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We examined relationships between neurocognition and immune activation in Ugandan adolescents with perinatally acquired HIV (PHIV). Eighty-nine adolescents in Kampala, Uganda (32 virally suppressed [<400 copies/mL] PHIV and 57 socio-demographically matched HIV- controls) completed a tablet-based neurocognitive test battery. Control derived z-scores for 12 individual tests and a global/overall z-score were calculated. We measured plasma (soluble CD14 and CD163), monocyte (proportions of monocyte subsets), and T cell (expression of CD38 and HLA-DR on CD4+ and CD8+) activation and gut markers. Spearman's rank correlations and median regressions examined associations between test performance and immune activation. Median [IQR] age was 15[13-16] years, 40% were females. Median time on ART was 10 years [7-11] for PHIV; 87% had viral load <50 copies/mL. Compared to controls, global z-scores were lower among PHIV (p=0.05), and significantly worse on tests of executive functioning and delayed recall (p's≤0.05). Overall, monocyte activation significantly correlated with worse test performance on global z-score (r=0.21, p=0.04), attention, processing speed, and motor speed (r=0.2-0.3, p≤0.01). T cell activation was significantly correlated with worse performance on tests of learning, executive functioning, and working memory (r=0.2-0.4, p≤0.04). In PHIV, after adjusting for age, sex, and ART duration, activated CD4 T cells remained associated with worse memory (ß-0.3, 95% CI, -0.55, -.07, p=0.01). PHIV with virologic suppression on ART show evidence of worse neurocognitive test performance compared to controls. Monocyte and T cell activation is correlated with worse neurocognition in Ugandan youth with and without HIV which has not been previously investigated in this setting.
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Introduction: Neurocognitive impairment (NCI) is commonly exhibited among patients experiencing their first episode of psychosis. However, there are few resources in many low-income countries, such as Uganda, that allow for the administration of extensive neurocognitive test batteries for the detection of NCI. NeuroScreen is a brief tablet-based neurocognitive assessment battery that can be administered by all levels of healthcare staff. We examined the validity of NeuroScreen to assess neurocognition and detect NCI in first-episode psychosis (FEP) patients in Uganda. Methods: We enrolled 112 participants FEP patients and matched controls at Butabika Mental Referral Hospital. Each participant completed NeuroScreen and a traditionally administered neurocognitive battery: the MATRIC Consensus Cognitive Battery (MCCB). We examined correlations between participant performance on NeuroScreen and the MCCB. A ROC curve determined sensitivity and specificity of NeuroScreen to detect NCI as determined by MCCB criterion. Results: There was a large, statistically significant correlation between overall performance on NeuroScreen and the MCCB [r(112) = 0.64, p < .001]. Small to large correlations were found between tests in the MCCB and NeuroScreen batteries. The ROC curve of NeuroScreen performance to detect MCCB-defined NCI had an area under curve of 0.80 and optimal sensitivity and specificity of 83 % and 60 %, respectively. Conclusion: There was a moderate positive correlation between overall performance on both batteries. NeuroScreen shows promise as a valid assessment battery to assess neurocognition and detect NCI in FEP patients in Uganda. Further studies of NeuroScreen in healthy individuals and in a range of mental disorders are recommended.
ABSTRACT
OBJECTIVE: Deficits in neurocognitive functioning are common among adolescents and young adults (AYA) with perinatally acquired HIV (PHIV). Limitations of traditional neuropsychological tests hinder assessment of neurocognition in low- and middle-income countries where most AYA with PHIV reside. Computerized testing could make assessment of neurocognition more accessible in these countries. This study examined a culturally modified NeuroScreen, a tablet-based neurocognitive testing app, for use in Thailand. Construct validity was examined among Thai AYA (13-23 years) with and without PHIV. METHOD: NeuroScreen underwent adaptation including language, content, and usability review by Thai psychologists, AYA, and clinical staff. One hundred Thai AYA (50 PHIV; 50 HIV-uninfected, matched controls) were administered the adapted NeuroScreen and a battery of traditional paper-and-pencil neuropsychological tests. Correlations, mean differences, and proportions with impaired performance were examined across NeuroScreen and the traditional tests. RESULTS: The Thai version of NeuroScreen was deemed understandable and culturally appropriate. A large correlation (.82) between overall performance on the NeuroScreen and traditional batteries was observed. Small-to-large correlations were found between conceptually similar NeuroScreen and traditional tests of processing speed, working memory, motor speed, and executive functioning. Mean test performance differences between AYA with PHIV and controls were similar between test batteries. Both sets of tests identified similar rates of impaired participants. CONCLUSIONS: Results provide support for the acceptability and construct validity of the Thai NeuroScreen tests to assess neurocognition in Thai AYA with PHIV. An easy-to-use tool to assess neurocognition can help Thai providers provide better care for AYA with PHIV. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Subject(s)
HIV Infections , Adolescent , Young Adult , Humans , Thailand , HIV Infections/complications , HIV Infections/diagnosis , HIV Infections/psychology , Neuropsychological Tests , Executive Function , CognitionABSTRACT
Tannery wastewater is one of the most toxic waste generated in industries. In spite of this, there still remains a paucity of information on characteristics of wastewater generated from artisanal tanneries. This study, therefore, assessed the water consumption, wastewater generation rates, physicochemical and microbiological characteristics of wastewater produced from each process unit of an artisanal tannery in Ghana. The study revealed that the total amount of water use in the tannery ranged between 1171 and 2120L/day whilst the total volume of wastewater generated was within 820 and 1324L/day. Physicochemical characteristics of the different wastewater types generated at the tannery including chemical oxygen demand (13600-24333.30 mg/L), biochemical oxygen demand (1445.64-2803 mg/L), ammonia (3.20-21.38 mg/L), colour (950.35-53900.10PtCo), electrical conductivity (8170 - 10080 µS/cm), turbidity (450.24-1805NTU), suspended (1033.50-3216.40 mg/L) and dissolved (26166.50-4996.65 mg/L) solids exceeded the guidelines set by the Ghana Environmental Protection Agency. There were also high levels of chlorides, sodium, sulphates and calcium ions. The most dominant anion and cation in the wastewater were chlorides (715-20490.60 mg/L) and sodium ions (258-14056.45 mg/L) respectively. Heavy metals identified in the wastewater included zinc, aluminium, iron and chromium ions with the most dominant one being aluminium ions (0.58-78.18 mg/L). Whilst the E-coli was below detectable limit, the count of total coliforms ranged between 0 and 4.5 × 104CFU/100mL. Five helminth egg species (Ascaris lumbricoides, hookworm, Trichuris trichiura, Strongyloides stercoralis, and Enterobius vermicularis) were identified with their numbers surpassing the safe limit set by the World Health Organisation for irrigation purposes. These results indicated that the indiscriminate discharge of the untreated wastewater on the bare soil as it is practised at the tannery has the potential to adversely affect public and environmental health. Appropriate treatment schemes are therefore, required to treat the wastewater to safe limits prior to discharge.
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High generation of fecal sludge without proper treatment is a major sanitation problem. A key step in curbing this problem is producing value-added resources such as vermicompost from fecal sludge through substrate enrichment. Substrate enrichment is a vermicomposting technique that involves augmenting vermibed substrates with organic rich materials to provide additional nutrients, as well as underlying layers needed for microcosm development to produce desirable vermicompost. The aim of this study was to investigate effects of substrate enrichment with organic soils (black soil, red laterite soil and sandy soil) combined with coconut coir as bulking material, on the fecal sludge vermicomposting process and quality of the end-product. The purpose of the study was to promote the development of highly nutritive vermicompost from fecal sludge using substrate enrichment as a low-cost innovative vermicomposting technique. The enriched substrates were prepared with 160g of coconut coir, 120g of fecal matter (65-70% dry matter) and 80g of organic soil. The treatments were labelled T1, T2 and T3 representing systems containing black soil, red laterite soil and sandy soil respectively. The control treatment (T4) contained no soil. Triplicate treatments were setup and about 20 3-week old clitellated earthworms of the species Eisenia. fetida with live weights ranging from 255 to 275mg, released into each system for vermicomposting over a period of 12 weeks. Physicochemical parameters such as pH, Organic Carbon (Corg), Total Nitrogen (Ntot), Available Phosphorus (Pavail), Exchangeable Calcium (Caexch), Iron (Fe), Lead (Pb) and Aluminium (Al) were determined for both the fecal sludge and the vermicompost. The vermicompost in the setup with black soil (T1) showed the highest Corg mineralization and Ntot, Pavail and Caexch enhancement followed by T2, T3 and T4. Treatment T1 also resulted in the lowest concentration of Fe, Pb and Al in the vermicompost. Concentrations of these heavy metals were found to be higher in the other treatments in increasing order of T2, T3 and T4. Less than 16% earthworm mortality was recorded in all treatments except T4, in which the mortality was about 38% (38.33 ± 13.74). The enriched substrates were therefore found to provide a more suitable microclimate for earthworm development and produced vermicompost with high nutrient content. However, a more comprehensive study on metal accumulation in the earthworm tissues as a potential metal contaminant is needed to establish a strong hypothesis in the safe use of earthworms for this vermicomposting technique.
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BACKGROUND: It is estimated that almost half of all people living with HIV have some form of neurocognitive impairment, but few studies have looked at the risk of neurocognitive impairment and its associated factors in Ghana, due in part to limited resources for such testing. OBJECTIVES: To examine neurocognitive performance in a group of Ghanaians living with HIV and possible factors that contribute to their performance. METHODS: One hundred and four patients were assessed using a selection of brief non-invasive neuropsychological assessments as well as the International HIV Dementia Scale. Psycho-behavioural factors (alcohol use, depression, and medication adherence) as well as demographic characteristics and functional daily activities were assessed to determine their association with neurocognitive performance, using linear regression and receiver operating characteristic analyses. RESULT: About 48% of the participants met the criteria for risk of neurocognitive impairment. Age, education, and symptoms of depression were found to be significantly associated with the risk of impairment. CONCLUSION: Some people living with HIV showed risk of neurocognitive impairment, which was significantly associated with education, age and depressive symptoms. It is therefore important to consider routine neurocognitive screening in HIV management to recognize any risks for early interventions.
Subject(s)
AIDS Dementia Complex/epidemiology , Antiretroviral Therapy, Highly Active/adverse effects , Cognition Disorders/epidemiology , Depression/epidemiology , HIV Infections/complications , HIV Infections/drug therapy , AIDS Dementia Complex/psychology , Adult , Age Factors , Anti-HIV Agents/therapeutic use , Antiretroviral Therapy, Highly Active/methods , Cognition Disorders/etiology , Cross-Sectional Studies , Depression/etiology , Educational Status , Female , Ghana/epidemiology , HIV Infections/epidemiology , HIV Infections/psychology , Humans , Male , Medication Adherence , Middle Aged , Neuropsychological Tests/statistics & numerical data , Prevalence , Psychomotor Performance , Severity of Illness Index , Socioeconomic FactorsABSTRACT
This study sets out to develop an approach that couples attainable regions and fuzzy multicriteria decision methods for modeling optimal configurations of multistage digesters without using a kinetic model of the process. The approach is based on geometric analysis of methane curves as their shapes contain valuable insight into substrate biodegradability characteristics during anaerobic digestion. With the case study of abattoir waste, the results indicate that the optimal batch operation policy involves four anaerobic sequencing batch reactors operated in series with fresh feed being added at the second and the four stages (fed-batch systems). For continuous mode operation, the optimal configuration involves a continuous stirred tank digester with bypass from feed followed by an anaerobic baffled digester, which has been used to obtain a novel prototype. The methodological framework presented in this study can be adopted to enhance design of multistage anaerobic digesters especially when reliable kinetic models are unavailable.
Subject(s)
Bioreactors , Methane , AnaerobiosisABSTRACT
Unlike high-rate anaerobic digesters that employ some mechanism to retain microbial sludge mass, low-rate systems use sufficiently long hydraulic retention times to ensure process stability, which becomes economically unattractive for treating large quantities of waste. This study presents the use of attainable region to develop a new strategy to enhance the stability of low-rate digesters. By considering three digestion cases, diary manure only (batch 1) or diary manure with granular (batch 2) or lagoon (batch) sludge as innoculum, the following findings were obtained. (1) For a given concentration of volatile acids in an anaerobic digester, higher concentrations of methanogenic archae can be attained using a digester structure (combination of different digesters) as opposed to single digester. (2) For a given digested substrate, a change in the source of inoculum results in a change in the limits of achievability by the system (attainable limits for batches 1, 2 and 3 were 46.486(g/L)2, 5.562(g/L)2 and 0.551(g/L)2, which resulted in performance improvements of 118.604%,175.627% and 200.436% respectively), and hence optimal digester structure. The evidence from this study suggests that the technique can be used to simultaneously improve process stability, define performance targets and propose digester structures required to achieve a given target.
Subject(s)
Bioreactors , Euryarchaeota , Anaerobiosis , Manure , Methane , SewageABSTRACT
High performance clay swelling inhibitors play a vital role in improving inhibition characteristics of shales. The linkages between the inhibition's characteristics of the non-ionic surfactant extract from bio-based inhibitors are yet to be fully explored in the literature. This paper reports the use of a crude extract containing saponins from Chromolaena odorata (CO) leaf, which act as surfactants for inhibiting shale hydration. Determination of the inhibitive property of nonionic surfactant was made through measurements of surface-active properties, inhibition tests, filtration, rheological and strength test. The experimental findings on CO showed that it was highly compatible and very stable with conventional water-based drilling fluids (WBDFs), a highly effective shale inhibitor and a works through plugging and viscosity acting effect in the shale system.
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Nanostructured mesoporous titanium dioxide (TiO2) particles with high specific surface area and average crystallite domain sizes within 2 nm and 30 nm have been prepared via the sol-gel and hydrothermal procedures. The characteristics of produced nanoparticles have been tested using X-Ray Diffraction (XRD), Brunauer-Emmett-Teller (BET) surface area analysis, Scanning Electron Microscopy (SEM), Fourier Transform Infra-Red (FTIR), and Raman Spectroscopy as a function of temperature for their microstructural, porosity, morphological, structural and absorption properties. The as-synthesized TiO2 nanostructures were attempted as catalysts in Rhodamine B and Sudan III dyes' photocatalytic decomposition in a batch reactor with the assistance of Ultra Violet (UV) light. The results show that for catalysts calcined at 300 °C, â¼100 % decomposition of Sudan III dye was observed when Hydrothermal based catalyst was used whiles â¼94 % decomposition of Rhodamine B dye was observed using the sol-gel based catalysts. These synthesized TiO2 nanoparticles have promising potential applications in the light aided decomposition of a wide range of dye pollutants.