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- Medizinische Klinik und Poliklinik II (23)
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- Department of Medicine A, University Hospital of Münster, Münster, Germany (1)
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ResearcherID
- B-4606-2017 (1)
Background
Increasing bacterial resistance to antibiotics is a serious problem worldwide. We sought to record the acquisition of antibiotic-resistant Escherichia coli (E. coli) in healthy infants in Northern Thailand and investigated potential determinants.
Methods
Stool samples from 142 infants after birth, at ages 2wk, 2mo, 4 to 6mo, and 1y, and parent stool samples were screened for E. coli resistance to tetracycline, ampicillin, co-trimoxazole, and cefazoline by culture, and isolates were further investigated for multiresistance by disc diffusion method. Pulsed-field gel electrophoresis was performed to identify persistent and transmitted strains. Genetic comparison of resistant and transmitted strains was done by multilocus sequence typing (MLST) and strains were further investigated for extra- and intra-intestinal virulence factors by multiplex PCR.
Results
Forty-seven (33%) neonatal meconium samples contained resistant E. coli. Prevalence increased continuously: After 1y, resistance proportion (tetracycline 80%, ampicillin 72%, co-trimoxazole 66%, cefazoline 35%) almost matched those in parents. In 8 infants (6%), identical E. coli strains were found in at least 3 sampling time points (suggesting persistence). Transmission of resistant E. coli from parents to child was observed in only 8 families. MLST showed high diversity. We could not identify any virulence genes or factors associated with persistence, or transmission of resistant E. coli. Full-term, vaginal birth and birth in rural hospital were identified as risk factors for early childhood colonization with resistant E. coli.
Conclusion
One third of healthy Thai neonates harboured antibiotic-resistant E. coli in meconium. The proportion of resistant E. coli increased during the first year of life almost reaching the value in adults. We hypothesize that enhancement of infection control measures and cautious use of antibiotics may help to control further increase of resistance.
Zn\(^{2+}\) deficiency in the human population is frequent in underdeveloped countries. Worldwide, approximatively 2 billion people consume Zn\(^{2+}\)-deficient diets, accounting for 1–4% of deaths each year, mainly in infants with a compromised immune system. Depending on the severity of Zn\(^{2+}\) deficiency, clinical symptoms are associated with impaired wound healing, alopecia, diarrhea, poor growth, dysfunction of the immune and nervous system with congenital abnormalities and bleeding disorders. Poor nutritional Zn\(^{2+}\) status in patients with metastatic squamous cell carcinoma or with advanced non-Hodgkin lymphoma, was accompanied by cutaneous bleeding and platelet dysfunction. Forcing Zn\(^{2+}\) uptake in the gut using different nutritional supplementation of Zn\(^{2+}\) could ameliorate many of these pathological symptoms in humans. Feeding adult rodents with a low Zn\(^{2+}\) diet caused poor platelet aggregation and increased bleeding tendency, thereby attracting great scientific interest in investigating the role of Zn\(^{2+}\) in hemostasis. Storage protein metallothionein maintains or releases Zn\(^{2+}\) in the cytoplasm, and the dynamic change of this cytoplasmic Zn\(^{2+}\) pool is regulated by the redox status of the cell. An increase of labile Zn\(^{2+}\) pool can be toxic for the cells, and therefore cytoplasmic Zn\(^{2+}\) levels are tightly regulated by several Zn\(^{2+}\) transporters located on the cell surface and also on the intracellular membrane of Zn\(^{2+}\) storage organelles, such as secretory vesicles, endoplasmic reticulum or Golgi apparatus. Although Zn\(^{2+}\) is a critical cofactor for more than 2000 transcription factors and 300 enzymes, regulating cell differentiation, proliferation, and basic metabolic functions of the cells, the molecular mechanisms of Zn\(^{2+}\) transport and the physiological role of Zn\(^{2+}\) store in megakaryocyte and platelet function remain elusive. In this review, we summarize the contribution of extracellular or intracellular Zn\(^{2+}\) to megakaryocyte and platelet function and discuss the consequences of dysregulated Zn\(^{2+}\) homeostasis in platelet-related diseases by focusing on thrombosis, ischemic stroke and storage pool diseases.
Background
Almost 90% of cancer patients suffer from symptoms of fatigue during treatment. Supporting treatments are increasingly used to alleviate the burden of fatigue. This study examines the short-term and long-term effects of yoga on fatigue and the effect of weekly reminder e-mails on exercise frequency and fatigue symptoms.
Methods
The aim of the first part of the study will evaluate the effectiveness of yoga for cancer patients with mixed diagnoses reporting fatigue. We will randomly allocate 128 patients to an intervention group (N = 64) receiving yoga and a wait-list control group (N = 64) receiving yoga 9 weeks later. The yoga therapy will be performed in weekly sessions of 60 min each for 8 weeks. The primary outcome will be self-reported fatigue symptoms. In the second part of the study, the effectiveness of reminder e-mails with regard to the exercise frequency and self-reported fatigue symptoms will be evaluated. A randomized allocated group of the participants (“email”) receives weekly reminder e-mails, the other group does not. Data will be assessed using questionnaires the beginning and after yoga therapy as well as after 6 months.
Discussion
Support of patients suffering from fatigue is an important goal in cancer patients care. If yoga therapy will reduce fatigue, this type of therapy may be introduced into routine practice. If the reminder e-mails prove to be helpful, new offers for patients may also develop from this.
WUEMoCA is an operational scientific webmapping tool for the regional monitoring of land and water use efficiency in the irrigated croplands of the transboundary Aral Sea Basin that is shared by Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, and Afghanistan. Satellite data on land use, crop pro-duction and water consumption is integrated with hydrological and economic information to provide of a set indicators. The tool is useful for large-scale decisions on water distribution or land use, and may be seen as demonstrator for numerous applications in practice, that require independent area-wide spatial information.
A series of photoactivatable CO‐releasing molecules (PhotoCORMs) was prepared from manganese pentacarbonyl bromide and 1H‐benzimidazol‐2‐ylmethyl‐(N‐phenyl)amine ligands (L) bearing different electron‐donating and electron‐withdrawing groups R = H, 4‐CH\(_3\), 4‐OCH\(_3\), 4‐Cl, 4‐NO\(_2\), 2‐, 3‐, and 4‐COOCH\(_3\) on the phenyl substituent to give octahedral manganese(I) complexes of the general formula [MnBr(CO)\(_3\)(L)]. Aerated DMSO solutions of the compounds are stable in the dark for 16 h with no CO release. However, the compounds rapidly release CO upon illumination at 412–525 nm, depending on the substitution pattern. Its influence on the photophysical and photochemical properties was systematically explored using UV/Vis spectroscopy and CO release measurements with a commercial gas sensor system. In the nitro‐substituted compound, the electronically excited state switched from benzimidazole‐ to phenyl‐centered, leading to a markedly different photochemical behavior of this visible‐light activated PhotoCORM.
Summary
Introduction. Rapid and uncontrolled industrialisation and urbanisation in most developing countries are resulting in land, air and water pollution at rates that the natural environment cannot fully renew. These contemporary environmental issues have attracted local, national and international attention. The problem of urban garbage management is associated with rapid population growth in developing countries. These are pertinent environmental crises of sustainability and sanitation in Sub-Saharan Africa and other Third World countries. Despite efforts of the various tiers of government (the case of Nigeria with three tiers: Federal, State and Local governments) in managing solid waste in urban centres, it is still overflowing open dumpsites, litters streets and encroaches into water bodies. These affect the quality of urban living conditions and the natural environment.
Sub-Saharan and other developing countries are experiencing an upsurge in the accumulation and the diversity of waste including E-waste, waste agricultural biomass and waste plastics. The need for effective, sustainable and efficient management of waste through the application of 3Rs principle (Reduce, Reuse, and Recycle) is an essential element for promoting sustainable patterns of consumption and production. This study examined waste management in Imo State, Nigeria as an aspect correlated to the sustainability of its environment.
Materials and methods. To analyse waste management as a correlate of environmental sustainability in Sub-Saharan Africa, Imo State, in eastern Nigeria was chosen as a study area. Issues about waste handling and its impact on the environment in Imo have been reported since its creation in 1976; passing through the State with the cleanest State capital in 1980 to a ‘dunghill’ in 2013 and a ‘garbage capital’ on October 1, 2016. Within this State, three study sites were selected – Owerri metropolis (the State capital) Orlu and Okigwe towns. At these sites, households, commercial areas, accommodation and recreational establishments and schools, as well as dumpsites were investigated to ascertain the composition, quantity, distribution, handling patterns of waste in relation to the sustainability of the State’s environment. This was done conveniently but randomly through questionnaires, interviews, focus group discussions and non-participant observation; these were all heralded by a detailed deskwork. Data were entered using Microsoft Office Excel and were explored and analysed using the Statistical Package for Social Sciences - SPSS.
Data were made essentially of categorical variables and were analysed using descriptive statistics. The association between categorical variables was measured using Cramer’s V the Chi-Square that makes the power and the reliability of the test. Cramer’s V is a measure of association tests directly integrated with cross-tabulation. The Chi-Square test of equal proportions was used to compare proportions for significant differences at 0.05 levels. The statistical package - the Epi Info 6.04d was also used since a contingency table had to be created from several sub-outputs and determine the extent of association between the row and column categories.
The scale variable ‘quantity of waste generated’ was described using measures of central tendency. It was screened for normality using the Kolmogorov-Smirnov and Shapiro-Wilk tests for normality; in all context, the normality assumption was violated (P<0.05). Five null hypotheses were tested using Logistic Regression model. The explanatory power of individual conceptual component was calculated using the Cox & Snell R2 and that of individual indicators was also appraised using the Likelihood Ratio test.
In the context of this work, the significance of the variability explained by the model (baseline model) was appraised using the Omnibus Tests of Model Coefficients, the magnitude of this variability explained by the model using the Cox & Snell R2 and the effects of individual predictors using the Likelihood Ratio test.
Qualitatively, data from open-ended items, observations and interviews were analysed using the process of thematic analysis whereby concepts or ideas were grouped under umbrella terms or keywords. The results were presented using tables, charts, graphs, photos and maps.
Findings and discussions. The total findings and analyses indicated that proper waste handling in Imo State, Nigeria has a positive impact on the environment. This was assessed by the community’s awareness of waste management via sources like the radio and the TV, their education on waste management and schools’ integration of environmental education in their program. Although most community members perceived the State’s environment as compared to it about 10 years’ back has worsened, where they were conscious of proper waste handling measures, the environment was described to be better. This influence of environmental awareness and education on environmental sustainability appraised using Logistic Regression Model, portrayed a significant variability (Omnibus Tests of Model Coefficients: χ2=42.742; P=0.014), inferring that environmental awareness and education significantly predict environmental sustainability.
The findings also revealed that organic waste generation spearheaded amongst other waste types like paper, plastic, E-waste, metal, textile and glass. While waste pickers always sorted paper, plastics, aluminium and metal, some of them also sorted out textile and glass. Statistically (P<0.05), in situations where waste was least generated (i.e., 1-2kg per day), community members maintained that the environmental quality was better in comparison to 10 years’ back. Waste items like broken glass and textile as well as the remains of E-waste after the extraction of copper and brass were not sorted for and these contributed more to environmental degradation.
Similarly, the influence of wealth on environmental sustainability was appraised using Logistic Regression Model including development index related indicators like education, occupation, income and the ability to pay for waste disposal. Harmonising the outcome, farmers, who were mostly the least educated claimed to notice more environmental improvement. In addition, those who did not agree to pay for waste disposal who were mostly those with low income (less than 200,000 Naira, i.e. about 620 Euros monthly) perceived environmental improvement more than those with income above 200,000 Naira. This irony can be attributed to the fact that those with low educational backing lack the capacity to appreciate environmental sustainability pointers well as compared to those with a broader educational background with critical thinking.
The employment and poverty reduction opportunities pertaining to waste management on environmental sustainability was appraised using qualitative thematic analysis. All community members involved in sorting, buying and selling of waste items had no second job. They attested that the money earned from their activities sustained their livelihood and families. Some expressed love for the job, especially as they were their own masters. Waste picking and trading in waste items are offering employment opportunities to many communities around the world. For instance, in the waste recycling, waste composting, waste-to-energy plants and die Stadtreiniger in Würzburg city. The workers in these enterprises have jobs as a result of waste.
Waste disposal influence on environmental sustainability was appraised using the Binary Logistic Regression Model and the variability explained by the model was significant. The validity was also supported by the Wald statistics (P<0.05), which indicates the effect of the predictors is significant. Environmental sustainability was greatly reliant on indicators like the frequency at which community members emptied their waste containers; how/where waste is disposed of, availability of disposal site or public bin near the house, etc. Imolites who asserted to have public waste bins or disposal sites near their houses maintained that the quality of the State’s environment had worsened as such containers/disposal sites were always stinking as well as had animals and smoke around them. Imolites around disposal sites complained of traits like diarrhoea, catarrh, insect bites, malaria, smoke and polluted air.
Conclusions. The liaison between poor waste management strategies and the sustainability of the Imo State environment was considered likely as statistically significant ineffectiveness, lack of awareness, poverty, insufficient and unrealistic waste management measures were found in this study area. In these situations, the environment was said to have not improved. Such inadequacies in the handling of generated waste did not only expose the citizenry to health dangers but also gave rise to streets and roads characterized by filth and many unattended disposal sites unleashing horrible odour to the environment and attracting wild animals. This situation is not only prevalent in Imo State, Nigeria but in many Sub-Saharan cities.
Future Perspectives. To improve the environment in Sub-Saharan Africa, it is imperative to practice an inclusive and integrated sustainable waste management system. The waste quantity in this region is fast growing, especially food/organic waste. The region should aim at waste management laws and waste reduction strategies, which will help save and produce more food that it really needs. Waste management should be dissociated from epidemic outbreaks like cholera, typhoid, Lassa fever and malaria, whose vectors thrive in filthy environments. Water channels and water bodies should not be waste disposal channels or waste disposal sites.