Multi-stage optimization approach for sustainable municipal solid waste collection systems in urban areas of Asia's newly industrialized countries.

A multi-stage optimization approach for sustainable collection system design for urban municipal solid waste is developed for megacities in Asia's newly industrialized countries. The approach combines four methods-analysis of waste and area characteristics, data acquisition and evaluation by GIS, mathematical projection of existing and future collection systems, and identification of most suitable alternatives through comparative multi-criteria decision analysis (MCDA). The approach is applied in Bangalore, India with 1.66 million inhabitants and 46.7-km2 area of investigation, and stratified based on population density. Two possible collection mechanisms (door-to-door (D2D) and community bin (CB)) are analyzed with a varied combination of collection coverage and waste segregation level. The study results confirm that both operational and investment expenses of the collection system decrease with an increasing rate of CB collection. Moreover, overall CO2 emissions of waste collection from the entire area of investigation decrease from 5.2 to 3.1 tons per day if the present 100% D2D collection is replaced with 100% CB collection system. Also, the increase of segregation at source contributes to the reduction of operational expenses and CO2 emissions; for example, a 20% increase of segregation level for D2D collection system leads to a 6% reduction of CO2 emissions. Considering all decision parameters through MCDA, a collection system comprising only CB with one separate compartment for wet waste and another combined compartment for dry and mixed waste is determined to be the most favorable approach.

Level of Vitamin D and Its Relation with Incident Hypertension among Bangladeshi Adults.

Effect of vitamin D level on incident hypertension was not elucidated in our country perspective. The objective of the study was to report the level of vitamin D and its relation with incident hypertension among the Bangladeshi adults. This cross-sectional assessment was conducted in Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh for a period of one year (1st January 2019 to 31st December 2019). A total of 187 participants who had no known history of hypertension and comorbidities were included. Vitamin D assay and risk factors assessment for hypertension were performed for each patient. Data collection was done using a structured questionnaire and the study was conducted in compliance with current declaration of Helsinki. Analysis was conducted with SPSS 26.0. Out of 187 participants 33(17.6%) was newly diagnosed with hypertension. Predominant age group was 31-40 years (30.5%) and the average of incidence ±SD was 36.76±12.14 years. Sufficient, insufficient and deficient vitamin D was present in 11.8%, 32.6% and 55.6% cases, respectively. Mean±SD SBP and DBP were 117.41±12.84 and 76.87±9.46 mm of Hg. Hypertension was significantly more common in male than female (p=0.047), but there was no association of vitamin D with hypertension (p=0.262). Both hypertensive and normotensive patients shared similar risk factor profile in terms of age, gender, BMI, unhealthy food habit, extra salt intake, tobacco use, caffeine consumption, hormonal contraceptive of female (p>0.05 for all). Nearly one-fifth participants had newly diagnosed hypertension and more than fifty percent had vitamin D deficiency. However, vitamin D level didn't have any statistically significant association with incident hypertension.

The relationship between visceral adiposity and left ventricular diastolic function: results from the Baltimore Longitudinal Study of Aging.

BACKGROUND AND AIMS: It is unclear whether subcutaneous and visceral fat are differentially correlated to the decline in left ventricular (LV) diastolic function with aging. This study sought to examine the hypothesis that age-related changes in the regional fat distribution account for changes in LV diastolic function and to explore potential mediators of this association. METHODS AND RESULTS: In this cross-sectional study, we evaluated 843 participants of the Baltimore Longitudinal Study of Aging with echocardiogram, dual-energy X-ray absorptiometry (DEXA), abdominal computed tomography (CT) and blood tests performed at the same visit. LV diastolic function was assessed by parameters of LV relaxation (E/A ratio, Em and Em/Am ratio) and LV filling pressures (E/Em ratio). Total body fat was computed by DEXA, while visceral and subcutaneous fat were determined from abdominal CT. In multivariate models adjusted for demographics, cardiovascular risk factors, antihypertensive medications, physical activity and LV mass, both visceral and subcutaneous fat were associated with LV diastolic dysfunction. When both measures of adiposity were simultaneously included in the same model, only visceral fat was significantly associated with LV diastolic dysfunction. Triglycerides and sex-hormone binding globulin, but not adiponectin and leptin, were found to be significant mediators of the relationship between visceral fat and LV diastolic function, explaining 28-47% of the association. Bootstrapping analyses confirmed the significance of these findings. CONCLUSIONS: Increased visceral adiposity is associated with LV diastolic dysfunction, possibly through a metabolic pathway involving blood lipids and ectopic fat accumulation rather than adipokines.

Spiritual Wellbeing and Quality of Life among Hemodialysis Patients in Jordan: A Cross-Sectional Correlational Study.

Purpose: Nursing research studies investigating the relationship between spiritual wellbeing and health-related quality of life are lacking among Arab hemodialysis patients in Jordan or any other Arab country. The purpose of this study was to explore the associations between spiritual wellbeing, its religious and existential wellbeing dimensions, and health-related quality of life among Jordanian Muslim hemodialysis patients. Design: A cross sectional, quantitative correlational study. Methods: A convenience sample of 150 Jordanian hemodialysis patients completed a structured, self-administered questionnaire. Descriptive, bivariate, and multivariate regression models were used. Findings: The Jordanian hemodialysis patients had a moderate level of spiritual wellbeing and religious wellbeing, a low level of existential wellbeing, and a poor health-related quality of life. The findings revealed a significant moderate positive correlation between the spiritual wellbeing and its dimensions, and health-related quality of life. The existential wellbeing was the strongest predictor, with a large, positive, and significant effect after controlling for other spiritual, demographic and medical-related variables. Conclusion: Overall, the study suggests Jordanian hemodialysis patients use their religious and spiritual beliefs and practices as a coping mechanism, especially as sources of satisfaction, peace, comfort, strength and support, to help improve their health-related quality of life.

Health related Quality of Life with HIV/AIDS in different stages of HIV infection.

Disease stages of HIV infection is one of the important predictor of Health related Quality of Life (HQoL) of the people living with HIV/AIDS. This cross sectional study was an attempt to compare the HQoL of HIV-infected patients across the three CDC stages of HIV-infection namely, asymptomatic, symptomatic, and AIDS-related conditions. A total of 82 patients, 28 in asymptomatic, 26 in symptomatic, and 28 in AIDS-related conditions, from three NGOs and one Infectious Disease Hospital (IDH) were interviewed using interviewer administered semi structured questionnaire developed by adopting "World Health Organization Quality of Life HIV BREF (WHOQOL-HIV BREF) instrument". Analysis revealed that AIDS-related conditions and symptomatic patients were experiencing significantly poorer quality of life than asymptomatic patients in the domain of physical (F=7.006, p <0.005), level of independence) F=6.552, p<0.005(, overall perception of health related quality of life (F=3.634, p<0.05) and overall general health perception (F=7.842, p<0.001).

Pattern of Neonatal Danger Signs and its Related Factors in a Tertiary Level Hospital.

Considering very limited information in the pattern of neonatal danger signs with associated risk factors in our perspective, the aim of the study was to understand the country-context pattern of neonatal danger signs and its related factors in a tertiary level hospital. This cross-sectional study was conducted among 259 mothers and their neonates in Dhaka Medical College Hospital, Dhaka, Bangladesh from 01 January 2015 to 31 December 2015. Data were collected by face to face interview from mother by pre-tested semi structure questionnaire which was adopted from WHO-UNICEF list of newborn danger signs. Measurement of weight was taken from hospital record. Observation of danger signs were done by following check list. Data analysis was done by SPSS 20.0. Of all, majority (41.6%) was in the age group of 20-24 years & was educated up to secondary level (42.47%). More than half of the participants (54.1%) had family income >10,000 BDT. Sixty percentage of mother took ANC visit <3 times during their pregnancy period. About 42.1% had ≥1 co-morbidities. Hospital was the predominate place of birth with 48.3% caesarean delivery. At least one neonatal danger sign was present in 20.1% while 39.4% had at least 2 danger signs. Rest of the child had ≥2 danger signs at a time. The distribution of danger signs were not feeding since birth or stop feeding 206(79.5%), severe chest in drawing 145(56.1%) respiratory rates 60 or more 126(48.6%), convulsion 72(27.8%), yellow soles 68(26.3%). Factors like 'fail to identify with an expert health assistant', trial of delivery at home, delivery at home, older neonatal age (8-28 days), presence of injury at birth, and cutting of umbilical cord by blade during delivery were associated with higher number of danger signs (p<0.05 in all cases). About 80% neonate in our setting had ≥1 sign and had association with fail to identify with an expert health assistant', trial of delivery at home, delivery at home, older neonatal age, presence of injury at birth, and cutting of umbilical cord by blade during delivery.

Blood pressure in relation to selected anthropometric measurements in senior citizens.

This cross-sectional study was done to assess the blood pressure of the senior citizens in relation to the anthropometric measurements and indices. It was conducted among the Bangladeshi elderly citizens of selected areas of Dhaka city. Samples were selected by convenient technique. A pre-tested questionnaire and a check list were used for data collection. Data analysis was done by SPSS for Windows. Three areas of Dhaka city namely Nakhal Para, Badda and Mirpur were selected in this study. The study was conducted during January to June 2006. A total of 317 samples were studied. Mean age of the respondents was 67.1 years (+/-6.6 SD). Mean SBP and DBP measured were 126 mm of Hg (+/-20 SD) and 72 mm of Hg (+/-12 SD), respectively. Among them, 33.1% were hypertensive on BP measurement; amongst which 32.4% had both SBP and DBP raised; 55.2% had isolated systolic hypertension and 12.4% had DBP raised. Of them 44.8% were identified finally as hypertensive considering BP measurement and those taking antihypertensive medication. The majority were well nourished and at less health risk in terms of BMI, WC and WHR. There was a tendency of being hypertensive with overweight/obese (p<0.05), high WC (male p<0.05 and female p<0.01) and high WHR (female p<0.001). Percentage of hypertensive was higher among the seniors of the study areas especially among those who were overweight/obese or at health risk by WC/WHR.

Assessment of Jordanian Patient's Colorectal Cancer Awareness and Preferences towards CRC Screening: Are Jordanians Ready to Embrace CRC Screening?

BACKGROUND: Colorectal cancer (CRC is increasingly becoming a major cause of cancer morbidity and mortality in Jordan. However the population's level of awareness about CRC, CRC screening test preferences and willingness to embrace screening are not known. The aim of this study was to assess the level of CRC awareness and screening preferences among Jordanian patients. MATERIALS AND METHODS: A survey assessing the CRC knowledge levels was distributed among patients attending outpatient gastroenterology clinics in public hospitals throughout Jordan. A total of 800 surveys were distributed and of these 713 (89.1%) were returned. RESULTS: Only 22% of the participants correctly judged CRC among the choices provided as the commonest cause of cancer related deaths. The majority of participants (68.3%) underestimated their risk for CRC. Only 26.8% correctly judged their life time risk while 5% overestimated their risk. Two thirds of participants (66%) were willing to pay 500 Jordanian Dinars (equivalent to 706 US$) in order to get a prompt colonoscopy if recommended by their physician, while 25.5% reported that they would rather wait for 6 months in order to get a free colonoscopy. CONCLUSIONS: Although the participants tended to underestimate their risk for CRC, they were mostly aware of CRC as a major cause of mortality and were willing to embrace the concept of CRC screening and bear the related financial costs. These findings about CRC awareness and propensity for screening provide a good foundation as the Jordanian health system moves forward with initiatives to promote CRC screening and prevention.

Characterization of mouse fibroblast (NIH3T3) and fibrosarcoma cell lines (WEHI-164 and MFS 8) using PMRS.

Proton magnetic resonance Spectroscopy (PMRS) has been used to study the differences between immortalized fibroblasts and fibrosarcoma cells of different grade. One and two dimensional purged correlation spectroscopy (PCOSY) have been used to assess intact viable fibroblast and fibrosarcoma cells, and differences in the triglyceride, cellular metabolite, and cell surface fucosylation patterns between the three cell lines have been observed. The clinical implication of this study is the potential use of PMRS as an adjunct to conventional histopathology.

Calix[8]arene-mediated self-assembly of tetrapeptide H-Leu-Leu-Ile-Leu-OMe.

Conformational analysis of peptide 1, H-Leu-Leu-Ile-Leu-OMe on complexing with macro cycle calix[8]arene has been carried out using (1)H-NMR and FTIR spectroscopic techniques. Stoichiometry of the complex formed in the 1:8 ratio was evidenced by a Job plot. NMR studies of the above peptide show a marked downfield shift and an increase in (3)J values for NH resonances on complexing with calix[8]arene. The characteristic NOE connectivity between N(i+1)H and C(ialpha)H confirm beta-sheet conformation in the complexed state. Both (1)H-NMR and FTIR results indicate that the alpha-amino group of Leu I is proximal to the macrocycle and is involved in hydrogen bond formation with phenolic hydrogen atom of the calix[8]arene. This suggests that calix[8]arene provides a suitable platform for peptide 1 to self-assemble in a parallel beta-sheet conformation. The nature of calix[8]arene interaction with peptide 1 has been studied using dynamic NMR studies, which concludes that a bifurcated hydrogen bonding interaction exists in the molecular interfaces of the assembly.