age of participants ranged from 7 to 78 with mean age of 29.22 (±10.77) years. In this study 82.2% (n=97) of the isolates were sensitive to the four first line anti-tuberculosis drugs and resistance to any of the four drugs tested was 17.8% (n=21). A high frequency of any resistance was observed in isoniazid, 13.6%, (n=16) followed by streptomycin, 11.8% (n=14). No significant association of isoniazid resistance with HIV, sex and history of previous TB treatment was observed but there was significant association with age, high between 31-35 years of age (p=0.01). Majority, 89.9% (n=128) of participants were new cases and only 11.1% (n=16) had history of previous TB treatment. No MDR-TB from new cases and 2 MDRTB (13.3%) was isolated from re-treatment cases which was significantly associated with previous TB treatment (p<0.01). Thirty two different types of spoligotype patterns were identified and 74.1% were grouped in to 13 clusters. The dominant strains were SIT 25, 18.1% (n=21), SIT 53, 17.2% (n=20) and SIT 149, 8.6% (n=10). Lineage 4 is the predominant lineage followed by lineage 3 and lineage 7 comprising 65.5% (n=76), 28.4% (n=33) and 6% (n=7) respectively. Majority of strains from lineage 3 and 4 were SIT 25 (63.6%) and SIT 53 (26.3%) whereas SIT 343 was the dominant strain from lineage 7 (71.4%). Conclusion: Wide spread of lineage 3 and lineage 4 of the modern lineage and high number of strain cluster indicates high ongoing transmission. The high proportion resistance to any of the first line anti-tuberculosis drugs may be a potential source in the emergence of MDR-TB. Wide spread of SIT 25 and SIT 53 having a tendency of ease transmission and presence of higher resistance of isoniazid in working and mobile age group, 31-35 years of age may increase risk of drug resistant strains transmission.

Keywords: tuberculosis, drug susceptibility, strain diversity, lineage, Ethiopia, spoligotyping

Procedia PDF Downloads 375