bluuebunny/crossref_metadata_2025 huggingface dataset:
Emic ethnographic encounters: Researching elderly female household heads’ experience with climate change in rural Zimbabwe
Authors: Gutsa Ignatius
Published: July 2021

In this article, I discuss the experiences of conducting ethnographic research in my village of origin in Zimbabwe. The issues I discuss in this article are the methodological approach, the deconstruction of prior assumptions, challenges in meeting respondents, positionality and grappling with multiple identities in the field, the unintended therapeutic effect of life histories, learning the art of patience in fieldwork, reciprocity, friendship and the challenge of spontaneity. This discussion is important in the debates on the challenges of conducting emic ethnographic research, reflexivity and positionality. The article therefore makes a significant contribution to the body of knowledge focusing on the dynamics of carrying out ethnographic research in one’s cultural backyard.
A preliminary study on visually impaired students in Bangladesh during the COVID-19 pandemic
Authors: Mahfuz Saifullah , Sakib Md Nazmus , Husain MM
Published: July 2021

This article problematizes the status of the visually impaired students in Bangladesh under the COVID-19 global pandemic. We inquire into two inter-related questions: (a) what level and quality of technological access does a visually impaired student have in their higher education institution (e.g. a university or government-affiliated college operating under a university)? And, (b) how are these students coping academically under the pandemic? Our preliminary study employed mixed methods for data collection, encompassing a quantitative survey questionnaire followed by qualitative phone interviews. We reached out to approximately 15 male and female students enrolled in public and private higher educational institutions in the country. The findings will be instrumental to initiate a collaborative discussion among academics and practitioners in the government, non-government and private sectors in the country and around the Global South.
Percutaneous Saphenous Vein Arterialization
Authors: Migliara Bruno , Cappellari Tania Francesca , Mirandola Mattia , Griso Andrea , Feriani Giovanni , Prosdocimi Linda , Nicoletti Cristian
Published: July 2021

Purpose

In patients with no-option critical limb-threatening ischemia, venous foot arterialization can be considered the last chance before major amputation. Up until now, a really significant limitation of endovascular arterialization compared with surgery was the possibility to obtain arterial flow into the foot only through the deep plantar network.

Technique

Two 5-mm snares are placed: one in the proximal tibial artery and the other in the great saphenous vein. After passing through these snares with a needle and a guidewire and closing the snares, the guidewire is pulled through the proximal arterial sheath and the distal venous sheath. Thus, the arterial-venous connection is created. A covered stent is, then, placed between the artery and the vein to avoid leakage.

Conclusions

Based on our knowledge, this is the first described totally percutaneous arterialization of the superficial dorsal venous foot system, through reverse flow in the great saphenous vein.
Customization of hierarchical air filter media by tailoring the structural parameters of needle punched nonwoven
Authors: Roy Rupayan , Ishtiaque SM
Published: July 2021

An attempt has been made to investigate the filtration behaviour of filter media with gradient structure created through layers of needle punched nonwoven. Batts of different fibre orientation influenced by carding parameters were prepared. Carding parameters i.e. feeder, cylinder and doffer speed were optimized by using response surface methodology to achieve the batts of different fibre orientation. Three batts with a wide range of fibre orientation were selected to create the gradient structures by placing them in a different position in the layered structure. The physical, mechanical and functional properties of nonwoven were evaluated. The different order of fibre orientation of batts was also analysed with the help of SEM images. The fabric with inverse gradient structure having batts in increasing order of fibre orientation in the layered structure provided very high (close to the highest) filter efficiency and very low (close to lowest) pressure drop instead of having higher (close to highest) mean flow pore size.
Youth Court: A Restorative Practice? A Case to Consider
Authors: Lustick Hilary
Published: July 2021

The current case demonstrates the complexities of utilizing Youth Court as a restorative practice in an urban high school, by focusing on the complexities it presents for one student in particular. In this case, there are reasons why Youth Court clearly is not working at this particular school site as intended. However, more importantly for leadership preparation, the case surfaces dilemmas of cultural difference, teacher preparation, leadership preparation, and school policy that leaders must address prior to restorative implementation in order to ensure sustainable restorative practice moving forward.
Per-pass analysis of recanalization and good neurological outcome in thrombectomy for stroke: Systematic review and meta-analysis
Authors: Arturo Larco Jorge , Abbasi Mehdi , Liu Yang , Madhani Sarosh Irfan , Shahid Adnan Hussain , Kadirvel Ramanathan , Brinjikji Waleed , Savastano Luis E
Published: July 2021

Background and aim

First pass effect (FPE) is defined as achieving a complete recanalization with a single thrombectomy device pass. Although clinically desired, FPE is reached in less than 30% of thrombectomy procedures. Multiple device passes are often necessary to achieve successful or complete recanalization. We performed a systematic review and meta-analysis to determine the recanalization rate after each pass of mechanical thrombectomy and its association with good neurological outcome.

Methods

A literature search was performed for studies reporting the number of device passes required for either successful (mTICI 2b or higher) or complete (mTICI 2c or higher) recanalization. Using random-effect meta-analysis, we evaluated the likelihood of recanalization and good neurological outcome (measured with the modified Rankin Score <2 at 90 days) after each device pass.

Results

Thirteen studies comprising 4197 patients were included. Among cases with failed first pass, 24% of them achieved final complete recanalization and 45% of them achieved final successful recanalization. Independently to the total number of previously failed attempts, the likelihood of achieving successful recanalization was 30% per pass, and the likelihood to achieve complete recanalization was about 20% per pass. The likelihood of good neurological outcome in patients with final successful recanalization decreased after each device pass: 55% after the first pass, 48% after the second pass, 42% after the third pass, 36% after the fourth pass, and 26% for 5 passes or more.

Conclusion

Each pass is associated with a stable likelihood of recanalization but a decreased likelihood of good neurological outcome.
Conversion control of a tilt tri-rotor unmanned aerial vehicle with modeling uncertainty
Authors: Chen Chao , Zhang Jiyang , Wang Nuan , Shen Lincheng , Li Yiyong
Published: July 2021

The tilt-rotor unmanned aerial vehicle (TRUAV) has vertical take-off and landing and high-speed flight capabilities through conversion and reconversion modes, thereby presenting wide application prospects. This article presents a compact tilt tri-rotor UAV. For flying in the conversion mode, the TRUAV needs to realize the transition of two control logic and two kinds of actuators in both of the rotor and fixed-wing modes, achieving the control of the multi-input multioutput, input nonaffine, and nonlinear multichannel cross-coupling UAV system. Furthermore, the lateral dynamics of a tilt tri-rotor UAV is more unstable for unpaired rotors. These system characteristics present a great challenge to conversion control. To solve these problems, the nonlinear dynamic model of the vehicle in the conversion mode is provided. Furthermore, a cascade control system consisting of position control, velocity control, angle control, angular velocity control, and control mixer is proposed. The simulation result of the control system shows steady flight and a fast transition in the conversion mode with modeling uncertainty in case of no wind.
Embedded in two worlds: The university academic manager’s work, identity and social relations
Authors: Frenkel Stephen J
Published: July 2021

The university academic manager (AM) or head of school/department is typically positioned in a hierarchical world: as a middle manager ‘sandwiched’ between senior management and subordinates. I propose a different framing: the AM cohabits two worlds, the worlds of hierarchy and collegiality respectively. Using an ideal type framework and data based mainly on interviews with 20 AMs, I examine AMs’ tasks, identity and social relations, showing that AMs adopt a dual work identity that is associated with the ‘two worlds’ imagery which explains their orientation towards their tasks and social relations. This interpretation enables a deeper understanding of how AMs enact their role and encourages dialogue about the future of middle-level university management.
Seeding of breast cancer cell line (MDA-MB-231LUC+) to the mandible induces overexpression of substance P and CGRP throughout the trigeminal ganglion and widespread peripheral sensory neuropathy throughout all three of its divisions
Authors: Gutierrez Silvia , Eisenach James C , Boada M Danilo
Published: July 2021

Some types of cancer are commonly associated with intense pain even at the early stages of the disease. The mandible is particularly vulnerable to metastasis from breast cancer, and this process has been studied using a bioluminescent human breast cancer cell line (MDA-MB-231LUC+). Using this cell line and anatomic and neurophysiologic methods in the trigeminal ganglion (TG), we examined the impact of cancer seeding in the mandible on behavioral evidence of hypersensitivity and on trigeminal sensory neurons. Growth of cancer cells seeded to the mandible after arterial injection of the breast cancer cell line in Foxn1 animals (allogeneic model) induced behavioral hypersensitivity to mechanical stimulation of the whisker pad and desensitization of tactile and sensitization of nociceptive mechanically sensitive afferents. These changes were not restricted to the site of metastasis but extended to sensory afferents in all three divisions of the TG, accompanied by widespread overexpression of substance P and CGRP in neurons through the ganglion. Subcutaneous injection of supernatant from the MDA-MB-231LUC+ cell culture in normal animals mimicked some of the changes in mechanically responsive afferents observed with mandibular metastasis. We conclude that released products from these cancer cells in the mandible are critical for the development of cancer-induced pain and that the overall response of the system greatly surpasses these local effects, consistent with the widespread distribution of pain in patients. The mechanisms of neuronal plasticity likely occur in the TG itself and are not restricted to afferents exposed to the metastatic cancer microenvironment.
Can discreet performance banding, as compared to bio-banding, discriminate technical skills in male adolescent soccer players? A preliminary investigation
Authors: Moran Jason , Cervera Victor , Jones Benjamin , Hope Edward , Drury Ben , Sandercock Gavin
Published: July 2021

Maturation-related changes in body dimensions and performance can lead to physical mismatches and drop out from youth sport. Here, we propose a new method termed ‘discreet performance banding’ (DPB). We aimed to determine if dividing youths by actual physical performance of a discreet skill or ability (‘change or direction’ [COD] ability) could discriminate between the most and least skilled players better than a marker of implied performance, such as an assessment of biological maturation. 182 male academy Spanish soccer players (age: 13-18 years height: 143 to 188 cm; mass: 32.3 to 81.4 kg) were divided into maturation groups (Tanner stages 2 through 5) and COD groups (‘fast’, ‘intermediate’ and ‘slow’). Players’ skills (passing, shooting, ball control) were evaluated on a six-point scale with a value of ‘1’ considered ‘very bad’ and a value of ‘6’ as ‘very good’. When divided by maturity status, analyses revealed no significant differences between groups in soccer skill. However, when divided into COD groups, the analyses revealed significant differences between the fast and intermediate players ([p < 0.001] favouring the fast group) and between the intermediate and slow players ([p < 0.026] favouring the slow group). There was no significant difference in skill between the fast and slow groups, though the fast group demonstrated a higher skill level as indicated by a small effect size. Fast players were more skilful than both the intermediate and slower players, indicating that COD status can be a differentiating factor between players of different skill levels. DPB could be used to equalise competition in youth sport and to enhance the overall level of enjoyment that youths derive from engagement in sport.
The Nicaragua Protest Crisis in 2018–2019: Assessing the Logic of Government Responses to Protests
Authors: Klein Graig R. , Cuesta José , Chagalj Cristian
Published: July 2021

Despite constant monitoring, we lack a good explanation for the 2018–2019 protest crisis in Nicaragua. The escalation of protests, repression, duration, and the death toll are surprising. Applying a novel political and economic cost framework, we benchmark Nicaragua’s historical and recent political protests and explain the Ortega administration’s responses, thus providing a rich case (with comparative data for context) that makes sense of this extraordinary period of protest. The empirical analysis buttresses our qualitative case study of protest motivations and tactics and extreme state violence that define four phases of the conflict. The combination of qualitative and quantitative analyses creates one of the first robust studies of protest–response dynamics of this protest crisis. We conclude that these protests are unique with respect to previous protests in the country and the region and that government repression was a logical response in some phases but was inconsistently applied.
Intraoperative Use of Ultrasonography in the Reduction of Zygomatico-Maxillary Complex Fractures
Authors: Eswari Jagdish , Ravindran C. , Deepak C.
Published: July 2021

Study Design:

A single blind randomized controlled study.

Objective:

The aim of this study is to evaluate the use of ultrasonography intraoperatively to assess the reduction of unilateral zygomatic complex fractures with a control group using the conventional blind digit palpation.

Methods:

The study comprised of a sample size of 24 patients with 21 male and 3 female patients. Patients of all age groups diagnosed with unilateral displaced zygomatic complex fracture with or without mandible fracture were included in the study. The subjects were randomized into study and control groups based on a standard protocol with a total of 24 patients. Imaging was in the form of a preoperative and postoperative 3D computed tomography scan with reconstruction of the maxilla and mandible to interpret the diagnosis for all subjects. The inter-fracture distance of the fractured infraorbital rim were measured in 3 dimensions (antero-posterior, medio-lateral and supero-inferior) and compared pre and postoperatively. Preoperative, intraoperative and postoperative ultrasonographic examination was performed and recorded on all patients at the frontozygomatic region, infraorbital rim and zygomatic buttress to assess the proximity of the fractured margins pre reduction, post reduction and post fixation of the fracture segments.

Result:

Statistical analytic results were significant in all 3 dimensions when measured postoperatively using computed tomography.

Conclusion:

Ultrasonography is an effective screening and intraoperative tool in the armamentarium of oral and maxillofacial surgery to assess zygomatic complex fractures, avoiding incisions in aesthetic areas of the maxillofacial region.
Supraspinatus Tenotomy in Reverse Shoulder Arthroplasty for Fractures: A Comparative Cohort Study
Authors: Siebenbürger Georg , Fleischhacker Evi , Gleich Johannes , Helfen Tobias , Böcker Wolfgang , Ockert Ben
Published: July 2021

Background:

The aim of this study was to evaluate the functional and radiographic outcome in patients with reverse total shoulder arthroplasty (RSA) for displaced proximal humeral fractures (PHF) with or without tenotomy of the supraspinatus tendon.

Methods:

Between June 2011 and June 2018, 159 patients (age >65 years) with a displaced proximal humeral fracture underwent reverse total shoulder arthroplasty (Grammont design) in a single-center study and were longitudinally followed up. In all cases, the tuberosities were attached to the prosthesis in a standardized procedure. Functional outcome, range of motion as well as tuberosity integration, resorption and displacement were assessed at final follow-up. Outcomes were compared between patients that underwent RSA in combination with tenotomy of the supraspinatus (ST) and patients that underwent RSA without supraspinatus tenotomy (NT).

Results:

At a mean follow up of 22.2 ± 16.4 months 76 patients (mean age 77.1 ± 7.2 years, 83% women) could be evaluated (follow-up rate 47.8%). There were no statistically significant differences between the ST (n = 29) and NT groups (n = 47) in tuberosity integration, resorption </≥50%, or displacement (p = 0.99/0.31/0.7/0.99). Functional outcome was better in ST group (Constant score 76.2 ± 5.9 vs. 64.5 ± 12.8; p < 0.05) especially regarding mean active external rotation (>20°: 65.5% vs. 14.9%, p < 0.05) and active abduction (>120°: 89.7% vs. 21.3%, p < 0.05). Tuberosity integration (ST and NT together: n = 34) showed better functional results than resorption or displacement (p < 0.05).

Conclusions:

Tenotomy of the supraspinatus tendon in RSA for displaced PHF leads to similar radiographic results regarding tuberosity integration, resorption and displacement but better functional outcome with regard to range of motion.

Level of Evidence:

III
Drivers Affecting the Acceptance and Use of Electronic Learning Among Ugandan University Students in the COVID-19 Era: A Cross-Sectional Survey Among Three Universities
Authors: Twinamasiko Nelson , Nuwagaba Julius , Maria Gwokyalya Anna , Nakityo Innocent , Wasswa Enock , Sserunjogi Emmanuel
Published: July 2021

COVID-19 is an emerging and highly infectious disease that is becoming a global health challenge affecting all sectors. To prevent COVID-19 transmission, all education institutions were closed and advised to turn to online learning. The present study sought to determine the factors affecting the acceptance and use of electronic learning among Ugandan University students in three universities. The study relied on two data collection instruments: a questionnaire and a semi-structured interview. An online cross-sectional survey was conducted on a population of students in three pre-selected universities: Kyambogo (KYU), Makerere (MAK), and Kampala International University (KIU). Of the 614 questionnaires returned, 578 were valid; 65.4% of the respondents were males; 60.7% were from MAK and the majority being in their third year of study (49%). Overall, 69.2% had good knowledge, 22.5% had positive attitudes toward e-learning. The semi-structured interviews revealed connectivity and skills challenges as the main barriers to the implementation of e-learning. For better implementation of e-learning by Universities, effective planning needs to be done with active students’ involvement to avert negative attitudes. We recommend more studies be done on the Universities’ preparedness for the implementation of e-learning. Universities should collaborate with telecommunication companies to provide subsidized prices for internet costs and information and communications technology (ICT) equipment to students.
How Phishers Exploit the Coronavirus Pandemic: A Content Analysis of COVID-19 Themed Phishing Emails
Authors: Akdemir Naci , Yenal Serkan
Published: July 2021

This empirical study is an exploration of the influence methods, fear appeals, and urgency cues applied by phishers to trick or coerce users to follow instructions presented in coronavirus-themed phishing emails. To that end, a content analysis of 208 coronavirus-themed phishing emails has been conducted. We identified nine types of phishing messages crafted by phishers. Phishing emails purporting to provide information about the spread of the disease were the most common type of unsolicited emails. Authority, liking and commitment emerged as the most common influence methods. Fear appeals and urgency cues were present in almost all of the sampled phishing messages. Finally, the analysis of coronavirus-themed phishing emails revealed a shift in the modus operandi of phishers. The implications of these results are discussed in this paper.
Can Workplace Fun Moderate Organizational Identification and Job Satisfaction Relationship
Authors: Ugheoke Solomon Ozemoyah , Mashi Munir Shehu , Isa Mohd Faizal Mohd
Published: July 2021

Job satisfaction is critical to the changing and growing challenges of the service sector. The present research study investigates the moderation effect of workplace fun on the relationship between organizational identification (OID) and job satisfaction. The sample was 220 frontline employees in 57 hotels in Nigeria. We found that OID positively influenced job satisfaction. Additionally, workplace fun moderated the effect of OID onjob satisfaction. The findings suggest that organizational leaders can use fun to generate favorable organizational outcomes. We also found that OID promotes workplace fun, which, in turn, results in high job satisfaction. The implication is that when employees feel a sense of oneness within an organization, they will effectively define their work roles and feel accountable for the decision. Organizations that want to inspire positive customer relation behaviors should encourage employees’ OID and implement friendly workplace practices. The study added twofold values to this research area. We explore OID and workplace fun. The study also explores the moderation effect of workplace fun on the relationship between OID and job satisfaction. Thus, managers can increase employee job satisfaction by encouraging workplace fun.
Developing Adult Vaccination Ecosystem in India: Current Perspective and the Way Forward
Authors: Ghia Canna Jagdish , Rambhad Gautam Sudhakar
Published: July 2021

Introduction:

A high burden of vaccine-preventable diseases, increasing elderly population, immunosenescence, and emerging drug resistance emphasize the need for robust adult immunization in India. While immunization guidelines from various societies exist, there is inadequate implementation of the same.

Aim:

We undertook this narrative review of the adult vaccination ecosystem in India to (i) gain insights into existing adult vaccination practices, (ii) identify barriers to adult vaccination and possible solutions, and (iii) improve collaboration between various stakeholders to help establish adult vaccination centers in the country.

Results:

Besides the high cost and lack of insurance coverage, the lack of adult vaccination centers contributes to the low coverage of adult immunization.

Discussion:

These challenges can be addressed through multiple approaches including community awareness and immunization programs, setting up mobile vaccination vans, patient/consumer education, and adequate training of healthcare providers. Successful implementation of these strategies requires active collaboration between the government, hospitals, different stakeholders, and policymakers.
Open Latarjet-Patte Procedure for Anterior Shoulder Stabilization: Critical Steps and Pearls for the Walch Technique
Authors: Bauer Stefan , Coron Charline , Lannes Xavier , Walch Gilles , Blakeney William G.
Published: July 2021

Background:

Latarjet is a term used for different techniques and modifications to expose the glenoid and to transfer and fix the coracoid. The procedure is intricate and technically demanding. Outcomes and complications are heterogeneous in the literature. A master technique, the Walch technique, has been practiced for decades, with outstanding long-term results and patient satisfaction.

Indications:

Documented anterior dislocations with evidence for emergency reduction, with or without hyperlaxity and confirmation of a traumatic capsuloligamentous lesion. Contraindications include voluntary dislocations and multidirectional instability without these criteria. The Instability Severity Index Score can guide decision making on whether Bankart surgery is sufficient. Large Hill-Sachs lesions may be an indication for additional remplissage.

Technique Description:

Three key maneuvers and 6 surgical stages need to be mastered for consistent results. Key maneuvers include: (1) arm positioning for all stages, (2) retractor placement, and (3) safe conjoint tendon releases. Six key stages include: (1) coracoid exposure and initial release; (2) osteotomy and subsequent release; (3) bone preparation; (4) subscapularis split and arthrotomy; (5) 360° scapula neck exposure; and (6) cornerstone drill hole positioning, fixation, and simple capsuloplasty. Specific arm positioning facilitates coracoid exposure, releases, subscapularis split, arthrotomy, and retractor insertion, as well as capsular repair. A 360° anterior scapula neck exposure is crucial to drill the inferior cornerstone hole (2.5 for 4.0 partially threaded cancellous screw) 7 mm medial to the articular surface with mandatory direction parallel to the articular surface. The bone block can be dialed to the exact position, preventing lateral overhang. The capsule is closed to the coracoacromial ligament stump in 45° of external rotation.

Results:

A series of >80 cases with minimum 1-year follow-up (range: 1-5 years) demonstrated excellent results. Outcomes were good to excellent (Subjective Shoulder Value >80% in 95% of cases; Constant score >90% and Rowe score > 90%) in keeping with the Walch results (>1000 cases). The complication rate was low: 1 early coracoid fracture (1.3%), no dislocation and neurological complications, no new arthritis or progression, and good coracoid position without lateral overhang.

Conclusion:

The Walch technique, although technically demanding, provides excellent, consistently reproducible results once the 3 key surgical maneuvers and 6 stages of the procedure are mastered.
JAK inhibition for murine HLH requires complete blockade of IFN-γ signaling and is limited by toxicity of JAK2 inhibition
Authors: Chaturvedi Vandana , Lakes Nora , Tran Minh , Castillo Natalie , Jordan Michael B.
Published: July 2021

Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory disorder in which numerous cytokines are elevated, though interferon-γ (IFN-γ) is central to disease pathogenesis and a key therapeutic target. Experimental and early clinical reports have shown that ruxolitinib, a small molecule inhibitor of Janus kinases (JAKs), which are essential for cytokine signaling, may be therapeutic in HLH. In contrast, we found that intermittently administered ruxolitinib at various dose levels failed to prevent HLH development or treat established murine HLH. High doses of ruxolitinib blocked IFN-γ signaling only transiently after administration, consistent with human pharmacokinetics, and only continuously administered drug could prevent HLH development or treat established HLH. Continuously administered ruxolitinib was therapeutic in only a narrow dose range and intermittently dosed ruxolitinib worsened survival and decreased bone marrow cellularity of animals concurrently treated with anti-IFN-γ antibody, indicating a narrow therapeutic window and potential toxicity. Because JAK2 is essential for hematopoietic cytokine signaling, we also tested a JAK1-selective inhibitor and observed therapeutic benefit without apparent toxicity, though it did not improve survival when combined with anti-IFN-γ. We conclude that continuous blockade of IFN-γ signaling is necessary for optimal control of HLH and that JAK2 inhibition may be toxic in this disorder.
Viral infections that alter estrogen levels during pregnancy may contribute to the etiology of cryptorchidism
Authors: Hadziselimovic Faruk
Published: July 2021

Cryptorchidism is as common as type 2 diabetes or celiac disease. Boys with congenital cryptorchidism are at increased risk of infertility and testicular cancer. Zika syndrome, which affects pregnant women, is associated with a high incidence of undescended testes in the infant, accompanied by epididymal anomalies. Zika and influenza virus infections during pregnancy trigger a strong anti-inflammatory immune response and elevated estradiol levels. Elevated estradiol and α-fetoprotein in syncytiotrophoblasts from women who have given birth to cryptorchid boys are indicative of increased estradiol levels in the fetus. Here, I present a hypothesis that hypogonadotropic hypogonadism, cryptorchidism, and retarded epididymal development may be due to elevated fetal estradiol levels caused by viral infection during pregnancy.
Selection of functional EPHB2 genotypes from ENU mutated grass carp treated with GCRV
Authors: Nissa Meher un , Jiang Zhu-Xiang , Zheng Guo-Dong , Zou Shu-Ming
Published: July 2021

Background

N-ethyl-N-nitrosourea (ENU) mutagenesis is a useful method for the genetic engineering of plants, and the production of functional mutants in animal models including mice and zebrafish. Grass carp reovirus (GCRV) is a haemorrhagic disease of grass carp which has caused noteworthy losses in fingerlings over the last few years. To overcome this problem, we used ENU mutant grass carp in an attempt to identify functional resistance genes for future hereditary rearing projects in grass carp.

Results

This study used ENU-mutated grass carp to identify genetic markers associated with resistance to the haemorrhagic disease caused by GCRV. Bulked segregant analysis (BSA) was performed on two homozygous gynogenetic ENU grass carp groups who were susceptible or resistant to GCRV. This analysis identified 466,162 SNPs and 197,644 InDels within the genomes of these mixed pools with a total of 170 genes annotated in the associated region, including 49 genes with non-synonymous mutations at SNP sites and 25 genes with frame shift mutations at InDel sites. Of these 170 mutated genes, 5 randomly selected immune-related genes were shown to be more strongly expressed in the resistant group as compared to the susceptible animals. In addition, we found that one immune-related gene, EPHB2, presented with two heterozygous SNP mutations which altered the animal’s responded to GCRV disease. These SNPs were found in the intron region of EPHB2 at positions 5859 (5859G > A) and 5968 (5968G > A) and were significantly (p = 0.002, 0.003) associated with resistance to GCRV. These SNP sites were also shown to correlate with the GCRV-resistant phenotype in these ENU grass carp. We also evaluated the mortality of the different ENU fish genotypes in response to GCRV and the SNPs in EPHB2. The outcomes of these evaluations will be useful in future selections of GCRV-resistant genes for genetic breeding in grass carp.

Conclusion

Our results provide a proof of concept for the application of BSA-sequence analysis in detecting genes responsible for specific functional genotypes and may help to develop better methods for marker-assisted selection, especially for disease resistance in response to GCRV.
Comparison of base excess, lactate and pH predicting 72-h mortality of multiple trauma
Authors: Qi Junfang , Bao Long , Yang Peng , Chen Du
Published: July 2021

Objective

To compare the predictive values of base excess (BE), lactate and pH of admission arterial blood gas for 72-h mortality in patients with multiple trauma.

Methods

This was a secondary analysis based on a publicly shared trauma dataset from the Dryad database, which provided the clinical data of 3669 multiple trauma patients with ISS > = 16. The records of BE, lactate, pH and 72-h prognosis data without missing values were selected from this dataset and 2441 individuals were enrolled in the study. Logistic regression model was performed to calculate the odds ratios (ORs) of variables. Area under the curve (AUC) of receiver operating curve (ROC) was utilized to evaluate the predictive value of predictors for 72 h in-hospital mortality. Pairwise comparison of AUCs was performed using the Delong’s test.

Results

The statistically significant correlations were observed between BE and lactate (r = − 0.5861, p < 0.05), lactate and pH (r = − 0.5039, p < 0.05), and BE and pH (r = − 0.7433, p < 0.05). The adjusted ORs of BE, lactate and pH for 72-h mortality with the adjustment for factors including gender, age, ISS category were 0.872 (95%CI: 0.854–0.890), 1.353 (95%CI: 1.296–1.413) and 0.007 (95%CI: 0.003–0.016), respectively. The AUCs of BE, lactate and pH were 0.693 (95%CI: 0.675–0.712), 0.715 (95%CI: 0.697–0.733), 0.670 (95%CI: 0.651–0.689), respectively.

Conclusions

There are significant correlations between BE, lactate and pH of the admission blood gas, all of them are independent predictors of 72-h mortality for multiple trauma. Lactate may have the best predictive value, followed by BE, and finally pH.
Identification of novel genes involved in apoptosis of HIV-infected macrophages using unbiased genome-wide screening
Authors: Dong Simon X. M. , Vizeacoumar Frederick S. , Bhanumathy Kalpana K. , Alli Nezeka , Gonzalez-Lopez Cristina , Gajanayaka Niranjala , Caballero Ramon , Ali Hamza , Freywald Andrew , Cassol Edana , Angel Jonathan B. , Vizeacoumar Franco J. , Kumar Ashok
Published: July 2021

Background

Macrophages, besides resting latently infected CD4+ T cells, constitute the predominant stable, major non-T cell HIV reservoirs. Therefore, it is essential to eliminate both latently infected CD4+ T cells and tissue macrophages to completely eradicate HIV in patients. Until now, most of the research focus is directed towards eliminating latently infected CD4+ T cells. However, few approaches have been directed at killing of HIV-infected macrophages either in vitro or in vivo. HIV infection dysregulates the expression of many host genes essential for the survival of infected cells. We postulated that exploiting this alteration may yield novel targets for the selective killing of infected macrophages.

Methods

We applied a pooled shRNA-based genome-wide approach by employing a lentivirus-based library of shRNAs to screen novel gene targets whose inhibition should selectively induce apoptosis in HIV-infected macrophages. Primary human MDMs were infected with HIV-eGFP and HIV-HSA viruses. Infected MDMs were transfected with siRNAs specific for the promising genes followed by analysis of apoptosis by flow cytometry using labelled Annexin-V in HIV-infected, HIV-exposed but uninfected bystander MDMs and uninfected MDMs. The results were analyzed using student’s t-test from at least four independent experiments.

Results

We validated 28 top hits in two independent HIV infection models. This culminated in the identification of four target genes, Cox7a2, Znf484, Cstf2t, and Cdk2, whose loss-of-function induced apoptosis preferentially in HIV-infected macrophages. Silencing these single genes killed significantly higher number of HIV-HSA-infected MDMs compared to the HIV-HSA-exposed, uninfected bystander macrophages, indicating the specificity in the killing of HIV-infected macrophages. The mechanism governing Cox7a2-mediated apoptosis of HIV-infected macrophages revealed that targeting respiratory chain complex II and IV genes also selectively induced apoptosis of HIV-infected macrophages possibly through enhanced ROS production.

Conclusions

We have identified above-mentioned novel genes and specifically the respiratory chain complex II and IV genes whose silencing may cause selective elimination of HIV-infected macrophages and eventually the HIV-macrophage reservoirs. The results highlight the potential of the identified genes as targets for eliminating HIV-infected macrophages in physiological environment as part of an HIV cure strategy.
The hidden burden of adolescent pregnancies in rural Sri Lanka; findings of the Rajarata Pregnancy Cohort
Authors: Agampodi Thilini Chanchala , Wickramasinghe Nuwan Darshana , Jayakodi Hemali Gayathri , Amarasinghe Gayani Shashikala , Warnasekara Janith Niwanthaka , Hettiarachchi Ayesh Umeshana , Jayasinghe Imasha Upulini , Koralegedara Iresha Sandamali , Gunarathne Sajaan Praveena , Somasiri Dulani Kanchana , Agampodi Suneth Buddhika
Published: July 2021

Background

Adolescent fertility is a main indicator of the Sustainable Developmental Goal (SGD) three. Although Sri Lanka is exemplary in maternal health, the utilization of Sexual and Reproductive Health services (SRH) by adolescents is less documented. We describe the hidden burden, associated biological and psychosocial factors and utilization patterns of pre-conceptional services among pregnant adolescents in rural Sri Lanka.

Methods

The study is based on the baseline assessment of the Rajarata Pregnancy Cohort (RaPCo) in Anuradhapura. Pregnant women newly registered from July to September 2019 were recruited to the study. The period of gestation was confirmed during the second follow-up visit (around 25–28 weeks of gestation) using ultra sound scan data. A history, clinical examination, anthropometric measurements, blood investigations were conducted. Mental health status was assessed using the Edinburgh Postpartum Depression Scale (EPDS).

Results

Baseline data on gestation was completed by 3,367 pregnant women. Of them, 254 (7.5%) were adolescent pregnancies. Among the primigravida mothers (n = 1037), 22.4% (n = 233) were adolescent pregnancies. Maternal and paternal low education level, being unmarried, and less time since marriage were statistically significant factors associated with adolescent pregnancies (p < 0.05). Contraceptive usage before pregnancy, utilization of pre-conceptional health care services, planning pregnancy and consuming folic acid was significantly low among adolescents (p < 0.001). They also had low body mass index (p < 0.001) and low hemoglobin levels (p = 0.03). Adolescent mothers were less happy of being pregnant (p = 0.006) and had significantly higher levels of anxiety (p = 0.009).

Conclusion

One fifth of women in their first pregnancy in this study population are adolescents. Nulli-parous adolescents exert poor social stability and compromised physical and mental health effects. The underutilization and/or unavailability of SRH services is clearly associated with adolescent pregnancies.
Reliability of last menstrual period recall, an early ultrasound and a Smartphone App in predicting date of delivery and classification of preterm and post-term births
Authors: Majola Linda , Budhram Samantha , Govender Vani , Naidoo Megeshinee , Godlwana Zukiswa , Lombard Carl , Moodley Dhayendre
Published: July 2021

Background

A reliable expected date of delivery (EDD) is important for pregnant women in planning for a safe delivery and critical for management of obstetric emergencies. We compared the accuracy of LMP recall, an early ultrasound (EUS) and a Smartphone App in predicting the EDD in South African pregnant women. We further evaluated the rates of preterm and post-term births based on using the different measures.

Methods

This is a retrospective sub-study of pregnant women enrolled in a randomized controlled trial between October 2017-December 2019. EDD and gestational age (GA) at delivery were calculated from EUS, LMP and Smartphone App. Data were analysed using SPSS version 25. A Bland–Altman plot was constructed to determine the limits of agreement between LMP and EUS.

Results

Three hundred twenty-five pregnant women who delivered at term (≥ 37 weeks by EUS) and without pregnancy complications were included in this analysis. Women had an EUS at a mean GA of 16 weeks and 3 days). The mean difference between LMP dating and EUS is 0.8 days with the limits of agreement 31.4–30.3 days (Concordance Correlation Co-efficient 0.835; 95%CI 0.802, 0.867). The mean(SD) of the marginal time distribution of the two methods differ significantly (p = 0.00187). EDDs were < 14 days of the actual date of delivery (ADD) for 287 (88.3%;95%CI 84.4–91.4), 279 (85.9%;95%CI 81.6–89.2) and 215 (66.2%;95%CI 60.9–71.1) women for EUS, Smartphone App and LMP respectively but overall agreement between EUS and LMP was only 46.5% using a five category scale for EDD-ADD with a kappa of .22. EUS 14–24 weeks and EUS < 14 weeks predicted EDDs < 14 days of ADD in 88.1% and 79.3% of women respectively. The proportion of births classified as preterm (< 37 weeks) was 9.9% (95%CI 7.1–13.6) by LMP and 0.3% (95%CI 0.1–1.7) by Smartphone App. The proportion of post-term (> 42 weeks gestation) births was 11.4% (95%CI 8.4–15.3), 1.9% (95%CI 0.9–3.9) and 3.4% (95%CI 1.9–5.9) by LMP, EUS and Smartphone respectively.

Conclusions

EUS and Smartphone App were the most accurate to estimate the EDD in pregnant women. LMP-based dating resulted in misclassification of a significantly greater number of preterm and post-term deliveries compared to EUS and the Smartphone App.
Optimizing parenteral nutrition to achieve an adequate weight gain according to the current guidelines in preterm infants with birth weight less than 1500 g: a prospective observational study
Authors: Wang Nan , Cui Lianlian , Liu Zhen , Wang Yan , Zhang Yuhua , Shi Changsong , Cheng Yanbo
Published: July 2021

Aim

European Society for Clinical Nutrition and Metabolism released the guidelines on pediatric parenteral nutrition in 2018. We aimed to compare the parenteral nutrition (PN) regimen with the current guidelines, evaluate weight gain and explore the correlation of parenteral macronutrient and energy intakes with weight gain outcome in preterm infants with birth weight less than 1500 g.

Methods

A prospective observational study was conducted. Parenteral macronutrients and energy intakes were described. Weight gain during PN was assessed. Nutritional factors associated with weight gain outcome after PN were identified using a cox proportional hazards model.

Results

A total of 163 infants were included in this study, in which 41 were extremely low birth weight (ELBW) infants and 122 were very low birth weight (VLBW) infants. Average glucose, amino acid, lipid, and energy during the first postnatal week were 7.5 g/kg/d, 2.4 g/kg/d, 0.8 g/kg/d, 48 kcal/kg/d. Median maximum glucose, amino acid, lipid, and energy were 11.1 g/kg/d, 3.5 g/kg/d, 3 g/kg/d, 78 kcal/kg/d. Median days to maximum glucose, amino acid, lipid, and energy were 10, 9, 12, 11 days. The proportion of appropriate for gestational age (AGA) infants was 76.9%. The ratio of infants without poor weight gain outcome after PN was 38%. With every 0.1 g/kg/d decrease of maximum amino acid and average lipid during the first postnatal week, the probability of appropriate weight gain outcome decreased by 77.6 and 74.4% respectively. With each additional day to maximum glucose and energy, the probability of appropriate weight gain outcome decreased by 5.6 and 6.1% respectively.

Conclusions

Most preterm infants with birth weight less than 1500 g remain below the latest recommended nutrition goals. The poor weight gain outcome of these infants after PN is related to insufficient parenteral macronutrient and energy intakes. PN strategies should be improved according to the latest evidence-based recommendations.
The characteristics and trend of adverse events following immunization reported by information system in Jiangsu province, China, 2015–2018
Authors: Hu Ran , Peng Shanshan , Liu Yuanbao , Tang Fengyang , Wang Zhiguo , Zhang Lei , Gao Jun , Guo Hongxiong
Published: July 2021

Objective

Adverse events following immunization is an important factor influencing public trust in vaccination. Publicizing its incidence timely can increase public trust. The aim of this study is to describe the incidence and characteristics of adverse events following immunization in Jiangsu province of China from 2015 to 2018.

Methods

All information of adverse events following immunization (AEFIs) was gained from Jiangsu Province Vaccination Integrated Service Management Information System. The reported AEFI trend was analyzed using Chi-square test.

Results

A total of 77,980 AEFI cases were reported through the AEFI system; Among which, 77,731 were classified as non-serious AEFI cases and 249 were serious AEFI cases. The male to female ratio was 1.31:1, cases less than 7 years old accounted for 97.7%. The total estimated AEFI rate was 62.70/100,000 doses. By severity, 60.75/100,000, 4.46/100,000 and 0.11/100,000 AEFI cases were common vaccine reaction, rare vaccine reaction, and serious rare vaccine reaction, respectively. The top two serious AEFI were thrombocytopenic purpura and febrile. The incidence rates showed the increasing trend and the linear trend of the increasing incidence rates passed the significant test at 0.05 levels.

Conclusion

The sensitivity of AEFI monitoring in Jiangsu Province is increasing and higher than the national average and most countries. The majority of AEFI cases were common adverse reactions, while the serious vaccine reactions caused by vaccines were extremely low. To elevate the sensitivity of AEFI surveillance may reduce the incidence of developing serious AEFI cases.
Current practices of waste management in teaching hospitals and presence of incinerators in densely populated areas
Authors: Khalid Salma , Haq Najibul , Sabiha Zia-ul-Ain , Latif Abdul , Khan Muhammad Amjad , Iqbal Javaid , Yousaf Nowsher
Published: July 2021

Background

Hospital waste management (HWM) practices are the core need to run a proper health care facility. This study encompasses the HWM practices in teaching hospitals of Peshawar, Pakistan and examine the enforcement of Pak HWM (2005) rules and risks through transmission of pathogens via blood fluids, air pollution during waste incineration and injuries occurring in conjunction with open burning and dumping.

Methods

A questionnaire based on World Health Organization (WHO) recommendations was used to survey the selected private and public teaching hospital (n = 16). Site visits and personnel observations were also included in the data. It was spatio-statistically analyzed using descriptive statistics, Krushkal-wallis and Fisher’s exact tests.

Results

The findings revealed that the lack of HWM practices in all surveyed hospitals (p > 0.05), besides statistical difference (p < 0.017) in waste generation/day. No proper segregation of waste from generation point to final disposal was practiced. However, the performance of private teaching hospitals (50%) was found better in terms of HWM personnel and practices. In surveyed hospitals, only nine hospitals (56.3%) were found with the incinerator facility while rest of the hospitals (43.7%) practiced open dumping. Moreover, operational parameters of the incinerators were not found satisfactory and located in densely populated areas and emitting hazardous gases.

Conclusion

Proper HWM practices are not being followed in the light of WHO guidelines. Hospital waste impose serious menace to healthcare workers and to nearby population. WHO issued documents for improving HWM practices but triggered no change in Pakistan. To improve the situation, insights in this context is need for enforcement of rules.