Factors in the Adoption of Beef Cattle Artificial Insemination (AI) Technology in Brebes Regency

Efforts to increase beef cattle population and genetic in Brebes Regency can be done by using artificial insemination (AI) technology approach.Therefore this study aims to determine the factors that influence the ability of beef cattle farmers in adopting artificial insemination technology (AI) in Brebes Regency. Survey method was applied to observe beef cattle and farmers. Sampling technique used Slovin formula with 90% significant rate to observe variables, namely the ability of farmers to adopt AI technology (Y); social factors (X1) consisting of age (X1.1), educational background (X1.2), farming experience (X1.3), herd size (X1.4); technical factors consisting of S/C (X2.1) and oestrous detection (X2.2); and economic factor is AI costs (X3). The research data obtained were analysed using descriptive analysis and correlation. The results showed that adoption of artificial insemination in beef cattle in Brebes Regency had a negative correlation with age (X1.1) (rs = -0.498), did not correlate with educational background (X1.2) (rs = 0.221), farming experience ( rs = X1.3) (rs = -0.056), and the herd size (X1.4) (rs = 0.094) as social factors; does not correlate with the value of S/C (X2.1) (rs = 0.203) and estrous detection (X2.2) (rs = 0.259) as technical factors; and negatively correlate.ed with AI cost (X3) (rs = -0,661) as an economic factor. From the results of the study, it can be concluded that the adoption of artificial insemination in beef cattle in Brebes Regency is influenced by social and economic factors, especially from the age factor and AI cost factor that is less supportive

Assessment and Management of Scabies in Primary Care Settings

Scabies is an overlooked tropical illness that yet has significant worldwide effects and lasting health repercussions. The condition is caused by the mite Sarcoptes scabei var. hominis, which is a parasitic organism that dwells on the outer layer of the human skin. Scabies is prevalent in impoverished neighborhoods as a result of the high population density in locations such as nursing homes, correctional facilities, and among homeless and displaced children. Nevertheless, modern nations are also prone to scabies infestations, particularly in cases of institutional outbreaks or mini epidemics occurring after conflict or natural calamities. Scabies diagnosis can be aided by both invasive and noninvasive techniques. This paper reviews assessment diagnosis, and management of scabies in primary health care settings

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

A unilateral middle ear mass as an initial presentation of a probable IgG4-related disease: Case presentation

Over the past few years, multiple studies have shed light on the novel autoimmune inflammatory condition termed IgG4-related disorder (IgG4-RD). It predominantly affects middle-aged and older men, has an insidious presentation, and can affect multiple organs in the body. The presentation of this disease is highly variable, and many of its clinical manifestations have been described as “idiopathic”. The exact pathogenesis of this disease is not fully understood; however, it is important to consider this diagnosis when encountering patients, as initiating management early in the course of the disease can prevent it from progressing to a late, irreversible stage.In this report, we present a case of a 70-year-old male who presented with a history of left aural fullness, vertigo pulsatile tinnitus, and progressive hearing loss. Radiological investigations revealed a soft tissue lesion in the middle ear cleft. The patient underwent exploration of the middle ear under general anesthesia; intraoperatively, a friable hemorrhagic lesion encapsulating the facial nerve and eroding the ossicles, the tegmen, and the labyrinth was found, and a complete excision was achieved. Histopathological evaluation of the lesion suggested a probable diagnosis of IgG4-RD.Early recognition of IgG4-RD is essential to provide the optimum patient care and prevent further progression of the disease. This report discusses an atypical presentation of IgG4-RD of the left temporal bone

Virus-encoded glycosyltransferases hypermodify DNA with diverse glycans

Summary: Enzymatic modification of DNA nucleobases can coordinate gene expression, nuclease protection, or mutagenesis. We recently discovered a clade of phage-specific cytosine methyltransferase (MT) and 5-methylpyrimidine dioxygenase (5mYOX) enzymes that produce 5-hydroxymethylcytosine (5hmC) as a precursor for enzymatic hypermodifications on viral genomes. Here, we identify phage MT- and 5mYOX-associated glycosyltransferases (GTs) that catalyze linkage of diverse sugars to 5hmC nucleobase substrates. Metavirome mining revealed thousands of biosynthetic gene clusters containing enzymes with predicted roles in cytosine sugar hypermodification. We developed a platform for high-throughput screening of GT-containing pathways, relying on the Escherichia coli metabolome as a substrate pool. We successfully reconstituted several pathways and isolated diverse sugar modifications appended to cytosine, including mono-, di-, or tri-saccharides comprised of hexoses, N-acetylhexosamines, or heptose. These findings expand our knowledge of hypermodifications on nucleic acids and the origins of corresponding sugar-installing enzymes

Rapid-Freeze-Quench Magnetic Circular Dichroism of Intermediate X in Ribonucleotide Reductase: New Structural Insight

To elucidate the electronic structure of intermediate X in the oxygen activation reaction of the R2 subunit of ribonucleotide reductase, a protocol has been developed to perform magnetic circular dichroism (MCD) on a rapid-freeze-quench, strain free optical sample. RFQ-MCD data have been collected on intermediate X in the double mutant of R2, Y122/Y356F. While X has been reported to exhibit a broad absorption band at 365 nm, there are at least 10 electronic transitions observed at low-temperature MCD. From C0/D0 ratios, the transitions of X can be divided into three regions: 16 000-22 000 cm-1 region involving spin-allowed ligand field transitions of the Fe(IV), 23 000-24 000 cm-1 region of spin-forbidden, spin-flip transitions on the Fe(IV), and the charge transfer (CT) region from 26 000 to 32 000 cm-1. The C0/D0 ratios from d --> d and CT transitions strongly support significant Fe(IV) character coupled into the paramagnetic center. Ligand field (spin-allowed d --> d region) analysis allows the bis-mu-oxo and mu-oxo plus other monoanionic bridge possibilities for the structure of intermediate X to be distinguished, providing new insight into the molecular mechanism of the cluster formation in R2

Spectroscopic and electronic structure studies of intermediate X in ribonucleotide reductase R2 and two variants: a description of the Fe IV-oxo bond in the FeIII-O-FeIV dimer

Spectroscopic and electronic structure studies of the class I Escherichia coli ribonucleotide reductase (RNR) intermediate X and three computationally derived model complexes are presented, compared, and evaluated to determine the electronic and geometric structure of the Fe-Fe active site of intermediate X. Rapid freeze-quench (RFQ) EPR, absorption, and MCD were used to trap intermediate X in R2 wild-type (WT) and two variants, W48A and Y122F/Y356F. RFQ-EPR spin quantitation was used to determine the relative contributions of intermediate X and radicals present, while RFQ-MCD was used to specifically probe the Fe/Fe active site, which displayed three Fe d-d transitions between 16 700 and 22 600 cm, two Fe d-d spin-flip transitions between 23 500 and 24 300 cm, and five oxo to Fe and Fe charge transfer (CT) transitions between 25 000 and 32 000 cm. The Fe d-d transitions were perturbed in the two variants, confirming that all three d-d transitions derive from the d-π manifold. Furthermore, the Fe d-π splittings in the WT are too large to correlate with a bis-μ-oxo structure. The assignment of the Fe d-d transitions in WT intermediate X best correlates with a bridged μ-oxo/μ-hydroxo [Fe (μ-O)(μ-OH)Fe] structure. The μ-oxo/μ-hydroxo core structure provides an important σ/π superexchange pathway, which is not present in the bis-μ-oxo structure, to promote facile electron transfer from Y122 to the remote Fe through the bent oxo bridge, thereby generating the tyrosyl radical for catalysis