Quality of glycemic control in type 2 diabetes mellitus (T2DM) and its association with markers of coagulation and inhibitors of fibrinolysis: A case–control study in the upper west region, Ghana

Background and Aims: Type 2 diabetes mellitus (T2DM) individuals are at a higher risk of developing diabetes complications, with approximately 80% complication-related mortality. The increased morbidity and mortality among T2DM patients are partly due to dysregulated hemostasis. This study determined the quality of glycemic control in T2DM and its association with markers of coagulation and inhibitors of fibrinolysis. Methods: This case–control study recruited 90 participants involving: 30 T2DM patients with good glycemic control, 30 with poor glycemic control, and 30 nondiabetic subjects as controls at a Municipal Hospital in Ghana. Fasting blood glucose, glycated hemoglobin, activated partial thromboplastin time (APTT), prothrombin time (PT), calculated international normalized ratio (INR), and full blood count (FBC) were determined for each respondent. Plasma levels of plasminogen activator inhibitor-1 (PAI-1) and thrombin activatable fibrinolysis inhibitor (TAFI) were determined using the solid-phase sandwich enzyme-linked immunosorbent assay method. Data were analyzed using R language software. Results: Plasma PAI-1 antigen levels were significantly higher in the participants with poor glycemic control as compared to participants with good glycemic control (p \u3c 0.0001). There was no significant difference in plasma TAFI levels between the participants with poor glycemic control as compared to participants with good glycemic control (p = 0.900). T2DM patients had significantly shorter APTT, PT, and INR than controls (p \u3c 0.05). At a cut-off of ≥ 161.70 pg/μL, PAI was independently associated with increasing odds (adjusted odds ratio = 13.71, 95% confidence interval: 3.67–51.26, p \u3c 0.0001) of poor glycemic control and showed the best diagnostic accuracy for poor glycemic control (area under the curve = 0.85, p \u3c 0.0001). Conclusion: PAI-1 levels were significantly increased in T2DM with poor glycemic control and emerged as the best predictor for poor glycemic control. Good glycemic management to control the plasma levels of PAI-1 is required to prevent hypercoagulability and thrombotic disorders

Removal of soluble selenium in the presence of nitrate from coal mining-influenced water

Biological treatment to remove dissolved selenium from mining-influenced water (MIW) is inhibited by co-contaminants, especially nitrate. It was hypothesized that selenium reducing microorganisms can be obtained from native mine bacteria at sites affected by MIW due to the selection pressure from elevated selenium concentrations at those sites. Enrichment of these microorganisms and testing of their capacity to remove dissolved selenium from actual coal MIW was the objective of this dissertation. Fifteen sediments were collected from eleven different vegetated or non-vegetated seepage collection ponds and one non-impacted natural wetland. Nine sediments achieved greater than 90% dissolved selenium removal within 72 hours when inoculated into selenate-reducing bacteria growth medium. To find microorganisms capable of removing dissolved selenium in the presence of nitrate, six of the sediments were inoculated into two different types of growth media; one with selenate as the sole electron acceptor and the other with both nitrate and selenate as electron acceptors. Both media were otherwise identical and contained lactate as the electron donor. Decrease in dissolved selenium concentration was observed in all enrichments, but the effect of nitrate on the rate and extent of removal was variable. Nitrate inhibited dissolved selenium removal rates in four of the enrichments. However, in one instance, microorganisms enriched from a natural vegetated marsh receiving coal MIW (Goddard Marsh) were not inhibited by nitrate and the dissolved selenium removal rates were similar in both media. In another instance, the presence of nitrate enhanced dissolved selenium removal by enrichments from a pond receiving coal mine waste seepage (Lagoon A). When enrichments from Lagoon A and Goddard Marsh, respectively, were tested for dissolved selenium removal from actual coal MIW, the former achieved greater (40%) than the latter (10%). Through 16S and whole genome sequencing studies, species capable of removing selenate in the enrichments were classified as Bacteroides, Serratia, Clostridium and Methanosarcina. However, most of these species did not survive in the MIW. The dominant species in the MIW were classified as Sulfurospirillium, Veillonella, Pseudomonas and Bacteroides, which were shown to be capable of reducing selenium, based on putative metagenome assembled genomes (MAGs) obtained for these species.Applied Science, Faculty ofChemical and Biological Engineering, Department ofGraduat

Delectric heating pretreatment of organic slurries

This study reports on the research findings from the investigations of three studies conducted on dielectric heating treatments of separated dairy manure and sewage sludge for the purpose of solids disintegration and nutrients release were carried out under batch operation. The treatment processes investigated included; radiofrequency/hydrogen peroxide advanced oxidation process (RF/H2O2-AOP), microwave/hydrogen peroxide advanced oxidation process (MW/H2O2-AOP) and combination of conventional heating (CH) and MW/H2O2-AOP. The broad objectives were to investigate the effects and factors affecting these processes. Significant factors affecting the RF/H2O2-AOP process; hydrogen peroxide dosage, heating time and input power were optimized using surface response methodology. The optimized operating conditions were determined to be an input power of 63%, holding time 60 min and H2O2 dose of 1.1% for orthophosphate release, and an input power of 71%, holding time 5 min and H2O2 dose of 2.4% for soluble chemical oxygen demand. The second study was to examine the effects of organic acids (acetic, oxalic and citric) and mineral acids (sulfuric and hydrochloric acid) as acidifying reagents in MW/H2O2-AOP. The results showed that organic acids were good acidifying reagents comparable to mineral acids. The MW/H2O2-AOP and oxalic acid treatment could be combined into a single-stage process which could release phosphates, solubilize solids and remove calcium from dairy manure at the same time. A mixture of oxalic and mineral acids could produce the maximum volume of clear supernatant. A combination of CH and MW/H2O2-AOP was applied for the treatment of aerobic sewage sludge and dairy manure in the final study. The substrates were preheated by CH method (40oC, 50oC and 60oC) followed by MW/H2O2-AOP (100oC and 120oC). The maximum SCOD/TCOD ratio obtained for sewage sludge and dairy manure were 60% and 22%, respectively. The best treatment conditions for COD solubilization for both sewage sludge and dairy manure was obtained for the treatment set conducted at CH temperature of 60ºC followed by MW temperature 120ºC with hydrogen peroxide. A maximum ortho-P/TP ratio of 50% and 98% was obtained for sludge and dairy manure, respectively. The overall results suggest that dielectric heating was effective in the treatment of dairy manure and sewage.Applied Science, Faculty ofCivil Engineering, Department ofGraduat