Seroprevalence of Bovine Herpes Virus-1, Bovine Herpes Virus-4 and Bovine Viral Diarrhea Virus in Dairy Cattle in Sudan

A survey was conducted to determine prevalence of antibodies against Bovine herpes virus-1 (BoHv-1), Bovine herpes virus-4 (BoHv-4) and Bovine viral diarrhea (BVD) in dairy cattle in farms with reproductive problems in two areas in Sudan. Sera samples were collected from Khartoum state and central Sudan during 2005-2008 and analyzed using direct ELISA. The prevalence of antibodies was discussed with respect to age, season, sex, breed and locality BoHv-1 and BVD antibodies were highly prevalent in Khartoum state (51.7 and 50.4%, respectively) while in central Sudan BoHv-1 (32.7%) antibodies were the most prevalent followed by, BVD (25.7%) and BoHv-4 (19.3%). The highest prevalence of antibodies against the three viruses in both areas was found during the rainy season (July to October). The prevalence of antibodies to viruses studied was significantly associated with female sex except for BoHv-1. Prevalence of antibodies to BoHv-4 was significantly associated with breed while those of BoHv-1 and BVD were not. The present results indicated that older cattle were more likely to be seropositive in case of BoHv-4 but to BoHv-1 or BVD viruses. Furthermore, it was found that BoHv-1 and BVD antibodies were highly prevalent in aborted dams. While, infertility problems were highly associated with BoHv-1 antibodies. BVD antibodies showed the highest prevalence in case of death after birth. The results of this study provide better understanding of viral epidemics of reproductive disorders and represent the first report of BoHv-4 antibodies in cattle in Sudan

Morphological responses of the small intestine of broiler chicks to dietary supplementation with a probiotic, acidifiers, and their combination

This study was conducted to investigate the effects of dietary supplementation of a probiotic (Bacillus subtilis), acidifiers, and their combination on the mucosa of the broiler small intestine. A total of 220 straight run 1-day-old broiler chicks (Ross 308) were distributed into 4 experimental treatments with 5 replicates per treatment as a 2 × 2 factorial arrangement. The factors were probiotic and a blend of acidifiers with 2 levels: 0.0% and 0.05% for probiotic, and 0.0% and 0.2% for acidifiers. On day 42, tissue samples from the duodenum, jejunum, and ileum of 5 birds from each group were collected and processed for histology, immunohistochemistry, and scanning electron microscopy. Duodenal villus height (VH) increased (P ≤ 0.05) when probiotic was added to the diet. Chickens fed the probiotic had a significantly higher (P ≤ 0.05) percentage of intact villi compared to the other groups. The jejunum showed an increased VH in the group of birds supplemented with acidifiers. The ileum showed decreased (P ≤ 0.05) VH when probiotic was added to the diet, and increased VH when given acidifiers. Dietary supplementation of probiotic only or in combination with acidifiers showed a reduction (P ≤ 0.05) in the number of somatostatin immunoreactive cells (SIC) in the duodenal villi. A decrease in the number of SIC was also noted in the jejunal villi of birds receiving acidifiers. In conclusion, dietary supplementation with the probiotic, B. subtilis, or acidifiers improved the mucosal morphology of the small intestine in the broilers used in the present study. The 2 additives, however, did not show any synergistic effect on the intestinal morphology.https://academic.oup.com/japr2020-03-01hj2019Anatomy and Physiolog

The Association of Lymphocyte count, CRP, D-Dimer, and LDH with Severe Coronavirus Disease 2019 (COVID-19): A Meta-Analysis

Background: The rapid progression of Coronavirus disease 2019 (COVID-19) and its increasing burden on health systems necessitate the identification of parameters of severe infection to help in monitoring, prognoses and development of treatment algorithms. Objectives: This review aims to investigate the association of lymphocyte count, CRP, LDH, and D-Dimer with the severity of COVID-19. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), and ScienceDirect were used for the systematic search. Random effects model was used to estimate the pooled standardized mean differences (SMD) with the corresponding 95% confidence interval (CI), using OpenMeta Analyst software. Results: A total of 11 studies, with 2437 COVID-19 patients, which fulfilled the eligibility criteria were included in the meta-analysis. The analysis revealed that lymphocyte count was significantly lower in patients with the severe form of COVID-19 (SMD = - 1.025, P value <.001). Also, the analysis of SMD showed that patients with severe COVID-19 have a significantly higher serum levels of CRP (SMD = 3.363, P value <.001), D-Dimer (SMD = 1.073, P value <.001), and LDH (SMD = 3.345, P value <.001). Conclusion: Low lymphocyte count and high levels of CRP, LDH, and D-Dimer are associated with severe COVID-19. These laboratory markers could be used as clinical indicators of worsening illness and poor prognosis of COVID-19

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved