Assessing the economic and energy use efficiencies of hybrid and inbred rice varieties through omission-plot technique in Lamjung, Nepal.

Agricultural productivity relies upon energy input in the form of improved seeds, fertilizers, chemicals, irrigation and mechanization including management practices. This energy input is crucial for enhancing crop yields and meeting the demands of an ever-growing population. The increasing demand for rice production from an ever-increasing population and the dwindling nature of natural resources as a result of their continuous and excessive use underscore the urgency of studying energy use efficiency and sustainability in rice production. By conducting this experiment, the goal was to assess the yields, economics, and energy use efficiencies in rice. The experiment employed a Randomized Complete Block Design (RCBD) with three replications, comprising ten treatment combinations viz. US-312 + 60:30:20 kg NPK ha-1, US-312 + 0:30:20 kg NPK ha-1, US-312 + 60:0:20 kg NPK ha-1, US-312 + 60:30:0 kg NPK ha-1, US-312 + 0:0:0 kg NPK ha-1, Sukhadhan-2+60:30:20 kg NPK ha-1, Sukhadhan-2+0:30:20 kg NPK ha-1, Sukhadhan-2+60:0:20 kg NPK ha-1, Sukhadhan-2+60:30:0 kg NPK ha-1, Sukhadhan-2+ 0:0:0 kg NPK ha-1. Results revealed that the highest grain yield and yield attributes were obtained from US-312 + 60:30:20 kg NPK ha-1 (4.98 t ha-1) followed by US-312 + 60:30:0 kg NPK ha-1 (4.76 t ha-1), and US-312 + 60:0:20 kg NPK ha-1 (4.54 t ha-1). The highest energy use efficiency of 3.95 was observed under US-312 + 60:30:0 kg NPK ha-1 which was supported by the highest output energy obtained from grain and biomass yield (153 GJ ha-1) and the highest net energy (117 GJ ha-1). The benefit-cost ratio was found highest in US-312 + 60:30:20 kg NPK ha-1 (1.98), signifying its economic viability and potential profitability. In the context of the western mid-hills of Nepal, the rice variety US-312, coupled with a nutrient composition of 60:30:20 kg NPK ha-1 proved to be an optimal selection. This combination demonstrated higher grain yields and noteworthy economic efficiency.

Identifying canonical and replicable multi-scale intrinsic connectivity networks in 100k+ resting-state fMRI datasets.

Despite the known benefits of data-driven approaches, the lack of approaches for identifying functional neuroimaging patterns that capture both individual variations and inter-subject correspondence limits the clinical utility of rsfMRI and its application to single-subject analyses. Here, using rsfMRI data from over 100k individuals across private and public datasets, we identify replicable multi-spatial-scale canonical intrinsic connectivity network (ICN) templates via the use of multi-model-order independent component analysis (ICA). We also study the feasibility of estimating subject-specific ICNs via spatially constrained ICA. The results show that the subject-level ICN estimations vary as a function of the ICN itself, the data length, and the spatial resolution. In general, large-scale ICNs require less data to achieve specific levels of (within- and between-subject) spatial similarity with their templates. Importantly, increasing data length can reduce an ICN's subject-level specificity, suggesting longer scans may not always be desirable. We also find a positive linear relationship between data length and spatial smoothness (possibly due to averaging over intrinsic dynamics), suggesting studies examining optimized data length should consider spatial smoothness. Finally, consistency in spatial similarity between ICNs estimated using the full data and subsets across different data lengths suggests lower within-subject spatial similarity in shorter data is not wholly defined by lower reliability in ICN estimates, but may be an indication of meaningful brain dynamics which average out as data length increases.

Spatial Dynamic Subspaces Encode Sex-Specific Schizophrenia Disruptions in Transient Network Overlap and its Links to Genetic Risk.

Background: Recent advances in resting-state fMRI allow us to study spatial dynamics, the phenomenon of brain networks spatially evolving over time. However, most dynamic studies still use subject-specific, spatially-static nodes. As recent studies have demonstrated, incorporating time-resolved spatial properties is crucial for precise functional connectivity estimation and gaining unique insights into brain function. Nevertheless, estimating time-resolved networks poses challenges due to the low signal-to-noise ratio, limited information in short time segments, and uncertain identification of corresponding networks within and between subjects. Methods: We adapt a reference-informed network estimation technique to capture time-resolved spatial networks and their dynamic spatial integration and segregation. We focus on time-resolved spatial functional network connectivity (spFNC), an estimate of network spatial coupling, to study sex-specific alterations in schizophrenia and their links to multi-factorial genomic data. Results: Our findings are consistent with the dysconnectivity and neurodevelopment hypotheses and align with the cerebello-thalamo-cortical, triple-network, and frontoparietal dysconnectivity models, helping to unify them. The potential unification offers a new understanding of the underlying mechanisms. Notably, the posterior default mode/salience spFNC exhibits sex-specific schizophrenia alteration during the state with the highest global network integration and correlates with genetic risk for schizophrenia. This dysfunction is also reflected in high-dimensional (voxel-level) space in regions with weak functional connectivity to corresponding networks. Conclusions: Our method can effectively capture spatially dynamic networks, detect nuanced SZ effects, and reveal the intricate relationship of dynamic information to genomic data. The results also underscore the potential of dynamic spatial dependence and weak connectivity in the clinical landscape.

Awareness and Knowledge of Glaucoma and their Associated Factors among People Visiting a Tertiary Level Hospital in Central Nepal.

Background Glaucoma is one of the major causes of irreversible blindness globally. Almost 60 million people globally are affected by glaucoma making it the second leading cause of blindness worldwide. Diagnosis of glaucoma early on is vital for timely management and prevention of blindness. However, it is challenging to diagnose it early because it is asymptomatic in the initial stage, and there is also the dearth of appropriate screening tools. Awareness, knowledge, and beliefs are believed to influence the treatment-seeking behavior of people as well as their uptake of services. Objective To assess the awareness and knowledge about glaucoma among general patients and patient attendants visiting Dhulikhel Hospital. Method We conducted a cross sectional quantitative study among general patients visiting Dhulikhel Hospital. We collected data using face-to-face interviews with semistructured questionnaires. We analyzed data in R version 4.0.3 (2020-10-10). We presented numerical variables as mean and standard deviation whereas categorical variables as frequency and percentage. We determined factors associated with awareness and knowledge of glaucoma using logistic regression analysis and estimated adjusted odds ratio (AOR) with 95% confidence interval. Result Of 379 participants, a total of 214 (56.5%) participants had heard about glaucoma. Out of the participants who heard about glaucoma, the mean knowledge score was 48.3±21.7 and 53.3% had good knowledge on glaucoma. The odds of having heard about glaucoma were two percent lower (AOR=0.98; 95%CI: 0.97-0.99; p-value 0.036) in the older participants compared to one year younger participant, 1.98 (95%CI:1.01-3.86; p-value 0.046) times higher among literates and 2.79 (95%CI: 1.76- 4.41; p-value < 0.001) times among participants with previous ocular examination. The odds of having good knowledge was 1.94 (95%CI: 1.10-3.42; p value 0.021) times among participants with previous ocular examinations. Conclusion The knowledge and awareness regarding glaucoma in a hospital-visiting population in central Nepal was low. Half of the participants were unaware of the disease glaucoma and half of the participants who heard of the glaucoma had poor knowledge on glaucoma.

Effects of hot water spray and sub-zero saline chilling on bacterial decontamination of broiler carcasses.

Reduction of Salmonella on poultry carcasses is one way to prevent salmonellosis. The purpose of this research was to evaluate the effects of subzero saline chilling (SSC) with/without hot water spray (HWS) on broiler carcasses prior to chilling for bacterial reduction. Eviscerated broiler carcasses were subjected to water immersion chilling (WIC, 0% NaCl/0.5°C) or SSC (4% NaCl/-2.41°C) with/without prior HWS at 71°C for 1 min. Broiler carcasses in SSC were chilled faster than those in WIC, regardless of HWS. The combination of HWS and SSC resulted in the best reduction of mesophilic aerobic bacteria, Escherichia coli, and total coliforms on the carcasses over the WIC, SSC, and HWS/WIC. No Salmonella was detected on the carcasses in SSC and HWS/SSC while Salmonella positive was observed on the carcasses chilled in WIC and HWS/WIC. A trace of Gram-negative genus was detected on carcasses in HWS/SSC while many other microbiomes were observed on those in WIC, SSC, and HWS/WIC when quantitative microbiota profiles of 16S rRNA gene sequences were evaluated. Based on these results, chilling of broiler carcasses in 4% NaCl/-2.41°C after HWS at 71°C for 1 min significantly reduced carcass chilling time and bacterial contamination over the control chilling.

Moving beyond the 'CAP' of the Iceberg: Intrinsic connectivity networks in fMRI are continuously engaging and overlapping.

Resting-state functional magnetic resonance imaging is currently the mainstay of functional neuroimaging and has allowed researchers to identify intrinsic connectivity networks (aka functional networks) at different spatial scales. However, little is known about the temporal profiles of these networks and whether it is best to model them as continuous phenomena in both space and time or, rather, as a set of temporally discrete events. Both categories have been supported by series of studies with promising findings. However, a critical question is whether focusing only on time points presumed to contain isolated neural events and disregarding the rest of the data is missing important information, potentially leading to misleading conclusions. In this work, we argue that brain networks identified within the spontaneous blood oxygenation level-dependent (BOLD) signal are not limited to temporally sparse burst moments and that these event present time points (EPTs) contain valuable but incomplete information about the underlying functional patterns. We focus on the default mode and show evidence that is consistent with its continuous presence in the BOLD signal, including during the event absent time points (EATs), i.e., time points that exhibit minimum activity and are the least likely to contain an event. Moreover, our findings suggest that EPTs may not contain all the available information about their corresponding networks. We observe distinct default mode connectivity patterns obtained from all time points (AllTPs), EPTs, and EATs. We show evidence of robust relationships with schizophrenia symptoms that are both common and unique to each of the sets of time points (AllTPs, EPTs, EATs), likely related to transient patterns of connectivity. Together, these findings indicate the importance of leveraging the full temporal data in functional studies, including those using event-detection approaches.

A modular computational framework for medical digital twins.

This paper presents a modular software design for the construction of computational modeling technology that will help implement precision medicine. In analogy to a common industrial strategy used for preventive maintenance of engineered products, medical digital twins are computational models of disease processes calibrated to individual patients using multiple heterogeneous data streams. They have the potential to help improve diagnosis, prognosis, and personalized treatment for a wide range of medical conditions. Their large-scale development relies on both mechanistic and data-driven techniques and requires the integration and ongoing update of multiple component models developed across many different laboratories. Distributed model building and integration requires an open-source modular software platform for the integration and simulation of models that is scalable and supports a decentralized, community-based model building process. This paper presents such a platform, including a case study in an animal model of a respiratory fungal infection.

Pilonidal sinus of the cheek: an extremely rare clinical entity-case report and brief review of the literature.

BACKGROUND: Pilonidal sinus is commonly seen at the sacrococcygeal region and few other sites, usually located at the midline, at areas where hairs collect or near protuberances or some adjacent rubbing surfaces. Its presence elsewhere is uncommon. We share an interesting case of a recurrent discharging sinus from the cheek bulge of a male which turned out to be a pilonidal sinus containing tuft of hairs on exploration and wide excision. CASE PRESENTATION: A 37 years old hirsute male presents to us with a non-healing discharging sinus at the bulge of the cheek. Exploration after a course of antibiotics showed 2 subcutaneous cavities with tuft of hairs. The area was excised along with a margin, thorough irrigation and curettage was done and the wound was closed primarily; a Z-plasty was incorporated in the central part to break the resultant suture line. Histopathological examination was done to confirm the diagnosis and rule out an off-midline dermoid cyst or an underlying/coexisting malignancy. Post-operative course was uneventful. The patient has been recurrence free for 1.5 years and is satisfied with the nature of the scar. CONCLUSIONS: Pilonidal sinus of the cheek bulge is an extremely rare entity. Complete excision and clinical suspicion are important for cure of this nagging ailment, especially at unexpected areas.

Comparison between Simple and Classical Techniques to Create Closed Pneumoperitoneum.

Background Closed method of pneumoperitoneum using Veress needle is an established technique. Classical closed technique is popular. Simple technique is a modified closed technique. Objective To compare the classical and simple techniques of closed pneumoperitoneum. Method This study was conducted in the department of urology, Bir hospital from August 1st 2019 to March 30th 2021. Total 114 patients were randomized into simple and classical technique of creating closed pneumoperitoneum. Time taken for creation of pneumoperitoneum, complications and failure of creating pneumoperitoneum in each group noted and analyzed. Chi square test, Fischer exact test and student t test were used and p < 0.05 considered significant. Result Among 114 patients, 61 in simple and 53 in classical technique allocated. In simple technique, mean age was 42.98±18.21 years, BMI was 21.84±2.57 kg/m2 , mean time for pneumoperitoneum creation was 108.07±21.14 seconds. In classical technique, mean age was 40.15±17.58 years, BMI was 21.94±2.54 (kg/m2 ), mean time for pneumoperitoneum creation was 189.70±32.21 seconds. Mean time was less in simple technique than classical technique (p < 0.001). Complication rate observed was 6% in each technique (p=0.797) with cumulative rate of 10%. Omental injury was seen in 3.2% in simple technique and 5.6% in classical technique (p=0.662). Retroperitoneal insufflation was seen in 6.5% in simple technique and 5.6% in classical technique (p=0.842). No failed pneumoperitoneum was observed in both groups. Conclusion Simple technique is as effective, reproducible and safe method as classical technique of creating closed pneumoperitoneum.

The use of multiple hypothesis-generating methods in an outbreak investigation of Escherichia coli O121 infections associated with wheat flour, Canada 2016-2017.

A Canadian outbreak investigation into a cluster of Escherichia coli O121 was initiated in late 2016. When initial interviews using a closed-ended hypothesis-generating questionnaire did not point to a common source, cases were centrally re-interviewed using an open-ended approach. The open-ended interviews led cases to describe exposures with greater specificity, as well as food preparation activities. Data collected supported hypothesis generation, particularly with respect to flour exposures. In March 2017, an open sample of Brand X flour from a case home, and a closed sample collected at retail of the same brand and production date, tested positive for the outbreak strain of E. coli O121. In total, 76% (16/21) of cases reported that they used or probably used Brand X flour or that it was used or probably was used in the home during their exposure period. Crucial hypothesis-generating techniques used during the course of the investigation included a centralised open-ended interviewing approach and product sampling from case homes. This was the first outbreak investigation in Canada to identify flour as the source of infection.

Evaluation of in ovo Bacillus spp. based probiotic administration on horizontal transmission of virulent Escherichia coli in neonatal broiler chickens.

This study evaluated the effect of in ovo Bacillus spp. base probiotic (BBP) administration on hatchability, Gram-negative bacteria (GNB) recovery, performance, and microbiota composition in 2 independent trials using a virulent E. coli seeder challenge model. In each trial, one hundred and eighty 18-day-old embryos were allocated into 1 of 2 groups: Control and treated group (inoculated with 107 BBP). On day 19 of embryogenesis, seeder embryos (n = 18) were inoculated with 4.5 × 104E. coli/mL+272 µg/mL tetracycline and segregated into mesh hatching bags. Twelve chicks per group were euthanized at hatch and at day 7 to evaluate the gastrointestinal composition of total GNB or total aerobic pasteurized bacteria. Also, in trial 2, ceca content from five chickens at day 7 were collected to evaluate microbiota composition. Embryos inoculated with BBP showed a significant (P < 0.05) reduction in the total number of GNB at day-of-hatch (DOH) and day 7. Probiotic treatment increased BW at DOH and day 7, and BW gain (days 0 to 7) when compared with Control chickens. Proteobacteria phylum was significantly reduced, while the Firmicutes was significantly increased by the BBP as compared to the Control (P < 0.05). At family level, Enterobacteriaceae was significantly decreased, while the Lachnospiraceae was significantly elevated in the BBP as compared to the Control group (P < 0.05). The genus Oscillospira was significantly enriched in the BBP group, whereas the unidentified genus of family Enterobacteriaceae in the Control group (P < 0.05). The BBP group increased the bacterial species richness, although there was no significant difference between treatments (P > 0.05). Interestingly, beta diversity showed a significant difference in bacterial community structure between Control and BBP groups (P < 0.05). The results of the present study suggest that in ovo administration of a BBP can reduce the severity of virulent E. coli horizontal transmission and infection of broiler chickens during hatch. The reduction in the severity of the transmission and infection by the BPP might be achieved through alterations of microbiota composition and its community structure.

A Rare Case of Fibrous Hamartoma of Infancy: A Clinicopathological Diagnosis at a Tertiary Hospital, Eastern Nepal.

BACKGROUND: Fibrous hamartoma of infancy is a rare soft tissue lesion of infants and young children with characteristic triphasic morphology. CASE DESCRIPTION: An 18-month-old female child was presented with complaints of swelling over right leg shin since birth. On examination, a lump of size 7x3 cm was identified which was mobile and nontender. Local excision was performed and tissue sent for histopathological examination. On gross examination, a globular, capsulated, firm to hard tissue had cut section revealing solid grey-white to grey-brown lesion with myxoid areas identified. Microscopic examination revealed a poorly circumscribed lesion comprising intersecting trabeculae of fibrous tissue, areas of immature oval and stellate cell within myxoid matrix, and varying amounts of interspersed mature fat cells. CONCLUSION: Even though fibrous hamartoma of infancy is a rare benign entity with limited clinical knowledge, proper diagnosis is mandatory as its prognosis is excellent.

Analysis of Factors Associated with Thyroid Dysfunction: A Hospital Based Study.

Background Thyroid dysfunction (TD) is one of the major public health concerns in Nepal. This study intends to identify factors in association with thyroid dysfunction and its hospital based prevalence. Objective To determine hospital-based prevalence of thyroid dysfunction and to identify and analyze factors in association with thyroid dysfunction. Method A retroprospective cross-sectional study was conducted among patients attending Dhulikhel Hospital-Kathmandu University Hospital (DH,KUH) from January to December, 2015 with prospective part carried out from July to December 2015 in the patients visiting Dhulikhel hospital for health check-up and requested for Thyroid Function Tests (TFTs). Thyroid Function Tests of 1530 subjects were performed in the biochemistry laboratory and semi-structured questionnaire were introduced to 312 participants with convenient sampling method and their anthropometric measurements were taken. Chi-square test, Pearson's correlation and student-t test were used as a measure to analyze factors. Result Out of total 1530 subjects, 35.3% were having thyroid dysfunction with the prevalence of overt hyperthyroidism, subclinical hyperthyroidism, overt hypothyroidism and subclinical hypothyroidism to be 2.5%, 2.4%, 5.6% and 24.8% respectively. The distribution of thyroid dysfunction was preponderant among females and among older age. The prevalence of thyroid dysfunction was highest among Terai/Madhesi (40.0%) and lowest among Newars (28.5%) with higher fraction of hypothyroidism in each ethnic group. There were significant correlation between Thyroid Stimulating Hormone (TSH) with waist-hip ratio (p<0.05) and weight (kg) with free thyroxine (fT4) (p<0.05). Direct pesticide exposure (p<0.05) was significantly associated with hypothyroidism. The serum fT4 was significantly different (p<0.05) among vegetarian and non-vegetarian whereas TSH and free triiodothyronine (fT3) were not significantly different. Smoking, alcoholism, dietary food habits, diabetes and hypertension were not significantly associated with thyroid dysfunction. Conclusion Thyroid dysfunction was highly prevalent among participants with higher proportion of subclinical hypothyroidism. Besides, direct pesticide exposure found to be factor in association with hypothyroidism, this study could not find significance relation with other established risk factors.

Knowledge, Attitude and Practice on Hypertension Among Antihypertensive Medication Users.

INTRODUCTION: Hypertension is growing among the population of Nepal. We aimed to determine the current knowledge, attitude and practice of hypertension among hypertensive patients taking antihypertensive medication in the community of Central Nepal. METHODS: A cross-sectional study was conducted among the hypertensive patients in Bharatpur, Chitwan, Nepal from July 2015 to September 2015 using clustered sampling technique. Suitably designed and validated questionnaire of knowledge, attitude and practice on hypertension consisting of 27 questions were used to determine the KAP scores. The difference in the median KAP scores between sex, level of education and duration of hypertension were assessed using Mann-Whitney U test. RESULTS: A total of 200 patients met the inclusion criteria and majority of them were male (60%), had received primary education (36%) and had hypertension for ≥5 years (46.5%). The blood pressure ranged from 100-180/60-110 mmHg. The median K, A and P scores were 8 (6), 5 (1) and 6 (3) respectively. K and A were statistically associated with sex both at p<0.001 and level of education (K at p<0.001 and A at p=0.016). CONCLUSIONS: The current knowledge, attitude and practice among hypertensive patients using antihypertensive medication can be improved.

A dominant TRPV4 variant underlies osteochondrodysplasia in Scottish fold cats.

OBJECTIVE: Scottish fold cats, named for their unique ear shape, have a dominantly inherited osteochondrodysplasia involving malformation in the distal forelimbs, distal hindlimbs and tail, and progressive joint destruction. This study aimed to identify the gene and the underlying variant responsible for the osteochondrodysplasia. DESIGN: DNA samples from 44 Scottish fold and 54 control cats were genotyped using a feline DNA array and a case-control genome-wide association analysis conducted. The gene encoding a calcium permeable ion channel, transient receptor potential cation channel, subfamily V, member 4 (TRPV4) was identified as a candidate within the associated region and sequenced. Stably transfected HEK293 cells were used to compare wild-type and mutant TRPV4 expression, cell surface localisation and responses to activation with a synthetic agonist GSK1016709A, hypo-osmolarity, and protease-activated receptor 2 stimulation. RESULTS: The dominantly inherited folded ear and osteochondrodysplasia in Scottish fold cats is associated with a p.V342F substitution (c.1024G>T) in TRPV4. The change was not found in 648 unaffected cats. Functional analysis in HEK293 cells showed V342F mutant TRPV4 was poorly expressed at the cell surface compared to wild-type TRPV4 and as a consequence the maximum response to a synthetic agonist was reduced. Mutant TRPV4 channels had a higher basal activity and an increased response to hypotonic conditions. CONCLUSIONS: Access to a naturally-occurring TRPV4 mutation in the Scottish fold cat will allow further functional studies to identify how and why the mutations affect cartilage and bone development.

Hopelessness and Suicidal Ideation among Patients with Depression and Neurotic Disorders Attending a Tertiary Care Centre at Eastern Nepal.

BACKGROUND: Hopelessness is thought to result from a negative appraisal system and interacts with, and worsens, appraisals of defeat and trap which in turn interact with suicide schema and lead to suicidal behaviour. This study was intended to assess hopelessness and suicidal ideation among patients with depression and neurotic disorders at tertiary care centre of eastern Nepal. METHODS: A cross sectional design included 70 respondents by purposive sampling technique. Beck Hopelessness Scale and Scale of Suicidal Ideation were used to measure hopelessness and suicidal ideation, respectively. Data were analyzed using SPSS statistical software. Pearson chi-square, binary logistic regression and Spearmans' rho, test were applied at 95% confidence interval. RESULTS: Mean ± SD age was 32.8 ± 13.5 years. Most (62.8%) of the patients were female and with the diagnosis of depression. Majority (66%) of the patients had hopelessness. There was no significant difference in hopelessness among patients with depression and neurotic disorders. About 17% respondents had suicidal ideation, among them 82.4% were female. There was no significant difference of suicidal ideation among patients with depression and neurotic disorders (p=0.013). Significant positive correlation between hopelessness and suicidal ideation was found (p=0.001). Binary logistic regression revealed hopelessness was independently related to income and family history of mental illness. Similarly, suicidal ideation was independently related to depression and family history of mental illness. CONCLUSIONS: Female respondents, people living under poverty and positive family history of mental illness had more hopelessness and suicidal ideation.

Association of Previous Smoking Habit and Perceived Social Discrimination with the Risk of Multi-Drug Resistant Tuberculosis in Central Nepal.

BACKGROUND: Multidrug-resistant tuberculosis (MDR TB) caused by Mycobacterium tuberculosis resistant to both Isoniazid and Rifampicin with or without resistant to other drug, is among the most alarming pandemic problem. The objectives of this study was to assess the risk factors of MDR TB in Central Nepal. METHODS: A matched case control study was conducted among 186 cases of MDR TB and 372 non-MDR TB controls from central region of Nepal. Pretested questionnaires containing socio-economic, cultural & behavioral; environmental, biological and health service factors were used. Variables significant in bivariate analysis were entered in multiple regression models for further analysis. RESULTS: After adjusting for confounders, previous smoking habit (aOR= 4.5,(95%CI(1.24-16.2)) (p=0.04), and perceived social discrimination (aOR=5.83,95%CI (1.77-19.71)) (P=0.021) independently predicted greater MDR TB risk. CONCLUSIONS: Encouraging MDR TB cases for smoking cessation through awareness activities should be a priority. Stigma reduction programs should include the empowerment of patients and communities while promoting TBrelated research for further exploration into the risk factors of TB and associated stigma.

Production of succinic acid from sugarcane molasses supplemented with a mixture of corn steep liquor powder and peanut meal as nitrogen sources by Actinobacillus succinogenes.

The potential of using corn steep liquor powder (CSLP), peanut meal (PM), soybean meal (SM), cotton meal (CM) and urea as the substitute of yeast extract (YE) as the nitrogen source was investigated for producing succinic acid (SA). Actinobacillus succinogenes GXAS137 was used as the fermenting bacterium and sugarcane molasses was used as the main substrate. None of these materials were able to produce SA as high as YE did. The CSLP could still be considered as a feasible and inexpensive alternate for YE as the yield of SA produced using CSLP was second only to the yield of SA obtained by YE. The use of CSLP-PM mixed formulation (CSLP to PM ratio = 2·6) as nitrogen source produced SA up to 59·2 g l(-1) with a productivity of 1·2 g l(-1) h(-1). A batch fermentation using a stirred bioreactor produced up to 60·7 g l(-1) of SA at the same formulation. Fed-batch fermentation that minimized the substrate inhibition produced 64·7 g l(-1) SA. These results suggest that sugarcane molasses supplemented with a mixture of CSLP and PM as the nitrogen source could be used to produce SA more economically using A. succinogenes. Significance and impact of the study: Succinic acid (SA) is commonly used as a platform chemical to produce a number of high value derivatives. Yeast extract (YE) is used as a nitrogen source to produce SA. The high cost of YE is currently the limiting factor for industrial production of SA. This study reports the use of a mixture of corn steep liquor powder (CSLP) and peanut meal (PM) as an inexpensive nitrogen source to substitute YE. The results showed that this CSLP-PM mixed formulation can be used as an effective and economic nitrogen source for the production of SA.