Incidence and Predictors of Tuberculosis Among Adult PLWHA at Public Health Facilities of Hawassa City

Tuberculosis (TB) is the most frequently diagnosed opportunistic infection (OI) and disease in people living with HIV/AIDS (PLWHA), world-wide. This study aimed at determining the incidence and predictors of tuberculosis among people living with HIV.A Six year retrospective follow up study was conducted among adult PLHIV. The Cox proportional hazards model was used to identify predictors.A total of 554 patients were followed and produced 1830.3 person year of observation. One hundred sixty one new TB cases occurred during the follow up period. The overall incidence density of TB was 8.79 per 100 person-year (PY). It was high (148.71/100 PY) in the first year of enrolment. The cumulative proportion of TB free survival was 79% and 67% at the end of first and sixth years, respectively. Not having formal education(AHR=2.68, 95%CI: 1.41, 5.11 ), base line WHO clinical stage IV (AHR = 3.22, 95% CI=1.91-5.41), CD4 count <50 cell/ul (AHR=2.41, 95%CI=1.31, 4.42), Being bed redden (AHR= 2.89, 95%CI=1.72, 3.78), past TB history (AHR=1.65, 95% CI = 1.06,2.39), substance use (AHR=1.46, 95% CI=1.03,2.06) and being on pre ART (AHR=1.62, 95%CI:1.03-2.54 ) were independently predicted tuberculosis occurrence. Advanced WHO clinical stage, limited functional status, past TB history, addiction and low CD4 (<50cell/ul) count at enrollment were found to be the independent predictor of tuberculosis occurrence. Therefore early initiation of treatment and intensive follow up is important

Farmers Perception on Climate Change and Determinants of Adaptation Strategies in Benishangul-Gumuz Regional State of Ethiopia

Adaptation to climate change involves changes in agricultural technologies in particular and management practices in general to reduce its risk and effects. To minimize the losses due to climate change factors, farmers have employed different climate change adaptation strategies. Consequently, this study examines farmer adaptation strategies to climate change in Benishangul-Gumuz Regional State of Ethiopia based on a cross-section data of three representative zones of Assosa, Kamashi zones and Mao-komo special district. The study describes the perceptions of smallholder farmers to changes in climate change indicators and adaptation measures at the farm household level using multivariate discrete choice model to identify the determinants of adaptation strategies. The econometric model has showed that households demographic factors, resources endowments (land, labor, livestock), institutional factors (access to extension services, cooperative membership and access to credit) are some of the important determinants of farm-level adaptation. The policy implication from our finding is that improving access to credit, production factors (like land, labor) enhancing the bargaining power of smallholder farmers can significantly increase farm-level adaptation to climate change. Moreover, adopting different improved crop varieties have showed better yield gains than non-adopters. Thus, policies and strategies should focus at research and development on appropriate technologies that help smallholder farmers’ adaptation capacity to climate changes hereby varietal development, appropriate agronomic recommendations, pre-extension demonstration and popularization of improved cultivars and promoting appropriate farm-level adaptation measures such as use of irrigation technologies

The syringe sampler: An inexpensive alternative borehole sampling technique for CO2-rich fluids during mineral carbon storage

Mineral carbon storage involves the dissolution of injected gaseous or supercritical CO2 followed by interaction of the carbonated solution with the host rock at depth resulting in the precipitation of carbonate minerals. Monitoring of elemental chemistry and tracers is required to evaluate the evolution of the fluid geochemistry and the degree of CO2 mineralization during its injection into the subsurface. To avoid degassing during sampling, which is a common feature of commercial groundwater samplers, especially vacuum samplers, a syringe-like sampler was designed, constructed, and tested in the lab and field. This system was successfully deployed during the injection of 175 tons of pure gaseous CO2 at the CarbFix injection site in Hellisheidi, SW Iceland. This study presents in detail this sampling tool and its application to the monitoring of the CO2-rich fluid evolution during subsurface carbonation. The syringe sampler was developed as a flexible and mobile unit of low investment and operating costs making it an attractive option for deployment at small scale carbon storage demonstration sites that do not command the budgets to deploy commercial alternatives, e.g. from the oil and gas industry

Prop-2-yn-1-yl 4,6-di-O-acetyl-2,3- dideoxy-a-D-erythro-hex-2-enopyranoside

The absolute structure of the title compound, C13H16O6, was determined. The pyranosyl ring adopting an envelope conformation. The acetyl groups are located in equatorial positions. The crystal structure features weak C—H O interactions

Thyroid Hormone Tests Ordering Practice and Cost-Effectiveness in Samples Referred to International Clinical Laboratories from Addis Ababa Health Facilities

BACKGROUND: Thyroid dysfunction accounts for majority of endocrine disorders. In sub-Saharan Africa Graves’ disease and hypothyroidism have accounted for 13.1% and 8.8% while the burden of thyroid disorder has ranged from 6.18 to47.34% among countries in the Arab world. The cost for a primary thyroid test done to evaluate the gland function constituted a large proportion of the public health budget. For instance, 10 million thyroid functions have been done each year by laboratories which cost 30 million UK pounds, and they represent 8% of laboratory charge in the US. When a TSH-only protocol (guideline) was used, 95% of the requests were sufficient for diagnosis without requiring further tests, thereby resulting in 50% savings on FT4 reagent and reducing the annual TFT reagent cost by 25%. This is an original study, and its objective was to assess the ordering pattern of TSH tests and their cost-effectiveness in patients’ samples referred to ICL from Addis Ababa health facilities between July2015 to June 2016METHOD: An institution-based cross-sectional study design was utilized to study the ordering pattern of thyroid function tests using one-year retrospective data from ICL.RESULTS: Thyroid profiles were ordered more frequently (49.5%) compared to TSH only (24.3%). An additional 2625.70 USD was paid by patients for individual components in the profile tests that turned out normal.CONCLUSION: Guidelines advocate TSH as the initial test for thyroid dysfunction, but the use of a combination of tests is more common

Overview of Hazardous Waste Management Status in Malaysia

This chapter reviews the status of hazardous waste management in Malaysia. It highlights the sources of the hazardous waste, government policies on waste generation and management, the involvement of the stakeholders, and the various management procedures adopted in Malaysia. Currently, the manufacturing sector is the major contributor in hazardous waste generated in Malaysia. Other sectors that contribute include household, agriculture, medical, and other industrial sectors. Malaysian government’s resolve on human health protection and safeguarding the environment prompted various acts, regulations, and orders such as the popular Environmental Quality Act (EQA) 1974. The regulations made pursuant to the Environmental Quality Act have continuously improved to address the issues on the definition and classifications of hazardous waste and the management process in Malaysia. The management of hazardous waste in Malaysia is effectively growing as a result of continuous review of the regulations and enforcement of the acts. The stakeholders in the industries have also been active in keeping to the EQA regulations to keep the environment safe as much as possible

Prop-2-yn-1-yl 4,6-di-O-acetyl-2,3-dide­oxy-α-d-erythro-hex-2-enopyran­o­side

The absolute structure of the title compound, C13H16O6, was determined. The pyranosyl ring adopting an envelope conformation. The acetyl groups are located in equatorial positions. The crystal structure features weak C—H⋯O inter­actions

Calpain mediates proteolysis of the voltage-gated sodium channel alpha-subunit

Alterations in the expression, molecular composition, and localization of voltage-gated sodium channels play major roles in a broad range of neurological disorders. Recent evidence identifies sodium channel proteolysis as a key early event after ischemia and traumatic brain injury, further expanding the role of the sodium channel in neurological diseases. In this study, we investigate the protease responsible for proteolytic cleavage of voltage-gated sodium channels (NaChs). NaCh proteolysis occurs after protease activation in rat brain homogenates, pharmacological disruption of ionic homeostasis in cortical cultures, and mechanical injury using an in vitro model of traumatic brain injury. Proteolysis requires Ca2+ and calpain activation but is not influenced by caspase-3 or cathepsin inhibition. Proteolysis results in loss of the full-length {alpha}-subunits, and the creation of fragments comprising all domains of the channel that retain interaction even after proteolysis. Cell surface biotinylation after mechanical injury indicates that proteolyzed NaChs remain in the membrane before noticeable evidence of neuronal death, providing a mechanism for altered action potential initiation, propagation, and downstream signaling events after Ca2+ elevation

Ontogeny of Recognition Specificity and Functionality for the Broadly Neutralizing Anti-HIV Antibody 4E10

The process of antibody ontogeny typically improves affinity, on-rate, and thermostability, narrows polyspecificity, and rigidifies the combining site to the conformer optimal for binding from the broader ensemble accessible to the precursor. However, many broadly-neutralizing anti-HIV antibodies incorporate unusual structural elements and recognition specificities or properties that often lead to autoreactivity. The ontogeny of 4E10, an autoreactive antibody with unexpected combining site flexibility, was delineated through structural and biophysical comparisons of the mature antibody with multiple potential precursors. 4E10 gained affinity primarily by off-rate enhancement through a small number of mutations to a highly conserved recognition surface. Controverting the conventional paradigm, the combining site gained flexibility and autoreactivity during ontogeny, while losing thermostability, though polyspecificity was unaffected. Details of the recognition mechanism, including inferred global effects due to 4E10 binding, suggest that neutralization by 4E10 may involve mechanisms beyond simply binding, also requiring the ability of the antibody to induce conformational changes distant from its binding site. 4E10 is, therefore, unlikely to be re-elicited by conventional vaccination strategies