The formation of the ventricles of the heart involves numerous carefully regulated temporal events, including the initial specification and deployment of ventricular progenitors, subsequent growth and maturation of the ventricles through “ballooning” of chamber myocardium, the emergence of trabeculations, the generation of the compact myocardium, and the formation of the interventricular septum. Several genes have been identified through studies on mouse knockout and transgenic models, which have contributed to our understanding of the molecular events governing these developmental processes. Interpretation of these studies highlights the fact that even the smallest perturbation at any stage of ventricular development may lead to cardiac malformations that result in either early embryonic mortality or a manifestation of congenital heart disease.


Nowadays, there is a constantly increasing concern regarding the mutagenic and carcinogenic potential of a variety of harmful environmental factors to which humans are exposed in their natural and anthropogenic environment. These factors exert their hazardous potential in humans' personal  and occupational environment that constitute part of the anthropogenic environment. It is well known that genetic damage due to these factors has dramatic implications for human health. Since most of the environmental genotoxic factors induce arrest or delay in cell cycle progression, the conventional analysis of chromosomes at metaphase may underestimate their genotoxic potential. Premature Chromosome Condensation (PCC) induced either by means of cell fusion or specific chemicals, enables the microscopic visualization of interphase chromosomes whose morphology depends on the cell cycle stage, as well as the analysis of structural and numerical aberrations at the G1 and G2 phases of the cell cycle. The PCC has been successfully used in problems involving cell cycle analysis, diagnosis and prognosis of human leukaemia, assessment of interphase chromosome malformations resulting from exposure to radiation or chemicals, as well as elucidation of the mechanisms underlying the conversion of DNA damage into chromosomal damage. In this report, particular emphasis is given to the advantages of the PCC methodology used as an alternative to conventional metaphase analysis in answering questions in the fields of radiobiology, biological dosimetry, toxicogenetics, clinical cytogenetics and experimental therapeutics.


There are errors in the eighth and ninth sentences of the Abstract. The correct sentences are: Although there were age differences  and sex differences  in emotion regulation, age and sex were not significantly associated with proneness to shame and guilt. The positive relations with maladaptive emotion regulation underscore the dysfunctional nature of shame-proneness.


Traditional medicine is an important component of the health care system of most developing countries. However, indigenous knowledge about herbal medicines of many Ghanaian cultures has not yet been investigated. The aim of the present study was to document herbal medicines used by traditional healers to treat and manage human diseases and ailments by some communities living in Ghana. The study was conducted in eight communities in southern Ghana. Data were collected from 45 healers using ethnobotanical questionnaire and voucher specimens were collected. A total of 52 species of plants belonging to 28 plant families were reportedly used for treatment and management of 42 diseases and ailments. Medicinal plants were commonly harvested from the wild and degraded lowland areas in the morning from loamy soil. Herbal medicines were prepared in the form of decoctions (67%) and infusions (33%). Oral administration of the herbals was most (77%) common route of administration whereas the least used routes were nasal (1%) and rectal (2%). The results of the study show that herbal medicines are used for treatment and management of both common and specialized human diseases and that factors of place and time are considered important during harvesting of plants for treatments. According to the World Health Organization (WHO) about 80% of developing countries depend on traditional medicines for their primary health care needs . In Ghan materia medica of the Fanti, Ga, and Ashanti has changed considerably over time . SpecieLeaves formed 57% of the herbal medicines documented. Other plant parts used were fruits, barks, and whole plants . Leaves https://www.cdc.gov/globalhealth/countries/ghana/). Knowledge of frequently reported diseases and/ailments can be an indication of health care issues in a region and it should be of great importance to health care organizations and government.Herbal medicines were reportedly used for treatment and management of 42 diseases and ailments. Two or more herbal medicines were reportedly used for treatment and management of 17 the diseases and/ailments, and the herbals were most commonly used for treatment and management of stroke, fevers, and diabetes . The herAbout 43% of the species of plants were reportedly used in treatment of a single disease whereas the rest of the plants (57%) were involved in treatment of more than one disease/ailment. Medicinal plants are commonly used in the management of different ailments because they contain a variety of bioactive agents such as alkaloids and terpenoids , 19. It Almost all the healers (98%) interviewed harvested plant materials from lowland areas . About hThe time of harvesting medicinal plants was investigated with respect to time of day (24 hr. duration) and season (dry versus wet season) of the year. About 57% of healers harvested plants in the morning followed by 28.9% who collected plants anytime of the day and then 4.4% that collected plants in the afternoon. None of the healers collected plant materials in the night and about 9% considered time of the day unimportant when harvesting plant materials for herbal preparations. Plants materials were harvested in the morning because of the importance of healthcare to healers as they collected plants first thing in the day. About 28% of the healers harvested plants anytime of the day, which might suggest that healers also collected plants as when they are needed. According to the healers they collected plants any time of the day because they sometimes needed to treat emergency cases. There is scientific evidence to support the fact that yield of some plant chemical constituents differs within a time span of 24 hours due to the interconversions of compounds . AccordiThe harvested plant materials were used in preparation of 81 herbal medicines mainly in the form of decoctions (67%) and infusions (33%). Although it is documented that a variety of methods have been used for preparation of herbal medicines the methods of decoctions and infusions have been the widely reported . HoweveThe routes of administration of the remedies reported in this study were oral, rectal, topical, and nasal . HoweverIn this paper, we have documented the current state of knowledge and use of herbal medicines for treatment and management of human diseases among some communities living in southern Ghana. This documentation contributes primary data to the wealth of data stored on the indigenous knowledge on medicinal plants from Ghana. The findings from the study suggest that healers are consulted for herbal medicines for the treatment and management of both common and specialized diseases and ailments. The extent to which the people living in the area consult the healers is unknown but it is important to understanding this in order to determine the proper role of herbal medicine in the health care system of the people. It is also essential to scientifically evaluate the specific uses of the medicinal plants reported in the current study using plant materials from the area through pharmacological, toxicological, and clinical studies in order to ensure the safety of the people consuming the medicines and for possible drug development. The results of the study have also confirmed that factors of time and place are given considerations during harvesting of plant materials by healers. Further studies on the methods and quantities of plant materials that are harvested for treatment will improve our understanding on the impacts of harvesting of medicinal plants on biodiversity conservation in the area.


The atlas is designed to be accessed using SHIVA, a free Java application. The atlas is extensible and can contain other types of information including anatomical, physiological, and functional descriptors. It can also be linked to online resources and references. This digital atlas provides a framework to place various data types, such as gene expression and cell migration data, within the normal three-dimensional anatomy of the developing quail embryo. This provides a method for the analysis and examination of the spatial relationships among the different types of information within the context of the entire embryo.We present an archetypal set of three-dimensional digital atlases of the quail embryo based on microscopic magnetic resonance imaging (μMRI). The atlases are composed of three modules: (1) images of fixed


Implantable devices in the brain can reestablish functional connectivity in neural circuits disrupted in major depression, obsessive-compulsive disorder, and other psychiatric disorders. The most frequently used device of this type is deep brain stimulation (DBS) Benabid,  Other neInstead of enabling the formation of new memories, could a device implanted in the brain erase memories that have been encoded, consolidated, and reconsolidated? DBS can modulate dysfunctional circuits mediating sensorimotor, cognitive, and emotional processing. Theoretically, this or a similar stimulating technique could selectively erase a pathological fear memory by inactivating neurons and excitatory synapses constituting the memory trace. This could disrupt reconsolidation of the memory stored as information in the brain. Erasing fear memories identified as the source of anxiety, panic, phobia, and post-traumatic stress disorder (PTSD) could be an effective therapy when they fail to respond to other treatments Pitman, .content associated with the emotional representation of the memory. These are distinct from different forms of amnesia, which is a disorder of memory capacity (Kopelman, Neuroscientists can use PET or fMRI to measure changes in neural activity and synaptic connectivity following manipulation of neural circuits associated with different memory systems. Neuroimaging could confirm erasure of a memory trace based on these changes. Hypothetically, electrical stimulation from an implantable device like DBS could reduce activity in neurons constituting the emotionally charged memory trace underlying conditioned responses to aversive stimuli and enable a subject to unlearn pathological behavior. In the psychiatric disorders I have mentioned, the emotional representation, or trace, of a memory of a disturbing or traumatizing event remains embedded in the brain beyond any short-term adaptive function. This disrupts the memory network regulating fear and results in pathological thought and behavior (Parsons and Ressler, The source of these disorders is hyperactivity in the basolateral amygdala of the fear memory network. This occurs when a negative emotional memory of a fearful experience or a series of such experiences forms and solidifies in the brain through the processes of consolidation and reconsolidation. One theory of fear memory consolidation following a traumatic experience is that the memory embeds in the amygdala from the release of noradrenaline in response to the subject's stress reaction to the experience. The memory becomes more firmly embedded in this brain region from behavior in which the subject learns to link an aversive stimulus with a conditioned stimulus. Memories must be updated constantly to remain stored in the brain. Updating memories consists in reconsolidating them after retrieval. This process serves an adaptive purpose by enabling the subject to make information in the brain relevant to current and future circumstances (Nader et al., A different and potentially more effective way of blocking reconsolidation would be to eradicate the emotional representation of the memory. In principle, certain drugs could block reconsolidation of the fear memory by blocking protein synthesis in the basolateral amygdala where the memory trace was located. During retrieval, infusion of a protein synthesis inhibitor such as anisomycin in this brain region might disrupt reconsolidation and effectively erase the memory trace (Schacter and Loftus, A major challenge to pharmacological erasure of memory is the selectivity of this intervention. Many memories of fearful experiences are adaptive and critical to survival because they enable us to recognize and react appropriately to threatening situations. Not all fear memories are pathological or maladaptive. Because of the distributed and non-discriminating effects of psychotropic drugs, a drug intended to erase the trace could have unintended expanding effects and impair normal functions of the fear memory system. A drug infused in the brain could alter both targeted and non-targeted nuclei in the limbic system and alter normal emotional processing. This could introduce a new psychopathology.The more focused action of deep brain electrical stimulation of the neurons and synapses within the memory trace might be able to overcome the problem of selectivity. Direct stimulation of these constituents of the trace at the critical frequency could neutralize the effects of LTP, CREB, and protein synthesis on the persistence of the memory. It could remove any obstacles to destabilizing and removing the memory as stored information in the brain. In addition, by precisely targeting the neurons within the trace, electrical stimulation could reduce the risk of expanding effects on adaptive fear memories and positive emotional memories. Combined with its neuromodulating action, the ability of DBS to probe circuits and nodes within these circuits would enable investigators to monitor its effects on the critical neurons and synapses (Lozano and Lipsman, The selectivity problem is a problem about localization. The main question is whether a particular maladaptive fear memory would be localized enough for DBS to erase it while leaving adaptive fear memories intact. One hypothesis that could support the idea of selectively erasing a maladaptive fear memory is that functional imaging could reveal higher levels of activation in the nuclei associated with that memory when a subject was asked to recall the traumatic experience as the source of it (Pitman et al., enhance certain types of memory in these studies is in contrast to the goal of using DBS to erase other types of memory. Enhancing memory would require activating metabolically underactive nuclei associated with LTP, CREB, and protein synthesis. Erasing memory would require inhibiting metabolically overactive nuclei associated with these same processes. The second mechanism would be similar, in some respects, to the modulating effects of high-frequency DBS on metabolically overactive circuits in treatment-resistant depression (Mayberg et al., Even if imaging showed localized metabolic overactivation in nuclei associated with the memory, there are questions about whether DBS could inactivate it. Although many studies have confirmed the neuromodulating effects of DBS, the mechanisms of action of the technique are not well understood. DBS increased glucose metabolism in the entorhinal cortex of a group of epilepsy patients and enhanced learning and spatial memory (Sulthana et al., Although direct stimulation of the hippocampus and medial temporal lobes can disrupt episodic memory (Merkow et al., Suppose that investigators could use electrical stimulation from a device implanted in the brain to erase not just pathological fear memories but also less emotionally charged memories of disturbing experiences. If the emotional representation of some of these memories was localized in discrete limbic nuclei, the critical neurons, and excitatory synapses could be inactivated and the memory trace erased by DBS, should it be?Remembering mistaken choices and actions can haunt one for years and make one indecisive when choosing between alternative courses of action in the present and future. Yet memories of these mistakes and of more emotionally disturbing experiences are necessary for character development and moral growth. They promote this development and growth by enabling the moral emotions of remorse and regret. They also enable us to reflect on our motivational states in forming and executing action plans that promote prudence and moral sensitivity toward others. Disturbing memories can provide constraints on decision-making that are necessary for effective rational and moral agency. Erasing a few disturbing memories might not undermine or impede the development and exercise of these capacities. However, erasing a broader set of memories could weaken agency and have deleterious effects on one's behavior. The mental capacity to integrate both positive and negative episodic memories in a unified autobiography also enables one to construct meaning from them. Deleting more than a critical number of memories could disrupt the psychological connectedness and continuity that constitute personal identity, the experience of persisting through time as the same person Parfit, . EpisodiResearch into manipulating the content of memory has been limited to animal models. Psychiatric researchers will have to address many theoretical and technical challenges in moving from animal to first-in-human studies. Functional neuroimaging will be critical in identifying changes in brain activity correlating with a weakened or erased memory trace at neuronal and synaptic levels. The most important question is whether the critical neurons can be altered at a localized, discrete level. The idea of erasing a particular pathological fear memory with DBS or similar implantable electrical stimulation devices is still speculative. Yet it could become a way of treating what are currently treatment-resistant psychiatric disorders of memory content.The author confirms being the sole contributor of this work and approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The posterior tibial artery normally arises from tibial-fibular trunk at the popliteal fossa, together with the fibular artery. The classic course of the posterior tibial artery is to run between the triceps surae muscle and muscles of the posterior compartment of the leg before continuing its course posteriorly to the medial malleolus, while the fibular artery runs through the lateral margin of the leg. Studies of both arteries are relevant to the fields of angiology, vascular surgery and plastic surgery. To the best of our knowledge, we report the first case of an anastomosis between the posterior tibial artery and the fibular artery in their distal course. The two arteries joined in an unusual “X” format, before division of the posterior tibial artery into plantar branches. We also provide a literature review of unusual variations and assess the clinical and embryological aspects of both arteries in order to contribute to further investigations regarding these vessels. The femoral artery supplies the thigh, while the popliteal artery supplies the leg and foot.,,The posterior tibial artery (PTA) and the fibular artery (FA) are branches of the tibial-fibular trunk (TFT), located at the popliteal fossa. The TFT usually describes a trajectory of 1 to 8 cm after the popliteal artery emits the anterior tibial artery (ATA). It is usually followed by two veins and the tibial nerve. The PTA runs down the posterior face of the leg, following the posterior surface of the tibia, accompanied by two veins, and is located posteriorly to the triceps surae muscle and anteriorly to the posterior tibialis muscle and the flexor digitorum longus muscle, giving off muscular branches for the posterior compartment.,,,,In the foot, the PTA runs along the medial retromaleolar canal, medially to the calcaneal tendon, emitting malleolar and calcaneal branches before dividing into the lateral and medial plantar arteries. It is responsible for the blood supply to the posterior muscles of the leg and the plantar region of the foot.,,-Variants differing from this pattern can be explained by segmental hypoplasia, abnormal fusions or absence.Moreover, with the recent increase in the numbers of diabetic patients, critical limb ischemia due to multiple and large occlusions of the lower limb vessels is becoming more and more common; therefore knowledge of these arteries is needed in order to avoid amputations.We report a previously undescribed anatomic variation of the PTA and FA and present a review of significant anatomic variations and their clinical and embryological features.A 50-year-old male cadaver fixed with a 10% formalin solution (cause of death unknown) was dissected during Anatomy classes. While dissecting the right lower limb, we observed an uncommon relationship between the PTA and the FA along their course . The lefIn this case, the origins of both arteries were as normal, but in the ankle the vessels underwent an “X-shaped” anastomosis, prior to the origin of the plantar branches from the PTA .,,,,,Studies showed that the arteries of the lower limb are derived from the dorsal region of the umbilical artery, which forms the sciatic artery (SA), a branch of the internal iliac artery.,,,,Anatomic variants of these vessels often appear as result of persistent primitive arterial segments, segmental hypoplasia, abnormal fusions, or complete absence; furthermore, these mechanisms can frequently occur in combination.,,,,,,,Variations in the origin and course of the PTA and the FA have often been described after being detected either during dissection of cadaveric specimens or by arteriograms, Doppler exams, and duplex scanning of living subjects. In our analysis, we found that the PTA can be absent, hypoplastic or replaced in its distal portion or replaced altogether by the FA,,,,In cases of hypoplasia or aplasia of the PTA, the FA exhibits compensatory hyperplasia, giving off branches to what would normally be the PTA’s vascular territory.,The FA also provides many fasciocutaneous and musculocutaneous perforators to supply the skin and muscles, albeit they are more common in the distal portion of the FA. These branches exhibit arterial anastomoses with each other in the subcutaneous tissue, and it appears that the second, third and fourth musculocutaneous branches have larger diameters and should be used for fibular flaps.,,,,-Knowledge of these variant patterns is important for evaluation of lower limb arteriograms and also in respect for their clinical and surgical significance for procedures such as vascular grafts, surgical repair, transluminal angioplasty, and embolectomy and for diagnosis of arterial injury.Although rare, true aneurysms of the PTA have been described in the literature and they can often compromise vessels and nerves.The free fibular flap (FFF) has recently come to be preferred for correction of mandible defects because of its low morbidity and the fact that this procedure allows a two-team approach.,,Since the PTA and the FA provide the blood supply to the foot, their distal portions and trajectories should be studied, due to the fact that ankle arthroscopy is becoming a popular procedure to treat arthritis and anatomical variations on this region can increase risk.Traumatic events in the Achilles region require free-tissue transfer. A study performed by Vaienti et al.Any type of vascular surgery in this area should be planned preoperatively, since there are many variations of the vessels in this region and some patterns of vascular distribution can contraindicate fibular flaps. Knowledge about the lower limb arteries is extremely important in a number of conditions, since anatomic variations can cause difficulties with diagnostic and surgical procedures.


The dataset contains thermal properties of soil such as thermal conductivity, thermal diffusivity, temperature and specific heat capacity in an agricultural farm within the University of Ibadan, Ibadan, Nigeria. The data were acquired in forty (40) sampling points using thermal analyzer called KD-2 Pro. Soil samples taken at these sampling points were analyzed in the laboratory for their moisture content following the standard reference of American Association of State Highway and Transport Officials (AASHTO) T265. The data were acquired within the first and second weeks in the month of April, 2012. Statistical analyses were performed on the data set to understand the data. The data is made available publicly because thermal properties of soils have significant role in understanding the water retention capacity of soil and could be helpful for proper irrigation water management. Specifications TableValue of the data•The dataset can be used to monitor soil moisture content.•The knowledge of the dataset can help to improve irrigation scheduling in the area.•The knowledge of the irrigation scheduling would help to optimize water usage for improved crop productivity.•The dataset would help farmers to save cost.•The dataset could also be used for academic purposes to understand the applications of thermal properties of soil(s). Several similar Researches to this data article can be found in 1The dataset contains thermal properties of soil and their moisture contain in an agricultural farm within University of Ibadan, Ibadan, Nigeria. These thermal properties include thermal conductivity, thermal diffusivity, temperature and specific heat capacity. The data also contain moisture contents that were measured in the laboratory following the standard reference of American Association of State Highway and Transport Officials (AASHTO) T265 2The understanding of the thermal properties of soil is very important in agricultural science. This is because there is exchange of heat at the soil surface. The availability of the dataset on soil thermal properties would help in the improvements of wider applications of the heat of soil and modelling of the water transport in the soil. The availability of these dataset would also help in the understanding of seed germination and crop yield. Several works have been carried out on the various applications of thermal properties of soil 2.1Pro  measurements were conducted. Also, after taking the first measurement, the probe was then allowed to rest for more than 15 min before taking subsequent readings. This time is called measurement interval, which allows thermal gradients to dissipate (i.e. for equilibration between readings).Field sampling design was conducted prior to the data acquisition on the field and random sampling technique was adopted. The surface of the ground was scooped before measurements to remove the effects of top soil on the acquired data. The thermal sensor was calibrated using a white plastic cylinder (a two-hole Delrin block). This was done with a view to test the functionality of the sensor Forty sample points were considered for thermal properties measurements while soil samples were collected at these points to determine their moisture contents in the laboratory. These soil samples were put in polythene bags and stored in a cool dry place after which necessary laboratory analyses were carried out on them. Moisture contents were determined in the laboratory following the standard reference of AASHTO T265 2.2The detailed descriptive statistics which provide basic statistical information about the measured thermal properties and moisture contents are presented in


This review gives an overview of morphological and functional characteristics in the human prostate. It will focus on the current knowledge about transient receptor potential (TRP) channels expressed in the human prostate, and their putative role in normal physiology and prostate carcinogenesis. Controversial data regarding the expression pattern and the potential impact of TRP channels in prostate function, and their involvement in prostate cancer and other prostate diseases, will be discussed.


The parasitic twin was connected to the sternum of the autosite by a tract of cartilage. Furthermore, parasite was sharing the liver with the autosite. The extrahepatic bile duct system of the parasite was separated after ligating it. The main vascular pedicle of the parasite originated from the falciform ligament of the autosite  are rare type of monozygotic monochorionic asymmetrical conjoined twins. Embryological basis of EHT has been debated between the incomplete fission versus the fusion theory. It is generally considered to be a product of error in blastogenesis by incomplete fission of a single zygote post 14 days of fertilization.,3 th of all the reported cases.[EHTs are generally common in males accounting for almost 3/4Source of Support: NoneConflict of Interest: None


The negative symptoms of schizophrenia cause significant distress and impairment. The treatment of them is a challenge, with medications having none or little effect. So, new treatments are necessary for this condition. The aim of the study was to ascertain the efficacy of tDCS in treating negative symptoms of schizophreniaThis study was designed to be a randomized, sham-controlled, double-blinded trial using tDCS for the treatment of negative symptoms of schizophrenia. One-hundred  patients will be enrolled and submitted to ten tDCS session over the left dorsolateral prefrontal cortex  and left temporo-parietal junction-left , over 5 consecutive days, with 2 mA of current. Participants were assessed with clinical and neuropsychological tests before and after the intervention. The primary outcome was change (over time and across groups) in the scores of the Negative Subscale of Positive and Negative Symptoms Syndrome (PANSS). Our secondary outcomes consist of others scales as SANSS , Calgary and the AHRS .From 70% of the sample the active tDCS was significantly superior to sham at endpoint at 6 weeks by negative sub scale of PANSS . The total PANSS and the hallucinations scale had no differences between both groups. The other times of analysis were not found differences between sham and active groups. The others scales .The results of our studies suggests a potential role of tDCS for the treatment of negative symptoms of schizophrenia. The effect size was small. This is the biggest study with tDCS for treating negative symptoms of schizophrenia until now. At the meeting all the data will be analyzed (100 patients), it these could change our preliminary results.


The immunopathology of chronic obstructive pulmonary disease (COPD) is based on the innate and adaptive inflammatory immune responses to the chronic inhalation of cigarette smoking. In the last quarter of the century, the analysis of specimens obtained from the lower airways of COPD patients compared with those from a control group of age-matched smokers with normal lung function has provided novel insights on the potential pathogenetic role of the different cells of the innate and acquired immune responses and their pro/anti-inflammatory mediators and intracellular signaling pathways, contributing to a better knowledge of the immunopathology of COPD both during its stable phase and during its exacerbations. This also has provided a scientific rationale for new drugs discovery and targeting to the lower airways. This review summarises and discusses the immunopathology of COPD patients, of different severity, compared with control smokers with normal lung function.


Variations of radial artery, in both its course and branching pattern in the anatomical snuffbox, are clinically significant for the plastic surgeons, cardiologists, and radiologists. Reports on its abnormal high origin and subsequent superficial course have been well documented. Herein, we report an unusual superficial branch of the radial artery given off before its entry into the palm by passing between the two heads of first dorsal interosseous. It eventually divided into princeps pollicis and radialis indicis arteries at the first web space of palm as a unique vascular variation. Apart from this, in the present case, the tendon of extensor digiti minimi and of extensor indicis divided into two parts. The split tendons of extensor digiti minimi were inserted to the dorsal digital expansion of the digitus minimus. However, lateral tendon of split extensor indicis was inserted along with the tendon of extensor digitorum to the index finger and the medial one was inserted along with the tendon of extensor digitorum to the middle finger. Unusual superficial branch of radial artery on the dorsum of the hand is vulnerable for an iatrogenic injury during surgical approaches in the region. Supplementary extensor tendons on the hand are one of the potential causes for the tenosynovitis. Accurate and detailed knowledge of the relationships and possible anatomical variations of the branching pattern of radial artery is vital during reparative surgery in this region. In addition, iatrogenic trauma due to occurrence of superficial branches may lead to a life-threatening hemorrhage. Inadequate knowledge of the anatomical variations of the arterial pattern may make surgery difficult.Radial artery is the terminal branch of the brachial artery given off in the cubital fossa. Following its origin, it assumes superficially downward course to the wrist along the radial side of the forearm. At the distal part of the forearm it winds around the lateral side of forearm after giving superficial palmar branch and enters into the anatomical snuff box, before reaching proximal end of the first interosseous space where it passes between the two heads of first dorsal interosseous muscle and between two heads of adductor pollicis to form the deep palmar arch of the palm .In the anatomical snuff box it gives dorsal carpal branch for the formation of dorsal carpal arch. Before its entry to the palm, on the dorsum of the hand it gives slender branches to the lateral side of the dorsum of the thumb and first dorsal metacarpal artery. In the palm it generally gives princeps pollicis artery and radialis indicis branches before it contributes to deep palmar arch.Normally, the extensor muscles have single tendon on the dorsum of hand except for extensor digitorum. The tendon of extensor digitorum divides distally into 4 tendons which pass in a common synovial sheath together with tendon of extensor indicis and diverge on the dorsum of the hand to get inserted into the medial four digits .The extensor tendons of the hand are distally interconnected by oblique interconnections known as juncturae tendinum. Knowledge of detailed pattern of the tendons and their oblique interconnections is important in hand assessment and other reconstructive procedures .Combined variations of radial artery and extensor tendons are rare. We discuss the clinical importance of concurrent variations of radial artery and the extensor tendons in this report. Anatomical knowledge on variant branching pattern of radial artery as well as abnormal tendon disposition on the dorsum of the hand is of considerable importance during several clinical approaches and therapeutic practices.During the dissection of the left upper limb of an adult male cadaver aged approximately 70 years, we found concurrent variations of radial artery and tendons of long extensors of the digits. The radial artery, after passing through the anatomical snuff box, gave a large superficial branch before continuing into the palm by passing between the two heads of first dorsal interosseous. The superficial branch ran distally over the first dorsal interosseous and terminated by dividing into princeps pollicis and radialis indicis arteries at the first web space . This vaThe extensor digitorum divided into four tendons, which had normal insertion as described in the Anatomy textbooks. Tendon of extensor digiti minimi divided into two equal parts as it passed deep to the extensor retinaculum. Both the tendons were inserted to the dorsal digital expansion of the digitus minimus. Tendon of extensor indicis divided into two parts. The lateral part was inserted along with the tendon of extensor digitorum to the index finger and the medial one was inserted along with the tendon of extensor digitorum to the middle finger. The tendons going to the medial three digits were connected to each other through broad tendinous interconnections .Awareness of radial arterial variation in its origin and branching pattern has great importance in various clinical fields and basic medical studies. High origin of radial artery from brachial artery is one among its frequent anatomical variations as its prevalence is reported to be 14.26% in cadaveric studies and 9.75% in angiographic studies [The superficial arteries often pose iatrogenic traumatic complications as they are mistaken for veins during intravenous injections , 8. AwarExtensor muscles of the forearm have a relatively consistent architecture. However, at times they may have prominent anatomic variations in their tendons, particularly on the ulnar side of the hand . Tanaka EDM tendon triggering is a less common disease when compared with other tendons triggering. Its impingement on the extensor retinaculum aggravates the condition into double triggering . Zilber Kocabiyik et al. reported bilateral extensor tendon variations which included tripled tendon for middle finger from the extensor digitorum, double tendons to ring finger, and extensor digiti minimi having duplicate tendon with an abnormal communicating tendon between extensor digitorum tendon to ring finger and extensor digiti minimi muscle tendons. While these variant tendon dispositions were observed in one hand, on the other hand abductor pollicis tendon itself trifurcated and one of these tendons also attached to tendon of abductor pollicis brevis as an additional slip .Seradge et al. reported EDM in which two tendon slips attached to the little finger and one to the ring finger's metacarpophalangeal joint . Extensovon Schroeder and Botte have reported two infrequent variant forms of extensor indicis proprius, namely, the extensor medii proprius (EMP) which gets inserted into the long finger and the extensor indicis et medii communis (EIMC) that splits into two tendons which get inserted into both index and long fingers . The varOccurrence of hand extensor tendon variations cannot be ignored as surgeons must bear in mind the existence of these variations when performing common tendon transfers. It is also important to the orthopedic surgeons to ascertain the existence of additional tendons during the treatment of tenosynovitis.The variations observed in our case with an anomalous superficial branch of radial artery at anatomical snuff box may be of significance in clinical point of view especially to vascular and plastic surgeons. The superficial arteries of the upper extremity may often be mistaken for veins, which may become a basis for intra-arterial injections instead of intended intravenous injections. Anatomic variation of extensor compartment of the hand may contribute to the development of tenosynovitis and limit the usefulness in the tendon transfer.


Ethiopia experienced several WPV importations with a total of 10 WPV1 cases confirmed during the 2013 outbreak alone before it is closed in 2015. We evaluated supplemental immunization activities (SIAs), including lessons learned for their effect on the routine immunization program during the 2013 polio outbreak in Somali regional state.We used descriptive study to review documents and analyse routine health information system reports from the polio outbreak affected Somali regional state.All data and technical reports of the 15 rounds of polio SIAs from June 2013 through June 2015 and routine immunization coverages for DPT-Hib-HepB 3 and measles were observed. More than 93% of the SIAs were having administrative coverage above 95%. The trend of routine immunization for the two antigens, over the five years (2011 through 2015) did not show a consistent pattern against the number of SIAs. Documentations showed qualitative positive impacts of the SIAs strengthening the routine immunization during all courses of the campaigns.The quantitative impact of polio SIAs on routine immunization remained not so impressive in this study. Clear planning, data consistencies and completeness issues need to be cleared for the impact assessment in quantitative terms, in polio legacy planning as well as for the introduction of injectable polio vaccine through the routine immunization. The global burden of poliomyelitis has decreased by ≥ 99% since the time the World Health Assembly endorsed the initiative for global polio eradication in 1988. The burden of the wild poliovirus (WPV) has shown significant reduction in Africa with the last case confirmed in July 2014 in Nigeria. Ethiopia joined the polio eradication effort in 1996 and was able to interrupt endemic WPV transmission in 2001. However, the country experienced several WPV importations where between 2004 and 2008 a total of 44 cases were confirmed associated with six different importations. The last importation of WPV was in August 2013 following the outbreak that was declared in the Horn of Africa in April 2013. A total of 10 WPV 1 cases were confirmed with onset of paralysis of the last case on 5 January 2014.Since the late 1980s, use of Supplemental Immunization Activities (SIAs) has been a key strategy of the Global Polio Eradication Initiative (GPEI). Polio SIAs are mass vaccination campaigns that aim to administer additional doses of Oral Poliovirus Vaccine (OPV) to each child , regardless of their vaccination history. In doing so, SIAs attempt to remedy the limited ability of routine immunization services to reach at-risk children with the number of OPV doses required to generate immunity. Several rounds of polio SIAs were conducted in Ethiopia following each outbreak as per the recommendation of the polio Global Advisory Committee. Like the majority of polio outbreaks which were controlled within 6 months with OPV, it took about five months in the country to limit further new incidence of the WPV; however the outbreak response extended to 2 years between June 2013 and June 2015 and the country responded with 15 SIAs out of which four were National Immunization Days (NIDs) . ResourcPrior use of routine immunization services and compliance with the routine OPV schedule has strong positive association with SIA participation . On the Study area: administratively Ethiopia is divided into nine Regional States and two City Administrations. One of the regional states is Somali region and it comprises nine zones. The region shares porous border with Somalia and Kenya which puts it at increased risk of importation of WPV. The total population of the region was estimated to be 5,446,968 in 2015 and the <5 years of age comprised 10.1% of the total population .Study design: we conducted a descriptive study design using campaign and routine health management information system (HMIS) data from June 2013 to June 2015 to explore lessons from the SIAs and observe trends in the routine immunization coverage in relation with the number of polio SIAs conducted in Somali region of Ethiopia.Method of sampling and recruitment: we purposefully selected Somali region of the country as it was epi-center for the polio outbreak during mid-2013. In addition, all rounds of the polio SIAs included the region in the subsequent campaigns until closure of the outbreak in June 2015. Except during the four NIDs conducted from 2013 through 2015, the remaining regions had intermittent polio response campaigns during the 2 years outbreak period.Procedures: we obtained technical reports of all the SIAs conducted as part of the outbreak response in Somali region from June 2013 to June 2015 as well as quarterly program review documents. The technical reports of each of the polio SIAs rounds were reviewed for coverage of the SIAs, lessons learned and best practices out of the campaigns as to their contribution to strengthen the routine immunization were narrated and summarized in tables and graphs. We also compiled the periodic HMIS reports from the region to see the trends in uptake of the routine immunization coverage on key indicators of  over the same 2 years period.Statistical analyses: after the data compilation was completed, we checked the data manually for completeness and consistency. We entered the data into an MS Excel spreadsheet and checked for major outliers, and then analysed for proportions, percentages and trends. We used frequency distribution and percentages used to describe the variables, and compiled results and presented those using tables, graphs, and narrations.As shown in Routine immunization service provisions were integrated with the SIAs starting from the May 2014 round with all antigens. During their house to house visits, vaccinators sought for unvaccinated or under vaccinated children based on the national schedule for all the routine immunization antigens and referred them to nearby temporary fixed stations established for vaccination. As shown in The trend of routine immunization for DPT-Hib-HepB3 and measles coverage, over the five years (2011 through 2015) did not show a consistent pattern; however the trend in coverage based on the two indicators was parallel to each other . Throughimmunization: review of the technical reports of the 15 SIA rounds and minutes of the quarterly joint program review meetings of Expanded Program on Immunization (EPI) and surveillance for contributions of the campaigns to support the routine immunization services are stated below.Pre-implementation: the planning exercises helped to develop or update the social maps in the areas of the campaign. Intense participation of the community at the lower level during microplan development increased the community engagement and program sustainability. Bottom-up microplans were developed or updated in each of the campaigns which were claimed to have boosted the local capacity. During each of the rounds, basic and practical trainings to vaccinators was given where routine immunization and surveillance components were included. All campaign preparation trainings included the following major topics: recording and reporting techniques, vaccine management and distribution, identification of hard to reach and high risk populations, inter personal communication, monitoring and supervision which all boost the routine immunization in general. Deployment of technical assistants with skills in routine immunization and campaigns also helped in coaching and mentoring to the health workers. In majority of the reports of the SIA rounds, immunization task force committees were established up to district level with technical sub working groups. The launching ceremonies for the SIAs and advocacy visits to different level political and community leaders, nongovernmental organizations and other potential partners have helped to gain support and political commitment for immunization as a whole. On the campaign mobilization events, key immunization messages were passed. Functionality and capacity of refrigerators, inventory of cold boxes and vaccine carriers, temperature recording, pattern and placement of routine EPI vaccines were assessed at all levels. In some rural health facilities where electricity supply was not available, kerosene was distributed to start up the refrigerators and maintain the cold chain. In most places, ice pack production was initiated days before the actual implementation of the campaign date. Additionally, in places where nearby health facilities were not available, identification of vaccine distribution points were carried out. In areas where shortage of vaccine carriers was noticed, re-distribution of supplies was made from some health facilities.Intra-campaign: inter sectoral collaboration among different sectors and partners with mix of technical capacities were increased. School involvement in the campaign helped the partnership by motivating teachers and school administrators for vaccine preventable diseases (VPD). Close supervision and monitoring of the campaigns were also done at all levels which supported monitoring of the routine immunization as well.Post campaign: in order to evaluate quality of SIAs and take immediate action in low performing areas rapid convenience surveys were conducted where the number of children with zero dozes were monitored and shared for subsequent inclusion in the routine immunization programme. At the end of each SIAs round, regional review meetings were organized with participation of all level supervisors. Strengths and weaknesses were discussed and action points taken for the subsequent round. The routine immunization strengthening efforts were discussed during the review periods.We found that the administrative coverages in almost all (93.3%) of the 15 polio SIA rounds in Somali region after WPV importations met the cut off for a high quality campaign as supported by the Rapid convenience survey findings as well. Despite this fact the number of zero dose children in both age groups of 0-11 months and 12-59 months of age did not show satisfactory decrease in number along the course of subsequent campaigns. We also found from the campaign coverage trends that lessons and strategies from previous rounds of campaigns were not well documented or not implemented in subsequent campaigns which would have be reflected in an increase of campaign quality/coverage.We also found that good number of children have got access to routine immunization services integrated with the SIAs as service providers visit the community and link eligible children to prearranged temporary fixed vaccination posts; however the proportion of children accessed and tracked back to the immunization service could not be measured as there were no targets set for vaccination with routine vaccines before the vaccinators went for the activities.Despite the reported positive qualitative impacts of the campaigns on the political commitment and health workers' knowledge and skill on the routine immunization, the impact of the repeated number of polio SIAs on routine immunization coverages in the region could not be conclusively determined in this study as there was no clear pattern with immunization coverage for the key indicators of DPT-Hib-HepB 3 and measles vaccines. This finding is consistent with the study conducted in seven countries of South Asia and sub-Saharan Africa that assessed impacts of polio eradication activities on key health system functions including routine immunization using mixed methods data.Despite the major financial and technical investments on immunization in the region, the fact that the study area was already disadvantaged in terms of infrastructures and other facilities due to scattered geographic settlement, pastoralist nature, social insecurity and others could have masked the positive effects of the SIAs on routine immunization in the region with high chance of persistently missing immunization , 10. In In conclusion, SIA response should have been more focused in system strengthening and polio eradication activities can provide support for the routine immunization as part of the primary health care; their quantitative impact on routine immunization remained not so impressive in this study. As it is seen in other studies, absence of periodic documentation and tracking effects of the polio SIAs on RI and health system might have contributed to conceal the anticipated positive impacts of the campaigns on the routine immunization following increased commitment to scaling up best practices could lead to significant positive impacts to the routine system . AdditioUse of Supplemental Immunization Activities (SIAs) and strengthening of routine immunization have both been key strategies of the Polio Eradication Initiative;Several rounds of polio SIAs were conducted in Ethiopia following each outbreak as per the recommendation with additional intention to strengthen the routine immunization by identifying never-vaccinated children and linking to further completion of their immunization with other infant antigens as well;The different studies conducted elsewhere have a mixed outcome of effects of the polio SIAs on routine immunization.This study tries to summarize the qualitative impact of the rounds of polio SIAs in the outbreak focus, Somali region, during the 2013 outbreak period through review of different campaign technical reports and review meeting proceedings;Documentation on quantitative impact of polio SIAs appear to be inexistent or patchy in Ethiopia; this study tries to assess impact of the polio SIAs on coverages with regard to DTP3 and measles coverages in routine immunization;This study also triggers further statistical analysis to seek associations and statistical significant relations between the polio SIAs and on the routine immunization uptake, the dependent variable.Authors declared they have no competing interests. The views expressed in the perspective articles are those of the authors alone and do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated and the position of World Health Organization.


WHO pharmacovigilance indicators have been recommended as a useful tool towards improving pharmacovigilance activities. Nigeria with a myriad of medicines related issues is encouraging the growth of pharmacovigilance at peripheral centres. This study evaluated the status of pharmacovigilance in tertiary hospitals in the South-South zone of Nigeria with a view towards improving the pharmacovigilance system in the zone.A cross-sectional descriptive survey was conducted in six randomly selected tertiary hospitals in the South-South zone of the country. The data was collected using the WHO core pharmacovigilance indicators. The language of assessment was phrased and adapted in this study for use in a tertiary hospital setting. Data is presented quantitatively and qualitatively.A total of six hospitals were visited and all institutions had a pharmacovigilance centre, only three could however be described as functional or partially functional. Only one centre had a financial provision for pharmacovigilance activities. Of note was the absence of the national adverse drug reaction reporting form in one of the hospitals. The number of adverse drug reaction reports found in the databases of the centres ranged from none to 26 for the previous year and only one centre had fully committed their reports to the National Pharmacovigilance Centre. There were few documented medicines related admissions ranging from 0.0985/1000 to 1.67/1000 and poor documentation of pharmacovigilance activities characterised all centres.This study has shown an urgent need to strengthen the pharmacovigilance systems in the South-South zone of Nigeria. Improvement in medical record documentation as well as increased institutionalization of pharmacovigilance may be the first steps to improve pharmacovigilance activities in the tertiary hospitals.The online version of this article (10.1186/s40360-018-0217-2) contains supplementary material, which is available to authorized users. Pharmacovigilance in Nigeria commenced in the late 80s and early 90s initially in a tertiary hospital with some preparatory activities at the national level prior to its admission into the WHO program for international drug monitoring (PIDM) in 2004 , 2. It hThe growth of pharmacovigilance in Nigeria has been propelled by a number of factors including the establishment of the regulatory agency  by Decree 15 of 1993 (as amended) now cited as Act Cap N1 laws of the Federal Republic of Nigeria 2004, the formulation of the Nigerian National Drug Policy in 2005 . The actPharmacovigilance has a wide scope with increasing product concerns. The main focus in the Nigeria context has been on adverse drug reactions, substandard and falsified medical products , 8–10. OReporting of drug safety concerns by health-workers in Nigeria is voluntary and the reasons for under-reporting are partly due to fear of litigation, poor understanding of the subject matter, feeling that the “known” Adverse Drug Reactions (ADRs) need not be reported, time constraints and cumbersome reporting processes –21. LackWHO advocates regional centres as an effective way of enhancing pharmacovigilance activities  as obserThe aims of the creation of the zonal centres was to decentralize the activities of the National Pharmacovigilance Centre (NPC), e.g. distribution of ADR forms and collection of the Individual Case Safety Reports (ICSRs) from reporters and perform preliminary evaluation with prompt reporting, also transmission of acknowledgements and feedback information to the reporters and dissemination of information from the national centre to the patients and health care workers. Furthermore, they were created to monitor the progress of pharmacovigilance activities at institutional levels as well as support the training and capacity building for pharmacovigilance in the areas of their jurisdiction . These mCurrently, the assessment of pharmacovigilance had been largely done at the national level using various tools including evaluating the attainment of minimum requirements for a national centre with interviews of focal persons , and recThe status of the pharmacovigilance system in the tertiary centres is presently unknown as the WHO indicators and related metrics for evaluating these centres have just been recently released  and therThis study was carried out in the South-South Zone of Nigeria which is located in the coastal region of Nigeria. It comprises six states namely Akwa-Ibom, Bayelsa, Cross Rivers, Delta, Edo and Rivers with a population of 21,014, 655 million persons . Health care professionals in all tiers of hospitals in this zone could send their reports either directly or through the zonal pharmacovigilance centre for onward transmission to the national centre. The South-South zonal pharmacovigilance centre is domiciled in the University of Benin Teaching Hospital, a tertiary hospital for research and learning.In Nigeria, heath care is delivered at three levels: primary, secondary and tertiary. Tertiary care hospitals provide the highest level of care and serve as referral centres for the secondary and primary centres. Furthermore, there are three main types of tertiary centres. Firstly: the teaching hospitals, which provide teaching  as well as for research and health care services. Secondly: Federal Medical Centres which are mainly for health care services as well as providing residency training in some departments and lastly the specialty hospitals which focuses on particular disease entities of public health importance such as neuro-psychiatric hospitals, orthopaedic hospitals and ophthalmic hospitals among others.This study was directed at the teaching hospitals because they provide the widest access to all patients with an inclusiveness of all cadres of health care workers. In the South-South zone there are eight teaching hospitals, seven are government owned, and one privately owned.University of Benin Teaching Hospital Benin-City, Edo State, (UBTH).Delta State University Teaching Hospital Oghara, Delta State, (DELSUTH).Niger Delta University Teaching Hospital Okolobri, Bayelsa State, (NDUTH).University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, (UPTH).University of Uyo Teaching Hospital, Uyo, Akwa- Ibom State, (UUTH).University of Calabar Teaching Hospital, Calabar Cross-River State, (UCTH).Eligibility criteria: teaching hospitals were used to ensure inclusiveness of all clinical disciplines and staff complement. All six states in the zone were represented by a teaching hospital. An institutional approval was required from the Chief Medical Director / Management prior to inclusion in the study. The study was subsequently carried out in 6 tertiary health institutions selected through simple random sampling in the various states namely:Prior to visiting the study sites for data collection, ethical approval was obtained from the research and ethics committee of each of the selected tertiary hospitals. Furthermore, the heads of the institution were contacted for approval and access to the pertinent data. The focal persons in charge of pharmacovigilance in the institution provided answers for the indicator assessments.the background information, structural indicators, process indicators, outcome/impact indicators. The phrasing of the assessment questions was adapted to address the tertiary hospital setting . Furthermore, to compute the duration of hospital stay, the crude estimates of the duration of admission of patients with serious adverse reactions who were hospitalised was calculated from the adverse drug reaction reports obtained for the previous year.The Analysis was both qualitative and quantitative. All hospitals participating in the study were described according to each indicator. The core Structural indicators are qualitative indicators with categorical data analysed descriptively. The presence or absence of the parameter measured was described for each institution.Analysis of the core Process and Outcome Indicators are quantitative indicators reflecting rates of reports and actual numbers. They were calculated using frequencies and absolute numbers as dictated by the indicator. The data was analysed with descriptive statistics using Microsoft excel 2007.All six institutions were visited and the focal Pharmacovigilance persons or committees interviewed following a meeting with the various heads of the institutions. The teaching hospitals in this study are all government owned and serve as referral centres to the primary and secondary tier hospitals. However, they are of varying sizes in terms of bed and staff complement. The demographic characteristics of the institutions at the commencement of the study late January to mid-March 2016 were as follows  while a centre neither had copies of the national nor local forms available. There were no standard forms available which addressed the subset of assessment questions covering the scope of pharmacovigilance in all of the centers  was carried out and completed in UBTH in the five years preceding the analysis as a form of active surveillance. There were limited numbers of reports on ADRs, medication errors, lack of therapeutic effectiveness etc. in most of the centers. Documentation of feedback and causality assessment carried out on reports in the centers was equally poor in this study  modified the ADR form showing their own hospital logo and domiciling the ADR form to their setting. This showed the willingness of the centre to improve patient safety through a sense of ownership. The inclusion of health facilities in the Nigerian national pharmacovigilance policy was to increase their participation in the pharmacovigilance activities . The stuThe processes and outcomes were however poor in all the facilities probably due to lack of awareness of measuring indices to monitor and evaluate pharmacovigilance. Again, the pharmacovigilance system in this setting is still in their infancy and the requisite culture to ensure effective operations yet to be established. However, it was noted that a cohort event monitoring of antimalarials (artemisinin-based combination therapy) was conducted in UBTH as a part of a national program. This active surveillance of medicines used in a disease of public health importance is useful in obtaining better insights into the safety and tolerability pattern in our setting . The neeThe poor record keeping in all the facilities also made computations of the process and outcomes indicators difficult to achieve. The documentation of medicine related events especially adverse drug reactions were equally poor in this study, this contributed to lack of data even in hospitals where the international coding of diseases was been done. This is not different from what has been reported in other studies about under-recognition of adverse drug reactions and drug related events , 34. It In the utilization of the WHO pharmacovigilance indicators, it is evident that the scope of reportable incidents by the facilities have been broadened and it is hoped that with the implementation framework of the Nigerian national pharmacovigilance policy, there would be a wider dissemination of the roles that tertiary hospitals are to play in the promotion of pharmacovigilance. The WHO pharmacovigilance indicators would be useful in assessing other tertiary hospitals as it would enable the hospital management develop a strategy towards improving patient safety through pharmacovigilance. It may also help identify areas that need urgent intervention or modification in the health information system management of the tertiary hospitals especially since it is recommended that the indicators be reapplied as needed in the facilities.The WHO indicators have proven to be quite useful in this assessment. However, absence of trained pharmacovigilance personnel hindered the provision of results for the pharmacovigilance process indicators in the centers. Of note is the limitation of the structural pharmacovigilance indicators to fully capture the functionality of the pharmacovigilance system. Furthermore, the overall poor documentation in all centers limited the derivation of the indicators. Again the derivation of the outcome/impact indicator required in-depth survey which young pharmacovigilance systems are unable to execute. There might be a need to develop a scoring system to quantify the indices thus highlighting the deficiencies in numerical terms.This study has shown an urgent need to strengthen the pharmacovigilance systems in the South-South zone of Nigeria. The WHO pharmacovigilance indicators have been proven to be helpful in assessing the pharmacovigilance system in the zone. Improvement in medical record documentation as well as increased institutionalization of pharmacovigilance may be the first steps to improve pharmacovigilance activities in the tertiary hospitals.Additional file 1:Assessment of the state of Pharmacovigilance in the South-South Zone of Nigeria using WHO Pharmacovigilance indicators. WHO Core Pharmacovigilance Indicators including changes made to phrasing of the assessment questions. (PDF 347 kb)


The paper is devoted to the study of facial region temperature changes using a simple thermal imaging camera and to the comparison of their time evolution with the pectoral area motion recorded by the MS Kinect depth sensor. The goal of this research is to propose the use of video records as alternative diagnostics of breathing disorders allowing their analysis in the home environment as well. The methods proposed include (i) specific image processing algorithms for detecting facial parts with periodic temperature changes; (ii) computational intelligence tools for analysing the associated videosequences; and (iii) digital filters and spectral estimation tools for processing the depth matrices. Machine learning applied to thermal imaging camera calibration allowed the recognition of its digital information with an accuracy close to 100% for the classification of individual temperature values. The proposed detection of breathing features was used for monitoring of physical activities by the home exercise bike. The results include a decrease of breathing temperature and its frequency after a load, with mean values −0.16 °C/min and −0.72 bpm respectively, for the given set of experiments. The proposed methods verify that thermal and depth cameras can be used as additional tools for multimodal detection of breathing patterns. The use of different sensors is essential for the study of many physiological and mental activities, neurological diseases ,2 and moSpecial attention is paid to temperature changes of facial parts affected by emotions, mental activities, or neurological disorders. The study of the temperature distribution over different parts of the face can be used in face and emotion detection ,10,11,12Noninvasive methods of breathing monitoring include electrical impedance tomography, respiratory inductance plethysmography ,21, capnThe respiratory rate is an important indicator  for moniThe present paper is devoted to the noninvasive analysis of the breathing rate by facial temperature distribution using a thermal imaging camera ,29 and bA special attention is paid to the adaptive detection of facial thermographic regions. The present paper applies specific methods for their recognition allowing to detect the breathing rate or to recognize facial neurological disorders.The proposed method of respiratory data processing is based on their statistical and numerical analysis using different functional transforms for the fast and robust estimation of desired features ,23. The The block diagram of the thermal imaging camera shown in An alternative approach to breathing data acquisition using an MS Kinect depth sensor is presented in The range imaging methods used in depth sensors are based on the specific computational technologies that create the matrices whose elements carrying the information about the distance of the corresponding image component from the sensor ,33. The The sequence of images recorded by the thermal camera were acquired with the changing temperature ranges associated with each videoframe as presented in The accuracy of the thermal camera was tested for a flat surface with equal temperature values and analysis of individual image frames as presented in Facial temperature values are useful for detection of neurological disorders and facial symmetry analysis. The time stability and precision of the thermal camera was tested for a sequence of images recorded with a sampling period of 5 s in the face area with a stable temperature distribution over a short period of time for a healthy individual. The area around the eyes illustrated in videorecording of the face area during a selected time range,extraction of thermographic frames with the selected sampling frequency (of 10 Hz) and a given resolution,automatic determination of temperature ranges in each thermographic frame and the adaptive calibration of each thermal image,detection of the mouth area using the selected number of initial frames with the largest temperature changes and the adaptive update of this ROI for each subsequent thermal image,evaluation of the mean temperature in the specified window of a changing position and size in each frame.The area (ROI) for the time evolution of temperature changes was specified empirically according to the first frame at first, as presented in An example of the time evolution of the mean breathing temperature in the selected mouth region is presented in An alternative analysis of breathing based upon thorax movement  was baseM, resulting in a new sequence The analysis of multimodal records The spectral components were then calculated by the discrete Fourier transform forming the sequenceThe detection of breathing features was verified during monitoring of physical activities by the home exercise bike. Each experiment was 40 min long and it included two periods of physical exercises followed by two restful periods with each of them 10 min long. The total number of 25 experiments was performed by one individual in similar home conditions.The resulting mean temperatures recorded by the thermal imaging camera evaluated from the fixed and the adaptively specified and moving temperature regions of interest are presented in Both thermal imaging and motion data can be used for monitoring of the breathing rate during physical activity. The proposed method of adaptive specification of the breathing area and temperature range recognition was applied for the analysis of the evolution of the breathing features recorded during physical exercise and in the following resting time period. This paper proposes a method for the use of thermal and depth sensors to detect breathing features. The presentation includes a description of a machine learning method for the recognition of the temperature ranges as well as an adaptive specification of the mouth region using the sequence of thermographic images. The application is devoted to the study of selected physiological features evaluated during physical activities.The results achieved show an example of simple sensors application for breathing analysis using simple thermal imaging cameras for the detection of temperature changes and MS Kinect depth sensors for the analysis of the motion in the chest area. The proposed method of thermographic regions detection allows both analysis of the breathing rate and the study of neurological problems in the facial area.It is assumed that simple sensors can form an alternative tool for the detection of medical disorders, including sleep and breathing analysis in the home environment.


Accurate mapping of the auroral oval into the equatorial plane is critical for the analysis of aurora and substorm dynamics. Comparison of ion pressure values measured at low altitudes by Defense Meteorological Satellite Program (DMSP) satellites during their crossings of the auroral oval, with plasma pressure values obtained at the equatorial plane from Time History of Events and Macroscale Interactions during Substorms (THEMIS) satellite measurements, indicates that the main part of the auroral oval maps into the equatorial plane at distances between 6 and 12 Earth radii. On the nightside, this region is generally considered to be a part of the plasma sheet. However, our studies suggest that this region could form part of the plasma ring surrounding the Earth. We discuss the possibility of using the results found here to explain the ring-like shape of the auroral oval, the location of the injection boundary inside the magnetosphere near the geostationary orbit, presence of quiet auroral arcs in the auroral oval despite the constantly high level of turbulence observed in the plasma sheet, and some features of the onset of substorm expansion. Accurate mapping of the auroral oval onto the equatorial plane is necessary in determining the locations of substorm expansion phase onsets. In very early studies of auroral morphology, Akasofu  showed tE  models of high latitude transverse currents , using data from the THEMIS mission. Later, Antonova et al.  and ground-based measurements. This implies that only upward field-aligned currents can produce visible auroras, which is supported by the comprehensive analyses of Ohtani et al.  events by Baumjohann et al. , 1990 anOur analysis demonstrates the necessity to improve existing mapping techniques by using specific plasma features, so-called “natural tracers”, which conserve their characteristic signatures along magnetic field lines. We show here that plasma pressure can be successfully used as one such “natural tracer”.E.A comparison of the pressure distributions measured in the equatorial plane by the THEMIS satellites with those measured by DMSP satellite above the auroral oval under both quiet and moderately disturbed geomagnetic conditions, reveals the role of the plasma ring surrounding the Earth in substorm dynamics. The results indicate that the popular approach of mapping the auroral oval into the plasma sheet must be modified and that the main part of the oval, especially its equatorial boundary, should not be mapped into the plasma sheet proper, but rather into the plasma ring surrounding the Earth. Such mapping explains the ring-like shape of the auroral oval, the location of the injection boundary inside the magnetosphere near the geostationary orbit, and the presence of quiet auroral arcs in the auroral oval despite the high level of plasma turbulence constantly observed in the plasma sheet. Subsequent studies to further verify and enhance the precision of these results should focus on an analysis of the processes occurring at geocentric distances between around 6–7 and 10–12 R


Penile lesions are encountered in a variety of fields from family medicine practice through urology, to sexual health specialists. It is important that practitioners consider and recognize fixed drug eruptions of the penis while being able to initiate appropriate treatment in order to avoid misdiagnosis and avoidable stress. In summary, withdrawal of the offending medication and initiation of corticosteroid therapy remain the cornerstones of treatment of fixed drug eruptions of the penis.


The seasonal abundance patterns of insects inhabiting the understory vegetation of a mixed deciduous forest were examined with the help of the sweep-net sampling method. During the study period of 2 years, insects were sampled regularly from the understory vegetation of the three selected habitats  of the mixed deciduous forest. Insect abundance was maximum in the moist-deciduous habitat and minimum in the teak plantation. Generally, insect abundance was the highest during the southwest monsoon in all habitats. The temporal pattern of fluctuations in the insect abundance followed more or less the same pattern in all the three habitats studied. The insect abundance of the understory vegetation varied among the habitats studied, while the pattern of seasonal fluctuations in insect abundance was comparable among habitats. Composition of the insect community also indicated prominent seasonal changes within habitats than interhabitat changes within a season.


In 1968, the American Heart Association recommended the consumption of no more than 300 mg/day of dietary cholesterol and emphasized that no more than 3 eggs should be eaten per week, resulting in substantial reductions in egg consumption, not just by diseased populations but also by healthy individuals, and more importantly by poor communities in undeveloped counties who were advised against consuming a highly nutritious food. These recommendations did not take into account that eggs not only contain important nutrients for overall health but also components which exert protection against chronic disease. The newly-released 2015 dietary guidelines finally took into consideration the epidemiological information and the data from clinical interventions and eliminated an upper limit for dietary cholesterol. This special issue addresses the history of the recommendations for eggs ,5,6, theThe history of the recommendations of dietary cholesterol and the politics behind those recommendations as well as the perception of the public and the creation of the Egg Nutrition Center in the US are thoroughly discussed alongside the lines of evidence on which the original recommendations were based . The numEggs have been recognized as functional foods due to the presence of bioactive components, which may play a role in the prevention of chronic and infectious diseases . The preThe role of eggs on the healthy eating index (HEI) was evaluated in 139 obese post-partum Mexican American women . This arThere is controversy regarding egg consumption and patients diagnosed with diabetes . While i


The personality construct alexithymia is characterized by the difficulty in identifying and describing feelings with an externally oriented thinking pattern and a limited imaginative capacity  are one of the conditions associated with alexithymia that has a high prevalence  are classic psychosomatic diseases Sifneos, , and sevMost of studies which listed in Table Alexithymia may contribute to an increased severity of FGID or a poor outcome independent of anxiety and depression from the epidemiological studies listed in Table Enhanced perception of visceral stimuli called visceral hypersensitivity is one of the key features of IBS  and hypothalamic-pituitary-adrenal (HPA) axis. These systems are main mediators of brain-gut interaction and alteration of these systems has been reported in FGIDs Chang, . SubjectIn conclusion, alexithymia may contribute to an increased severity of FGID or a poor outcome measured by TAS-20. The empirical data may indicate that the association between FGIDs and alexithymia may not be explained simply by “somatosensory amplification,” but biased interpretation of their symptoms not based on appropriate bodily sensation. The physiological component of the emotional or stress response system may be altered; however, the direction of causation between these alterations and the alexithymic cognitive and affective style is not clear. The studies on the association between alexithymia and physiological aspect of FGID has been sparse. Future studies are required to make a consensus of measurement of alexithymia, and elucidate the physiological mechanism of link between alexithymia and FGID.MK: Drafting of the manuscript and critical revision of the manuscript; YE: Critical revision of the manuscript; SF: Critical revision of the manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Abiotic factors influenced the capacity of the strains to form biofilms. Classification of the adhesion type is related with the optical density measured on the biofilm formation of tested strains. The relationship between the biofilm formation in real values with theoretical values of the strains was used to determine the mechanism involved during mixed cultures. Specifications TableValue of the dataThe data provide useful information for producers and consumers concerning biofilms formation on mango fruits.The presence of these Enterobacteria reminds the importance of the application of good agricultural practices.Effect of microbial interactions on biofilm formation are important for the industry considering the impact to human health.1The optical density of cristal violeta absorbed by Enterobacteria involved in the biofilm formation at surface fruit, by individual and mixed strains and also the mechanism of interaction between strains during biofilms formation.2All experiments were conducted at least in 3 independent times in duplicates. The data were analyzed with the statistical software SAS v. 9.0. Statistical significance was determined by Tukey test using one-way analysis of variance (ANOVA). Fruits were harvested and selected without damage. Enterobacteria were previously isolated from mango surface. The type of mechanism between strains was assessed comparing the amount of biofilm formation in absorbance units


In this study, the removal capacity of deionized water was investigated against five gaseous carbonyl compounds  by means of the gas stripping method. To determine the trapping behavior of these odorants by water, gaseous working standards prepared at three different concentration levels  were forced through pure water contained in an impinger at room temperature. The removal efficiency of the target compounds was inspected in terms of two major variables: (1) concentration levels of gaseous standard and (2) impinger water volume . Although the extent of removal was affected fairly sensitively by changes in water volume, this was not the case for standard concentration level changes. Considering the efficiency of sorption media, gas stripping with aqueous solution can be employed as an effective tool for the removal of carbonyl odorants.


A full-scale experimental test was conducted to analyze the composite behavior of insulated concrete sandwich wall panels (ICSWPs) subjected to wind pressure and suction. The experimental program was composed of three groups of ICSWP specimens, each with a different type of insulation and number of glass-fiber-reinforced polymer (GFRP) shear grids. The degree of composite action of each specimen was analyzed according to the load direction, type of the insulation, and number of GFRP shear grids by comparing the theoretical and experimental values. The failure modes of the ICSWPs were compared to investigate the effect of bonds according to the load direction and type of insulation. Bonds based on insulation absorptiveness were effective to result in the composite behavior of ICSWP under positive loading tests only, while bonds based on insulation surface roughness were effective under both positive and negative loading tests. Therefore, the composite behavior based on surface roughness can be applied to the calculation of the design strength of ICSWPs with continuous GFRP shear connectors. Insulation is a basic aspect of passive construction for reducing energy through eco-friendly and highly-efficient air-conditioning and heating systems; together with new and renewable energies, insulation is the most important element in zero-energy construction. While external insulation methods may offer energy-saving effects up to the level of zero energy and zero carbon, complex construction and durability issues are impediments to full realization in the field. The insulated concrete sandwich wall panel (ICSWP), which consists of an insulating material and internal/external concrete wythes, is a good alternative that can satisfy the levels of both structural and insulation performance required for buildings. For ICSWP to be used as an efficient load-bearing element, however, it is necessary to improve its structural performance by increasing the degree of composite of the internal/external concrete wythes.et al. et al., (exp) and the theoretical moment of inertia of full-composite action (Ic) and non-composite action (Inc). Once the experimental moment of inertia of each specimen is calculated using Equation (4), Equation (3) is used to compare the degree of composite action of the specimens in terms of the initial stiffness (κ1). The degree of composite action in terms of the ultimate strength (κ2) is calculated using Equation (5). The degree of composite action based on the theoretical/experimental initial stiffness and ultimate strengths of the specimens is summarized in Iexp is the experimentally-determined moment of inertia; Ic and Inc are the theoretical, uncracked, full- and non-composite moments of inertia, respectively; Pexp is the experimental ultimate strength of specimens; and Pc and Pnc are the theoretical ultimate strengths of full- and non-composite action, respectively.The degree of composite action for each specimen was evaluated in terms of the initial stiffness and ultimate strength. The method defined by Pessiki and MIynarczyk 2003) [003 [2] wIn All groups except the EPS_P group show that the ultimate strength is strongly dependent on the number of GFRP grids; the EPS_P group shows similar ultimate strength to the other group because the adhesive bonds contribute more to the composite action than the number of GFRP grids. Also, the degree of composite action according to the surface roughness is compared to determine the effect of the mechanical bond. The degree of composite action in terms of initial stiffness and ultimate strength of the XPSST_P group is higher, at 3%–6% and 24%–29%, than that of the XPSNB_P group, and that of the XPSST_N group are higher, at 13%–18% and 14%–32%, than that of the XPSNB_P group. The mechanical bond based on surface roughness has an effect on the composite action and is effective in both positive and negative loading tests.It has been experimentally proven that the shear capacity of connecting elements, which is thought to affect the composite action of test specimens, changed depending on not only the type of insulation and the number of GFRP shear grids, but also the loading direction. For example, a higher degree of composite action was obtained under the negative loading test compared to the degree of composite action of the XPSST and XPSNB groups with equal GFRP shear grids according to loading direction. The EPS specimens with equal GFRP shear grids; however, exhibited a higher degree of composite action under the positive loading test. In other words, the shear capacity of connecting elements increases under negative loading more than under positive loading tests for XPSST and XPSNB specimens; the opposite results are observed in EPS specimens. Because the adhesive bond had no effect during the negative loading test, the mechanical bond strength is investigated to explain the higher degree of composite action. Also, there was the different grid shear flow strength between positive and negative loading test that contributes to the ultimate strength of the test specimens.The upper and lower concrete wythes are connected by connecting elements comprised of GFRP grids, insulation, and bond. If the shear flow capacity of the connecting elements are calculated from the shear flow strength of the GFRP grids only, the results of the higher degree of composite action of XPSST specimens than XPSNB specimens will not be reflected in the overall shear flow capacity of the connecting elements. Therefore, the shear capacity of the connecting elements is determined via the shear flow strength of the GFRP grids and the bond between the concrete wythes and insulation.In this experimental test, the bonds can by divided into mechanical bonds based on friction between the XPSST foam and concrete wythe, and adhesive bonds based on the absorptiveness of the EPS foam. Adhesive bonds are difficult to quantify, while mechanical bonds can be determined experimentally through comparison of XPSST and XPSNB groups with equal numbers of GFRP grids. The first load peak, which was considered to be the bond strength of each specimen, is investigated in the load-deflection curve, and c) is defined in Equation (6) and the value summarized in 4, and 5,760,000 mm3, respectively (see reference [The shear flow strength of the GFRP grids can be obtained theoretically from the number of effective strands subjected to tensile force, because GFRP grids are easily buckled when subjected to compressive force. eference  for a deIn In this study, the composite behavior of ICSWP reinforced with GFRP grids is investigated with respect to load direction, using both positive and negative loading. An experimental program, including eighteen full-scale specimens, was conducted with test variables, including the type of insulation, surface roughness, and number of GFRP shear grids. The failure modes of each specimen are examined to compare the structural behavior according to load direction. The degree of composite behavior is analyzed in terms of the initial stiffness, taking into account the varying moment of inertia due to crack propagation and ultimate strength. In addition, the mechanical bond strength based on surface roughness is analyzed at the first load peak and then effective shear flow strength of GFRP grids is calculated from the ultimate and mechanical bond strengths.EPS_P group showed similar flexural strength with weak dependence on the number of shear grids. In this group, a material characteristic of absorptiveness in the EPS foam resulted in a high adhesive bond between the concrete and insulation that governed the flexural and composite behavior. However, the flexural strength of the EPS_N groups showed a dependence on the number of shear grids under negative loading, because the effect of the adhesive bonds were weakened by the tensile force. XPSST_P and XPSNB_P groups showed that flexural strength is governed by the number of shear grids; mechanical bonds based on surface roughness have a consistent effect on the initial stiffness and ultimate strength. Also, the flexural strength of the XPSST_N and XPSNB_N groups shows a tendency to depend on the number of shear grids, which is similar to the results of the positive loading test. We confirmed that the mechanical bond based on surface roughness is effective under negative as well as positive loading.The higher degree of composite action under negative loading was obtained in XPSST and XPSNB groups. The primary reason for this was the difference in shear flow strength of each GFRP shear grid between positive and negative loading tests. In the case of negative loading, the tensile force acting on the shear grids from concrete wythe allowed the GFRP strands in both orthogonal directions to make some contribution to the load-carry capacity, and the effective strands resisted against the flexural-shear force. On the contrary, the compressive force acting on the shear grids from concrete wythes during positive loading weakened the load-carrying capacity of the shear grids. As result, the shear flow strength under negative loading was higher by approximately 21% than that under positive loading, contributing to the higher ultimate strength under negative loading.The specimens in the EPS_N group showed that the adhesive bond is weakened in negative loading tests; thus, composite behavior based on the adhesive bond is not expected. The design strength of the ICSWP with EPS foam may be governed by the shear flow strength of grids. On the other hand, since the mechanical bond of the XPS foam are based on the surface roughness, they were effective under positive and negative loading tests, so it concludes that the composite behavior from mechanical bonds can be applied to the design strength of the ICSWP with continuous GFRP shear connectors.


TFIIH is organized into a seven-subunit core associated with a three-subunit Cdk-activating kinase (CAK) module. TFIIH has roles in both transcription initiation and DNA repair. During the last 15 years, several studies have been conducted to identify the composition of the TFIIH complex involved in DNA repair. Recently, a new technique combining chromatin immunoprecipitation and western blotting resolved the hidden nature of the TFIIH complex participating in DNA repair. Following the recruitment of TFIIH to the damaged site, the CAK module is released from the core TFIIH, and the core subsequently associates with DNA repair factors. The release of the CAK is specifically driven by the recruitment of the DNA repair factor XPA and is required to promote the incision/excision of the damaged DNA. Once the DNA lesions have been repaired, the CAK module returns to the core TFIIH on the chromatin, together with the release of the repair factors. These data highlight the dynamic composition of a fundamental cellular factor that adapts its subunit composition to the cell needs.


Dementia & Neuropsychologia, Nunes and colleaguespresent an interesting paper evaluating the effect of educational level on thephenomenon of reduction of the asymmetry of processing by the cerebral hemispheres withaging. An intriguing observation was that although no difference between individualswith low or high educational level was seen on cognitive tests, differences were incerebral processing were evident on magnetoencephalography.1 This group of researchers led by AlexandreCastro-Caldas, of the University of Lisbon, Portugal, has been investigating the effectsof illiteracy and low educational level on the brain by means of more current andsophisticated methods of analysis of the functional organization of the central nervoussystem.In this issue of 2 The relevance of taking advantage of more elaborate methods tostudy hitherto less investigated phenomena, or those have been evaluated using onlyclinical or conventional research methods, is one of the most important non explicitcontributions of this group of researchers and is reflected by the paper published inthis issue.In 1998, Castro-Caldas and colleagues in their already classic study, employed positronemission tomography (PET) with statistical parametric mapping to evaluate thedifferences between illiterates and non-illiterates on verbal tasks, and concluded thatthe functional organization of the adult brain is modified by learning to read and writein childhood. At the time the study was devised, PET was not available in Portugal, sothe authors had to seek support from the Karolinska Institute of Stockholm, Sweden,where patients were flown to undergo the examination.3 Within the sphereof particular interest to Dementia & Neuropsychologia, it is apt toremind that the modifications of the silver impregnation methods proposed by MaxBielschowsky paved the way for Alois Alzheimer to describe the pathological hallmarks ofAlzheimer’s disease,4 while it was thevery appropriate choice of Aplysia californica that made possible manyof the remarkable advances in mechanisms of memory achieved by Eric Kandel and histeam.5The use of novel methods or models of study has been critical for the advance of science.Indeed, it was the application of the silver impregnation methods, only recentlyreported by Camilo Golgi at the time, that allowed Santiago Ramón y Cajal to goon and produce what is probably the most seminal page on neurosciences ever written byany one individual.Dementia & Neuropsychologia isthe publication of papers investigating the effects of education and cultural phenomenaon the central nervous system as well as studies on diseases that are more common indeveloping countries than in developed regions. Methods are the essence of science andnew methods and models will certainly shed new and brighter light on these relativelyneglected fields.Numbering among the main motivations of


The results also envisaged that the different yield attributes viz. height, total number of branches, and number of leaves per plant have been found to be varied with treatments, being highest in the treatment where Zn was applied as both soil and foliar spray without the application of P. The results further indicated that the yield and yield attributes of stevia have been found to be decreased in the treatment where Zn was applied as both soil and foliar spray along with P suggesting an antagonistic effect between Zn and P.A greenhouse experiment was conducted at the Indian Institute of Horticultural Research (IIHR), Bangalore to study the interaction effect between phosphorus (P) and zinc (Zn) on the yield and yield attributes of the medicinal plant stevia. The results show that the yield and yield attributes have been found to be significantly affected by different treatments. The total yield in terms of biomass production has been increased significantly with the application of Zn and P in different combinations and methods, being highest (23.34 g fresh biomass) in the treatment where Zn was applied as both soil (10 kg ZnSO