e - proctoring exams at a Regional University during Covid-19: understanding the challenges

The ongoing Coronavirus (COVID-19) pandemic has had an effect on most sectors in the countries affected by Covid-19 cases. Even in the South Pacific region, countries were forced to go under lockdown, flights were cancelled, businesses, schools and universities closed. Similar to most institutes in the region that were forced to close, the University of the South Pacific (USP) cancelled its face-to-face (F2F) studies and instead switched to Emergency Remote Teaching (ERT) at all its 14 regional campuses. It is undeniable that teaching using ERT has challenges. However, teaching using ERT at a one-campus university may be easier than teaching at a regional university since it brings with it more challenges due to the geographical distance and the gap in support available at these campuses. USP faced similar challenges since academics could not travel to regional campuses for tutorial support. All support, tutorials and lectures were conducted online using BigBlueButton (BBB) or Zoom. That, in itself led to additional online training of staff and students to better familiarize them with online learning and teaching. Courses offered at USP have used Moodle as its learning management system (LMS) since 2006. ERT during COVID-19 lockdowns meant courses that were offered F2F were switched to online. Switching from F2F, courses to Online mode during lockdowns in 2022 and 2021 did not hinder much with the staff and student preparedness since all courses were on the LMS. The only major change that needed to be introduced was the inclusion of online assessments in these courses. One of the components for online assessment included the introduction of e-proctoring as a system to supervise students attempting online exams to meet the requirements of the accrediting bodies. There are various e-proctoring software that can be used for such supervisions. USP used Proctorio during the recent lockdowns. This paper shares the experience of testing, reviewing and getting students ready for online assessments using e-proctoring, as well as adjusting the LMS to support the online assessment navigation system. The paper additionally discusses the success and challenges faced while using e-proctoring for such online assessments

IN VITRO STUDY OF THE CONTRACEPTIVE SPERMICIDAL ACTIVITY OF ENSETE SUPERBUM ON HUMAN SPERM

Objective: The present study was conducted to determine the spermicidal and contraceptive efficacy of ethanolic extract of Ensete superbum seeds on human sperm in vitro. Methods: The hypo-osmotic swelling (HOS) and the sperm viability test were used to detect the integrity of sperm membrane and vitality. The sperm revival test was also done to check the recovery of the sperm motility. Results: Ensete superbum extract at 100 mg/ml concentration, induced complete immobilization of human spermatozoa and kill 100% spermatozoa within 20s in vitro. The sperm revival test did not show any spermatozoa that recovered their motilities. In the 100 mg/ml extract and N-9 treated groups, the rate of the normal HOS (swollen tails) and the viable sperms (unstained) was 0%, and the rate of the abnormal HOS (unswollen tails) and nonviable sperms (stained) was 100% indicating the plasma membrane degradation of the sperm. Conclusion: The current study indicates that ethanolic seed extract of Ensete superbum possesses appreciable spermicidal potential, which may be explored as an effective vaginal contraceptive

Effects of ions on the characteristics of monolayer at brine/oil interfaces

The advanced waterflooding technologies through salinity and ionic content adjustment can make favorable impacts on rock wettability and oil recovery. In carbonate reservoirs, SmartWater at low ionic strength showed strong chemical interactions with carbonate minerals and oil components. As a result, several hypotheses are proposed in literature as ionic exchange, rock dissolution, surface charges and others. The applied macroscopic and microscopic technologies have certain limitations in identifying the structures at interfaces especially at monolayers. In this paper, advanced Sum Frequency Generation (SFG) spectroscopy is utilized for the first time to characterize the chemical structures of molecules at the brine/oil interfaces. Different brines recipes and model oil are tested to determine the effects of individual and combined ions on the monolayer structures. Stearic acid is also mixed with hydrocarbons to mimic the acidity condition of fluids in the reservoir. The change in the chemical structure is mo nitored with time at a broad wavenumber range from 1,000 to 3,800 cm-1. Distinct spectral signatures of oil components and water ions are detected at different pH conditions. The SFG data is compared with the previous macroscopic wettability results to predict the components that are highly affected during waterflooding and enhanced oil recovery (EOR) processes. This study brings new insights on understanding the chemical structures at the thin monolayers of flat and curved geometric at different aqueous interfaces. The measured spectra, coupled with a wide range of laser polarization settings, and signal intensity trends are discussed in terms of composition, and structure of organic and inorganic components. For example, the intensity for SmartWater at certain wavenumber is three folds higher when compared to high salinity water. This indicates that the interactions at oil/water interfaces are enhanced at lower ionic strengths. In addition, these findings are also confirmed with similar behaviors at a higher salinity brine as connate formation brine. The novelty of this interfacial study can provide better understanding of the reaction mechanisms altering the ionic strength and salinity of injection water and its impact due to the changes in geometric interfaces. Such understanding is also crucial to optimize the chemistry of injection water and its interaction with oil components and carbonate rock, to ultimately alter wettability toward water-wet

Global survey on the surgical management of patients affected by colorectal cancer with synchronous liver metastases: impact of surgical specialty and geographic region

BACKGROUND: Consensus on the best surgical strategy for the management of synchronous colorectal liver metastases (sCRLM) has not been achieved. This study aimed to assess the attitudes of surgeons involved in the treatment of sCRLM. METHODS: Surveys designed for colorectal, hepato-pancreato-biliary (HPB), and general surgeons were disseminated through representative societies. Subgroup analyses were performed to compare responses between specialties and continents. RESULTS: Overall, 270 surgeons (57 colorectal, 100 HPB and 113 general surgeons) responded. Specialist surgeons more frequently utilized minimally invasive surgery (MIS) than general surgeons for colon (94.8% vs. 71.7%, p < 0.001), rectal (91.2% vs. 64.6%, p < 0.001), and liver resections (53% vs. 34.5%, p = 0.005). In patients with an asymptomatic primary, the liver-first two-stage approach was preferred in most respondents' centres (59.3%), while the colorectal-first approach was preferred in Oceania (83.3%) and Asia (63.4%). A substantial proportion of the respondents (72.6%) had personal experience with minimally invasive simultaneous resections, and an expanding role for this procedure was foreseen (92.6%), while more evidence was desired (89.6%). Respondents were more reluctant to combine a hepatectomy with low anterior (76.3%) and abdominoperineal resections (73.3%), compared to right (94.4%) and left hemicolectomies (90.7%). Colorectal surgeons were less inclined to combine right or left hemicolectomies with a major hepatectomy than HPB and general surgeons (right: 22.8% vs. 50% and 44.2%, p = 0.008; left: 14% vs. 34% and 35.4%, p = 0.002, respectively). CONCLUSION: The clinical practices and viewpoints on the management of sCRLM differ between continents, and between and within surgical specialties. However, there appears to be consensus on a growing role for MIS and a need for evidence-based input

The circadian cryptochrome, CRY1, is a pro-tumorigenic factor that rhythmically modulates DNA repair.

Mechanisms regulating DNA repair processes remain incompletely defined. Here, the circadian factor CRY1, an evolutionally conserved transcriptional coregulator, is identified as a tumor specific regulator of DNA repair. Key findings demonstrate that CRY1 expression is androgen-responsive and associates with poor outcome in prostate cancer. Functional studies and first-in-field mapping of the CRY1 cistrome and transcriptome reveal that CRY1 regulates DNA repair and the G2/M transition. DNA damage stabilizes CRY1 in cancer (in vitro, in vivo, and human tumors ex vivo), which proves critical for efficient DNA repair. Further mechanistic investigation shows that stabilized CRY1 temporally regulates expression of genes required for homologous recombination. Collectively, these findings reveal that CRY1 is hormone-induced in tumors, is further stabilized by genomic insult, and promotes DNA repair and cell survival through temporal transcriptional regulation. These studies identify the circadian factor CRY1 as pro-tumorigenic and nominate CRY1 as a new therapeutic target

Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in southern Africa has been characterised by three distinct waves. The first was associated with a mix of SARS-CoV-2 lineages, whilst the second and third waves were driven by the Beta and Delta variants, respectively1-3. In November 2021, genomic surveillance teams in South Africa and Botswana detected a new SARS-CoV-2 variant associated with a rapid resurgence of infections in Gauteng Province, South Africa. Within three days of the first genome being uploaded, it was designated a variant of concern (Omicron) by the World Health Organization and, within three weeks, had been identified in 87 countries. The Omicron variant is exceptional for carrying over 30 mutations in the spike glycoprotein, predicted to influence antibody neutralization and spike function4. Here, we describe the genomic profile and early transmission dynamics of Omicron, highlighting the rapid spread in regions with high levels of population immunity

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

Background and purpose: Prospectively collected data comparing the safety and effectiveness of individual non-vitamin K antagonists (NOACs) are lacking. Our objective was to directly compare the effectiveness and safety of NOACs in patients with newly diagnosed atrial fibrillation (AF). Methods: In GLORIA-AF, a large, prospective, global registry program, consecutive patients with newly diagnosed AF were followed for 3&nbsp;years. The comparative analyses for (1) dabigatran vs rivaroxaban or apixaban and (2) rivaroxaban vs apixaban were performed on propensity score (PS)-matched patient sets. Proportional hazards regression was used to estimate hazard ratios (HRs) for outcomes of interest. Results: The GLORIA-AF Phase III registry enrolled 21,300 patients between January 2014 and December 2016. Of these, 3839 were prescribed dabigatran, 4015 rivaroxaban and 4505 apixaban, with median ages of 71.0, 71.0, and 73.0&nbsp;years, respectively. In the PS-matched set, the adjusted HRs and 95% confidence intervals (CIs) for dabigatran vs rivaroxaban were, for stroke: 1.27 (0.79–2.03), major bleeding 0.59 (0.40–0.88), myocardial infarction 0.68 (0.40–1.16), and all-cause death 0.86 (0.67–1.10). For the comparison of dabigatran vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 1.16 (0.76–1.78), myocardial infarction 0.84 (0.48–1.46), major bleeding 0.98 (0.63–1.52) and all-cause death 1.01 (0.79–1.29). For the comparison of rivaroxaban vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 0.78 (0.52–1.19), myocardial infarction 0.96 (0.63–1.45), major bleeding 1.54 (1.14–2.08), and all-cause death 0.97 (0.80–1.19). Conclusions: Patients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death. Registration: URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013