A comparison of outcomes between finger and pulp replantation/revascularization in a single centre

Background: Supermicrosurgery has allowed the replantation/revascularization of the pulp, but how does this currently compare with more proximal digit replantation/revascularization? Methods: In a retrospective case study over a 5-year period at our institute, a total of 21 patients (n = 21) had either finger or pulp replantation-revascularization posttrauma. All pulp replants had a single-vessel anastomosis viz., “artery-to-artery” or “artery-to-vein” only, with venous outflow dependent on the skin-shave technique, while more proximal replants had both arterial and venous anastomoses. Age, sex, ischemic time, handedness, smoker status, and injury-replant interval were compared between the two groups, with all procedures performed by a single surgeon. The outcome parameters studied were length of hospital stay, timeline for wound healing, viability, and functional outcomes. Results: Our patients consisted of 18 men and three women, of which 14.3% were smokers and 85.7% were right-handed. There were 11 finger replantation/revascularizations (n = 11) versus 10 pulp replantation/revascularizations (n = 10). The average age of digit replantation/revascularization patients was 44.8 years compared with 26.4 years in pulp replantation/revascularization patients (Student t test, P = 0.04). Mean ischemia time in digital replants was 67 minutes versus 32.3 minutes in pulp replantation/revascularization (Student t test, P = 0.056). Digital replantation/revascularization was viable in 72% of cases versus a 90% viability in the pulp subcohort. Conclusions: In our patient cohort, pulp replantation/revascularizations produced better postoperative viability. Where supermicrosurgery expertise is available, pulp replantation/revascularization should be considered a worthwhile option when compared with digital replantation/revascularization

Seasonal prevalence of gastrointestinal helminths in sheep and goats of middle agro-climatic zone of Jammu province

A total of 1920 faecal samples of sheep (960) and goats (960) of stationary flocks of the middle agro-climatic zone of Jammu province were examined, out of which 67.24 % animals were positive for helminthic infections. The different nematodes observed were strongyles (50.1 %), trichurids (12.1 %) and Strongyloides spp. (4.2 %). Trematode ova recorded were of amphistomes (8.3 %), Fasciola spp. (8.2 %) and Dicrocoelium spp. (5.4 %). No significant difference was observed between the infection level in sheep (68.54 %) and goats (65.94 %) which could be attributed to mixed grazing and sharing of pastures/sheds. Significantly (p < 0.05) higher infection was observed in monsoon as compared to winter. Strongyles were predominant during all the seasons, but significantly (p < 0.05) higher infection was observed in monsoon as compared to winter. Coproculture studies revealed that Haemonchus contortus (61.18 %) predominated during all the seasons, followed by Trichostrongylus spp. (13.67 %), Ostertagia spp. (12.17 %), Strongyloides spp. (4.14 %), Oesophagostomum spp. (3.84 %) and Bunostomum spp. (3.83 %). Eggs per gram of faeces (EPG) were the highest (sheep 1883.33 ± 117.6 and goats 1800 ± 110.21) during monsoon and the lowest during winter (sheep 640 ± 41.29 and goats 556.67 ± 33.01). Two peaks of EPG (the first in May and the second in August) were recorded during the 1 year study period. Infection was significantly (p < 0.05) higher in young (73.22 %) as compared to adults (61.25 %). Females showed a higher infection (73.33 %) as compared to males (61.14 %). The effect of prevailing agro-climatic conditions on the prevalence of gastrointestinal helminths has been discussed

Illustrating a new global-scale approach to estimating potential reduction in fish species richness due to flow alteration

Changes in river discharge due to human activities and climate change would affect the sustainability of freshwater ecosystems. To globally assess how changes in river discharge will affect the future status of freshwater ecosystems, global-scale hydrological simulations need to be connected with a model to estimate the durability of freshwater ecosystems. However, the development of this specific modelling combination for the global scale is still in its infancy. In this study, two statistical methods are introduced to link flow regimes to fish species richness (FSR): one is based on a linear relationship between FSR and mean river discharge (hereafter, FSR-MAD method), and the other is based on a multi-linear relationship between FSR and ecologically relevant flow indices involving several other flow characteristics and mean river discharge (FSR-FLVAR method). The FSR-MAD method has been used previously in global simulation studies. The FSR-FLVAR method is newly introduced here. These statistical methods for estimating FSR were combined with a set of global river discharge simulations to evaluate the potential impact of climate-change-induced flow alterations on FSR changes. Generally, future reductions in FSR with the FSR-FLVAR method are greater and much more scattered than with the FSR-MAD method. In arid regions, both methods indicate reductions in FSR because mean discharge is projected to decrease from past to future, although the magnitude of reductions in FSR is different between the two methods. In contrast, in heavy-snow regions a large reduction in FSR is shown by the FSR-FLVAR method due to increases in the frequency of low and high flows. Although further research is clearly needed to conclude which method is more appropriate, this study demonstrates that the FSR-FLVAR method could produce considerably different results when assessing the global role of flow alterations in changing freshwater ecosystems

Synthesis, FT-IR, UV-VIS, DFT studies and SCXRD structure of 1-(tert-butyl) 3-ethyl-3-(hydroxy(thiophen-2-yl)methyl)piperidine-1,3-dicarboxylate

The crystal structure of 1-(tert-butyl) 3-ethyl 3-(hydroxy(thiophen-2-yl)methyl)piperidine-1,3-dicarboxylate (C18H25NO5S) I has been determined by Single Crystal X-ray Diffraction (SCXRD) techniques. It crystallizes in the orthorhombic space group Pca21 with unit cell parameters a = 19.4502(13)Å, b= 6.3571(4)Å, c= 15.2577(10) Å and number of molecules per unit cell, z = 4. The intensity data have been collected at room température (293 K) and the structure has been solved by direct methods. The full matrix least-squares refinement has converged the final R-value to 0.035 for 2251 observed reflections. The piperidine ring adopts a chair conformation. The structure is stabilized by two C–H…O (intermolecular interactions) and five C–H…O (intramolecular interactions). The structural and spectral studies of 1-(tert-butyl) 3-ethyl 3-(hydroxy(thiophen-2-yl)methyl)piperidine-1,3-dicarboxylate have been carried out by using both experimental and quantum chemical techniques

Synthesis, FT-IR, UV-VIS, DFT studies and SCXRD structure of 1-(tert-butyl) 3-ethyl-3-(hydroxy(thiophen-2-yl)methyl)piperidine-1,3-dicarboxylate

1043-1056The crystal structure of 1-(tert-butyl) 3-ethyl 3-(hydroxy(thiophen-2-yl)methyl)piperidine-1,3-dicarboxylate (C18H25NO5S) I has been determined by Single Crystal X-ray Diffraction (SCXRD) techniques. It crystallizes in the orthorhombic space group Pca21 with unit cell parameters a = 19.4502(13)Å, b= 6.3571(4)Å, c= 15.2577(10) Å and number of molecules per unit cell, z = 4. The intensity data have been collected at room température (293 K) and the structure has been solved by direct methods. The full matrix least-squares refinement has converged the final R-value to 0.035 for 2251 observed reflections. The piperidine ring adopts a chair conformation. The structure is stabilized by two C–H…O (intermolecular interactions) and five C–H…O (intramolecular interactions). The structural and spectral studies of 1-(tert-butyl) 3-ethyl 3-(hydroxy(thiophen-2-yl)methyl)piperidine-1,3-dicarboxylate have been carried out by using both experimental and quantum chemical techniques

Identification of a Novel Aminopeptidase P-Like Gene (OnAPP) Possibly Involved in Bt Toxicity and Resistance in a Major Corn Pest (Ostrinia nubilalis)

Studies to understand the Bacillus thuringiensis (Bt) resistance mechanism in European corn borer (ECB, Ostrinia nubilalis) suggest that resistance may be due to changes in the midgut-specific Bt toxin receptor. In this study, we identified 10 aminopeptidase-like genes, which have previously been identified as putative Bt toxin receptors in other insects and examined their expression in relation to Cry1Ab toxicity and resistance. Expression analysis for the 10 aminopeptidase-like genes revealed that most of these genes were expressed predominantly in the larval midgut, but there was no difference in the expression of these genes in Cry1Ab resistant and susceptible strains. This suggested that altered expression of these genes was unlikely to be responsible for resistance in these ECB strains. However, we found that there were changes in two amino acid residues of the aminopeptidase-P like gene (OnAPP) involving Glu305 to Lys305 and Arg307 to Leu307 in the two Cry1Ab-resistant strains as compared with three Cry1Ab-susceptible strains. The mature OnAPP contains 682 amino acid residues and has a putative signal peptide at the N-terminus, a predicted glycosylphosphatidyl-inositol (GPI)-anchor signal at the C-terminal, three predicted N-glycosylation sites at residues N178, N278 and N417, and an O-glycosylation site at residue T653. We used a feeding based-RNA interference assay to examine the role of the OnAPP gene in Cry1Ab toxicity and resistance. Bioassays of Cry1Ab in larvae fed diet containing OnAPP dsRNA resulted in a 38% reduction in the transcript level of OnAPP and a 25% reduction in the susceptibility to Cry1Ab as compared with larvae fed GFP dsRNA or water. These results strongly suggest that the OnAPP gene could be involved in binding the Cry1Ab toxin in the ECB larval midgut and that mutations in this gene may be associated with Bt resistance in these two ECB strains

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990–2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold &gt;75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold &lt;0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold &lt;1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill &amp; Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH

Pre-Clinical Evaluation of a Novel Nanoemulsion-Based Hepatitis B Mucosal Vaccine

Hepatitis B virus infection remains an important global health concern despite the availability of safe and effective prophylactic vaccines. Limitations to these vaccines include requirement for refrigeration and three immunizations thereby restricting use in the developing world. A new nasal hepatitis B vaccine composed of recombinant hepatitis B surface antigen (HBsAg) in a novel nanoemulsion (NE) adjuvant (HBsAg-NE) could be effective with fewer administrations.Physical characterization indicated that HBsAg-NE consists of uniform lipid droplets (349+/-17 nm) associated with HBsAg through electrostatic and hydrophobic interactions. Immunogenicity of HBsAg-NE vaccine was evaluated in mice, rats and guinea pigs. Animals immunized intranasally developed robust and sustained systemic IgG, mucosal IgA and strong antigen-specific cellular immune responses. Serum IgG reached > or = 10(6) titers and was comparable to intramuscular vaccination with alum-adjuvanted vaccine (HBsAg-Alu). Normalization showed that HBsAg-NE vaccination correlates with a protective immunity equivalent or greater than 1000 IU/ml. Th1 polarized immune response was indicated by IFN-gamma and TNF-alpha cytokine production and elevated levels of IgG(2) subclass of HBsAg-specific antibodies. The vaccine retains full immunogenicity for a year at 4 degrees C, 6 months at 25 degrees C and 6 weeks at 40 degrees C. Comprehensive pre-clinical toxicology evaluation demonstrated that HBsAg-NE vaccine is safe and well tolerated in multiple animal models.Our results suggest that needle-free nasal immunization with HBsAg-NE could be a safe and effective hepatitis B vaccine, or provide an alternative booster administration for the parenteral hepatitis B vaccines. This vaccine induces a Th1 associated cellular immunity and also may provide therapeutic benefit to patients with chronic hepatitis B infection who lack cellular immune responses to adequately control viral replication. Long-term stability of this vaccine formulation at elevated temperatures suggests a direct advantage in the field, since potential excursions from cold chain maintenance could be tolerated without a loss in therapeutic efficacy