238 research outputs found
Effect of Tris and Biociphos-Plus Extenders on the Extracellular Enzyme Release of Phosphatases and Transferases in Punganur Bull Semen
The present investigation was carried out to study phosphatase and transferase enzymes leakage in the neat and extended Punganur bull semen before and after freezing with Tris and Biociphos-plus extenders. Among the bulls studied, the Alkaline Phosphatase (AKP) concentration in fresh semen was significantly different but Acid Phosphatase (ACP) was not significantly different and a positive correlation between the concentration of AKP and semen volume, individual motility, sperm concentration and total abnormalities were observed. Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) concentrations were not significantly different and positively correlated with individual motility, sperm concentration, percentage of live sperms and acrosomal damage. Leakage of AKP, ACP, AST and ALT enzymes before freezing the semen of Punganur bulls was observed to be significantly higher in the semen extended with Biociphos-plus extender
Clinico-pathological study of intradural extramedullary spinal tumors
Background: The intradural extramedullary tumours of the spine are one of the commonest tumours of the spine. Early diagnosis and surgical removal helps in best outcome. The objective of the study was to analyze the clinical presentation, imageology, resectability, to know the incidence of different types of tumours in intradural extramedullary compartment and to study the surgical outcome.Methods: This was a prospective study of 32 cases of intradural extramedullary tumours. The clinical presentation, imageology, resectability, histopathology, surgical outcome were studied. The patients were investigated with plain spinal radiography and MRI. All cases were treated surgically by posterior or posterolateral approaches. Outcome and complications were evaluated. They were followed up regularly and the results were analyzed. Ambulatory status was classified on admission by using Nurick-grading scheme.Results: The incidence of intradural extramedullary spinal tumours was 57.14%. Most of the tumours presented in the third decade (37.5%). Mean age of Presentation for meningioma was 36 years and for nerve sheath tumours was 39.5 years. The nerve sheath tumours contributed 35% followed by meningioma 28%. Nerve sheath tumours were found to be most commonly located in thoracic region (56%). Total excision of tumour was achieved in 87.7% cases.Conclusions: Nerve Sheath tumours and Meningiomas were the most common in intradural extramedullary spinal lesions and complete excision was possible in almost all cases. Prognosis was usually good, in spite of poor neurological status at the time of presentation.
Role of Threaded Tool Pin Profile and Rotational Speed on Generation of Defect Free Friction Stir AA 2014 Aluminium Alloy Welds
Influence of threads on tool pin and rotational speeds on defect occurrence in friction stir welding (FSW) of aluminum alloy AA 2014 T6 plates has been studied. The effect of FSW forces on the evolution of mechanistic defects, caused in turn through a variation in heat generation during the process has also been examined. In case of conical tool pin, relatively lower rotational speeds resulted in unbounded zones and micro defects while high speeds caused excessive flash, thereby resulting in surface defects and voids inside the weld. The FSW joints were defect-free at moderate speeds, hinting an optimum heat generation and flow. Reaction forces on the tool pin, in the welding direction, were correlated with the defect formation. Tools equipped with a threaded conical pin profile resulted in sound welds, irrespective of the tool rotational speeds in the entire range of 400 rpm - 2400 rpm. The threaded conical pin, with a relatively larger frictional area, may be contributing to higher levels of heat generation compared to a plain conical pin. Further, positive displacement of the hot plasticised material by the threads will carry away excess heat from the advancing-to-the-retracting side and simultaneously downwards, thus confining all heat within the weld zone.
Brugia malayi Microfilariae Induce a Regulatory Monocyte/Macrophage Phenotype That Suppresses Innate and Adaptive Immune Responses
Background Monocytes and macrophages contribute to the dysfunction of immune
responses in human filariasis. During patent infection monocytes encounter
microfilariae in the blood, an event that occurs in asymptomatically infected
filariasis patients that are immunologically hyporeactive. Aim To determine
whether blood microfilariae directly act on blood monocytes and in vitro
generated macrophages to induce a regulatory phenotype that interferes with
innate and adaptive responses. Methodology and principal findings Monocytes
and in vitro generated macrophages from filaria non-endemic normal donors were
stimulated in vitro with Brugia malayi microfilarial (Mf) lysate. We could
show that monocytes stimulated with Mf lysate develop a defined regulatory
phenotype, characterised by expression of the immunoregulatory markers IL-10
and PD-L1. Significantly, this regulatory phenotype was recapitulated in
monocytes from Wuchereria bancrofti asymptomatically infected patients but not
patients with pathology or endemic normals. Monocytes from non-endemic donors
stimulated with Mf lysate directly inhibited CD4+ T cell proliferation and
cytokine production (IFN-γ, IL-13 and IL-10). IFN-γ responses were restored by
neutralising IL-10 or PD-1. Furthermore, macrophages stimulated with Mf lysate
expressed high levels of IL-10 and had suppressed phagocytic abilities.
Finally Mf lysate applied during the differentiation of macrophages in vitro
interfered with macrophage abilities to respond to subsequent LPS stimulation
in a selective manner. Conclusions and significance Conclusively, our study
demonstrates that Mf lysate stimulation of monocytes from healthy donors in
vitro induces a regulatory phenotype, characterized by expression of PD-L1 and
IL-10. This phenotype is directly reflected in monocytes from filarial
patients with asymptomatic infection but not patients with pathology or
endemic normals. We suggest that suppression of T cell functions typically
seen in lymphatic filariasis is caused by microfilaria-modulated monocytes in
an IL-10-dependent manner. Together with suppression of macrophage innate
responses, this may contribute to the overall down-regulation of immune
responses observed in asymptomatically infected patients
An Empirical Comparison of Consumer Innovation Adoption Models: Implications for Subsistence Marketplaces
So called “pro-poor” innovations may improve consumer wellbeing in subsistence marketplaces. However, there is little research that integrates the area with the vast literature on innovation adoption. Using a questionnaire where respondents were asked to provide their evaluations about a mobile banking innovation, this research fills this gap by providing empirical evidence of the applicability of existing innovation adoption models in subsistence marketplaces. The study was conducted in Bangladesh among a geographically dispersed sample. The data collected allowed an empirical comparison of models in a subsistence context. The research reveals the most useful models in this context to be the Value Based Adoption Model and the Consumer Acceptance of Technology model. In light of these findings and further examination of the model comparison results the research also shows that consumers in subsistence marketplaces are not just motivated by functionality and economic needs. If organizations cannot enhance the hedonic attributes of a pro-poor innovation, and reduce the internal/external constraints related to adoption of that pro-poor innovation, then adoption intention by consumers will be lower
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700
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Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
Background
Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios.
Methods
To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline.
Findings
During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction.
Interpretation
Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world
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