bluuebunny/crossref_metadata_2025 huggingface dataset:
Extraction of Broken Tibial Interlock Nail with a Retrograde Hooked Guide Wire: A Novel Surgical Technique
Authors: Garg Bipul K , Dave Harshit
Published: August 2021

Introduction: Removal of a distal piece of a broken nail often possesses a technical challenge. Several methods have been described in the past to extract a distal piece by using specialized instruments like such as hooks, olive wires, and talwalkar radial square nail etc. It is difficult to extract a distal piece from a proximal incision site and often fracture or the nonunion site has to be opened. In this article, we describe a novel technique to extract a distal piece of broken intramedullary tibia nail by retrograde manner using a guide wire with a “‘U”’ shaped bend at its distal end to hook the tip of a distal piece of broken nail and help in extraction.
Case Report: A 43- year-s old male presented with complain of pain in left leg since 3 months. Patient had sustained left- sided compound Grade 2 tibia shaft fracture in a road traffic accident 4 years back. He was operated with tibia interlock nail followed by skin grafting for wound coverage in a different facility. On clinical examination: There was tenderness around distal tibia, no swelling, no coronal or sagittal plane fracture mobility, and no crepitus or loss of transmitted movements which suggested fracture union clinically. Radiographs confirmed complete union of tibia shaft fracture with hypertrophic nonunion of distal fibula with broken intramedullary nail IMN at the level of proximal most screw hole of distal locking holes with both distal locking screws broken. As fracture was united, we planned for removal of broken nail without opening fracture site. For extraction for distal tibial broken nail part, we used this new Retrograde Hooked Guide Wire technique.
Conclusion: It is a simple, cost effective, minimally invasive procedure with minimal blood loss and decrease time of surgery that can be used before attempting more invasive extraction methods and hence should be included in standard procedures for extraction.
Keywords: Tibia, interlock nail, broken nail, retrograde guide wire, nail removal.
Management for Bony Mallet Thumb with a Single Extension Blocking Kirschner Wire
Authors: Lim Sean-Tee J.M , Qadeer Muhammad Abrar , Kelly Martin , Lenehan Brian
Published: August 2021

Introduction: Mallet finger injury is defined by disruption of the terminal extensor tendon distal-to-distal interphalangeal (DIP) joint. While in the fingers, it is a relatively common injury, it is a rarely encountered entity when involving the thumb. Various conservative and operative treatment strategies have been reported for the management of mallet thumb with no consensus by clinicians.
Case Report: We present the case of a 27-year-old right hand dominant man with a left bony mallet thumb injury that occurred while playing hurling. Hurling is traditional Irish sport that is one of the fastest field games in the world, involving the use of a wooden Hurley and ball. Clinically, there was loss of active extension at the DIP joint of the non-dominant thumb with radiographs revealing an avulsion fracture involving more than one-third of the articular surface at the base of the distal phalanx. Closed reduction and percutaneous fixation using a single extension block Kirschner wire was performed without a transfixion wire across the DIP joint. Four months postoperatively, the patient had regained that good functional dexterity was able to return to playing hurling.
Conclusion: A single K-wire technique may be beneficial with theoretical reduction of chance of iatrogenic nail bed, bone fragment rotation, chondral damage, and bone injury. To the best of our knowledge, no previous reports of its application to bony mallet thumb have been described.
Keywords: Mallet fracture, K-wire, hurling, trauma, closed reduction
Management of Necrotizing Fasciitis with Proximal Tibia Fracture
Authors: Patil Shubhankar , Kumar Dilip , Rao Karthik , Dipu Navratan
Published: August 2021

Introduction: Necrotizing fasciitis is a rare disease of soft tissue infection with a high mortality. It is characterized by rapidly spreading inflammation and necrosis of fascial planes. It usually follows an injury, though the cause may be a small abrasion or an insect bite or surgical incisions. It is commonly caused by bacteria such as Group A streptococcus. It may be accompanied by septic shock. It causes rapid death unless it is diagnosed quickly and managed aggressively. Prompt surgical debridement must be done to reduce mortality. Rapid diagnosis, antibiotic therapy, fluid resuscitation, and surgical debridement of the infection are all needed in the management of this fatal disease. However, when necrotizing fasciitis is associated with an underlying fracture the treatment becomes even challenging and limb-threatening.
Case Report: A 48-year-male patient of South Asian descent came to Emergency Room with history of road traffic accident and sustained injury to the right (RT) leg. He was admitted with pain, swelling and blisters of the RT leg and suspected to have necrotizing fasciitis with proximal tibia fracture of the RT leg. He was treated with thorough surgical debridement, broad-spectrum antibiotics, free flap, and Masquelet’s technique with limb reconstruction system (LRS). At 18 months of follow-up the fracture healed, LRS was removed, pin tracts healed and patient was able to walk without any support.
Conclusion: Necrotizing fasciitis is rare, rapidly progressive disease with a high mortality rate which requires prompt diagnosis, early surgical debridement, broad-spectrum antibiotics, careful fluid, and electrolyte management. These patients require a combined multidisciplinary approach for their management.
Keywords: Necrotizing fasciitis, proximal tibia fracture, surgical debridement.
Post-traumatic Late Presentation of Morel–Lavallée: Case Report and Review of Literature
Authors: Boushnak Mohammad O , Rabah Hussein , Saleh Mohammad H , Aaraj George Al , Hajjar Samer , Moussa Mohamad K
Published: August 2021

Introduction: Morel–Lavallée (MLL) is an uncommon entity that is missed by many physicians, it is the result of a shearing force that leads to degloving of the subcutaneous fat from the underlying deep fascia.
Case Report: We present a case of a 15-year-old male patient who presented 3 months after the initial crush injury with a large MLL lesion at the lateral aspect of the right proximal thigh. He was treated with incision and drainage with compressive dressing and a negative pressure drain.
Conclusion: Diagnosis of MLL is usually clinical and can be aided with radiological tools like MRI that is the gold standard of imaging in this lesion. Several treatment options are available, ranging from conservative treatment with compressive bandages to percutaneous drainage, injection of sclerotic agents, and surgical treatment with incision, drainage, and debridement. Diagnosis and treatment should be familiar to all caregivers to prevent further complications that could be life or organ-threatening.
Keywords: Morel–Lavallée, thigh trauma, chronic Morel–Lavallée, thigh mass.
Highly stable sub-nanosecond Nd:YAG pump laser for optically synchronized optical parametric chirped-pulse amplification
Authors: Miyasaka Yasuhiro , Kondo Kotaro , Kishimoto Maki , Mori Michiaki , Kando Masaki , Kiriyama Hiromitsu
Published: August 2021

We developed an optically synchronized highly stable frequency-doubled Nd:YAG laser with sub-nanosecond pulse duration. The 1064 nm seed pulses generated by soliton self-frequency shift in a photonic crystal fiber from Ti:sapphire oscillator pulses were stabilized by controlling input pulse polarization. The seed pulses were amplified to 200 mJ by diode-pumped amplifiers with a high stability of only <0.2% (rms). With an external LBO doubler, the system generated 330 ps green pulse energy of 130 mJ at 532 nm with a conversion efficiency of 65%. The pulse duration was further extended to 490 ps by adjusting Nd:YAG crystal temperature. To the best of our knowledge, these results present a longer pulse duration with higher stability than previous Nd:YAG lasers with sub-nanosecond optical synchronization.
Dual-beam intracavity optical tweezers with all-optical independent axial and radial self-feedback control schemes
Authors: Kuang Tengfang , Liu Zijie , Xiong Wei , Han Xiang , Xiao Guangzong , Chen Xinlin , Yang Kaiyong , Luo Hui
Published: August 2021

The feedback control to optical tweezers is an obvious approach to improve the optical confinement. However, the electronic-based feedback controlling system in optical tweezers usually consists of complex software and hardware, and its performance is limited by the inevitable noise and time-delay from detecting and controlling devices. Here, we present and demonstrate the dual-beam intracavity optical tweezers enabling all-optical independent radial and axial self-feedback control of the trapped particle’s radial and axial motions. We have achieved the highest optical confinement per unit intensity to date, to the best of our knowledge. Moreover, both the axial and radial confinements are adjustable in real-time, through tuning the foci offset of the clockwise and counter-clockwise beams. As a result, we realized three-dimensional self-feedback control of the trapped particle’s motions with an equivalent level in the experiment. The dual-beam intracavity optical tweezers will significantly expand the range of optical manipulation in further studies of biology, physics and precise measurement, especially for the sample that is extremely sensitive to heat.
Widely-tunable single-frequency diamond Raman laser
Authors: Yang Xuezong , Bai Zhenxu , Chen Dijun , Chen Weibiao , Feng Yan , Mildren Richard P.
Published: August 2021

We report a diamond Raman laser that is continuously-tunable across the range from 590 nm to 625 nm producing continuous wave output with up to 8 W. The system is based on an all-fiber and tunable (1020–1072 nm) Yb-doped pump laser with a spectral linewidth of 25 GHz that is Raman-shifted and frequency doubled in a cavity containing diamond and a lithium triborate second harmonic crystal. Despite the broad pump spectrum, single frequency output is obtained across the tuning range 590–615 nm. The results reveal a practical approach to obtain tunable high-power single-frequency laser in a wavelength region not well served by other laser technologies.
Design of ultra-broadband absorption enhancement in plasmonic absorber by interaction resonance of multi-plasmon modes and Fabry-Perot mode
Authors: Zeng Li , Zhang Xinlei , Ye Haining , Dong Hanqing , Zhang Haifeng
Published: August 2021

This paper shows a strategy to realize ultra-broadband absorption of multi-spectral coverage. A vertical cascaded plasmonic absorber constructed by multilayer helical metallic nanostructure wrapped in a pyramid-shaped dielectric jacket is presented and investigated by numerical simulations. By premeditated planning of the scale proportions of the spirals and the dimension size of the pyramid-shaped dielectric, more than 90% of absorption is realized in 189-3896 nm, an ultra-wide spectral range that basically covers the bands of near-ultraviolet, visible light, and near-infrared. The excitation mechanism of electromagnetic resonance and the formation process of light trapping are both included in the investigation through the analysis of electromagnetic field distribution. The localized surface plasmon mode in the metallic nano-spiral and the Fabry-Perot cavity mode with the gap plasmon resonance in the dielectric gap cooperatively make a significant contribution to reduce the reflection and form the ultra-broadband absorption. The simulation results show that the proposed absorber is basically insensitive to the incident angle and polarization angle, which basically keeps more than 90% absorption within the incident angle of ± 80 °. Such a specific implementation idea can also be applied to the terahertz region by modifying the geometrical size of the structure. This presented design implies new viability to develop the broadband photodetectors, solar cells, and thermal emitters.
Genome scans of facial features in East Africans and cross-population comparisons reveal novel associations
Authors: Liu Chenxing , Lee Myoung Keun , Naqvi Sahin , Hoskens Hanne , Liu Dongjing , White Julie D. , Indencleef Karlijne , Matthews Harold , Eller Ryan J. , Li Jiarui , Mohammed Jaaved , Swigut Tomek , Richmond Stephen , Manyama Mange , Hallgrímsson Benedikt , Spritz Richard A. , Feingold Eleanor , Marazita Mary L. , Wysocka Joanna , Walsh Susan , Shriver Mark D. , Claes Peter , Weinberg Seth M. , Shaffer John R.
Published: August 2021

Facial morphology is highly variable, both within and among human populations, and a sizable portion of this variation is attributable to genetics. Previous genome scans have revealed more than 100 genetic loci associated with different aspects of normal-range facial variation. Most of these loci have been detected in Europeans, with few studies focusing on other ancestral groups. Consequently, the degree to which facial traits share a common genetic basis across diverse sets of humans remains largely unknown. We therefore investigated the genetic basis of facial morphology in an East African cohort. We applied an open-ended data-driven phenotyping approach to a sample of 2,595 3D facial images collected on Tanzanian children. This approach segments the face into hierarchically arranged, multivariate features that capture the shape variation after adjusting for age, sex, height, weight, facial size and population stratification. Genome scans of these multivariate shape phenotypes revealed significant (p < 2.5 × 10−8) signals at 20 loci, which were enriched for active chromatin elements in human cranial neural crest cells and embryonic craniofacial tissue, consistent with an early developmental origin of the facial variation. Two of these associations were in highly conserved regions showing craniofacial-specific enhancer activity during embryological development (5q31.1 and 12q21.31). Six of the 20 loci surpassed a stricter threshold accounting for multiple phenotypes with study-wide significance (p < 6.25 × 10−10). Cross-population comparisons indicated 10 association signals were shared with Europeans (seven sharing the same associated SNP), and facilitated fine-mapping of causal variants at previously reported loci. Taken together, these results may point to both shared and population-specific components to the genetic architecture of facial variation.
DNA methyltransferase CHROMOMETHYLASE3 prevents ONSEN transposon silencing under heat stress
Authors: Nozawa Kosuke , Chen Jiani , Jiang Jianjun , Leichter Sarah M. , Yamada Masataka , Suzuki Takamasa , Liu Fengquan , Ito Hidetaka , Zhong Xuehua
Published: August 2021

DNA methylation plays crucial roles in transposon silencing and genome integrity. CHROMOMETHYLASE3 (CMT3) is a plant-specific DNA methyltransferase responsible for catalyzing DNA methylation at the CHG (H = A, T, C) context. Here, we identified a positive role of CMT3 in heat-induced activation of retrotransposon ONSEN. We found that the full transcription of ONSEN under heat stress requires CMT3. Interestingly, loss-of-function CMT3 mutation led to increased CHH methylation at ONSEN. The CHH methylation is mediated by CMT2, as evidenced by greatly reduced CHH methylation in cmt2 and cmt2 cmt3 mutants coupled with increased ONSEN transcription. Furthermore, we found more CMT2 binding at ONSEN chromatin in cmt3 compared to wild-type accompanied with an ectopic accumulation of H3K9me2 under heat stress, suggesting a collaborative role of H3K9me2 and CHH methylation in preventing heat-induced ONSEN activation. In summary, this study identifies a non-canonical role of CMT3 in preventing transposon silencing and provides new insights into how DNA methyltransferases regulate transcription under stress conditions.
EGFRAP encodes a new negative regulator of the EGFR acting in both normal and oncogenic EGFR/Ras-driven tissue morphogenesis
Authors: Soler Beatty Jennifer , Molnar Cristina , Luque Carlos M. , de Celis Jose F. , Martín-Bermudo María D.
Published: August 2021

Activation of Ras signaling occurs in ~30% of human cancers. However, activated Ras alone is insufficient to produce malignancy. Thus, it is imperative to identify those genes cooperating with activated Ras in driving tumoral growth. In this work, we have identified a novel EGFR inhibitor, which we have namedEGFRAP, forEGFR adaptorprotein. Elimination ofEGFRAPpotentiates activated Ras-induced overgrowth in theDrosophilawing imaginal disc. We show that EGFRAP interacts physically with the phosphorylated form of EGFR via its SH2 domain. EGFRAP is expressed at high levels in regions of maximal EGFR/Ras pathway activity, such as at the presumptive wing margin. In addition, EGFRAP expression is up-regulated in conditions of oncogenic EGFR/Ras activation. Normal and oncogenic EGFR/Ras-mediated upregulation of EGRAP levels depend on the Notch pathway. We also find that elimination ofEGFRAPdoes not affect overall organogenesis or viability. However, simultaneous downregulation of EGFRAP and its ortholog PVRAP results in defects associated with increased EGFR function. Based on these results, we propose thatEGFRAPis a new negative regulator of the EGFR/Ras pathway, which, while being required redundantly for normal morphogenesis, behaves as an important modulator of EGFR/Ras-driven tissue hyperplasia. We suggest that the ability ofEGFRAPto functionally inhibit the EGFR pathway in oncogenic cells results from the activation of a feedback loop leading to increaseEGFRAPexpression. This could act as a surveillance mechanism to prevent excessive EGFR activity and uncontrolled cell growth.
Kinesin-2 transports Orco into the olfactory cilium of Drosophila melanogaster at specific developmental stages
Authors: Jana Swadhin Chandra , Dutta Priya , Jain Akanksha , Singh Anjusha , Adusumilli Lavanya , Girotra Mukul , Kumari Diksha , Shirolikar Seema , Ray Krishanu
Published: August 2021

The cilium, the sensing centre for the cell, displays an extensive repertoire of receptors for various cell signalling processes. The dynamic nature of ciliary signalling indicates that the ciliary entry of receptors and associated proteins must be regulated and conditional. To understand this process, we studied the ciliary localisation of the odour-receptor coreceptor (Orco), a seven-pass transmembrane protein essential for insect olfaction. Little is known about when and how Orco gets into the cilia. Here, usingDrosophila melanogaster, we show that the bulk of Orco selectively enters the cilia on adult olfactory sensory neurons in two discrete, one-hour intervals after eclosion. A conditional loss of heterotrimeric kinesin-2 during this period reduces the electrophysiological response to odours and affects olfactory behaviour. We further show that Orco binds to the C-terminal tail fragments of the heterotrimeric kinesin-2 motor, which is required to transfer Orco from the ciliary base to the outer segment and maintain within an approximately four-micron stretch at the distal portion of the ciliary outer-segment. The Orco transport was not affected by the loss of critical intraflagellar transport components, IFT172/Oseg2 and IFT88/NompB, respectively, during the adult stage. These results highlight a novel developmental regulation of seven-pass transmembrane receptor transport into the cilia and indicate that ciliary signalling is both developmentally and temporally regulated.
Multi-scale inference of genetic trait architecture using biologically annotated neural networks
Authors: Demetci Pinar , Cheng Wei , Darnell Gregory , Zhou Xiang , Ramachandran Sohini , Crawford Lorin
Published: August 2021

In this article, we present Biologically Annotated Neural Networks (BANNs), a nonlinear probabilistic framework for association mapping in genome-wide association (GWA) studies. BANNs are feedforward models with partially connected architectures that are based on biological annotations. This setup yields a fully interpretable neural network where the input layer encodes SNP-level effects, and the hidden layer models the aggregated effects among SNP-sets. We treat the weights and connections of the network as random variables with prior distributions that reflect how genetic effects manifest at different genomic scales. The BANNs software uses variational inference to provide posterior summaries which allow researchers to simultaneously perform (i) mapping with SNPs and (ii) enrichment analyses with SNP-sets on complex traits. Through simulations, we show that our method improves upon state-of-the-art association mapping and enrichment approaches across a wide range of genetic architectures. We then further illustrate the benefits of BANNs by analyzing real GWA data assayed in approximately 2,000 heterogenous stock of mice from the Wellcome Trust Centre for Human Genetics and approximately 7,000 individuals from the Framingham Heart Study. Lastly, using a random subset of individuals of European ancestry from the UK Biobank, we show that BANNs is able to replicate known associations in high and low-density lipoprotein cholesterol content.
Changing epidemiology of dengue in Sri Lanka—Challenges for the future
Authors: Malavige Gathsaurie Neelika , Jeewandara Chandima , Ghouse Azhar , Somathilake Gayasha , Tissera Hasitha
Published: August 2021

Background

Dengue infections are on the rise in Sri Lanka and are spreading to all areas in the country. Here, we discuss the changes in dengue epidemiology in Sri Lanka in relation to changes in age distribution, changes in seroprevalence rates over time, and possible reasons contributing to such changes.

Methods and findings

Although the incidence of dengue increased 20-fold from the year 2000 to 2012 and a further 3-fold from 2012 to 2019, this increase is not reflected in a similar increase in the age-stratified seropositivity rates for dengue. For instance, the annual seroconversion rates were 0.76% in 2013 and 0.91% in 2017. The annual seroconversion rates in the 6 to 17 age group were 1.5% per year in 2003, 3.9% in 2013, and 4.1% in 2017. In addition, although a 13-fold increase in dengue was seen in those who were <19 years of age, a 52.4-fold increase was seen in the 40- to 59-year age group. The case fatality rates (CFRs) have similarly changed, with 61.8% of deaths occurring in those <19 years of age in the year 2000, while in 2012 to 2018, the highest CFR were seen in those who were aged 20 to 39 years. Although there has been a marked increase in the number of cases, the vector densities did not change during a 4-year period. The proportion of adult individuals experiencing a secondary dengue infection has also remained between 65% and 75% between the years 2004 and 2018.

Conclusions

A change in the ratio of symptomatic to asymptomatic infections can give rise to changes in the reported incidence of dengue. In order to take an appropriate policy decision in dengue control activities, it would be important to study the changes in virus serotypes, vector dispersion, and densities. Further, the contribution of the rise in metabolic diseases to an increase in the symptomatic as well as more severe infections due to dengue is explored.
Peridomestic natural breeding sites of Nyssomyia whitmani (Antunes and Coutinho) in an endemic area of tegumentary leishmaniasis in northeastern Argentina
Authors: Manteca-Acosta Mariana , Cavia Regino , Utgés María Eugenia , Salomón Oscar Daniel , Santini María Soledad
Published: August 2021

The scarce information about breeding sites of phlebotomines limits our understanding of the epidemiology of tegumentary leishmaniasis. Identifying the breeding sites and seasons of immature stages of these vectors is essential to propose prevention and control strategies different from those targeting the adult stage. Here we identified the rural breeding environments of immature stages of Ny. whitmani, vector species of Leishmania braziliensis in the north of Misiones province, Argentina; then we determined and compared the environmental and structural characteristics of those sites. We also identified the season of greatest emergence and its relationship with adult abundance. During a first collection period, between 28 and 48 emergence traps were set continuously for 16 months in six environments of the farm peridomicile and domicile: below house, chicken shed, experimental chicken shed, forest edge, pigsty and under fruit tree. Traps were checked and rotated every 40 nights. A total of 146 newly emerged individuals were collected (93.8% of them were Ny. whitmani), totaling an effort of 23,040 emergence trap-nights. The most productive environments were chicken shed and below house, and the greatest emergence was recorded in spring and summer. During a second collection period, emergence traps and light traps for adult capture were placed in the chicken shed and below house environments of eight farms. Emergence traps were active continuously during spring, summer, and early autumn. Environmental and structural characteristics of each environment were recorded. A total of 84 newly emerged phlebotomines (92.9% Ny. whitmani; 72,144 emergence trap-nights) and 13,993 adult phlebotomines (147 light trap-nights) were recorded in the chicken shed and below house environments. A positive correlation was also observed between trap success of newly emerged phlebotomines and of adults after 120 days. A high spatial variability was observed in the emergence of Ny. whitmani, with the number of newly emerged individuals being highest in soils of chicken sheds with the highest number of chickens and closest to forest edge. Moreover, below house was found to be as important as chicken sheds as breeding sites of Ny. whitmani. Management of the number of chickens in sheds, soil moisture and pH, and the decision of where to localize the chicken sheds in relation to the houses and the forest edge, might contribute to reduce the risk of human vector exposure and transmission of Leishmania.
Expression of tdTomato and luciferase in a murine lung cancer alters the growth and immune microenvironment of the tumor
Authors: Huang Lei , Bommireddy Ramireddy , Munoz Luis E. , Guin Rohini N. , Wei Changyong , Ruggieri Amanda , Menon Ashwathi P. , Li Xiaoxian , Shanmugam Mala , Owonikoko Taofeek K. , Ramalingam Suresh S. , Selvaraj Periasamy
Published: August 2021

Imaging techniques based on fluorescence and bioluminescence have been important tools in visualizing tumor progression and studying the effect of drugs and immunotherapies on tumor immune microenvironment in animal models of cancer. However, transgenic expression of foreign proteins may induce immune responses in immunocompetent syngeneic tumor transplant models and augment the efficacy of experimental drugs. In this study, we show that the growth rate of Lewis lung carcinoma (LL/2) tumors was reduced after transduction of tdTomato and luciferase (tdTomato/Luc) compared to the parental cell line. tdTomato/Luc expression by LL/2 cells altered the tumor microenvironment by increasing tumor-infiltrating lymphocytes (TILs) while inhibiting tumor-induced myeloid-derived suppressor cells (MDSCs). Interestingly, tdTomato/Luc expression did not alter the response of LL/2 tumors to anti-PD-1 and anti-CTLA-4 antibodies. These results suggest that the use of tdTomato/Luc-transduced cancer cells to conduct studies in immune competent mice may lead to cell-extrinsic tdTomato/Luc-induced alterations in tumor growth and tumor immune microenvironment that need to be taken into consideration when evaluating the efficacy of anti-cancer drugs and vaccines in immunocompetent animal models.
Incidence and predictors of mortality among patients with head injury admitted to Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: A retrospective follow-up study
Authors: Assele Desalegn Dawit , Lendado Tigabu Addisu , Awato Merid Assefa , Workie Shimelash Bitew , Faltamo Wolde Facha
Published: August 2021

Introduction

Head injury is the leading cause of morbidity and mortality throughout the world, especially in resource-limited countries including Ethiopia. However, little is known about the mortality rate and its predictors among these patients in Ethiopia. Thus, the study aims to assess the incidence rate of mortality and its predictors among patients with head injury admitted at Hawassa University Comprehensive Specialized Hospital.

Methods

Institutional based retrospective follow-up study was conducted among 1220 randomly selected head injury patients admitted from July 2017 to July 2019. Bivariable and multivariable Cox regression models were fitted to identify the predictors of mortality. Proportionality assumption was tested by a global test based on the Schoenfeld residuals test.

Results

The incidence of the mortality rate was 2.26 (95%CI: 1.9–2.6) per 100-person day observation. The independent predictors of time to death were age above 65 years (AHR:3.49, 95%CI:1.63, 7.48), severe TBI (AHR: 8.8, 95%CI:5.13, 15.0), moderate TBI (AHR:3, 95%CI:1.73,5.31), hypotension (AHR:1.72, 95%CI: 1.11,2.66), hypoxia (AHR:1.92, 95%CI: 1.33,2.76), hyperthermia (AHR:1.8, 95%CI: 1.23,2.63) and hypoglycemic (AHR:1.94, 95%CI: 1.34, 2.81) positively associated with mortality, while underwent neurosurgery was negatively associated with mortality (AHR: 0.25, 95% CI: 0.11,0.53).

Conclusion

The incidence of mortality rate among head injury patients was high. Older age, moderate and severe TBI, hypotension and hypoxia at admission, neurosurgical procedure, and the episode of hyperthermia and hypoglycemia during hospitalization were the independent predictors of mortality among head injury patients. Therefore, intervention to reduce earlier deaths should focus on the prevention of secondary brain insults.
Subjects develop tolerance to Pru p 3 but respiratory allergy to Pru p 9: A large study group from a peach exposed population
Authors: Somoza Maria Luisa , Pérez-Sánchez Natalia , Victorio-Puche Laura , Martín-Pedraza Laura , Esteban Rodríguez Angel , Blanca-López Natalia , Abel Fernández González Eva , Ruano-Zaragoza María , Prieto-Moreno Pfeifer Ana , Fernández Caldas Enrique , Morán Morales Miriam , Fernández Sánchez Francisco Javier , López Sánchez José Damián , Jiménez Rodríguez Teodorikez Wilfox , Subiza Garrido-Lestache José Luis , Canto Díez Gabriela , Blanca Gómez Miguel , Cornejo-García José Antonio
Published: August 2021

Peach tree allergens are present in fruit, pollen, branches, and leaves, and can induce systemic, respiratory, cutaneous, and gastrointestinal symptoms. We studied the capacity of peach fruit/Pru p 1, Pru p 3, Pru p 4, Pru p 7 and peach pollen/Pru p 9 for inducing symptoms following oral or respiratory exposure in a large group of subjects. We included 716 adults (aged 21 to 83 y.o.) exposed to peach tree pollen and fruit intake in the study population. Participants completed a questionnaire and were skin tested with a panel of inhalant and food allergens, including peach tree pollen, Pru p 9 and peach fruit skin extract. Immunoglobulin E antibodies (SIgE) to Pru p 1, Pru p 3, Pru p 4 and Pru p 7 were quantified. Sensitised subjects underwent oral food challenge with peach fruit and nasal provocation test with peach tree pollen and Pru p 9. The prevalence of sensitisation to peach fruit was 5% and most of these had SIgE to Pru p 3, with a very low proportion to Pru p 4 SIgE and no SIgE to Pru p 1 and Pru p 7. In only 1.8%, anaphylaxis was the clinical entity induced. Cases with positive skin tests to peach and SIgE to Pru p 3 presented a good tolerance after oral challenge with peach fruit. The prevalence of skin sensitisation to peach tree pollen was 22%, with almost half recognising Pru p 9. This induced respiratory symptoms in those evaluated by nasal provocation. In a large population group exposed to peach fruit and peach tree pollen, most individuals were tolerant, even in those with SIgE to Pru p 3. A positive response to Pru p 9 was associated with respiratory allergy.
Visual impairment and its associated factors among medical and health sciences students at the University of Gondar, Northwest Ethiopia
Authors: Getnet Mihret , Akalu Yonas , Dagnew Baye , Gela Yibeltal Yismaw , Belsti Yitayeh , Diress Mengistie , Fekadu Sofonias Addis , Seid Mohammed Abdu
Published: August 2021

Background

Visual impairment (VI) is a decreased ability to see things which is critical problem for health professionals and students to whom normal vision is essential for their daily activity. If it is not timely managed, visual impairment leads to physical, psychological, and socio-economic malfunctions to the victims and nation. Despite the above impacts, currently there is no study in Ethiopia on this topic. Therefore, this study aimed to determine the prevalence of visual impairment and its associated factors among Medical and Health Science students at the University of Gondar.

Methods

A cross-sectional study was conducted from January to March 2020 among Medical and Health Science students. After recruiting study participants using systematic random sampling technique, we applied pre-tested self-administered questionnaire for sociodemographic variables and also visual acuity measurement was performed using Snellen chart placed at a distance of 6 meters. Visual acuity tested separately for each eye and for both eyes in a well- illuminated area. Pinhole was used for those participants with a visual acuity of < 6/9. Participants with a presenting visual acuity of < 6/12 in the better eye were diagnosed as having visual impairment. Epi data version 3.1 and stata version 14 were used for data entry and statistical analysis, respectively. Binary logistic regression was used, and the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the statistical significance and strength of association between VI and independent variables.

Results

A total of 654 students were screened for visual acuity. The prevalence of visual impairment was 12.5% (95% CI: 10.21, 15.31). Age above 25 years (AOR = 1.8; 95% CI: 1.02, 3.26) and current alcohol drinking (AOR = 2.9; 95% CI: 1.7, 5.00), were statistically significant factors of visual impairment.

Conclusion

The prevalence of visual impairment among medical and health science students was high. Age of study participant and current alcohol consumption were statically significant factors. This study warrants the routine screening of Medical and Health science students for visual impairment.
Managerial overconfidence in capital structure decisions and its link to aggregate demand: An agent-based model perspective
Authors: Rzeszutek Marcin , Godin Antoine , Szyszka Adam , Augier Stanislas
Published: August 2021

Objective

This study aims to connect two strands of the psychology and economics literature, i.e., behavioural finance and agent-based macroeconomics, to assess the impact of managerial overconfidence at the micro and macro levels of the economy as a whole.

Method

We build a macroeconomic stock-flow consistent agent-based model that is calibrated for the specific case of Poland to explore whether the overconfidence of top corporate managers in the context of their initial capital structure decisions is detrimental for the firms being managed in this way, the financial market dynamics, and the selected macroeconomic indicators. We model heterogeneous firms with different capital structure decision criteria depending on their degree of managerial overconfidence. Our model also includes a complete macroeconomic closure with aggregated households, capital producers, banking, and a public sector.

Results

We find that firms with overconfident managers outperform in terms of investment and size but are also more fragile, thereby making them more likely to default. Finally, we run policy shocks and show that while investors’ flight to liquidity creates financial turmoil and increases the probability of default.

Conclusions

This paper contributes to the knowledge base by linking behavioural corporate finance and agent-based macroeconomics. In general, the excess overconfidence on the micro level, either an increase in the proportion of overconfident firms or a higher degree of overconfidence among managers, has a strong destabilizing impact on the economy as a whole on the macro level.
Improving routine immunization data quality using daily short message system reporting platform: An experience from Nasarawa state, Nigeria
Authors: Akerele Adekunle , Uba Belinda , Aduloju Matthew , Etamesor Sulaiman , Umar Jamila A. , Adeoye Olorunsogo Bidemi , Enyojo Ameh , Josiah Friday , Ayandipo Esther , Olaoye Itse , Adegoke Oluwasegun Joel , Sidney Sampson , Bagana Murtala , Bassey Okposen , Ghiselli Margherita E. , Ndadilnasiya Waziri , Bolu Omotayo , Shuaib Faisal
Published: August 2021

Routine immunization (RI) delivery was declared a public health concern in Nigeria in 2017 because of persistently low immunization coverage rates reported in independent surveys. However, administrative coverage rates remain high, suggesting serious data quality issues. We posit that a shorter timespan between service provision and data reporting can improve the monitoring of RI data, and developed a short message system (SMS) text reporting strategy to generate daily RI data points from health facilities (HFs). The goal was to assess whether daily data collection produces complete, reliable and internally consistent data points. The SMS reporting platform was piloted between December 2017 and April 2018 in two Local Government Areas (LGAs, equivalent to districts) of Nasarawa state, Nigeria. The 145 healthcare workers from 55 HFs received one mobile phone and pre-configured SIM card, and were trained to send data through predefined codes. Healthcare workers compiled the data after each vaccination session and transmitted them via SMS. We analyzed completeness, number of weekly sessions, and supportive supervision conducted. During the pilot phase, we received data from 85% (n = 47) of the 55 HFs. We expected 66 fixed-post sessions and 30 outreach sessions per week, but received data for 33 fixed-post and 8 outreach weekly session on average. More HFs reported on Tuesdays compared to other days of the week. When assessing internal consistency, we observed that the reported number of children vaccinated was sometimes higher than the number of doses available from opening a given number of vaccine vials. When found, this discrepancy was noted for all antigens during fixed-post and outreach vaccination sessions. Despite these initial discrepancies, transmitting RI data sessions via texting is feasible and can provide real-time updates to the performance of the RI services at the HF level.
Comparative genome analysis of Salmonella enterica serovar Gallinarum biovars Pullorum and Gallinarum decodes strain specific genes
Authors: Vaid Rajesh Kumar , Thakur Zoozeal , Anand Taruna , Kumar Sanjay , Tripathi Bhupendra Nath
Published: August 2021

Salmonella entericaserovar Gallinarum biovar Pullorum (bvP) and biovar Gallinarum (bvG) are the etiological agents of pullorum disease (PD) and fowl typhoid (FT) respectively, which cause huge economic losses to poultry industry especially in developing countries including India. Vaccination and biosecurity measures are currently being employed to control and reduce theS. Gallinarum infections. High endemicity, poor implementation of hygiene and lack of effective vaccines pose challenges in prevention and control of disease in intensively maintained poultry flocks. Comparative genome analysis unravels similarities and dissimilarities thus facilitating identification of genomic features that aids in pathogenesis, niche adaptation and in tracing of evolutionary history. The present investigation was carried out to assess the genotypic differences amongstS.entericaserovar Gallinarum strains including Indian strainS. Gallinarum Sal40 VTCCBAA614. The comparative genome analysis revealed an open pan-genome consisting of 5091 coding sequence (CDS) with 3270 CDS belonging to core-genome, 1254 CDS to dispensable genome and strain specific genesi.e. singletons ranging from 3 to 102 amongst the analyzed strains. Moreover, the investigated strains exhibited diversity in genomic features such as virulence factors, genomic islands, prophage regions, toxin-antitoxin cassettes, and acquired antimicrobial resistance genes. Core genome identified in the study can give important leads in the direction of design of rapid and reliable diagnostics, and vaccine design for effective infection control as well as eradication. Additionally, the identified genetic differences among theS.entericaserovar Gallinarum strains could be used for bacterial typing, structure based inhibitor development by future experimental investigations on the data generated.
Estimating the effectiveness of national health insurance in covering catastrophic health expenditure: Evidence from South Korea
Authors: Jung Hyunwoo , Lee Junhyup
Published: August 2021

The catastrophic health expenditure (CHE) indicator has been used to measure the medical cost burden of households. Many countries have institutionalized their health insurance systems to reduce out-of-pocket payments, the main contributor to the financial burden. However, there is no method to estimate how the insurance coverage reduces the CHE. This study proposes an approach to evaluate the effectiveness of insurance in reducing the CHE impacts in terms of incidence and gap, which are based on a modified calculation method of CHE. Additionally, we apply these methods to data from the Korea Health Panel Survey (2011–2016). The results are as follows. First, under the setting of a threshold of 10%, the CHE incidence rate was 19.26% when the Korean national health insurance benefits reduced the CHE’s incidence for 15.17% of the population in 2017. Second, the results of the concentration index of CHE showed that the intensity approach of CHE is better than the incidence approach. Third, the new approach we applied revealed that health insurance reduces the burden of CHE to some degree, although it was not an efficient way to reduce CHE. In conclusion, this study provides new policy approaches to save the finances of national health insurance and reduce the intensity of CHE at the same time by raising the low-cost burden of medical services and lowering that of high cost. Moreover, we suggest that policymakers should focus on income level of the households rather than specific diseases.
Female Pacific walruses (Odobenus rosmarus divergens) show greater partitioning of sea ice organic carbon than males: Evidence from ice algae trophic markers
Authors: Koch Chelsea W. , Cooper Lee W. , Woodland Ryan J. , Grebmeier Jacqueline M. , Frey Karen E. , Stimmelmayr Raphaela , Magen Cédric , Brown Thomas A.
Published: August 2021

The expected reduction of ice algae with declining sea ice may prove to be detrimental to the Pacific Arctic ecosystem. Benthic organisms that rely on sea ice organic carbon (iPOC) sustain benthic predators such as the Pacific walrus (Odobenus rosmarus divergens). The ability to track the trophic transfer of iPOC is critical to understanding its value in the food web, but prior methods have lacked the required source specificity. We analyzed the H-Print index, based on biomarkers of ice algae versus phytoplankton contributions to organic carbon in marine predators, in Pacific walrus livers collected in 2012, 2014 and 2016 from the Northern Bering Sea (NBS) and Chukchi Sea. We paired these measurements with stable nitrogen isotopes (δ15N) to estimate trophic position. We observed differences in the contribution of iPOC in Pacific walrus diet between regions, sexes, and age classes. Specifically, the contribution of iPOC to the diet of Pacific walruses was higher in the Chukchi Sea (52%) compared to the NBS (30%). This regional difference is consistent with longer annual sea ice persistence in the Chukchi Sea. Within the NBS, the contribution of iPOC to walrus spring diet was higher in females (~45%) compared to males (~30%) for each year (p < 0.001), likely due to specific foraging behavior of females to support energetic demands associated with pregnancy and lactation. Within the Chukchi Sea, the iPOC contribution was similar between males and females, yet higher in juveniles than in adults. Despite differences in the origin of organic carbon fueling the system (sea ice versus pelagic derived carbon), the trophic position of adult female Pacific walruses was similar between the NBS and Chukchi Sea (3.2 and 3.5, respectively), supporting similar diets (i.e. clams). Given the higher quality of organic carbon from ice algae, the retreat of seasonal sea ice in recent decades may create an additional vulnerability for female and juvenile Pacific walruses and should be considered in management of the species.
The broad role of Nkx3.2 in the development of the zebrafish axial skeleton
Authors: Waldmann Laura , Leyhr Jake , Zhang Hanqing , Öhman-Mägi Caroline , Allalou Amin , Haitina Tatjana
Published: August 2021

The transcription factor Nkx3.2 (Bapx1) is an important chondrocyte maturation inhibitor. PreviousNkx3.2knockdown and overexpression studies in non-mammalian gnathostomes have focused on its role in primary jaw joint development, while the function of this gene in broader skeletal development is not fully described. We generated a mutant allele ofnkx3.2in zebrafish with CRISPR/Cas9 and applied a range of techniques to characterize skeletal phenotypes at developmental stages from larva to adult, revealing loss of the jaw joint, fusions in bones of the occiput, morphological changes in the Weberian apparatus, and the loss or deformation of bony elements derived from basiventral cartilages of the vertebrae. Axial phenotypes are reminiscent ofNkx3.2knockout in mammals, suggesting that the function of this gene in axial skeletal development is ancestral to osteichthyans. Our results highlight the broad role ofnkx3.2in zebrafish skeletal development and its context-specific functions in different skeletal elements.
A partial knowledge of friends of friends speeds social search
Authors: Elsisy Amr , Szymanski Boleslaw K. , Plum Jasmine A. , Qi Miao , Pentland Alex
Published: August 2021

Milgram empirically showed that people knowing only connections to their friends could locate any person in the U.S. in a few steps. Later research showed that social network topology enables a node aware of its full routing to find an arbitrary target in even fewer steps. Yet, the success of people in forwarding efficiently knowing only personal connections is still not fully explained. To study this problem, we emulate it on a real location-based social network, Gowalla. It provides explicit information about friends and temporal locations of each user useful for studies of human mobility. Here, we use it to conduct a massive computational experiment to establish new necessary and sufficient conditions for achieving social search efficiency. The results demonstrate that only the distribution of friendship edges and the partial knowledge of friends of friends are essential and sufficient for the efficiency of social search. Surprisingly, the efficiency of the search using the original distribution of friendship edges is not dependent on how the nodes are distributed into space. Moreover, the effect of using a limited knowledge that each node possesses about friends of its friends is strongly nonlinear. We show that gains of such use grow statistically significantly only when this knowledge is limited to a small fraction of friends of friends.