[Guidelines on the urological management of the adult patient with spinal dysraphism (spina bifida)]. / Recommandations sur la gestion du risque et la prise en charge urologique du patient adulte atteint de dysraphisme spinal (spina bifida).

INTRODUCTION: Improved life expectancy and prenatal screening have changed the demographics of spina bifida (spinal dysraphism) which has presently become a disease of adulthood. Urinary disorders affect almost all patients with spinal dysraphism and are still the leading cause of mortality in these patients. The aim of this work was to establish recommendations for urological management that take into account the specificities of the spina bifida population. MATERIALS AND METHODS: National Diagnosis and Management Guidelines (PNDS) were drafted within the framework of the French Rare Diseases Plan at the initiative of the Centre de Référence Maladies Rares Spina Bifida - Dysraphismes of Rennes University Hospital. It is a collaborative work involving experts from different specialties, mainly urologists and rehabilitation physicians. We conducted a systematic search of the literature in French and English in the various fields covered by these recommendations in the MEDLINE database. In accordance with the methodology recommended by the authorities (Guide_methodologique_pnds.pdf, 2006), proposed recommendations were drafted on the basis of this literature review and then submitted to a review group until a consensus was reached. RESULTS: Bladder dysfunctions induced by spinal dysraphism are multiple and varied and evolve over time. Management must be individually adapted and take into account all the patient's problems, and is therefore necessarily multi-disciplinary. Self-catheterisation is the appropriate micturition method for more than half of the patients and must sometimes be combined with treatments aimed at suppressing any neurogenic detrusor overactivity (NDO) or compliance alteration (anticholinergics, intra-detrusor botulinum toxin). Resort to surgery is sometimes necessary either after failure of non-invasive treatments (e.g. bladder augmentation in case of NDO resistant to pharmacological treatment), or as a first line treatment in the absence of other non-invasive alternatives (e.g. aponeurotic suburethral tape or artificial urinary sphincter for sphincter insufficiency; urinary diversion by ileal conduit if self-catheterisation is impossible). CONCLUSION: Spinal dysraphism is a complex pathology with multiple neurological, orthopedic, gastrointestinal and urological involvement. The management of bladder and bowel dysfunctions must continue throughout the life of these patients and must be integrated into a multidisciplinary context.

Implementing surgical mentorship in a resource-constrained context: a mixed methods assessment of the experiences of mentees, mentors, and leaders, and lessons learned.

BACKGROUND: A well-qualified workforce is critical to effective functioning of health systems and populations; however, skill gaps present a challenge in low-resource settings. While an emerging body of evidence suggests that mentorship can improve quality, access, and systems in African health settings by building the capacity of health providers, less is known about its implementation in surgery. We studied a novel surgical mentorship intervention as part of a safe surgery intervention (Safe Surgery 2020) in five rural Ethiopian facilities to understand factors affecting implementation of surgical mentorship in resource-constrained settings. METHODS: We designed a convergent mixed-methods study to understand the experiences of mentees, mentors, hospital leaders, and external stakeholders with the mentorship intervention. Quantitative data was collected through a survey (n = 25) and qualitative data through in-depth interviews (n = 26) in 2018 to gather information on (1) intervention characteristics including areas of mentorship, mentee-mentor relationships, and mentor characteristics, (2) organizational context including facilitators and barriers to implementation, (3) perceived impact, and (4) respondent characteristics. We analyzed the quantitative and qualitative data using frequency analysis and the constant comparison method, respectively; we integrated findings to identify themes. RESULTS: All mentees (100%) experienced the intervention as positive. Participants perceived impact as: safer and more frequent surgical procedures, collegial bonds between mentees and mentors, empowerment among mentees, and a culture of continuous learning. Over 70% of all mentees reported their confidence and job satisfaction increased. Supportive intervention characteristics included a systems focus, psychologically safe mentee-mentor relationships, and mentor characteristics including generosity with time and knowledge, understanding of local context, and interpersonal skills. Supportive organizational context included a receptive implementation climate. Intervention challenges included insufficient clinical training, inadequate mentor support, and inadequate dose. Organizational context challenges included resource constraints and a lack of common understanding of the intervention. CONCLUSION: We offer lessons for intervention designers, policy makers, and practitioners about optimizing surgical mentorship interventions in resource-constrained settings. We attribute the intervention's success to its holistic approach, a receptive climate, and effective mentee-mentor relationships. These qualities, along with policy support and adapting the intervention through user feedback are important for successful implementation.

[Autologous fascia pubovaginal slings in women with stress urinary incontinence at high risk of mesh/device-related complications]. / Bandelette aponévrotique pubovaginale pour incontinence urinaire d'effort chez les femmes à risque de complications prothétiques.

INTRODUCTION: Very popular in many parts of the world, autologous fascial pubovaginal sling (AFPVS) remains marginally used in France. However, it may be of particular interest in patients carrying a high risk of mesh-related or device-related related complications. The aim of the present series was to report the outcomes of AFPVS in this high-risk population. MATERIAL AND METHODS: The charts of all female patients who underwent a fascial sling for SUI at a single academic center between April 2019 and May 2021 were reviewed retrospectively. Only patients deemed at high-risk of device/mesh related complications were included in the present analysis: female with a neurological condition who were doing clean intermittent catheterization (CIC), female with SUI after radical cystectomy and ileal neobladder, female with urethral/bladder extrusion of any synthetic material placed for SUI. Success was defined as complete resolution of SUI at 3 months. RESULTS: Sixteen patients were included in this study: 13 rectus fascia slings and 3 fascia lata slings. The success rate was 56.3% (9/16 patients). Four patients were improved but not completely dry (25%). Two patients had major postoperative complications (i.e. Clavien grade 3 or higher, 11.2%). Two patients had a persisting significant post-void residual (PVR) postoperatively, managed by self-catheterization (transition to self-catheterization at 3 months: 2/8, 25%). CONCLUSION: The use of autologous fascia pubovaginal sling is an interesting option in female SUI patients with high risk of device/mesh related complications with satisfactory functional outcomes. LEVEL OF PROOF: 4.

[Female voiding dysfunction: Clean intermittent catheterization is not the only option]. / Troubles de la vidange vésicale chez la femme : l'autosondage n'est pas la seule solution.

Female voiding dysfunction exists but are largely underdiagnosed, especially in France. They can result from two different mechanisms: detrusor underactivity or bladder outlet obstruction, with very different pathophysiology and therapeutic management. There are many different therapeutic options, including surgical treatments, to offer as alternative to clean intermittent catheterization which are often burdensome for patients. Seeking voiding dysfunction in female patients with lower urinary tract symptoms and searching for their etiology to tackle it could lead to a paradigm change in these women: from standardized treatment to individualized treatment. In their practice, nurses can detect warning symptoms suspect of voiding dysfunction, and have thus a role to play in the improvement of patients' screening, education other healthcare providers, and management of female voiding dysfunction.

Pathogenesis, diagnostic challenges and treatment of zika virus disease in resource-limited settings.

The association of Zika virus (ZIKV) infection with congenital malformation and neurological sequelae has brought significant global concern. Consequently, the World Health Organization (WHO) declared it "a public health emergency of International concern" on 1 February, 2016. A critical review of its pathogenesis would lead to a better understanding of the clinical features and the neurological complications. This review is based on literature search in PubMed/Medline, Google Scholar and the WHO, http://www.who.int. This include all relevant articles written in English published through June 2018, with subject heading and keywords such as Zika, ZIKV, Zika pathogenesis, diagnosis of Zika, Zika Nigeria, Zika Africa and Zika resource-limited settings. Following ZIKV infection, viraemia ensues targeting primarily the monocytes for both the Asian and African strains. ZIKV infection by an African strain appears to be more pathogenic, in early pregnancy tends to result in spontaneous abortion. Whereas an Asian strain tends to be less pathogenic and more chronic, this allows the pregnancy to continue, ultimately resulting in congenital malformations. There is no routine laboratory diagnosis of ZIKV infection in resource-constrained countries. Serologic tests should be interpreted with caution since there can be cross-reactivity with other flaviviruses, especially in Africa where the burden of infection with flaviviruses is comparatively high. There is a paucity of well-equipped laboratories for comprehensive ZIKV diagnosis. It is imperative to strengthen the health systems, improve health workforce and diagnostic capacity of such settings.

Human Immunodeficiency Virus and Risk of Type 2 Diabetes in a Large Adult Cohort in Jos, Nigeria.

BACKGROUND: Human immunodeficiency virus (HIV) infection and the use of antiretroviral therapy (ART) may increase the risk of type 2 diabetes mellitus (T2DM). However, data from regions with a high burden of HIV/AIDS are limited. We determined the prevalence of T2DM at the time of presentation to a large HIV clinic in Nigeria, as well as the incidence of diabetes 12 months following ART initiation. METHODS: Data from patients enrolled for ART from 2011 to 2013 was analyzed, including 2632 patients on enrollment and 2452 reevaluated after 12 months of ART commencement. The presence of diabetes, and demographic, clinical, and biochemical data were retrieved from standardized databases. CD4(+), HIV RNA load, and hepatitis C virus status were noted. Bivariate and logistic regressions were used to identify risk factors for T2DM. RESULTS: Baseline T2DM prevalence was 2.3% (95% confidence interval, 1.8%-2.9%); age, but not body mass index (BMI), was a risk factor for diabetes. After 12 months of ART, an additional 5.3% had developed T2DM. Newly developed diabetes was not associated with age, but was associated with BMI. There were no significant associations between prevalent or incident diabetes and CD4(+), viral load, or type of ART. CONCLUSIONS: Diabetes is not uncommon in HIV-infected individuals at the time of presentation to HIV services. Patients initiating ART have a high risk of developing diabetes in the first year of ART. Excessive weight gain should be avoided, as incident diabetes was associated with a BMI ≥25.0 kg/m(2).

External radiation dose and cancer mortality among French nuclear workers: considering potential confounding by internal radiation exposure.

OBJECTIVES: French nuclear workers have detailed records of their occupational exposure to external radiation that have been used to examine associations with subsequent cancer mortality. However, some workers were also exposed to internal contamination by radionuclides. This study aims to assess the potential for bias due to confounding by internal contamination of estimates of associations between external radiation exposure and cancer mortality. METHODS: A cohort of 59,004 workers employed for at least 1 year between 1950 and 1994 by CEA (Commissariat à l'Energie Atomique), AREVA NC, or EDF (Electricité de France) and badge-monitored for external radiation exposure were followed through 2004 to assess vital status and cause of death. A flag based on a workstation-exposure matrix defined four levels of potential for internal contamination. Standardized mortality ratios were assessed for each level of the internal contamination indicator. Poisson regression was used to quantify associations between external radiation exposure and cancer mortality, adjusting for potential internal contamination. RESULTS: For solid cancer, the mortality deficit tended to decrease as the levels of potential for internal contamination increased. For solid cancer and leukemia excluding chronic lymphocytic leukemia, adjusting the dose-response analysis on the internal contamination indicator did not markedly change the excess relative risk per Sievert of external radiation dose. CONCLUSIONS: This study suggests that in this cohort, neglecting information on internal dosimetry while studying the association between external dose and cancer mortality does not generate a substantial bias. To investigate more specifically the health effects of internal contamination, an effort is underway to estimate organ doses due to internal contamination.

[Effects of chronic uranium internal exposure on mortality: results of a pilot study among French nuclear workers]. / Effets de la contamination chronique à l'uranium sur la mortalité : bilan d'une étude-pilote chez les travailleurs de l'industrie nucléaire en France.

BACKGROUND: This article presents the mortality data compiled among a cohort of workers at risk of internal uranium exposure and discusses the extent to which this exposure might differentiate them from other nuclear workers. METHODS: The cohort consisted of 2897 Areva-NC-Pierrelatte plant workers, followed from 1st January 1968 through 31st December 2006 (79,892 person-years). Mortality was compared with that of the French population, by calculating Standardized Mortality Ratios (SMR) and 95% confidence intervals (CI95%). External radiation exposure was reconstructed using external dosimetry archives. Internal uranium exposure was assessed using a plant-specific job-exposure-matrix, considering six types of uranium compounds according to their nature (natural and reprocessed uranium [RPU] and solubility [fast-F, moderate-M, and slow-S]). Exposure-effect analyses were performed for causes of death known to be related to external radiation exposure (all cancers and circulatory system diseases) and cancer of uranium target-organs (lung and hematopoietic and lymphatic tissues, HLT). RESULTS: A significant deficit of mortality from all causes (SMR=0.58; CI95% [0.53-0.63]), all cancers (SMR=0.72; CI95% [0.63-0.82]) and smoking related cancers was observed. Non-significant 30%-higher increase of mortality was observed for cancer of pleura (SMR=2.32; CI95 % [0.75-5.41]), rectum and HLT, notably non-Hodgkin's lymphoma (SMR=1.38; CI95 % [0.63-2.61]) and chronic lymphoid leukemia (SMR=2.36; CI95% [0.64-6.03]). No exposure-effect relationship was found with external radiation cumulative dose. A significant exposure-effect relationship was observed for slowly soluble uranium, particularly RPU, which was associated with an increase in mortality risk reaching 8 to 16% per unit of cumulative exposure score and 10 to 15% per year of exposure duration. CONCLUSION: The Areva-NC-Pierrelatte workers cohort presents a non-significant over-mortality from HLT cancers, notably of lymphoid origin, unrelated to external radiation exposure. The pilot study suggests an association between mortality from the HLT and lung cancers and exposure to slowly soluble RPU compounds. The results of this study should be investigated further in more powerful studies, with a dose-response analysis based on individual assessment of uranium absorbed dose to uranium-target organs.

Hospitalization and mortality outcomes among adult persons living with HIV in a tertiary hospital in South-western Nigeria: A cross-sectional study.

HIV infection continues to be a major public health issue, with significant morbidity and mortality especially in resource poor areas. Infection with HIV results in an increased risk of opportunistic infections and other complications, which may lead to hospital admission and death. Morbidity and mortality patterns among hospitalized persons living with HIV (PLHIV) have been well documented in high income countries, but there is paucity of such data in Nigeria. We investigated the reasons for hospitalization and predictors of death among adult PLHIV at the Federal Medical Center (FMC) Abeokuta, Nigeria. This was a hospital based cross-sectional study carried out over a 15-month period between January 2018 and March 2019. All consenting hospitalized adult PLHIV who met the inclusion criteria were enrolled into the study. Causes of hospitalization and death were obtained and analyzed. Over the study period, 193 hospitalizations of PLHIV were studied. Although a number of clinical syndromes were documented, Sepsis and Tuberculosis were the commonest causes of hospitalization and mortality. Mortality rate was 37(19.2%) for outcomes on day 30, with anaemia [OR 3.00 (95% C.I: 1.04-8.67)], poor adherence with Cotrimoxazole [OR 4.07 (95% C.I: 1.79-9.28)], poor adherence with cART [OR 13.40 (95% C.I: 3.92-45.44)], and a longer duration of fever [OR 3.34 (95% C.I: 1.10-9.99)] being predictors of mortality. Part of the study's limitation was resource-constraint of some of the indigent patient which affected their ability to access some diagnostic investigations and get optimal care thereby impacting on their outcome. Despite the upscaling of cART, opportunistic infections and sepsis remain common causes of hospitalization and death in adult PLHIV. More attention should therefore be placed on early diagnosis, prevention of immunosuppression and sepsis through timely administration and adherence to cART and other prophylactic measures.

Characteristics of two-dimensional quantum turbulence in a compressible superfluid.

Fluids subjected to suitable forcing will exhibit turbulence, with characteristics strongly affected by the fluid's physical properties and dimensionality. In this work, we explore two-dimensional (2D) quantum turbulence in an oblate Bose-Einstein condensate confined to an annular trapping potential. Experimentally, we find conditions for which small-scale stirring of the condensate generates disordered 2D vortex distributions that dissipatively evolve toward persistent currents, indicating energy transport from small to large length scales. Simulations of the experiment reveal spontaneous clustering of same-circulation vortices and an incompressible energy spectrum with k(-5/3) dependence for low wave numbers k. This work links experimentally observed vortex dynamics with signatures of 2D turbulence in a compressible superfluid.

Mortality associated with chronic external radiation exposure in the French combined cohort of nuclear workers.

OBJECTIVE: The long-term effects of protracted low level ionising radiation exposure are investigated in a combined analysis of French nuclear workers employed by the Commissariat à l'Energie Atomique (CEA), AREVA Nuclear Cycle (AREVA NC) and Electricité de France (EDF). Associations between cumulative external radiation dose and mortality due to solid cancers, leukaemia and circulatory disease were examined. METHODS: All workers hired by CEA, AREVA NC and EDF between 1950 and 1994 who were employed for at least 1 year, badge-monitored for radiation exposure and alive on 1 January 1968 were included. Individual data of annual exposure to penetrating photons (X-rays and gamma rays) were reconstructed for each worker. Estimates of radiation dose-mortality associations were obtained using a linear excess relative risk (ERR) Poisson regression model. RESULTS: Among the 59 021 nuclear workers, 2312 died of solid cancer, 78 of leukaemia and 1468 of circulatory diseases during the 1968-2004 period. Approximately 72% of the cohort had a non-zero cumulative radiation dose estimate, with a mean cumulative dose of 22.5 mSv. Positive but non-significant ERR/Sv were observed for all solid cancers, leukaemia excluding chronic lymphocytic leukaemia (CLL), ischaemic heart diseases and cerebrovascular diseases. A significant ERR/Sv was found for myeloid leukaemia. CONCLUSIONS: This is the first combined analysis of major French cohorts of nuclear workers. Results were consistent with risks estimated in other nuclear worker cohorts and illustrate the potential of a further joint international study to yield direct risk estimates in support to radiation protection standards.

Assessment of Post-Vaccination Immunologic Responses in Inactivated Virus COVID-19 Respondents.

Introduction: The Indonesian Government's plan to contain the COVID-19 pandemic, aside from implementing health protocols, also involves vaccinating everyone with the inactivated SARS CoV2 vaccine until herd immunity is reached. The aim of this study was to assess the post-vaccination immune response to inactivated SARS CoV2 vaccine, namely Sinovac/Sinopharm, by measuring the antibodies (IgM and IgG) in subjects after their second dose of vaccination. Materials and Methods: The design of the study was a cohort study using simple random sampling with 51 respondents aged 18-56 years who had received two doses of inactivated SARS-CoV-2 vaccine. All respondents were screened for SARS-CoV-2 infection prior to inclusion. Serum IgM and IgG antibodies were detected using a specific and sensitive automated chemiluminescent immunoassay (CLIA). CLIA uses the Cut Off Point (COI) value of >1 AU/ml for IgM and the Reactive Value of >10 AU/ml for IgG. Results: This study showed that the IgM levels using a reactive Cut Off Point (COI) >1 were 18% in the first month, 14% in the third month, and 10% in the sixth month. There was a constant decline in the third comparison. Meanwhile, compared to the first month, 59% of respondents had IgG levels with reactive values over 10 AU/ml, which after decreasing by 35% in the third month, the number increased by 47% in the sixth month. Conclusion: It has been evident that IgG and IgM antibody response could be induced by inactivated SARS-CoV-2 vaccine which can be influenced by age and detection time after the second dose of vaccination. Boosters, however, must be given after six months of the second dose, since antibody levels were seen to decrease after this period.

Selected micronutrient status of school-aged children at risk of Schistosoma haematobium infection in suburban communities of Nigeria.

Background: The parasite Schistosoma haematobium causes urogenital schistosomiasis, a chronic infectious disease that occurs mainly among school-age children. Objective: The prevalence of S. haematobium infection and level of intensity relative to age, gender and status of selected serum micronutrients among school-age children were investigated in suburban communities in Bekwarra, Nigeria. Methods: This cross-sectional school-based study randomly recruited 353 children aged between 4 and 16 years from five elementary schools between June 2019 and December 2019. We gathered socio-demographic data about each child using a semi-structured questionnaire. Blood samples were collected for micronutrient analysis and urine samples were collected for assessment of S. haematobium infection. Results: A total of 57 (16.15%) school-age children were infected with S. haematobium. Girls (n = 34; 9.63%) were more frequently infected than boys (n = 23; 6.52%). Infection was most frequent among children aged 8-11 years (n = 32; 23.19%) and was significantly associated with age (p = 0.022) and gender (p < 0.001). Serum levels of iron, calcium, copper and zinc among infected children were significantly lower than those of non-infected children. Intensity of infection was negatively associated with iron (r = -0.21), calcium (r = -0.24), copper (r = -0.61; p < 0.001) and zinc (r = -0.41; p < 0.002). Conclusion: This study showed that S. haematobium infection adversely impacted the micronutrient status of school-age children in suburban Nigeria. Measures to lower the prevalence of schistosomiasis among school-age children, including efficient drug distribution, education campaigns and community engagement, are necessary. What this study adds: This research emphasises the significance of implementing infection prevention and control interventions to mitigate the transmission and prevalence of schistosomiasis among school age children.

Prevalence of malaria parasitaemia in adult HIV-infected patients in Jos, North-central Nigeria.

BACKGROUND: Human immunodeficiency virus (HIV) and malaria co-infection has become an important public health problem in sub-Saharan Africa. Data on HIV and malaria interaction in Nigerian adults is scanty. We determined the prevalence of malaria parasitaemia in HIV-infected adults and further investigated the role of immune status in the HIV/malaria association. METHODS: This was a cross-sectional study involving 100 newly-diagnosed HIV-infected adults and 100 age and sex-matched HIV negative controls. Malaria parasitaemia was diagnosed by blood film microscopy using Giemsa staining technique and was defined as the presence of malaria parasites irrespective of species or parasite density. HIV infection was confirmed by western blot assay and CD4 T-lymphocyte count of the HIV-infected patients was quantified by flow cytometry. RESULTS: The prevalence of malaria parasitaemia was higher in HIV-infected adults (24%) than in the controls (9%) (chi2 = 8.17, p = 0.04). Participants residing in rural areas had higher prevalence of malaria parasitaemia than urban dwellers both for HIV-infected patients (34.1% Vs. 16.1%, chi2 = 4.3, p = 0.04) and controls (18.4%, Vs. 6.5%, chi2 = 3.4, p = 0.04). HIV-infected male patients tended to have malaria parasitemia more than their female counterparts (33.3% Vs. 17.2%, chi2 = 3.4, p = 0.06). Among HIV-infected patients, the prevalence of malaria parasitaemia progressively increased at lower CD4 cell counts, 10.3% for CD4 cell count of = 500, 17.5% for 200-499 and 45.2% for < 200 cells/microL (chi2 = 11.5, p = 0.003). CONCLUSION: HIV is likely to fuel malaria infection in tropical countries where both diseases are endemic. Malaria control practices should be further intensified in HIV-infected populations.

Effects of Moringa oleifera leaves extract, vitamin C, and taurine co-exposures on calcium and metallothionein levels, oxidative stress, and gill histopathological changes in Clarias gariepinus exposed to sub-lethal cadmium.

Cadmium aquatic environmental pollution poses great threats to fish and their would-be consumers. The present work investigated the effects of ethyl acetate extract of Moringa oleifera leaves (EAEMOL), vitamin C, and taurine co-exposures on calcium and metallothionein levels, oxidative stress, and gill histopathological changes in Clarias gariepinus exposed to sub-lethal cadmium (CdCl2) for 28 days. Fish were exposed to CdCl2 only (1.048 mg/L) as well as co-exposed with EAEMOL (20 mg/L), vitamin C (5 mg/L), and taurine (5 mg/L) separately. There was significant (p < 0.05) deterioration in fish water quality with increasing exposure period but no significant (p > 0.05) changes occurred between the exposed groups. However, the co-exposure of EAEMOL, vitamin C, and taurine did not significantly (p > 0.05) improve the CdCl2-induced fish water quality deterioration. Sub-lethal exposure to CdCl2 only caused significant (p < 0.05) increase in the serum malondialdehyde (MDA) and liver metallothionein (MT) levels with significant (p < 0.05) decrease in serum catalase activity only. However, EAEMOL, vitamin C, and taurine co-exposures did not significantly (p > 0.05) improve the MDA, superoxide dismutase, catalase, and glutathione activities, as well as MT and calcium (Ca2+) levels, condition factor (CF), hepatosomatic index (HSI), and gill histopathological changes induced by the CdCl2 exposure. Similarly, none of the present exposures, CdCl2 only or its co-exposures with EAEMOL, vitamin C, and taurine significantly (p > 0.05) altered the normal functioning of the gills despite the observed histopathological changes based on the degree of tissue change protocol. Therefore, EAEMOL, vitamin C, and taurine co-exposures, as administered in the present case, did not considerably alter the physicochemical parameters of the experimental fish water. However, outside significantly (p < 0.05) increasing MDA level, EAEMOL, vitamin C, and taurine co-exposures did not significantly (p > 0.05) improve the CdCl2-induced Ca2+, MT, CF, HSI, and gill histopathological alterations by sub-lethal CdCl2 exposure of C. gariepinus.

Observation of vortex dipoles in an oblate Bose-Einstein condensate.

We report experimental observations and numerical simulations of the formation, dynamics, and lifetimes of single and multiply charged quantized vortex dipoles in highly oblate dilute-gas Bose-Einstein condensates (BECs). We nucleate pairs of vortices of opposite charge (vortex dipoles) by forcing superfluid flow around a repulsive Gaussian obstacle within the BEC. By controlling the flow velocity we determine the critical velocity for the nucleation of a single vortex dipole, with excellent agreement between experimental and numerical results. We present measurements of vortex dipole dynamics, finding that the vortex cores of opposite charge can exist for many seconds and that annihilation is inhibited in our trap geometry. For sufficiently rapid flow velocities, clusters of like-charge vortices aggregate into long-lived multiply charged dipolar flow structures.

Quantum interference of currents in an atomtronic SQUID.

Quantum interference of currents is the most important and well known quantum phenomenon in a conventional superconducting quantum interference device (SQUID). Here, we report the observation of quantum interference of currents in an atomtronic SQUID. Analogous to a conventional SQUID, currents flowing through two junctions in an atomtronic SQUID interfere due to the phase difference from rotation. This interference results in modulation of critical currents. This modulation was observed for three different radii with clear modulation periods which were measured to be consistent with fundamental rotation rates. This observation shows the possibility of studying various interesting SQUID physics with an atomtronic SQUID and especially, macroscopic quantum phenomena with currents may be realized with an atomtronic SQUID toward the goal of quantum metrology of rotation sensing.

Heavy Metals Bioaccumulation and Health Risks with Associated Histopathological Changes in Clarias gariepinus from the Kado Fish Market, Abuja, Nigeria.

BACKGROUND: Aquatic pollution by heavy metals has become a global problem and is of great concern due to the detrimental effects on aquatic ecosystems and possible human uptake. OBJECTIVES: The present study aimed to evaluate tissue bioaccumulations of heavy metals and possible human health risks in addition to associated cellular damages in fish for sale in a fish market in Abuja, Nigeria. METHODS: Clarias gariepinus sold at the Kado Fish Market in Abuja, Nigeria, in March-April 2017 and March-April 2018 were randomly purchased and sampled. The heavy metal contents of the sampled fish were assayed and used to assess the extent of potential health risks to human consumers. The extent of histopathological changes associated with the bioaccumulations in the sampled fish were also evaluated according to standard procedures. RESULTS: Levels of most heavy metals were above permissible limits, except for lower levels of zinc (Zn) in liver and muscle and higher levels of lead (Pb) in muscle in the sampled fish. Similarly, significant (p<0.05) liver bioaccumulation occurred for Zinc (Zn), chromium (Cr), iron (Fe), and copper (Cu) compared to their levels in muscle. The total hazard index (non-cancer risk across all metals) was 0.0415, which is very low and acceptable. The cancer risks ranged between the acceptable values of 1.98 × 10-5 - 3.71 × 10-6. Associated histopathological changes, which occurred in the sampled fish, differed between the various assayed tissues. CONCLUSIONS: Most of the heavy metals were significantly bioaccumulated (p<0.05) and were above the permissible levels, particularly in liver samples. The levels of muscle heavy metal bioaccumulation in the sampled fish posed no apparent cancer or non-cancer health risks to human consumers. However, further efforts are needed to minimize heavy metal aquatic environmental pollution to safeguard the health of aquatic flora and fauna and human consumers because of the tendency of these pollutants to persist and bioaccumulate to toxic levels over time. COMPETING INTERESTS: The authors declare no competing financial interests.

Assessment of hand hygiene facilities and staff compliance in a large tertiary health care facility in northern Nigeria: a cross sectional study.

BACKGROUND: The burden of healthcare-associated infection (HAI) is 2 to 18 times higher in developing countries. However, few data are available regarding infection prevention and control (IPC) process indicators in these countries. We evaluated hand hygiene (HH) facilities and compliance amongst healthcare workers (HCW) in a 600-bed healthcare facility in Northcentral Nigeria providing tertiary care service for a catchment population of about 20 million. METHODS: An in-house facility assessment tool and the World Health Organization (WHO) direct observation method were used to assess the HH facilities and compliance, respectively. Factors associated with good compliance were determined by multivariate analysis. RESULTS: The facility survey was carried out in all 46 clinical units of the hospital. 72% of the units had no poster or written policy on HH; 87% did not have alcohol-based hand rubs; 98% had at least one handwash sink; 28% had flowing tap water all day while 72% utilized cup and bucket; and 58% had no hand drying facilities. A total of 406 HH opportunities were observed among 175 HCWs. The overall compliance was 31%, ranging from 18% among ward attendants to 82% among medical students. Based on WHO "5 moments" for HH, average compliance was 21% before patient contact, 23% before aseptic procedure, 63% after body fluid exposure risk, 41% after patient contact and 40% after contact with patients' surrounding. Being a medical student was independently associated with high HH compliance, adjusted odds ratio: 13.87 (1.70-112.88). CONCLUSIONS: Availability of HH facilities and HCW compliance in a large tertiary hospital in Nigeria is poor. Our findings confirm that HCWs seem more sensitized to their risk of exposure to potential pathogens than to the prevention of HAI cross-transmission. Inadequate HH facilities probably contributed to the poor compliance. Specific measures such as improved facilities, training and monitoring are needed to improve HH compliance.