Volume Infusion Markedly Increases Femoral dP/dtmax in Fluid-Responsive Patients Only.

OBJECTIVES: To evaluate the preload dependence of femoral maximal change in pressure over time (dP/dtmax) during volume expansion in preload dependent and independent critically ill patients. DESIGN: Retrospective database analysis. SETTING: Two adult polyvalent ICUs. PATIENTS: Twenty-five critically ill patients with acute circulatory failure. INTERVENTIONS: Thirty-five fluid infusions of 500 mL normal saline. MEASUREMENTS AND MAIN RESULTS: Changes in femoral dP/dtmax, systolic, diastolic, and pulse femoral arterial pressure were obtained from the pressure waveform analysis using the PiCCO2 system (Pulsion Medical Systems, Feldkirchen, Germany). Stroke volume index was obtained by transpulmonary thermodilution. Statistical analysis was performed comparing results before and after volume expansion and according to the presence or absence of preload dependence (increases in stroke volume index ≥ 15%). Femoral dP/dtmax increased by 46% after fluid infusion in preload-dependent cases (mean change = 510.6 mm Hg·s; p = 0.005) and remained stable in preload-independent ones (mean change = 49.2 mm Hg·s; p = 0.114). Fluid-induced changes in femoral dP/dtmax correlated with fluid-induced changes in stroke volume index in preload-dependent cases (r = 0.618; p = 0.032), but not in preload-independent ones. Femoral dP/dtmax strongly correlated with pulse and systolic arterial pressures and with total arterial stiffness, regardless of the preload dependence status (r > 0.9 and p < 0.001 in all cases). CONCLUSIONS: Femoral dP/dtmax increased with volume expansion in case of preload dependence but not in case of preload independence and was strongly related to pulse pressure and total arterial stiffness regardless of preload dependence status. Therefore, femoral dP/dtmax is not a load-independent marker of left ventricular contractility and should be not used to track contractility in critically ill patients.

African neuroscience on the global stage: Nigeria as a model.

Of the 572 neuroscience-related studies published in Nigerian from 1996 to 2017, <5% used state-of-the-art techniques, none used transgenic models, and only one study was published in a top-tier journal.

Regression of solid breast tumours in mice by Newcastle disease virus is associated with production of apoptosis related-cytokines.

BACKGROUND: Different strains of Newcastle disease virus (NDV) worldwide proved to have tumouricidal activity in several types of cancer cells. However, the possible anti-cancer activity of Malaysian NDV AF2240 strain and its mechanism of action remains unknown. The ability of cytokine-related apoptosis-inducing NDV AF2240 to treat breast cancer was investigated in the current study. METHODS: A total of 90 mice were used and divided into 15 groups, each group comprising of 6 mice. Tumour, body weight and mortality of the mice were determined throughout the experiment, to observe the effect of NDV and NDV + tamoxifen treatments on the mice. In addition, the toxic effect of the treatments was determined through liver function test. In order to elucidate the involvement of cytokine production induced by NDV, a total of six cytokines, i.e. IL-6, IFN-γ, MCP-1, IL-10, IL12p70 and TNF-α were measured using cytometric bead array assay (plasma) and enzyme-linked immunosorbent spot (isolated splenocytes). RESULTS: The results demonstrated that 4 T1 breast cancer cells in allotransplanted mice treated with AF2240 showed a noticeable inhibition of tumour growth and induce apoptotic-related cytokines. CONCLUSIONS: NDV AF2240 suppression of breast tumour growth is associated with induction of apoptotic-related cytokines. It would be important to further investigate the molecular mechanism underlaying cytokines production by Newcastle disease virus.

Correction to: Regression of solid breast tumours in mice by Newcastle disease virus is associated with production of apoptosis related-cytokines.

.

Interpretation of World Health Organization growth charts for assessing infant malnutrition: a randomised controlled trial.

AIMS: The study aims to assess the effects of switching from National Center for Health Statistics (NCHS) growth references to World Health Organization (WHO) growth standards on health-care workers' decisions about malnutrition in infants aged <6 months. METHODS: We conducted a single blind randomised crossover trial involving 78 health-care workers (doctors, clinical officers, health service assistants) in Southern Malawi. Participants were offered hypothetical clinical scenarios with the same infant plotted on NCHS-based weight-for-age charts and again on WHO-based charts. Additional scenarios compared growth charts with a single final weight against charts with the same final weight plus a preceding growth trend. Reported (i) level of concern, (ii) referral suggestions and (iii) feeding advice were elicited with a questionnaire. RESULTS: Even after adjusting for health-care worker type and experience, using WHO rather than NCHS charts increased: (i) concern: aOR 4.4 (95% CI 2.4-8.1); (ii) odds of referral: aOR 5.1 (95% CI 2.4-10.8); and (iii) odds of feeding advice which would interrupt exclusive breastfeeding (aOR 2.4, 95% CI 1.2-4.9). A preceding steady growth trend line did not affect concern, referral or feeding advice. CONCLUSIONS: Health-care workers take insufficient account of linear growth trend, clinical and feeding status when interpreting a low weight-for-age plot. Because more infants <6 months fall below low centile lines on WHO growth charts, their use may increase inappropriate referrals and risks undermining already low rates of exclusive breastfeeding. To avoid their being misinterpreted in this way, WHO charts need accompanying guidelines and training materials that recognise and address this possible adverse effect.

The impact of green credit legislation on business financing: Insights from Chinese polluting firms.

Introducing sustainable credit protection by companies depends on eco-friendly funding that accelerate businesses' technical development and transformation. This study investigates the sustainable financing roles through green credit legislation which impacted state owned enterprises and non state owned enterprises. We have investigated our hypothesis using the Propensity Score Matching Difference-in-Differences (PSM-DID) model. For this purpose we collected data of businesses listed on the Shanghai and Shenzhen stock exchanges that are country's most polluting publicly listed enterprises between 2009 and 2021. The results of the study reveals that liquid Finance and industrial Credit experienced a meteoric rise while the use of illiquid debt financing has dropped significantly among highly polluting organizations. This pattern has intensified after China introduced its "sustainable credit guidelines." Additionally, businesses in areas with lower sustainable development indices are more likely to feel the consequences of sustainable credit programs. However, there is still a need for prudent capital flow allocation in response to the personalized financing preferences resulting from the sustainable credit policy at the business level, even if China's sustainable credit rules have unquestionably reduced the use of illiquid debt financing by severely polluting enterprises. Policy implications include improving the direction signalled to these businesses via sustainable funding.

An assessment of bilateral debt swap financing indispensable for economic growth and environment sustainability: a policy implication for heavily indebted countries.

Bilateral debt swap is an innovative global financing mechanism designed to support heavily indebted countries (HICs). It is a debt-restructuring process involving donor countries forgiving debt owed by HICs in exchange for commitments to undertake projects on environment and socio-economic development. It is a unique approach designed to help heavily indebted countries get back on their feet. Effective debt swap financing can lead to both economic growth and environment sustainability, but they are challenging to implement. This study examines the impact of bilateral debt swap financing on economic growth and environment sustainability. For the purpose, we have used debt swap index developed with Kaiser-Meyer-Olkin (KMO) methodology. KMO widely used approach of Principle Component Analysis (PCA) to solve the problem of "over-identification" and make strong correlation among endogenous variables of interest. In order to validate the nexus empirically between bilateral debt swap financing with economic growth and environment sustainability, we have employed the Two-Step System Generalized Method of Moments (SYS-GMM) approach in 25 countries for the period of 2002 to 2021. This modern econometric method addresses endogeneity issues and controls for unobserved heterogeneity in panel data. At the same time, the technique addresses the simultaneity problem, reverse causality, and remove selection bias. Findings of the study shows that effective bilateral debt swap financing can boost economic growth and environment sustainability by investing domestic resources for targeted activities along with reduced debt burden. Empirical results reveal that 1% change in debt swap financing can lead to a maximum of 0.23% growth in the economy and 0.28% improvement in environment sustainability. However, it is important to note that in most empirical specifications, results are inconclusive. One possible reason for this is often ineffective debt swap practices coupled with inadequate monitoring and evaluation in HICs. Policymakers should focus on enhancing debt swap policies to promote economic growth and environment sustainability.

A comprehensive review of cystic fibrosis in Africa and Asia.

Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.

Analysis of PPI networks of transcriptomic expression identifies hub genes associated with Newcastle disease virus persistent infection in bladder cancer.

Bladder cancer cells can acquire persistent infection of oncolytic Newcastle disease virus (NDV) but the molecular mechanism(s) remain unelucidated. This poses a major barrier to the effective clinical translation of oncolytic NDV virotherapy of cancers. To improve our understanding of the molecular mechanism(s) associated with the development of NDV persistent infection in bladder cancer, we used mRNA expression profiles of persistently infected bladder cancer cells to construct PPI networks. Based on paths and modules in the PPI network, the bridges were found mainly in the upregulated mRNA-pathways of p53 signalling, ECM-receptor interaction, and TGF-beta signalling and downregulated mRNA-pathways of antigen processing and presentation, protein processing in endoplasmic reticulum, completement and coagulation cascades in persistent TCCSUPPi cells. In persistent EJ28Pi cells, connections were identified mainly through upregulated mRNA-pathways of renal carcinoma, viral carcinogenesis, Ras signalling and cell cycle and the downregulated mRNA-pathways of Wnt signalling, HTLV-I infection and pathways in cancers. These connections were mainly dependent on RPL8-HSPA1A/HSPA4 in TCCSUPPi cells and EP300, PTPN11, RAC1-TP53, SP1, CCND1 and XPO1 in EJ28Pi cells. Oncomine validation showed that the top hub genes identified in the networks that include RPL8, THBS1, F2 from TCCSUPPi and TP53 and RAC1 from EJ28Pi are involved in the development and progression of bladder cancer. Protein-drug interaction networks identified several putative drug targets that could be used to disrupt the linkages between the modules and prevent bladder cancer cells from acquiring NDV persistent infection. This novel PPI network analysis of differentially expressed mRNAs of NDV persistently infected bladder cancer cell lines provide an insight into the molecular mechanisms of NDV persistency of infection in bladder cancers and the future screening of drugs that can be used together with NDV to enhance its oncolytic efficacy.

Search engine optimisation (SEO) strategy as determinants to enhance the online brand positioning.

Background: Marketers face evolution of online brand positioning marketing strategy due to changes of search engine algorithm that affects the reaching out of brands to potential internet users. Brand owners realise that to be relevant in modern market, they need to transition and focus more into online market. However, many brand owners have ignored the power of search engine optimisation (SEO) strategy for attracting the online market, which is highly competitive and faces rapid changes.  A brand can be considered as old fashioned if it does not utilise the SEO as their marketing strategy, in penetrating the online marketplace. Various studies have analysed factors that can enhance the persistency of using the SEO strategy, however gaps remain regarding the relationship of this strategy with the online brand positioning. The main aim of this study was to identify the persistency of using the SEO strategy including the niche point of differentiation, valuable content, targeted keyword and scalable link building, as the determinants that enhance the success of online brand positioning. Methods: This study applies quantitative design using online survey to gather information from the online business entrepreneurs. The survey questionnaire was arranged to focus on the use of SEO as a new way to strategise online business. Results: Based on the results of this study, most online entrepreneurs have somewhat realised the effects of using the SEO strategy to enhance effectiveness of online brand positioning. Conclusion: This research provides insights into the importance of SEO strategy in online business positioning. It is hoped that online entrepreneurs will consider the SEO strategy in the positioning of their brand in the marketplace. Implication: This research focused on SEO as a new strategy to enhance brand positioning for online businesses. Future research may expand into another dimension of business such as customer satisfaction and business performance.

Determinants of renewable energy sources in Pakistan: An overview.

For successive economic growth of any society, sustainable energy plays a pivotal role. Considering this view, developing countries are facing serious challenges of energy at the present time. However, policymakers have outlined numerous policies to satisfy energy demand but still remain incapable to fill the gap between demand and supply. At a halt, 11% of the world population lacks access to different formulae of energy supply and access. Additionally, in different time periods, distinct policies have erupted for the progress of renewable energy. It includes especially those households of the far-flung areas having no gas and electricity availability. However, the basis of this research study is to determine the significant renewable energy source for Pakistan's economy with the economic benefits such as job creation in energy sector. This research study aims in finding ways to secure energy supplies and achieving economic benefits. The research study concludes by engaging renewable energy technologies with the least operational and externality cost that is the utmost choice in the future. In policy perspective, Pakistani government should take actions in favor of renewable energy and technological innovation that necessitates biomass resources to be tied to non-sustainable prolonged investments.

Knowledge, Attitude and Practices Toward Coronavirus Disease (COVID- 19) in Southeast and South Asia: A Mixed Study Design Approach.

Background: Coronavirus has spread to almost every country since its emergence in Wuhan, China and countries have been adopted an array of measures to control the rapid spread of the epidemic. Here, we aimed to assess the person's knowledge, attitude and practices (KAP) toward the COVID-19 epidemic in Southeast and South Asia applying the mixed study design (cross-sectional and systematic review). Methods: In the cross-sectional study, 743 respondents' socio-demographic and KAP-related information was collected through an online population-based survey from the Malaysian population. In the systematic review, the database PubMed, Web of Science and Google Scholar search engine were searched and related published articles from South and Southeast Asia were included. Frequency distribution, Chi-square association test and binary logistic regression were fitted using cross-sectional data whereas random effect model and study bias were performed in meta-analysis. We used 95% confidence interval and P <0.05 as statistical significances. Results: The prevalence of good knowledge, positive attitude and frequent practice toward COVID-19 epidemic were 52.6%, 51.8% and 57.1%, respectively, obtained by cross-sectional data analysis. The KAP prevalence were ranged from 26.53% (Thailand) to 95.4% (Nepal); 59.3% (Turkey) to 92.5% (Pakistan); and 50.2 (Turkey) to 97% (Afghanistan), respectively, obtained by 18 studies included in the meta-analysis. The prevalence of KAP was higher [84% vs. 79%, Pheterogeneity <0.001; 83% vs. 80%, Pheterogeneity <0.001; 85% vs. 83%, Pheterogeneity <0.001] in South Asia compared to Southeast Asia, obtained by subgroup analysis. Some studies reported mean level instead of the proportion of the KAP where the score varied from 8.15-13.14; 2.33-33.0; and 1.97-31.03, respectively. Having more knowledge and attitude were encouraged more likely to practice toward COVID-19. Study suggests age, gender, education, place of residence and occupation as the most frequent significant risk factors of KAP toward COVID-19. Conclusion: The study sufficiently informs how other countries in Southeast and South Asia enriches their KAP behaviors during the pandemic which may help health professionals and policymakers to develop targeted interventions and effective practices.

Patients' awareness of postoperative adhesions: results from a multi-centre study and online survey.

PURPOSE: To analyse and to compare how female patients are informed about adhesions and their related problems by surgeons preoperatively. METHODS: Over 8 weeks 105 patients (Germany) and 82 (UK) patients admitted for laparoscopic or open abdominopelvic surgery were interviewed preoperatively in a multi-centre study in Germany and the UK. 212 responses to an online survey were also analysed. RESULTS: Less than 50% of patients are made aware of adhesions. Even fewer patients were told about complications caused by adhesions. Lack of knowledge is cited by 46% of patients as a reason for health professionals not informing them about adhesions. 41% considered adhesions as not sufficiently important. Patients who had previously heard of adhesions were most commonly informed by physicians. CONCLUSIONS: There is lack of information among patients and physicians about adhesions and their complications. Written information before surgery and computer-based applications may help raise patient's awareness.

Establishing a Local Diagnostic Reference Level for Bone Scintigraphy in a Nigerian Tertiary Hospital.

It is of vital importance to optimize the radiation dose to patients undergoing radionuclide bone scanning. This is one of the most common nuclear medicine procedures in many parts of the world, including Nigeria, and the current study was performed as part of a national survey to establish diagnostic reference levels (DRLs) for common nuclear medicine procedures in Nigeria in order to optimize their use. Nuclear medicine was only recently introduced to the health-care system in Nigeria, with only 2 centers presently conducting these procedures. Methods: A retrospective, cross-sectional study was performed in the nuclear medicine department of a tertiary hospital in southwest Nigeria to determine the preliminary local DRL for radionuclide bone scanning. One hundred and nine patients who met the study criteria were included. Data were obtained from June 2017 to March 2019 and were analyzed to obtain the third quartile of the distributed administered activity and achievable dose (anthropometric variables and radiation dose to bone surface). Results: The mean administered activity, achievable dose, and DRL were 833.98 ± 106.93, 832.5, and 895.4 MBq, respectively. The calculated preliminary local DRL was larger than values reported in studies done in Sudan, the United Kingdom, and Australia or by the International Commission on Radiological Protection. Conclusion: The preliminary DRL from this first-of-its-kind study in Nigeria was high because of practitioners' lack of experience. However, the values were still within the international best-practice range, which when optimized will go a long way toward reducing medical exposure without compromising image quality.

Heterogeneous Data Approach on Financial development of Selected African Leading Economies.

The presentation of this data focuses on analysing the dynamic role of economic growth, foreign direct investment and financial globalization uncertainty on financial development of selected leading African economies, spanning the year 1970 to 2018, and the data were obtained from world development indicators and global financial development databases. Second generation econometrics techniques were deployed for the analysis. We began with the descriptive and correlation statistics in order to ascertain the normality of the data. Also, homogeneity and cross-sectional dependency tests were carried out to validate the whether or not the data is heterogeneous and depend upon each other across the series. As well, the [3] co-integration and dynamic common correlated effect [1] and pool mean group [2] estimates were applied to confirm the presence of long-run relationship and their effects on the financial development among the sampled countries.

Correction to: Environmental efficiency and the role of energy innovation in emissions reduction.

The correct affiliation of the 1st Author is shown in this paper.

Environmental efficiency and the role of energy innovation in emissions reduction.

Environmental problems, including extreme weather phenomena, unprecedented global warming, and environmental disasters caused by increasing levels of CO2 and other toxic emissions, along with rapidly increasing economic development and energy consumption, require global development and policies to meet sustainable development goals. The traditional data envelopment analysis (DEA) model has limited practical applicability for measuring environmental performance, as it lacks the computational capacity to deal with undesirable outputs. The current study employs "radial" and "non-radial" DEA technology, and acknowledges the associations of a mathematical foundation to increase the analytical capability of the environmental performance of DEA. Results show that in the measurement of environmental performance analysis, the non-radial DEA model has a higher discriminating power compared to radial DEA. Results show that the average values of radial and non-radial environmental performance are highest for Latin America and the Caribbean, at 0.99 and 0.96, respectively, while the former USSR has the lowest values of 0.22 and 0.32, respectively. The South Asian region shows relatively stable values of about 0.58 to 0.65, and Latin America & Caribbean countries and sub-Saharan Africa also show a stable radial environmental performance ranging from 0.82 to 1.00. These results indicate a considerable difference among the eight world regions.

The Nigerian Bioinformatics and Genomics Network (NBGN): a collaborative platform to advance bioinformatics and genomics in Nigeria.

Africa plays a central importance role in the human origins, and disease susceptibility, agriculture and biodiversity conservation. Nigeria as the most populous and most diverse country in Africa, owing to its 250 ethnic groups and over 500 different native languages is imperative to any global genomic initiative. The newly inaugurated Nigerian Bioinformatics and Genomics Network (NBGN) becomes necessary to facilitate research collaborative activities and foster opportunities for skills' development amongst Nigerian bioinformatics and genomics investigators. NBGN aims to advance and sustain the fields of genomics and bioinformatics in Nigeria by serving as a vehicle to foster collaboration, provision of new opportunities for interactions between various interdisciplinary subfields of genomics, computational biology and bioinformatics as this will provide opportunities for early career researchers. To provide the foundation for sustainable collaborations, the network organises conferences, workshops, trainings and create opportunities for collaborative research studies and internships, recognise excellence, openly share information and create opportunities for more Nigerians to develop the necessary skills to exceed in genomics and bioinformatics. NBGN currently has attracted more than 650 members around the world. Research collaborations between Nigeria, Africa and the West will grow and all stakeholders, including funding partners, African scientists, researchers across the globe, physicians and patients will be the eventual winners. The exponential membership growth and diversity of research interests of NBGN just within weeks of its establishment and the unanticipated attendance of its activities suggest the significant importance of the network to bioinformatics and genomics research in Nigeria.

Role of HRCT Temporal Bone in Pre-operative Assessment of Tegmen Height in Chronic Otitis Media Patients.

OBJECTIVES: High-resolution CT (HRCT) temporal bone has emerged as a useful option in pre-operative assessment of tegmen height in chronic otitis media patients. MATERIAL AND METHODS: A total of 60 patients with clinical suspicion of chronic otitis media were enrolled in the study. HRCT evaluation was done using Siemens Somatom Force 384 slice multidetector computed tomography machine. We radiologically assess tegmen height using lateral semicircular canal as a reference point on HRCT. Final result has been based on correlation of radiological and intraoperative findings. Diagnostic efficacy of HRCT temporal bone was evaluated in terms of sensitivity, specificity, PPV, NPV, and accuracy for pre-operative assessment of tegmen height. RESULTS: The correlation between actual tegmen height and estimated tegmen height (by equation) was 0.457 which is highly significant (P < 0.001). In the study, the mean tegmen height of exposed dura (ED) was 5.81 ± 1.71 (95% CI 4.91-6.70) while the mean tegmen height of non-exposed dura (NED) was 8.40 ± 1.31 (95% CI 8.02- 8.78). Highly significant difference was found in mean tegmen height between ED and NED cases (P < 0.001). CONCLUSION: Pre-operative CT assessment of tegmen height is an important parameter in assessing risk of dural injury during tympanomastoid surgeries.