Search results for: risk rating

Authors: Paula Lopez-Arce, Hector Altamirano, Dimitrios Rovas, James Berry, Bryan Hindle, Steven Hodgson

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Efficient mould remediation and accurate moisture diagnostics leading to condensation and mould growth in dwellings are largely untapped. Number of factors are contributing to the rising trend of excessive moisture in homes mainly linked with modern living, increased levels of occupation and rising fuel costs, as well as making homes more energy efficient. Environmental monitoring by means of data collection though loggers sensors and survey forms has been performed in a range of buildings from different UK regions. Air and surface temperature and relative humidity values of residential areas affected by condensation and/or mould issues were recorded. Additional measurements were taken through different trials changing type, location, and position of loggers. In some instances, IR thermal images and ventilation rates have also been acquired. Results have been interpreted together with environmental key parameters by processing and connecting data from loggers and survey questionnaires, both in buildings with and without moisture issues. Monitoring exercises carried out during Winter and Spring time show the importance of developing and following accurate protocols for guidance to obtain consistent, repeatable and comparable results and to improve the performance of environmental monitoring. A model and a protocol are being developed to build a diagnostic tool with the goal of performing a simple but precise residential atmospheric moisture diagnostics to distinguish the cause entailing condensation and mould generation, i.e., ventilation, insulation or heating systems issue. This research shows the relevance of monitoring and processing environmental data to assign moisture risk levels and determine the origin of condensation or mould when dealing with a building atmospheric moisture excess.

Keywords: environmental monitoring, atmospheric moisture, protocols, mould

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Authors: Sitarrine Thongpussawal, Dasarath Jayasuriya, Thanaroj Woraratprasert, Sakawtree Prajamwong

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Thailand grapples with recurrent floods causing substantial repercussions on its economy, society, and environment. In 2021, the economic toll of these floods amounted to an estimated 53,282 million baht, primarily impacting the agricultural sector. The existing flood monitoring system in Thailand suffers from inaccuracies and insufficient information, resulting in delayed warnings and ineffective communication to the public. The Office of the National Water Resources (OWNR) is tasked with developing and integrating data and information systems for efficient water resources management, yet faces challenges in monitoring accuracy, forecasting, and timely warnings. This study endeavors to evaluate the viability of enhancing Thailand's Flood Forecasting and Warning (FFW) systems. Additionally, it aims to formulate a comprehensive work package grounded in international best practices to enhance the country's FFW systems. Employing qualitative research methodologies, the study conducted in-depth interviews and focus groups with pertinent agencies. Data analysis involved techniques like note-taking and document analysis. The study substantiates the feasibility of developing and enhancing FFW systems in Thailand. Implementation of international best practices can augment the precision of flood forecasting and warning systems, empowering local agencies and residents in high-risk areas to prepare proactively, thereby minimizing the adverse impact of floods on lives and property. This research underscores that Thailand can feasibly advance its FFW systems by adopting international best practices, enhancing accuracy, and improving preparedness. Consequently, the study enriches the theoretical understanding of flood forecasting and warning systems and furnishes valuable recommendations for their enhancement in Thailand.

Keywords: flooding, forecasting, warning, monitoring, communication, Thailand

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Authors: Portia Muehlbauer

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This paper examines the evolving landscape of preventing and countering violent extremism (PCVE) by delving into the growing importance of integrating human rights principles into violence prevention strategies on the local, community level. This study sheds light on the underlying theoretical frameworks of violent extremism and the influence of gender while investigating the intersection between human rights preservation and violent extremism prevention. To gain practical insight, the research focuses on two prominent international non-governmental organizations, Women without Borders (WwB) and Hedayah, and their distinct PCVE initiatives. WwB adopts a gender-sensitive approach, implementing parental education programs that empower mothers in at-risk communities to prevent the spread of violent extremism. In contrast, Hedayah takes an indirect route, employing capacity building programs that enhance the capabilities of educators, social workers, and psychologists in early intervention, rehabilitation and reintegration efforts. Qualitative data for this comparative analysis was collected through an extensive four-month internship at WwB during the fall of 2020, a three-month internship at Hedayah in the spring of 2021, a thought-provoking semi-structured interview with the executive director of WwB, personal field notes, and a comprehensive discourse analysis of the prevailing literature on human rights considerations in PCVE practices. This study examines the merits and challenges of integrating human rights into PCVE programming through the lens of both organizations, WwB and Hedayah. The findings of this study will inform policymakers, practitioners, and researchers on the intricate relationship between human rights protection and effective PCVE strategies.

Keywords: preventing and countering violent extremism, human rights, counterterrorism, peacebuilding, capacity building programs, gender studies

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Authors: Staniek Halina

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The inappropriate trace elements supply such as iron(III) and chromium(III) may be risk factors of many metabolic disorders (e.g., anemia, diabetes, as well cause toxic effect). However, little is known about their mutual interactions and their impact on these disturbances. The effects of Cr(III) supplementation with a deficit or excess supply of Fe(III) in vivo conditions are not known yet. The objective of the study was to investigate the combined effect of different Fe(III) levels in the diet and simultaneous Cr(III) supplementation on the Ca distribution in organs in healthy rats. The assessment was based on a two-factor (2x3) experiment carried out on 54 female Wistar rats (Rattus norvegicus). The animals were randomly divided into 9 groups and for 6 weeks, they were fed semi-purified diets AIN-93 with three different Fe(III) levels in the diet as a factor A [control (C) 45 mg/kg (100% Recommended Daily Allowance for rodents), deficient (D) 5 mg/kg (10% RDA), and oversupply (H) 180 mg/kg (400% RDA)]. The second factor (B) was the simultaneous dietary supplementation with Cr(III) at doses of 1, 50 and 500 mg/kg of the diet. Iron(III) citrate was the source of Fe(III). The complex of Cr(III) with propionic acid, also called Cr₃ or chromium(III) propionate (CrProp), was used as a source of Cr(III) in the diet. The Ca content of analysed samples (liver, kidneys, spleen, heart, and femur) was determined with the Atomic Absorption Spectrometry (AAS) method. It was found that different dietary Fe(III) supply as well as Cr(III) supplementation independently and in combination influenced Ca metabolism in healthy rats. Regardless of the supplementation of Cr(III), the oversupply of Fe(III) (180 mg/kg) decreased the Ca content in the liver and kidneys, while it increased the Ca saturation of bone tissue. High Cr(III) doses lowered the hepatic Ca content. Moreover, it tended to decrease the Ca content in the kidneys and heart, but this effect was not statistically significant. The combined effect of the experimental factors on the Ca content in the liver and the femur was observed. With the increase in the Fe(III) content in the diet, there was a decrease in the Ca level in the liver and an increase in bone saturation, and the additional Cr(III) supplementation intensified those effects. The study proved that the different Fe(III) content in the diet, independently and in combination with Cr(III) supplementation, affected the Ca distribution in organisms of healthy rats.

Keywords: calcium, chromium(III), iron(III), rats, supplementation

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Authors: Ghaleb Bin Huraib, Fahad Al Harthi, Mohammad Mustafa, Abdulrahman Al-Asmari

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Introduction: Vitiligo is an acquired pigmentary skin disorder with the regional disappearance of melanocytes. Vitiligo affects 0.1 to 2% of the global population, and the incidence varies substantially depending on ethnicity. Glutathione S-transferase (GST) is a multigene family of enzymes that detoxify oxidative stress products. The oxidative stress-related GSTM1/GSTT1 genes deletion may cause epidermal melanocytes destruction and the development of vitiligo. Hence, the present study aimed to investigate the association of GST gene polymorphisms with vitiligo in the Saudi population, if any. Materials and Methods: The present study includes 129 vitiligo cases and 130 age-matched healthy controls. The proportion of male and female patients with vitiligo is almost equal. The multiplex polymerase chain reaction (PCR) method was used for polymorphic analysis. Results: Increased odds of generalized vitiligo was observed with the null genotypes of GSTT1- gene (OR = 1.91, 95% CI = 1.07-3.42, p = 0.019). The possible genetic combinations of GSTM1/GSTT1 and their genotypic distribution showed the frequency of GSTM1+/GSTT1+ 62/130 (47.69%) and GSTM1-/GSTT1+ 52/130 (40.00%) were higher in controls than in cases 44/129 (34.11%), 43/129 (33.34%), respectively while GSTM1+/GSTT1- and GSTM1-/GSTT1- null genotypes were higher 22/129 (17.05%) and 20/129 (15.50%) in vitiligo patients as compared to controls 11/130 (8.46%), 5/130 (3.84%), respectively. The strength of association of different genetic combinations with cases have shown GSTM1+/GSTT1- (OR = 2.81, 95% CI = 1.24-6.40, p = 0.009) and GSTM1-/GSTT1- (OR = 5.63, 95% CI = 1.96 - 16.16, p = 0.0004) were significantly higher in vitiligo cases as compared to controls. We did not observe any significant association of age and gender of patients with GST gene polymorphisms. Conclusions: The GSTT1-, GSTM1+/GSTT1- and GSTM1-/GSTT1- null genotypes were significantly associated with vitiligo. These genetic polymorphisms may be the associative genetic risk factor for vitiligo among Saudis. It could be used as a genetic marker for screening vitiligo patients among Saudis. Further studies on GSTs gene polymorphism in larger sample sizes from different geographical areas and ethnicity are needed to strengthen the present findings.

Keywords: vitiligo, GSTM1, GSTT1, gene polymorphism, oxidative stress

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Authors: Ryo Shikimoto, Hidehito Niimura, Hisashi Kida, Kota Suzuki, Yukiko Miyasaka, Masaru Mimura

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Introduction: In Japan, the most aged country in the world, it is important to explore predictive factors of cognitive function among the elderly. Coping behavior relieves chronic stress and improves lifestyle, and consequently may reduce the risk of cognitive impairment. One of the most widely investigated frameworks evaluated in previous studies is approach-oriented and avoidance-oriented coping strategies. The purpose of this study is to investigate the relationship between cognitive function and coping strategies among elderly residents in urban areas of Japan. Method: This is a part of the cross-sectional Arakawa geriatric cohort study for 1,099 residents (aged 65 to 86 years; mean [SD] = 72.9 [5.2]). Participants were assessed for cognitive function using the Mini-Mental State Examination (MMSE) and diagnosed by psychiatrists in face-to-face interviews. They were then investigated for their each coping behaviors and coping strategies (approach- and avoidance-oriented coping) using stress and coping inventory. A multiple regression analysis was used to investigate the relationship between MMSE score and each coping strategy. Results: Of the 1,099 patients, the mean MMSE score of the study participants was 27.2 (SD = 2.7), and the numbers of the diagnosis of normal, mild cognitive impairment (MCI), and dementia were 815 (74.2%), 248 (22.6%), and 14 (1.3%), respectively. Approach-oriented coping score was significantly associated with MMSE score (B [partial regression coefficient] = 0.12, 95% confidence interval = 0.05 to 0.19) after adjusting for confounding factors including age, sex, and education. Avoidance-oriented coping did not show a significant association with MMSE score (B [partial regression coefficient] = -0.02, 95% confidence interval = -0.09 to 0.06). Conclusion: Approach-oriented coping was clearly associated with neurocognitive function in the Japanese population. A future longitudinal trial is warranted to investigate the protective effects of coping behavior on cognitive function.

Keywords: approach-oriented coping, cognitive impairment, coping behavior, dementia

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Authors: Tuji Jemal Ahmed

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This paper is to provides a comprehensive review of current research works on foodborne illness and food safety, including the risks associated with foodborne illnesses, the latest research on food safety, and the mitigation strategies used to prevent and control foodborne illnesses. Foodborne illness is a major public health concern that affects millions of people every year. As foodborne illnesses have grown more common and dangerous in recent years, it is vital that we research and build upon methods to ensure food remains safe throughout consumption. Additionally, this paper will discuss future directions for food safety research, including emerging technologies, changes in regulations and standards, and collaborative efforts to improve food safety. The first section of the paper provides an overview of the risks of foodborne illness, including a definition of foodborne illness, the causes of foodborne illness, the types of foodborne illnesses, and high-risk foods for foodborne illness, Health Consequences of Foodborne Illness. The second section of the paper focuses on current research on food safety, including the role of regulatory agencies in food safety, food safety standards and guidelines, emerging food safety concerns, and advances in food safety technology. The third section of the paper explores mitigation strategies for foodborne illness, including preventative measures, hazard analysis and critical control points (HACCP), good manufacturing practices (GMPs), and training and education. Finally, this paper examines future directions for food safety research, including hurdle technologies and their impact on food safety, changes in food safety regulations and standards, collaborative efforts to improve food safety, and research gaps and areas for further exploration. In general, this work provides a comprehensive review of current research and future directions in food safety and understanding the risks associated with foodborne illness. The implications of the assessment for food safety and public health are discussed, as well as recommended for research scholars.

Keywords: food safety, foodborne illness, technologies, mitigation

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Authors: Le Xuan Cau

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Flash flood is occurred in short time rainfall interval: from 1 hour to 12 hours in small and medium basins. Flash floods typically have two characteristics: large water flow and big flow velocity. Flash flood is occurred at hill valley site (strip of lowland of terrain) in a catchment with large enough distribution area, steep basin slope, and heavy rainfall. The risk of flash floods is determined through Gridded Basin Flash Flood Potential Index (GBFFPI). Flash Flood Potential Index (FFPI) is determined through terrain slope flash flood index, soil erosion flash flood index, land cover flash floods index, land use flash flood index, rainfall flash flood index. Determining GBFFPI, each cell in a map can be considered as outlet of a water accumulation basin. GBFFPI of the cell is determined as basin average value of FFPI of the corresponding water accumulation basin. Based on GIS, a tool is developed to compute GBFFPI using ArcObjects SDK for .NET. The maps of GBFFPI are built in two types: GBFFPI including rainfall flash flood index (real time flash flood warning) or GBFFPI excluding rainfall flash flood index. GBFFPI Tool can be used to determine a high flash flood potential site in a large region as quick as possible. The GBFFPI is improved from conventional FFPI. The advantage of GBFFPI is that GBFFPI is taking into account the basin response (interaction of cells) and determines more true flash flood site (strip of lowland of terrain) while conventional FFPI is taking into account single cell and does not consider the interaction between cells. The GBFFPI Map of QuangNam, QuangNgai, DaNang, Hue is built and exported to Google Earth. The obtained map proves scientific basis of GBFFPI.

Keywords: ArcObjects SDK for NET, basin average value of FFPI, gridded basin flash flood potential index, GBFFPI map

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Authors: Chinumani Choudhury

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Heavy metal contamination is an alarming problem, which poses a serious risk to human health and the surrounding geology. Soils get contaminated with heavy metals due to the un-regularized industrial discharge of the toxic metal-rich effluents. Under such a condition, the remediation of the contaminated sites becomes imperative for a sustainable, safe, and healthy environment. Phytoextraction, which involves the removal of heavy metals from the soil through root absorption and uptake, is a viable remediation technique, which ensures extraction of the toxic inorganic compound available in the soil even at low concentrations. The soil present in the Silghat Region of Assam, India, is mostly contaminated with Zinc (Zn) and Lead (Pb), having concentrations as high as to cause a serious environmental problem if proper measures are not taken. In the present study, an extensive experimental study was carried out to understand the effectiveness of two commonly planted trees in Assam, namely, i) Indian Pennywort and ii) Fenugreek, in the removal of heavy metals from the contaminated soil. The basic characterization of the soil in the contaminated site of the Silghat region was performed and the field concentration of Zn and Pb was recorded. Various long-term laboratory pot tests were carried out by sowing the seeds of Indian Pennywort and Fenugreek in a soil, which was spiked, with a very high dosage of Zn and Pb. The tests were carried out for different concentration of a particular heavy metal and the individual effectiveness in the absorption of the heavy metal by the plants were studied. The concentration of the soil was monitored regularly to assess the rate of depletion and the simultaneous uptake of the heavy metal from the soil to the plant. The amount of heavy metal uptake by the plant was also quantified by analyzing the plant sample at the end of the testing period. Finally, the study throws light on the applicability of the studied plants in the field for effective remediation of the contaminated sites of Assam.

Keywords: phytoextraction, heavy-metals, Indian pennywort, fenugreek

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Authors: B. Karabuluter, O. Karaduman

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Traffic management and traffic planning are important issues, especially in big cities. Due to the increase of personal vehicles and the physical constraints of urban roads, the problem of transportation especially in crowded cities over time is revealed. This situation reduces the living standards, and it can put human life at risk because the vehicles such as ambulance, fire department are prevented from reaching their targets. Even if the city planners take these problems into account, emergency planning and traffic management are needed to avoid cases such as traffic congestion, intersections, traffic jams caused by traffic accidents or roadworks. In this study, in smart traffic management issues, proposed solutions using intelligent vehicles acting in cooperation with urban roads are examined. Traffic management is becoming more difficult due to factors such as fatigue, carelessness, sleeplessness, social behavior patterns, and lack of education. However, autonomous vehicles, which remove the problems caused by human weaknesses by providing driving control, are increasing the success of practicing the algorithms developed in city traffic management. Such intelligent vehicles have become an important solution in urban life by using 'swarm intelligence' algorithms and cooperative driving methods to provide traffic flow, prevent traffic accidents, and increase living standards. In this study, studies conducted in this area have been dealt with in terms of traffic jam, intersections, regulation of traffic flow, signaling, prevention of traffic accidents, cooperation and communication techniques of vehicles, fleet management, transportation of emergency vehicles. From these concepts, some taxonomies were made out of the way. This work helps to develop new solutions and algorithms for cities where intelligent vehicles that can perform cooperative driving can take place, and at the same time emphasize the trend in this area.

Keywords: intelligent traffic management, cooperative driving, smart driving, urban road, swarm intelligence, connected vehicles

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Authors: Dorna Kargar, Mehrasa Masih

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Due to its special geological and geographical conditions, Iran has always been exposed to various natural hazards. Earthquake is one of the natural hazards with random nature that can cause significant financial damages and casualties. This is a serious threat, especially in areas with active faults. Therefore, considering the population density in some parts of the country, locating and zoning high-risk areas are necessary and significant. In the present study, seismic hazard assessment via probabilistic and deterministic method for Tehran, the capital of Iran, which is located in Alborz-Azerbaijan province, has been done. The seismicity study covers a range of 200 km from the north of Tehran (X=35.74° and Y= 51.37° in LAT-LONG coordinate system) to identify the seismic sources and seismicity parameters of the study region. In order to identify the seismic sources, geological maps at the scale of 1: 250,000 are used. In this study, we used Kijko-Sellevoll's method (1992) to estimate seismicity parameters. The maximum likelihood estimation of earthquake hazard parameters (maximum regional magnitude Mmax, activity rate λ, and the Gutenberg-Richter parameter b) from incomplete data files is extended to the case of uncertain magnitude values. By the combination of seismicity and seismotectonic studies of the site, the acceleration with antiseptic probability may happen during the useful life of the structure is calculated with probabilistic and deterministic methods. Applying the results of performed seismicity and seismotectonic studies in the project and applying proper weights in used attenuation relationship, maximum horizontal and vertical acceleration for return periods of 50, 475, 950 and 2475 years are calculated. Horizontal peak ground acceleration on the seismic bedrock for 50, 475, 950 and 2475 return periods are 0.12g, 0.30g, 0.37g and 0.50, and Vertical peak ground acceleration on the seismic bedrock for 50, 475, 950 and 2475 return periods are 0.08g, 0.21g, 0.27g and 0.36g.

Keywords: peak ground acceleration, probabilistic and deterministic, seismic hazard assessment, seismicity parameters

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Authors: Chinwe Juliana Abara, Dayo Keshi

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Through cultural heritage materials, nations witness significant boom in the world of art and tourism as well as attract foreign investors and tourists to the benefit of the regions and countries where they are located. There are notable heritage sites which record visits by tourists in their thousands annually. According to UNESCO the cultural heritage reflects the life of the community, its history and its identity. Its preservation helps to rebuild broken communities, re-establish their identities, and link their past with their present and future. During any form of conflict or war, a lot happen. People die, houses destroyed and every other thing in the society suffers. Wars and conflicts in various countries have claimed antiquities, heritage materials, contemporary Arts, Galleries, Museums, Archives and very important Monuments and Heritage sites. My Paper deals with the effects of insurgencies and conflicts on cultural heritage and tourism industries in Nigeria and how they can be protected and restored so as to yield the desirable economic gains. Preceding from the premise that conflict of any type puts our cultural heritage at risk; this paper also explores the practical challenges and opportunities available to us in the face of incessant ethnic and Boko Haram (western education is abomination) insurgents and their wanton destruction of lives and properties. There will be a review of relevant literature and documents on the effects of violence on heritage materials and tourism industries in Nigeria particularly and other parts of the world in generally .My paper also highlights the activities the National Council for Arts and Culture as well as other Cultural Agencies in Nigeria have employed to sensitize the stakeholders, the youth, the elderly, and the community at large on the need for peaceful co-existence so as to collectively strive to safeguard and secure our cultural heritage in the face of all these challenges for posterity and desirable economic gains.

Keywords: cultural heritage, conflict, tourism, insurgency, challenges

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Authors: Mahesh M. Patil, K. A. Anu-Appaiah

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Overweight and obesity is a serious medical problem, increasing in prevalence, and affecting millions worldwide. Investigators have been trying from decades to articulate the burden of obesity and related risk factors. To answer this problem, we suggest a new therapeutic anti-obesity compounds from Garcinia xanthochymus fruit. However, there is little published scientific information on non-hydroxycitric acid Garcinia species. Our findings include biochemical characterization of the fruit; in vivo toxicity and bio-efficacy study of G. xanthochymus in high fat diet wistar rat model. We observed that Garcinia pericarp is a rich source of organic acids, polyphenols, mono- (40.63%) and poly-unsaturated fatty acids (16.45%; omega-3: 10.02%). Toxicological studies have showed that Garcinia is safe and had no observed adverse effect level up to 400 mg/kg/day. Body weight and food intake was significantly (P<0.05) reduced in oral gavage treated rats (sonicated Garcinia powder) in 13 weeks. Subcutaneous fat was significantly (P<0.05) reduced in Garcinia treated rats. Hepatocytes significantly (p<0.05) overexpressed sterol regulatory element binding protein 2, liver X receptor- α, liver X receptor- β, lipoprotein lipase and monoacylglycerol lipase. Fatty acid binding protein 1 and peroxisome proliferator activated receptor- α were down regulated as assessed by real time qPCR. Currently our research is focused on the adipocyte obesity related gene expressions, effect of Garcinia on 3T3-adipocyte cell lines and high fat diet induced mice model. This in vivo pre-clinical data suggests that G. xanthochymus may have clinical utility for the treatment of obesity. However, further studies are required to establish its potency.

Keywords: Garcinia xanthochymus, anti-obesity, high fat diet, real time qPCR

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Authors: Yasir Hassan Satti Mohammed

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The wheat cleaner was designed, manufactured, and tested in the workshop of the department of agricultural engineering, faculty of agricultural sciences, university of Dongola, the northern state of Sudan, for the purpose of enhancing productivity for small-scale-farmers who used to plant their saved wheat seeds every season with all risk of weed infestation and low viability. A one-season field experiment was then conducted according to the Randomized Complete Block Design (RCBD) experimental design in the demonstration farm of Dongola research station using clean seeds and unclean seeds of a local wheat variety (Imam); two different planting methods were also adopted in the experiment. One is the traditional seed drilling within the recommended seed rate (50 kg.feddan⁻¹), whereas the other was the precision seeding method using half of the recommended seed rate (25 kg.feddan⁻¹). The effect of seed type and planting method on field parameters were investigated, and the data was then analyzed using a computer application SAS system version 9.3. The results revealed significant (P ≥ 0.05) and highly significant (P ≥ 0.01) differences between treatments. The precision seeding method with clean seeds increased the number of kernels per spike (KS), tillers per plant (TPP), one thousand kernels mass (TKM), the biomass of wheat (BWT), and total yield (TOY), whereas weeds per area (WSM), the biomass of weeds (BWD) and weight of weed seeds were apparently decreased compared to seed drilling with unclean seed. Wheat seed cleaner could be of great benefit for small-scale wheat farmers in Sudan who cannot afford the cleaned seeds commercially provided by the local government.

Keywords: wheat cleaner, precision seeding, seed drilling method, small-scale farmers

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Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

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Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

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Authors: Denis Duagi, Ben Carter, Maria Farrelly, Stephen Lisk, June S. L. Brown

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Background: Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods: Searches were carried out on the 11ᵗʰ of August 2022 using five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science), as well as trial registers. Randomized controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The Cochrane risk of bias-2 quality assessment tool was used. The primary outcome was depression, and studies were pooled using a standardised mean difference, with an associated 95% confidence interval, p-value, and I². The study protocol was pre-registered (CRD42022348668). Findings: A total of 57 reports (n= 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with a standardised mean difference (SMD) at 1-year of -0.08 (95%CI -0.20, -0.03, p=0.002, I²=72%), 18-months SMD=-0.12, 95% CI -0.22, -0.01, p=0.03, I²=63%) and 2-years SMD=-0.12 (95% CI -0.20, -0.03, p=0.01, I²=68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K=18, SMD=-0.24, 95% CI -0.38, -0.10, p=0.001, I²=60%). No effects were detected for anxiety at any assessment. Conclusion: Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained for up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings such as schools.

Keywords: psychosocial, adolescent, interventions, depression, anxiety, meta-analysis, randomized controlled trial

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Authors: Çiğdem Sezer, Aksem Aksoy, Leyla Vatansever

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This study has been done for the purpose of evaluation of public health and identifying of enterotoxigenic Staphyloccocus aureus in kitchen of catering. In the kitchen of catering, samples have been taken by swabs from surface of equipments which are in the salad section, meat section and bakery section. Samples have been investigated with classical cultural methods in terms of Staphyloccocus aureus. Therefore, as a 10x10 cm area was identified (salad, cutting and chopping surfaces, knives, meat grinder, meat chopping surface) samples have been taken with sterile swabs with helping FTS from this area. In total, 50 samples were obtained. In aseptic conditions, Baird-Parker agar (with egg yolk tellurite) surface was seeded with swabs. After 24-48 hours of incubation at 37°C, the black colonies with 1-1.5 mm diameter and which are surrounded by a zone indicating lecithinase activity were identified as S. aureus after applying Gram staining, catalase, coagulase, glucose and mannitol fermentation and termonuclease tests. Genotypic characterization (Staphylococcus genus and S.aureus species spesific) of isolates was performed by PCR. The ELISA test was applied to the isolates for the identification of staphylococcal enterotoxins (SET) A, B, C, D, E in bacterial cultures. Measurements were taken at 450 nm in an ELISA reader using an Ridascreen-Total set ELISA test kit (r-biopharm R4105-Enterotoxin A, B, C, D, E). The results were calculated according to the manufacturer’s instructions. A total of 50 samples of 97 S. aureus was isolated. This number has been identified as 60 with PCR analysis. According to ELISA test, only 1 of 60 isolates were found to be enterotoxigenic. Enterotoxigenic strains were identified from the surface of salad chopping and cutting. In the kitchen of catering, S. aureus identification indicates a significant source of contamination. Especially, in raw consumed salad preparation phase of contamination is very important. This food can be a potential source of food-borne poisoning their terms, and they pose a significant risk to consumers have been identified.

Keywords: Staphylococcus aureus, enterotoxin, catering, kitchen, health

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Authors: Loyce Nahwera, Joy Wachira, Edwin Kiptolo, Constance Nsibambi, Mshilla Maghanga, Timothy Makubuya

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Introduction: Hypertension is one of the most prominent risk factors for cardiovascular diseases globally, and it can be modified through lifestyle interventions such as exercise. The objective of this study was to investigate the effects of a 12-week aerobic dance programme on systolic blood pressure (SBP) in stage 1 hypertensive individuals. Methods: This study employed an experimental research design. A total of 36 stage 1 hypertensive individuals who were randomly assigned into experimental and control groups completed the study. Systolic BP was measured using a mercury sphygmomanometer at baseline, mid-point and after the program. The experimental group participants trained 3 days a week, 45 minutes per session, at a moderate intensity of 40-60% of maximum oxygen consumption (VO2max) monitored by Garmin heart rate monitors. Data were analyzed using SPSS version 20. The significance level was set at p<0.05. A paired sample t-test was used to compare mean differences within the groups. Results: Data from the 36 participants (22 males and 14 females) (experimental; n=18, control; n=18) show that the experimental group had a mean SBP of 143.83±6.382 mmHg at baseline while the control had a mean of 137.61±6.400 mmHg. Following the end of a 6-week aerobic dance, the mean SBP of the experimental group reduced to 138.06±9.539 mmHg while that of the control marginally decreased to 137.00±8.073 mmHg. At the completion of a 12-week program, the mean SBP of the experimental group reduced to 136.33±9.191 mmHg, while that of the control marginally increased to 139.56±9.954 mmHg. This implies that both the 6-week and 12-week aerobic dance program reduced the SBP of the experimental group by 5.77±7.133 mmHg and 7.50±8.487 mmHg, respectively, while the control group fast reduced marginally by 0.61 before ultimately increasing by 1.95±7.974 mmHg at 12-weeks. The changes were statistically significant (p<0.05) at both 6 and 12 weeks of an aerobic dance program. Conclusion: The study concluded that aerobic dance is an effective non-pharmacological method for managing SBP of stage 1 hypertensive individuals both in the short-term (6 weeks) and long-term (12 weeks).

Keywords: aerobic dance, blood pressure, stage 1 hypertension, systolic blood pressure.

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Authors: Rowen Naicker, Dhiren Allopi

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One of the major problems the Port of Durban is experiencing is addressing shallow spots aggravated by megaships that berth. In the recent years, the vessels that call at the Port have increased in size which calls for draughts that are much deeper. For this reason, these larger vessels can only berth under high tide to avoid the risk of running aground. In addition to this, the ships cannot sail in fully laden which does not make it feasible for ship owners. Further during the berthing materials are displaced from the seabed which result in shallow spots being developed. The permitted draft (under-keel allowance) for the Durban Container Terminal (DCT) is currently 12.2 m. Transnet National Ports Authority (TNPA) are currently investing in a dredging fleet worth almost two billion rand. One of the highlights of this investment would be the building of grab hopper dredger that would be dedicated to the Port by 2017. TNPA are trying various techniques to dissolve the reduction of draughts by implementing dredging maintenance projects but is this sufficient? The ideal resolution would be the deepening and widening of the berths. Plans for this project is in place, but the implementation process is a matter of urgency. The intention of this project will be to accommodate three big vessels rather than two which in turn will improve the turnaround time in the port. The berthing will then no longer depend on high tide to avoid ships running aground. The aim of this paper is to prove the implementation of deepening and widening of the Port of Durban is a matter of urgency. If the plan to deepen and widen the berths at DCT is delayed it will mean a loss of business for the South African economy. If larger vessels cannot be accommodated in the Port of Durban, it will bypass the busiest container handling facility in the Southern hemisphere. Shipping companies are compelled to use larger ships as opposed to smaller vessels to lower port and fuel costs. A delay in the expansion of DCT could also result in an escalation of costs.

Keywords: DCT, deepening, berth, port

Procedia PDF Downloads 375

Authors: Selim M. Khan, Aaron A. Goodarzi, Joshua M. Taron, Tryggve Rönnqvist

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Indoor air quality, a prime determinant of health, is strongly influenced by the presence of hazardous radon gas within the built environment. As a health issue, dangerously high indoor radon arose within the 20th century to become the 2nd leading cause of lung cancer. While the 21st century building metrics and human behaviors have captured, contained, and concentrated radon to yet higher and more hazardous levels, the issue is rapidly worsening in Canada. It is established that Canadians in the Prairies are the 2nd highest radon-exposed population in the world, with 1 in 6 residences experiencing 0.2-6.5 millisieverts (mSv) radiation per week, whereas the Canadian Nuclear Safety Commission sets maximum 5-year occupational limits for atomic workplace exposure at only 20 mSv. This situation is also deteriorating over time within newer housing stocks containing higher levels of radon. Deep machine learning (LSTM) algorithms were applied to analyze multiple quantitative and qualitative features, determine the most important contributory factors, and predicted radon levels in the known past (1990-2020) and projected future (2021-2050). The findings showed gradual downwards patterns in Sweden, whereas it would continue to go from high to higher levels in Canada over time. The contributory factors found to be the basement porosity, roof insulation depthness, R-factor, and air dynamics of the indoor environment related to human window opening behaviour. Building codes must consider including these factors to ensure adequate indoor ventilation and healthy living that can prevent lung cancer in non-smokers.

Keywords: radon, building metrics, deep learning, LSTM prediction model, lung cancer, canada, sweden

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Authors: Mehrnoosh Abouzari, Shahrokh Sahraei

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Arrival of artificial intelligence or smart robots in the modern world put them in charge on pericise and at risk. So acting human activities with robots makes criminal or civil responsibilities for their acts or behavior. The practical usage of smart robots has entered them in to a unique situation when naturalization happens and smart robots are identifies as members of society. There would be some legal situation by adopting these new smart citizens. The first situation is about legal responsibility of robots. Recognizing the naturalization of robot involves some basic right , so humans have the rights of employment, property, housing, using energy and other human rights may be employed for robots. So how would be the practice of these rights in the society and if some problems happens with these rights, how would the civil responsibility and punishment? May we consider them as population and count on the social programs? The second episode is about the criminal responsibility of robots in important activity instead of human that is the aim of inventing robots with handling works in AI technology , but the problem arises when some accidents are happened by robots who are in charge of important activities like army, surgery, transporting, judgement and so on. Moreover, recognizing independent identification for robots in the legal world by register ID cards, naturalization and civilian rights makes and prepare the same rights and obligations of human. So, the civil responsibility is not avoidable and if the robot commit a crime it would have criminal responsibility and have to be punished. The basic component of criminal responsibility may changes in so situation. For example, if designation for criminal responsibility bounds to human by sane, maturity, voluntariness, it would be for robots by being intelligent, good programming, not being hacked and so on. So it is irrational to punish robots by prisoning , execution and other human punishments for body. We may determine to make digital punishments like changing or repairing programs, exchanging some parts of its body or wreck it down completely. Finally the responsibility of the smart robot creators, programmers, the boss in chief, the organization who employed robot, the government which permitted to use robot in important bases and activities , will be analyzing and investigating in their article.

Keywords: robot, artificial intelligence, personality, responsibility

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Authors: Gabriel Gomez

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The very concept of information seeking behavior, and the means by which librarians teach users to gain information, that is information literacy, are at the heart of how libraries deliver information, but big data will forever change human interaction with information and the way such behavior is both studied and taught. Just as importantly, big data will orient the study of behavior towards commercial ends because of a tendency towards instrumentalist views of human behavior, something one might also call a trend towards behaviorism. This oral presentation seeks to explore how the impact of big data on understandings of human behavior might impact a library information science (LIS) view of human behavior and information literacy, and what this might mean for social justice aims and concomitant community action normally at the center of librarianship. The methodology employed here is a non-empirical examination of current understandings of LIS in regards to social justice alongside an examination of the benefits and dangers foreseen with the growth of big data analysis. The rise of big data within the ever-changing information environment encapsulates a shift to a more mechanistic view of human behavior, one that can easily encompass information seeking behavior and information use. As commercial aims displace the important political and ethical aims that are often central to the missions espoused by libraries and the social sciences, the very altruism and power relations found in LIS are at risk. In this oral presentation, an examination of the social justice impulses of librarians regarding power and information demonstrates how such impulses can be challenged by big data, particularly as librarians understand user behavior and promote information literacy. The creeping behaviorist impulse inherent in the emphasis big data places on specific solutions, that is answers to question that ask how, as opposed to larger questions that hint at an understanding of why people learn or use information threaten library information science ideals. Together with the commercial nature of most big data, this existential threat can harm the social justice nature of librarianship.

Keywords: big data, library information science, behaviorism, librarianship

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Authors: Farah Naja, Nahla Hwalla, Leila Itani, Shirine Baalbaki, Abla Sibai, Lara Nasreddine

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Purpose: To propose an index for assessing adherence to a Middle-Eastern version of the Mediterranean diet as represented by the traditional Lebanese Mediterranean diet (LMD), to evaluate the association between the LMD and selected European Mediterranean diets (EMD); to examine socio-demographic and lifestyle correlates of adherence to Mediterranean diet (MD) among Lebanese adults. Methods: Using nationally representative dietary intake data of Lebanese adults, an index to measure adherence to the LMD was derived. The choice of food groups used for calculating the LMD score was based on results of previous factor analyses conducted on the same dataset. These food groups included fruits, vegetables, legumes, olive oil, burghol, dairy products, starchy vegetables, dried fruits, and eggs. Using Pearson’s correlation and scores tertiles distributions agreement, the derived LMD index was compared to previously published EMD indexes from Greece, Spain, Italy, France, and EPIC. Results: Fruits, vegetables and olive oil were common denominators to all MD scores. Food groups, specific to the LMD, included burghol and dried fruits. The LMD score significantly correlated with the EMD scores, while being closest to the Italian (r=0.57) and farthest from the French (r=0.21). Percent agreement between scores’ tertile distributions and Kappa statistics confirmed these findings. Multivariate linear regression showed that older age, higher educational, female gender, and healthy lifestyle characteristics were associated with increased adherence to all MD studied. Conclusion: A novel LMD index was proposed to characterize Mediterranean diet in Lebanon, complementing international efforts to characterize the MD and its association with disease risk.

Keywords: mediterranean diet, adherence, Middle-East, Lebanon, Europe

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Authors: Mohammed S. Mohammed, Asmaa M. S. Mohammed

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Background: To achieve the quality of cancer care, the oncologic academic programs should be continuously developed with establishing new ones. We highlighted three disciplines, Clinical nutrition, medical biophysics and radiobiology and Psycho-oncology programs; without a doubt, the Egyptian National Cancer Institute, in ‎the accreditation era, will be establishing them ‎ due to their importance in improving the skills of cancer practitioners. Methods: The first suggested program in Clinical Nutrition that is dealing with the assessment of the patient's well-being before, during and after treatment to avoid the defects in the metabolism resulting from the cancer disease and its treatment by giving the supplements in the patient's diet. The second program is Medical Biophysics and Radiobiology, which there's no denying that it ‎is ‎provided ‎in Cairo University as a good program in the faculty of science but lacks the clinical ‎practice. Hence, it is probably better to establish this program in our institute to ‎improve the ‎practitioner skills and introduce a tailored radiation therapy regimen for every patient according to ‎their characteristic profile.‎ While patients are receiving their treatment, the risk of post-traumatic stress disorder arises, so the importance of the third program, Psycho-Oncology, is clearly obtained. This program is concerned with the psychological, social, behavioral, and ethical aspects of cancer. The area of multi-disciplinary interest has boundaries with the major specialties in oncology: the clinical disciplines (surgery, medicine, pediatrics, and radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. Results: It is a prospective academic plan which is compatible with the institutional vision and its strategic plan. Conclusion: In this context, evaluating and understanding the suggested academic programs has become a mandatory part of cancer care. And it is essential to be provided by the NCI.

Keywords: clinical nutrition, psycho-oncology, medical biophysics and radiobiology, medical education

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Authors: Sumit Roy

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A clear understanding of pedestrian behaviour at road crossing at intersections is needed for providing necessary infrastructure and also for enhancing pedestrian safety at any intersection. Pedestrian road crossing behaviour is studied at Motijheel and Kakrail intersections where Motijheel intersection is a controlled roundabout, and Kakrail intersection is a signalized intersection. Around 60 people at each intersection were interviewed for a questionnaire survey and video recording at different time of a day was done for observation at each intersection. In case of Motijeel intersection, we got pedestrian road crossings were much higher than Kakrail intersection. It is because the number of workplaces here is higher than Kakrail. From questionnaire survey, it is found that 80% of pedestrians crosses at intersection to avail buses and their loading and unloading locations are at intersection, whereas at Kakrail intersection only 25% pedestrian crosses the road for buses as buses do not slow down here. At Motijheel intersection 25 to 40% of pedestrians choose to jump over the barricade for crossing instead of using overbridge for saving time and labour. On the other hand, the pedestrians using overbridge told that they use overbridge for safety. Moreover, pedestrian crosses at the same pace for both red and green interval with vehicle movement in the range of 12.5 to 14.5 km/h and gaps between vehicle were more than 4 m. Here pedestrian crossing speed varies from 3.5 to 7.2 km/h. In Kakrail intersection the road crossing situation can be classified into 4 categories. In case of red time, pedestrians do not wait to cross the road, and crossing speed varies from 3.5 to 7.2 km/h. When vehicle speed varies from 5.4 to 7.4 km/h, and gaps between vehicle vary from 1.5 to 2 m, most of the pedestrians initially choose to wait and try to cross the road in group with crossing speed 2.7 to 3.5 km/h. When vehicle speed varies from 10.8 to 18 km/h, and gaps between vehicles varies from 2 to 3 m most of the people waits and cross the road in group with crossing speed 3.5 to 5.4 km/h. When vehicle speed varies from 25.2 to 32.4 km/h and gaps between vehicles vary from 4 to 6 m most of the pedestrians choose to wait until red time. In Kakrail intersection 87% of people said that they cross the road with risk and 60% of pedestrians told that it is risky to get on and off the bus at this intersection. Planned location of loading and unloading area for buses can improve the pedestrian road crossing behaviour at intersections.

Keywords: crossing speed, pedestrian behaviour, road crossing, use of overbridge

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Authors: David Lloyd, David Owen, Martin Jardine

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Introduction: European weight regulations with respect to food products require a full understanding of regulation guidelines to assure regulatory compliance. It is suggested that the complexity of regulation leads to practices which result to over filling of food packages by food processors. Purpose: To establish current practices by food processors and the financial, sustainable and societal impacts on the food supply chain of ineffective food production practices. Methods: An analysis of food packing controls with 10 companies of varying food categories and quantitative based research of a further 15 food processes on the confidence in weight control analysis of finished food packs within their organisation. Results: A process floor analysis of manufacturing operations focussing on 10 products found over fill of packages ranging from 4.8% to 20.2%. Standard deviation figures for all products showed a potential for reducing average weight of the pack whilst still retain the legal status of the product. In 20% of cases, an automatic weight analysis machine was in situ however weight packs were still significantly overweight. Collateral impacts noted included the effect of overfill on raw material purchase and added food miles often on a global basis with one raw material alone creating 10,000 extra food miles due to the poor weight control of the processing unit. A case study of a meat and bakery product will be discussed with the impact of poor controls resulting from complex legislation. The case studies will highlight extra energy costs in production and the impact of the extra weight on fuel usage. If successful a risk assessment model used primarily on food safety but adapted to identify waste /sustainability risks will be discussed within the presentation.

Keywords: legislation, overfill, profile, waste

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Authors: Misganaw Ayele Gelaw

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This abstract presents an overview of agricultural investment in Ethiopia, with a focus on the Oromia Region. Ethiopia is a developing country that heavily relies on agriculture as a major contributor to its economic growth and employment. The Oromia Region, located in the central part of the country, is the largest region in Ethiopia and plays a significant role in the agricultural sector. The study aims to explore the current state of agricultural investment in the Oromia Region, focusing on the opportunities, challenges, and potential benefits that arise from such investments. It also highlights the key agricultural investment strategies and policies implemented by the Ethiopian government to attract domestic and foreign investors. To achieve these objectives, a comprehensive literature review and analysis of relevant reports, publications, and government policies will be conducted. The study will also incorporate qualitative and quantitative data collection methods, such as interviews, surveys, and statistical analysis, to provide a well-rounded understanding of agricultural investment dynamics in the Oromia Region. The findings of this study are expected to shed light on the impact of agricultural investments on local farmers, rural development, food security, income generation, and overall economic growth in the Oromia Region. It will also identify the key risk factors and potential mitigations associated with agricultural investment, offering recommendations to policymakers, investors, and stakeholders to improve the effectiveness and sustainability of investment efforts in the region. This abstract highlights the importance of agricultural investment in the Oromia Region and Ethiopia as a whole, as it strives to enhance productivity, increase farmers' income, and contribute to the country's long-term development goals. By understanding the challenges and opportunities associated with agricultural investment, policymakers and investors can develop targeted strategies to ensure inclusive and sustainable growth in the agricultural sector, leading to improved livelihoods and economic prosperity in the Oromia Region.

Keywords: agriculture, investment, agriculture policy, economy

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: According to the World Health Organization, caesarean section delivery rates of more than 10-15% caesarean section deliveries in any specific geographic region in the world are not justifiable. The aim of the study was to describe the level and analyse determinants of caesarean section delivery in Addis Ababa. Methods: Data was collected in Addis Ababa using a structured questionnaire administered to 901 women aged 15-49 years through a stratified two-stage cluster sampling technique. Binary logistic regression model was employed to identify predictors of caesarean section delivery. Results: Among the 835 women who delivered their last birth at healthcare facilities, 19.2% of them gave birth by caesarean section. About 9.0% of the caesarean section births were due to mother’s request or service provider’s influence without any medical indication. The caesarean section delivery rate was much higher than the recommended rate particularly among the non-slum residents (27.2%); clients of private healthcare facilities (41.1%); currently married women (20.6%); women with secondary (22.2%) and tertiary (33.6%) level of education; and women belonging to the highest wealth quintile household (28.2%). The majority (65.8%) of the caesarean section clients were not informed about the consequences of caesarean section delivery by service providers. The logistic regression model shows that older age (30-49), secondary and above education, non-slum residence, high-risk pregnancy and receiving adequate antenatal care were significantly positively associated with caesarean section delivery. Conclusion: Despite the unreserved effort towards achieving MDG 5 through safe skilled delivery assistance among others, the high caesarean section rate beyond the recommend limit, and the finding that caesarean sections done without medical indications were also alarming. The government and city administration should take appropriate measures before the problems become setbacks in healthcare provision. Further investigations should focus on the effect of caesarean section delivery on maternal and child health outcomes in the study area.

Keywords: Addis Ababa, caesarean section, mode of delivery, slum residence

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Authors: A. Kumar, D. Himanshu, Ak Vaish, K. Usman , A. Singh, R. Misra, V. Atam, S. P. Verma, S. Singhal

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Introduction: Resistant and uncontrolled hypertension offer great challenge, in terms of higher risk of morbidity, mortality and not the least, difficulty in diagnosis and management. Our study tries to identify the importance of two crucial aspects of hypertension management, i.e. drug compliance and optimum dosing and also the effect of spironolactone on blood pressure in cases of resistant hypertension. Methodology: A prospective study was carried out among patients, who were referred as case of resistant hypertension to Hypertension Clinic at Gandhi memorial and associated hospital, Lucknow, India from August, 2013 to July 2014. A total of 122 Subjects having uncontrolled BP with ≥3 antihypertensives were selected. After ruling out secondary resistance and with appropriate lifestyle modifications, effect of adherence and optimum doses was seen with monitoring of BP. Only those having blood pressure still uncontrolled were true resistant. These patients were given spironolactone to see its effect on BP over next 12 weeks. Results: Mean baseline BP of all (n=122) patients was 150.4±7.2 mmHg systolic and 92.1±5.7 mmHg diastolic. After promoting adherence to the regimen, there was reduction of 4.20±3.65 mmHg systolic and 2.08±4.74 mmHg Diastolic blood pressure, with 26 patients achieving target blood pressure goal. Further reduction of 6.66±5.99 mmHg in systolic and 2.59±3.67 mmHg in diastolic BP was observed after optimizing the drug doses with another 66 patients achieving target blood pressure goal. Only 30 patients were true resistant hypertensive and prescribed spironolactone. Over 12 weeks, mean reduction of 20.62±3.65 mmHg in systolic and 10.08 ± 6.46 mmHg in diastolic BP was observed. Out of these 30, BP was controlled in 24 patients. Side effects observed were hyperkalemia in 2 patients and breast tenderness in 2 patients. Conclusion: Improper adherence and suboptimal regimen appear to be the important reasons for uncontrolled hypertension. By virtue of maintaining proper adherence to an optimum regimen, target BP goal can be reached in many without adding much to the regimen. Spironolactone is effective in patients with resistant hypertension, in terms of blood pressure reduction with minimal side effects.

Keywords: resistant, hypertension, spironolactone, blood pressure

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Authors: V. Konjik, J. Schwartz, R. Sandhoff, M. Mack

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The rising number of multi-resistant pathogens demands the development of new antibiotics in order to reduce the lethal risk of infections. Here, we investigate roseoflavin, a vitamin B2 analogue which is produced by Streptomyces davawensis and Streptomyces cinnabarinus. We consider roseoflavin to be a 'Trojan horse' compound. Its chemical structure is very similar to riboflavin but in fact it is a toxin. Furthermore, it is a clever strategy with regard to the delivery of an antibiotic to its site of action but also with regard to the production of this chemical: The producer cell has only to convert a vitamin (which is already present in the cytoplasm) into a vitamin analog. Roseoflavin inhibits the activity of Flavin depending proteins, which makes up to 3.5 % of predicted proteins in organisms sequenced so far. We sequentially knocked out gene clusters and later on single genes in order to find the ones which are involved in the roseoflavin biosynthesis. Consequently, we identified the gene rosB, coding for the protein carrying out the first step of roseoflavin biosynthesis, starting form Flavin mononucleotide. Here we show, that the protein RosB has so far unknown features. It is per se an oxidoreductase, a decarboxylase and an aminotransferase, all rolled into one enzyme. A screen of cofactors revealed needs of oxygen, NAD+, thiamine and glutamic acid to carry out its function. Surprisingly, thiamine is not only needed for the decaboxylation step, but also for the oxidation of 8-demethyl-8-formyl Flavin mononucleotide. We had managed to isolate three different Flavin intermediates with different oxidation states, which gave us a mechanistic insight of RosB functionality. Our work points to a so far new function of thiamine in Streptomyces davawensis. Additionally, RosB could be extremely useful for chemical synthesis. Careful engineering of RosB may allow the site-specific replacement of methyl groups by amino groups in polyaromatic compounds of commercial interest. Finally, the complete clarification of the roseoflavin biosynthesis opens the possibility of engineering cost-effective roseoflavin producing strains.

Keywords: antibiotic, flavin analogue, roseoflavin biosynthesis, vitamin B2

Procedia PDF Downloads 215