59 research outputs found

    Access to pediatric surgery delivered by general surgeons and anesthesia providers in Uganda: Results from 2 rural regional hospitals.

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    Abstract Background Significant limitations in pediatric surgical capacity exist in low- and middle-income countries, especially in rural regions. Recent global children's surgical guidelines suggest training and support of general surgeons in rural regional hospitals as an effective approach to increasing pediatric surgical capacity. Methods Two years of a prospective clinical database of children's surgery admissions at 2 regional referral hospitals in Uganda were reviewed. Primary outcomes included case volume and clinical outcomes of children at each hospital. Additionally, the disability-adjusted life-years averted by delivery of pediatric surgical services at these hospitals were calculated. Using a value of statistical life calculation, we also estimated the economic benefit of the pediatric surgical care currently being delivered. Results From 2016 to 2019, more than 300 surgical procedures were performed at each hospital per year. The majority of cases were standard general surgery cases including hernia repairs and intussusception as well as procedures for surgical infections and trauma. In-hospital mortality was 2.4% in Soroti and 1% in Lacor. Pediatric surgical capacity at these hospitals resulted in over 12,400 disability-adjusted life-years averted/year. This represents an estimated economic benefit of 10.2 million US dollars/year to the Ugandan society. Conclusion This investigation demonstrates that lifesaving pediatric procedures are safely performed by general surgeons in Uganda. General surgeons who perform pediatric surgery significantly increase surgical access to rural regions of the country and add a large economic benefit to Ugandan society. Overall, the results of the study support increasing pediatric surgical capacity in rural areas of low- and middle-income countries through support and training of general surgeons and anesthesia providers

    Acute and post-acute phase of COVID-19: Analyzing expression patterns of miRNA-29a-3p, 146a-3p, 155-5p, and let-7b-3p in PBMC

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    Background: When a new pathogen, such as severe acute respiratory syndrome coronavirus 2, appears all novel information can aid in the process of monitoring and in the diagnosis of the coronavirus disease (COVID-19). The aim of the current study is to elucidate the specific miRNA profile which can act as new biomarkers for distinguishing acute COVID-19 disease from the healthy group and those in the post-acute phase of the COVID-19 disease. Methods: The expression level of selected miRNAs including let-7b-3p, miR-29a-3p, miR-146a-3p and miR-155-5p were evaluated in peripheral blood mononuclear cells (PBMCs) of COVID-19 patients, in both the acute and post-acute COVID-19 phase of the disease and healthy groups, by real-time PCR assays. Specificity and sensitivity of miRNAs was tested by receiver operating characteristic (ROC) analysis in COVID-19 patients. Results: The expression level of all miRNAs in COVID-19 patients was significantly higher than in the healthy group. Therefore, the expression pattern of miR-29a-3p, miR-146a-3p and let-7b-3p in the post-acute COVID-19 phase was significantly different from the acute COVID-19 phase. ROC analyses demonstrated that miR-29a-3p, -155-5p and -146a-3p may serve as the novel biomarker for COVID-19 diagnosis with high specificity and sensitivity. In addition, miR-29a-3p, and -146a-3p can maybe act as novel biomarkers for distinguishing acute from post-acute phase of COVID-19 disease. Discussion: The difference in miRNA expression pattern between COVID-19 patients and those in the healthy group, and between acute COVID-19 with post-acute COVID-19, suggested that cellular miRNAs could be used as promising biomarkers for diagnosis and monitoring of COVID-19. © 2021 Elsevier B.V

    Recombinant AAV-mediated HSVtk gene transfer with direct intratumoral injections and Tet-On regulation for implanted human breast cancer

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    BACKGROUND: HSVtk/ganciclovir (GCV) gene therapy has been extensively studied in tumors and relies largely on the gene expression of HSVtk. Most studies, however, have failed to demonstrate any significant benefit of a controlled gene expression strategy in cancer treatment. The Tet-On system is commonly used to regulate gene expression following Dox induction. We have evaluated the antitumor effect of HSVtk/ganciclovir gene therapy under Tet-On regulation by means of adeno-associated virus-2 (AAV-2)-mediated HSVtk gene transfer with direct intratumoral injections in mice bearing breast cancer tumors. METHODS: Recombinant adeno-associated virus-2 (rAAV) was constructed and transduced into MCF-7 cell line. GCV treatment to the rAAV infected MCF-7 cells was performed by MTT assay under the doxycycline (Dox) induction or without Dox induction at a vp (viral particle) number of ≥10(4 )/cell. The virus was administered intratumorally to nude mice that had also received GCV intraperitoneally. The antitumor effects were evaluated by measuring tumor regression and histological analysis. RESULTS: We have demonstrated that GCV treatment to the infected MCF-7 cells under the Dox induction was of more inhibited effects than those without Dox induction at ≥10(4 )vp/cell. In ex vivo experiments, tumor growth of BALB/C nude mice breast cancer was retarded after rAAV-2/HSVtk/Tet-On was injected into the tumors under the Dox induction. Infiltrating cells were also observed in tumors after Dox induction followed by GCV treatment and cells were profoundly damaged. The expression of HSVtk gene in MCF-7 cells and BALB/C nude mice tumors was up-regulated by Tet-On under Dox induction with reverse transcription-PCR (RT-PCR) analysis. CONCLUSION: The antitumor effect of rAAV-mediated HSVtk/GCV gene therapy under the Dox induction with direct intratumoral injections may be a useful treatment for breast cancer and other solid tumors

    Integrated Molecular Meta-Analysis of 1,000 Pediatric High-Grade and Diffuse Intrinsic Pontine Glioma.

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    We collated data from 157 unpublished cases of pediatric high-grade glioma and diffuse intrinsic pontine glioma and 20 publicly available datasets in an integrated analysis of >1,000 cases. We identified co-segregating mutations in histone-mutant subgroups including loss of FBXW7 in H3.3G34R/V, TOP3A rearrangements in H3.3K27M, and BCOR mutations in H3.1K27M. Histone wild-type subgroups are refined by the presence of key oncogenic events or methylation profiles more closely resembling lower-grade tumors. Genomic aberrations increase with age, highlighting the infant population as biologically and clinically distinct. Uncommon pathway dysregulation is seen in small subsets of tumors, further defining the molecular diversity of the disease, opening up avenues for biological study and providing a basis for functionally defined future treatment stratification

    Влияние фосфатных связующих на физико-механические свойства периклазохромитовых огнеупоров

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    У данній статті наведено та порівняно фізико-механічні властивості периклазо-хромітових матеріалів в залежності від різних типів фосфатних зв’язуючих та введення різних домішок. Визначено, що найбільш раціональним є введення триполіфосфату натрію.In given clause are resulted and the physycal-mechanical properties periclase-cgromite of materials are compared depending on different of types phosphate binding and introduction of the various additives. Is determined, that most rational is the introduction treepolyphosphate sodume

    Determining the minimum dataset for surgical patients in Africa : a Delphi study

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    BACKGROUND : It is often difficult for clinicians in African low- and middle-income countries middle-income countries to access useful aggregated data to identify areas for quality improvement. The aim of this Delphi study was to develop a standardised perioperative dataset for use in a registry. METHODS : A Delphi method was followed to achieve consensus on the data points to include in a minimum perioperative dataset. The study consisted of two electronic surveys, followed by an online discussion and a final electronic survey (four Rounds). RESULTS : Forty-one members of the African Perioperative Research Group participated in the process. Forty data points were deemed important and feasible to include in a minimum dataset for electronic capturing during the perioperative workflow by clinicians. A smaller dataset consisting of eight variables to define risk-adjusted perioperative mortality rate was also described. CONCLUSIONS : The minimum perioperative dataset can be used in a collaborative effort to establish a resource accessible to African clinicians in improving quality of care.https://link.springer.com/journal/268AnaesthesiologySDG-03:Good heatlh and well-bein

    The impact of the Institution for Educational Development\u27s visiting teacher programme on teachers of English

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    I explored the impact of the 1997, English VT programme on English language teachers, in terms of how the programme affected their classroom practices. This study revealed the programme\u27s indirect impact on other teachers through the VTs sharing of their learning experiences with their colleagues. I explored the familiarity of the VT\u27s with language teaching approaches, and I concluded that both the teachers I worked with were generally familiar with four major language teaching approaches. Nighat was familiar with three approaches, but was not clear about the fourth. Shama could not explain the approaches by specific names, but she appeared to be practising these approaches in her classroom. In regard to the four language skills, the study revealed that Nighat was clearly familiar with the term integration, as she immediately used the term integration in talking about her teaching. Shama did not use the term integration, but her practice in the real situation in the classroom suggested that she knew how to teach language through integration. In regard to the component of teaching grammar communicatively, both Nighat and Shama were clearly familiar with the term and this was evident not only by their informal discourse about teaching grammar communicatively, but also by observation. The study also revealed that Nighat and Shama were capable of analysing as well as evaluating the syllabi and textbooks, and of enriching both of these, through the creation of their own worksheets and activity sheets. The teachers also derived benefit from the component of the teaching practice in the VT programme. Their classroom practices revealed that the teachers did benefit from the component of teaching practice and that they continued with the significant events of teaching practice such as, teaching the syllabus communicatively, providing positive feedback to their colleagues and teaching of vocabulary by associating them with ideas. The teachers also benefited from the coverage of assessment. Both Nighat and Shama seemed familiar with alternative assessment practices. Nighat however, could not implement these because of the constraints of board examinations, but she was able to assist her other colleagues in designing assessment sheets. Shama seemed to implement these alternative assessment practices. The study suggested that both the teachers were familiar with the term reflection and reflective teaching. They were also aware of the benefits of writing reflective Dissertation Abstracts MEd III Class of 1999 18 journals. The study also revealed that Nighat and Shama had shared their new learning experiences with their colleagues in their respective schools

    Simulating cotton yield response to deficit irrigation with the FAO AquaCrop model

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    The Food and Agriculture Organization has reflected the importance of predicting yield response to water by developing the AquaCrop model. During three growing seasons (2007-2009), a field experiment was conducted in the South-East of Damascus (Syria) to assess the response of drip irrigated cotton grown under full (FI) and deficit irrigation (80, 65, 50% of FI). Input data and comparisons between simulated and observed canopy cover (CC), biomass production at harvesting, final seed cotton yield, and soil water content using data sets of the 2007 season, were used for model calibration. The calibrated model was validated using data sets of the 2008 and 2009 seasons, getting accurate simulation results for CC [root mean square error (RMSE) = 6.5%] and actual evapotranspiration- ETa (RMSE = 25 mm, index of agreement = 0.99). The predicted seed cotton yields were within 6% of measurements. The model predictions of soil water content in the 0.60 m profile were close in the general trend to the measurements. In spite of the good prediction of ETa and seed cotton yield for each treatment, there is an apparent tendency for AquaCrop to over-estimate water use efficiency (WUE) under water-deficit conditions. Therefore, in cases of limited input data, the AquaCrop could be a promising model for estimating crop productivity under deficit irrigation conditions
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