Genomic insights into the diversity, virulence, and antimicrobial resistance of group B Streptococcus clinical isolates from Saudi Arabia.

Introduction: Detailed assessment of the population structure of group B Streptococcus (GBS) among adults is still lacking in Saudi Arabia. Here we characterized a representative collection of isolates from colonized and infected adults. Methods: GBS isolates (n=89) were sequenced by Illumina and screened for virulence and antimicrobial resistance determinants. Genetic diversity was assessed by single nucleotide polymorphisms and core-genome MLST analyses. Results: Genome sequences revealed 28 sequence types (STs) and nine distinct serotypes, including uncommon serotypes VII and VIII. Majority of these STs (n=76) belonged to the human-associated clonal complexes (CCs) CC1 (33.71%), CC19 (25.84%), CC17 (11.24%), CC10/CC12 (7.87%), and CC452 (6.74%). Major CCs exhibited intra-lineage serotype diversity, except for the hypervirulent CC17, which exclusively expressed serotype III. Virulence profiling revealed that nearly all isolates (94.38%) carried at least one of the four alpha family protein genes (i.e., alphaC, alp1, alp2/3, and rib), and 92.13% expressed one of the two serine-rich repeat surface proteins Srr1 or Srr2. In addition, most isolates harbored the pilus island (PI)-2a alone (15.73%) or in combination with PI-1 (62.92%), and those carrying PI-2b alone (10.11%) belonged to CC17. Phylogenetic analysis grouped the sequenced isolates according to CCs and further subdivided them along with their serotypes. Overall, isolates across all CC1 phylogenetic clusters expressed Srr1 and carried the PI-1 and PI-2a loci, but differed in genes encoding the alpha-like proteins. CC19 clusters were dominated by the III/rib/srr1/PI-1+PI-2a (43.48%, 10/23) and V/alp1/srr1/PI-1+PI-2a (34.78%, 8/23) lineages, whereas most CC17 isolates (90%, 9/10) had the same III/rib/srr2/P1-2b genetic background. Interestingly, genes encoding the CC17-specific adhesins HvgA and Srr2 were detected in phylogenetically distant isolates belonging to ST1212, suggesting that other highly virulent strains might be circulating within the species. Resistance to macrolides and/or lincosamides across all major CCs (n=48) was associated with the acquisition of erm(B) (62.5%, 30/48), erm(A) (27.1%, 13/48), lsa(C) (8.3%, 4/48), and mef(A) (2.1%, 1/48) genes, whereas resistance to tetracycline was mainly mediated by presence of tet(M) (64.18%, 43/67) and tet(O) (20.9%, 14/67) alone or in combination (13.43%, 9/67). Discussion: These findings underscore the necessity for more rigorous characterization of GBS isolates causing infections.

Long COVID-19 and primary care: Challenges, management and recommendations / COVID-19 prolongado y atención primaria: desafíos, manejo y recomendaciones

Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by persistent symptoms after COVID-19 onset. This article explores the challenges, management strategies, and recommendations for addressing long COVID-19 in primary care settings. The epidemiology of long COVID-19 reveals significant variability, with a substantial portion of COVID-19 survivors experiencing post-acute symptoms. Pathophysiological mechanisms include viral persistence, endothelial dysfunction, autoimmunity, neurological dysregulation, and gastrointestinal dysbiosis. Multiple risk factors, including age, sex, pre-existing comorbidities, smoking, BMI, and acute COVID-19 severity, influence the development of long COVID-19. Effective management requires proactive measures such as vaccination, identification of high-risk populations, public awareness, and post-infection vaccination. Collaboration of primary care physicians with specialists is essential for holistic and individualized patient care. This article underscores the role of primary care physicians in diagnosing, managing, and mitigating the long-term effects of COVID-19. (AU)

La COVID-19 prolongada, también conocida como secuela postaguda de la infección por SARS-CoV-2, se caracteriza por síntomas persistentes después de la aparición de la COVID-19. Este artículo explora los desafíos, las estrategias de manejo y las recomendaciones para abordar la COVID-19 prolongada en entornos de atención primaria. La epidemiología de la COVID-19 prolongada revela una variabilidad significativa, y una parte sustancial de los supervivientes de la COVID-19 experimentan síntomas postagudos. Los mecanismos fisiopatológicos incluyen persistencia viral, disfunción endotelial, autoinmunidad, desregulación neurológica y disbiosis gastrointestinal. Múltiples factores de riesgo, como la edad, el sexo, las comorbilidades preexistentes, el tabaquismo, el IMC y la gravedad aguda de la COVID-19, influyen en el desarrollo de la COVID-19 prolongada. Una gestión eficaz requiere medidas proactivas, como la vacunación, la identificación de poblaciones de alto riesgo, la concienciación pública y la vacunación posterior a la infección. La colaboración de los médicos de atención primaria con los especialistas es esencial para una atención holística e individualizada al paciente. Este artículo subraya el papel de los médicos de atención primaria en el diagnóstico, el tratamiento y la mitigación de los efectos a largo plazo de la COVID-19. (AU)

Cost-effectiveness and public health impact of typhoid conjugate vaccine introduction strategies in Bangladesh.

PURPOSE: Typhoid fever causes substantial morbidity and mortality in Bangladesh. The government of Bangladesh plans to introduce typhoid conjugate vaccines (TCV) in its expanded program on immunization (EPI) schedule. However, the optimal introduction strategy in addition to the costs and benefits of such a program are unclear. METHODS: We extended an existing mathematical model of typhoid transmission to integrate cost data, clinical incidence data, and recently conducted serosurveys in urban, semi-urban, and rural areas. In our primary analysis, we evaluated the status quo (i.e., no vaccination) and eight vaccine introduction strategies including routine and 1-time campaign strategies, which differed by age groups targeted and geographic focus. Model outcomes included clinical incidence, seroincidence, deaths, costs, disability-adjusted life years (DALYs), and incremental cost-effectiveness ratios (ICERs) for each strategy. We adopted a societal perspective, 10-year model time horizon, and 3 % annual discount rate. We performed probabilistic, one-way, and scenario sensitivity analyses including adopting a healthcare perspective and alternate model time horizons. RESULTS: We projected that all TCV strategies would be cost saving compared to the status quo. The preferred strategy was a nationwide introduction of TCV at 9-12 months of age with a single catch-up campaign for children ages 1-15, which was cost saving compared to all other strategies and the status quo. In the 10 years following implementation, we projected this strategy would avert 3.77 million cases (95 % CrI: 2.60 - 5.18), 11.31 thousand deaths (95 % CrI: 3.77 - 23.60), and save $172.35 million (95 % CrI: -14.29 - 460.59) compared to the status quo. Our findings were broadly robust to changes in parameter values and willingness-to-pay thresholds. CONCLUSIONS: We projected that nationwide TCV introduction with a catch-up campaign would substantially reduce typhoid incidence and very likely be cost saving in Bangladesh.

Long COVID-19 and primary care: Challenges, management and recommendations.

Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by persistent symptoms after COVID-19 onset. This article explores the challenges, management strategies, and recommendations for addressing long COVID-19 in primary care settings. The epidemiology of long COVID-19 reveals significant variability, with a substantial portion of COVID-19 survivors experiencing post-acute symptoms. Pathophysiological mechanisms include viral persistence, endothelial dysfunction, autoimmunity, neurological dysregulation, and gastrointestinal dysbiosis. Multiple risk factors, including age, sex, pre-existing comorbidities, smoking, BMI, and acute COVID-19 severity, influence the development of long COVID-19. Effective management requires proactive measures such as vaccination, identification of high-risk populations, public awareness, and post-infection vaccination. Collaboration of primary care physicians with specialists is essential for holistic and individualized patient care. This article underscores the role of primary care physicians in diagnosing, managing, and mitigating the long-term effects of COVID-19.

Effectiveness of ten-valent pneumococcal conjugate vaccine on invasive pneumococcal disease among children <2 years old: A prospective population-based study in rural Bangladesh.

The 10-valent pneumococcal conjugate vaccine (PCV10) was introduced in March 2015 in Bangladesh. In this study, we aimed to estimate the impact of PCV10 on invasive pneumococcal disease (IPD) identified by blood cultures and severe pneumonia identified clinically and its effectiveness on invasive disease caused by vaccine serotypes. We conducted population-based surveillance among children aged 2- <24 months between April 2012 through March 2019 in Mirzapur, a rural sub-district of Bangladesh. We compared incidence of IPD and severe pneumonia before (April 2012 to March 2015) and after (April 2015 to March 2019) the introduction of PCV10. Vaccine effectiveness was measured using an indirect cohort analysis of data from four sentinel sites in which PCV10 vaccination status was compared between children with IPD caused by vaccine serotype vs. non-vaccine serotypes. We identified 24 IPD cases by blood culture and 1,704 severe pneumonia hospitalizations during the surveillance period. IPD incidence in under-2-year-old children fell 25 % (95 % CI: -1.2 % to 76 %; p-value = 0.59) from 106 cases per 100,000 child-years at baseline to 79.3 in April 2018- March 2019. Vaccine serotype-IPD incidence was lower (77 % reduction, 95 % CI: -0.45 % to 96 %; p-value = 0.068) in April 2018 - March 2019 than in the pre-vaccine period (85.7 cases to 19.8/100,000 child-years). A significant decline of 54.0 % (95 % CI: 47.0 % to 59.0 %; p-value < 0.001) was observed in hospitalizations due to severe pneumonia. From indirect cohort analysis, the effectiveness of PCV10 against vaccine serotype IPD was 37 % (95 % CI: -141.0 % to 83.5 %; p = 0.5) after the 1st dose and 63.1 % (95 % CI: -3.3 % to 85.9 %, p = 0.0411) after the 2nd or the 3rd dose. This study demonstrates that PCV10 introduction prevented hospitalizations with severe pneumonia and provided individual protection against vaccine serotypes.

Trends in antimicrobial resistance amongst Salmonella Paratyphi A isolates in Bangladesh: 1999-2021.

BACKGROUND: Typhoid and paratyphoid remain common bloodstream infections in areas with suboptimal water and sanitation infrastructure. Paratyphoid, caused by Salmonella Paratyphi A, is less prevalent than typhoid and its antimicrobial resistance (AMR) trends are less documented. Empirical treatment for paratyphoid is commonly based on the knowledge of susceptibility of Salmonella Typhi, which causes typhoid. Hence, with rising drug resistance in Salmonella Typhi, last-line antibiotics like ceftriaxone and azithromycin are prescribed for both typhoid and paratyphoid. However, unlike for typhoid, there is no vaccine to prevent paratyphoid. Here, we report 23-year AMR trends of Salmonella Paratyphi A in Bangladesh. METHODS: From 1999 to 2021, we conducted enteric fever surveillance in two major pediatric hospitals and three clinics in Dhaka, Bangladesh. Blood cultures were performed at the discretion of the treating physicians; cases were confirmed by culture, serological and biochemical tests. Antimicrobial susceptibility was determined following CLSI guidelines. RESULTS: Over 23 years, we identified 2,725 blood culture-confirmed paratyphoid cases. Over 97% of the isolates were susceptible to ampicillin, chloramphenicol, and cotrimoxazole, and no isolate was resistant to all three. No resistance to ceftriaxone was recorded, and >99% of the isolates were sensitive to azithromycin. A slight increase in minimum inhibitory concentration (MIC) is noticed for ceftriaxone but the current average MIC is 32-fold lower than the resistance cut-off. Over 99% of the isolates exhibited decreased susceptibility to ciprofloxacin. CONCLUSIONS: Salmonella Paratyphi A has remained susceptible to most antibiotics, unlike Salmonella Typhi, despite widespread usage of many antibiotics in Bangladesh. The data can guide evidence-based policy decisions for empirical treatment of paratyphoid fever, especially in the post typhoid vaccine era, and with the availability of new paratyphoid diagnostics.

3D Printing of continuous fiber composites using two-stage UV curable resin.

3D printing allows for moldless fabrication of continuous fiber composites with high design freedom and low manufacturing cost per part, which makes it particularly well-suited for rapid prototyping and composite product development. Compared to thermal-curable resins, UV-curable resins enable the 3D printing of composites with high fiber content and faster manufacturing speeds. However, the printed composites exhibit low mechanical strength and weak interfacial bonding for high-performance engineering applications. In addition, they are typically not reprocessable or repairable; if they could be, it would dramatically benefit the rapid prototyping of composite products with improved durability, reliability, cost savings, and streamlined workflow. In this study, we demonstrate that the recently emerged two-stage UV-curable resin is an ideal material candidate to tackle these grand challenges in 3D printing of thermoset composites with continuous carbon fiber. The resin consists primarily of acrylate monomers and crosslinkers with exchangeable covalent bonds. During the printing process, composite filaments containing up to 30.9% carbon fiber can be rapidly deposited and solidified through UV irradiation. After printing, the printed composites are subjected to post-heating. Their mechanical stiffness, strength, and inter-filament bonding are significantly enhanced due to the bond exchange reactions within the thermoset matrix. Furthermore, the utilization of the two-stage curable resin enables the repair, reshaping, and recycling of 3D printed thermosetting composites. This study represents the first detailed study to explore the benefits of using two-stage UV curable resins for composite printing. The fundamental understanding could potentially be extended to other types of two-stage curable resins with different molecular mechanisms.

Molecular typing and antimicrobial resistance of group B Streptococcus clinical isolates in Saudi Arabia.

OBJECTIVES: Group B Streptococcus (GBS) has emerged as an important cause of severe infections in adults. However, limited data are available regarding the epidemiology of GBS in Saudi Arabia. METHODS: Isolates were collected over a period of eight months from colonized (n = 104) and infected adults (n = 95). Serotypes and virulence determinants were detected by polymerase chain reactions (PCRs). Genetic relatedness was assessed using Multiple Locus Variable Number Tandem Repeat Analysis (MLVA). Antimicrobial susceptibilities were determined by disk diffusion. RESULTS: Serotypes III and V (25% each) were the most prevalent, followed by serotypes II (16.18%), Ia (13.24%), VI (9.31%), and Ib (8.82%), while five isolates remained non-typeable (2.45%). Hypervirulent serotype III/CC17 clone (n = 21) accounted for 41.18% of the serotype III isolates. Most isolates (53.92%) harboured pilus island (PI) 1 and 2a types, while PI-2b was predominantly detected in the hypervirulent clone. Isolates were variably resistant to tetracycline (76.47%), erythromycin (36.76%), clindamycin (25.49%), and levofloxacin (6.37%), but remained susceptible to penicillin. Macrolide resistant isolates exhibited constitutive (55.42%) and inducible macrolide-lincosamide-streptogramin B resistance phenotypes (33.74%), while a few had L (9.64%) or M (1.2%) phenotypes. MLVA patterns of dominant serotypes III and V revealed 40 different types divided into 12 clusters and 28 singletons. Interestingly, macrolide resistance was significantly associated with two major MLVA types. CONCLUSIONS: GBS isolates belonged predominantly to serotypes III and V, but there were no clear associations between serotypes and patient groups. The studied isolates exhibited high levels of resistance to erythromycin and clindamycin that need further surveillance.

Dual-Modal Electrical Imaging of Two-Phase Flow-Experimental Evaluation of the State Estimation Approach.

Accurate measurement of two-phase flow quantities is essential for managing production in many industries. However, the inherent complexity of two-phase flow often makes estimating these quantities difficult, necessitating the development of reliable techniques for quantifying two-phase flow. In this paper, we investigated the feasibility of using state estimation for dynamic image reconstruction in dual-modal tomography of two-phase oil-water flow. We utilized electromagnetic flow tomography (EMFT) to estimate velocity fields and electrical tomography (ET) to determine phase fraction distributions. In state estimation, the contribution of the velocity field to the temporal evolution of the phase fraction distribution was accounted for by approximating the process with a convection-diffusion model. The extended Kalman filter (EKF) and fixed-interval Kalman smoother (FIKS) were used to reconstruct the temporally evolving velocity and phase fraction distributions, which were further used to estimate the volumetric flow rates of the phases. Experimental results on a laboratory setup showed that the FIKS approach outperformed the conventional stationary reconstructions, with the average relative errors of the volumetric flow rates of oil and water being less than 4%. The FIKS approach also provided feasible uncertainty estimates for the velocity, phase fraction, and volumetric flow rate of the phases, enhancing the reliability of the state estimation approach.

A Single Tertiary Center 14-year Experience With Mesenteric Panniculitis in Turkey: A Retrospective Study of 716 Patients.

BACKGROUND: Mesenteric panniculitis is a chronic inflammatory process seen in mesenteric tissue. The purpose of this study was to assess the prevalence, clinical, laboratory, and radiological findings, and malignancy in patients diagnosed with mesenteric panniculitis using computed tomography. METHODS: A total of 716 patients with mesenteric panniculitis were retrospectively evaluated by screening all computed tomography scans performed between January 2005 and December 2018. RESULTS: Among 65 278 patients undergoing CT, 716 were diagnosed with mesenteric panniculitis. The prevalence of mesenteric panniculitis was 1.1%. The mean age was 56 ± 14 (20-91) years. The malignant and nonmalignant groups comprised 354 (49.4%) and 362 (50.6%) patients, respectively. The mean age of the malignant group was significantly higher than the nonmalignant group (P < .001). The most common malignancy was breast cancer (12.2%). A history of abdominal surgery was present in 179 (25%) patients with mesenteric panniculitis and it is higher in the malignant group than the nonmalignant group (128 [36.1%], 51 [14%], respectively, P < .001). Mean hemoglobin level and leukocyte count were lower in the malignant group than in the nonmalignant group (P < .001, P < .001, respectively). The mean erythrocyte sedimentation rate was higher in the malignant group than in the nonmalignant group (P = .030). Radiological criterion 2 was less common and radiological criterion 5 was more common in the malignant group than the nonmalignant group (91.0%, 96.4%, P = .004; 35.9%, 27.1%, respectively, P = .011). CONCLUSIONS: It is recommended to conduct research for malignancy in patients with mesenteric panniculitis, especially in the presence of clinical, laboratory, and radiological findings with high-risk features.

Species composition and population dynamics of some arthropod pests in cotton fields of irrigated and semi-arid regions of Punjab, Pakistan.

The present study aimed to record seasonal dynamics and diversity of different insect pests in cotton agroecosystems. Two well-known cotton growing districts i.e. district Layyah and Vehari were selected for the study from the cotton belt of Punjab, Pakistan. Sampling was done bi-weekly for two consecutive years from July to October during 2018 and 2019. Sweep netting, visual counting, hand picking, wet finger method, beat sheets, aspirator and pitfall trapping methods were used for collection. Shannon-Wiener and Simpson indices were used to compute diversity while Menhinick and Margalef indices were used for the estimation of species richness. A total of 94,343 individuals representing 43 species, 40 genera, 28 families and 6 orders were recorded. Family Aleyrodidae dominated over other pest families. Bemisia tabaci (Gennadius, 1889) of family Aleyrodidae was the dominant species with 39.68% share among all pest species. Estimated species richness of all arthropod pest species belonging to both districts were about 94%. The densities of pests fluctuated with time. The peaks of sucking pest densities were observed in July and August while densities of chewing pests peaked in late September or early October each year. Population densities of jassids Amrasca biguttula (Ishida), armyworm Spodoptera litura (Fabricius), and pink bollworm Pectinophora gossypiella (Saunders), showed strong negative correlation with temperature, humidity and rainfall while thrips population density showed positive correlation with these parameters. Minor loss due to pests are acceptable everywhere, but it is only possible when their populations remain below their economic threshold levels. Present study will aid to design pest management strategies in cotton growing areas round the globe.

Habitat selection by Asiatic black bear (Ursus thibetanus) in Siran and Kaghan Valleys, Pakistan / Seleção de habitat pelo urso-negro asiático (Ursus thibetanus) nos vales Siran e Kaghan, Paquistão

Asiatic black bear is present in variety of habitats like broad-leaves and coniferous forests, extending form sea level to 4300m elevation and change their habitat for food purpose seasonally. The present study was conducted at Kaghan and Siran Valleys, District Mansehra, Khyber Pakhtunkhwa, Pakistan to assess habitat of black bear. Line transect method was used for observation of bear signs. Twelve meter circular radius plots were selected for the concern vegetation’s i.e. (trees, shrubs and herbs) and three to six plots were placed in each transect. At the result of sign survey, thirteen different categories of bear signs were recorded and encounter rate was calculated for each sign. A total of 1858 signs were observed during field surveys. Total (81%) coniferous species were recoded among trees, with the highest appearance of Pinus wallichiana (34.22%) and Spruce spp (27.76%), similarly broad leaves trees (18.56%) were also recoded from habitat plots. Most of the signs were encountered in bushy areas, whereas high number of Viburnum Spp (60.29%) was present. It is indicated that black bear prefers blend of Coniferous Trees, Viburnum and Ferns Species; probably because these plants provide enough food, protection, and meticulous shelter because more than 80% of habitat composed of these three species. Currently habitat destruction and increase in human population are the up-growing issues for wild animals (especially Asiatic black bear), which is highly sensitive to such problems. High levels of conservation efforts are recommended for the protection of black bear habitat and to avoid human interference in their territory.

O urso-negro asiático está presente em uma variedade de habitats, como folhas largas e florestas de coníferas, estendendo-se do nível do mar até 4.300 m de altitude e mudando seu habitat para fins alimentares sazonalmente. O presente estudo foi conduzido nos vales Kaghan e Siran, distrito de Mansehra, Khyber Pakhtunkhwa, Paquistão, para avaliar o habitat do urso preto. O método de transecto linear foi usado para a observação de sinais do urso. Parcelas de raio circular de 12 m foram selecionadas para a vegetação de preocupação, ou seja, árvores, arbustos e ervas, e 3 a 6 parcelas foram colocadas em cada transecto. No resultado da pesquisa de sinais, 13 categorias diferentes de sinais de urso foram registradas e a taxa de encontro foi calculada para cada sinal. Um total de 1858 sinais foi observado durante os levantamentos de campo. O total (81%) de espécies de coníferas foi recodificado entre as árvores, com maior aparecimento de Pinus wallichiana (34,22%) e Spruce spp (27,76%); árvores de folhas largas (18,56%) também foram recodificadas em parcelas de habitat. A maioria dos sinais foi encontrada em áreas com arbustos, enquanto um alto número de Viburnum spp (60,29%) estava presente. É indicado que o urso-negro prefere a mistura de árvores coníferas, espécies de viburnos e samambaias; provavelmente porque essas plantas fornecem alimento suficiente, proteção e abrigo meticuloso porque mais de 80% do habitat é composto por essas três espécies. Atualmente, a destruição do habitat e o aumento da população humana são questões crescentes para os animais selvagens, especialmente o urso-negro asiático, que é altamente sensível a esses problemas. Altos níveis de esforços de conservação são recomendados para a proteção do habitat do urso-negro e para evitar a interferência humana em seu território.

Habitat selection by Asiatic black bear (Ursus thibetanus) in Siran and Kaghan Valleys, Pakistan

Abstract Asiatic black bear is present in variety of habitats like broad-leaves and coniferous forests, extending form sea level to 4300m elevation and change their habitat for food purpose seasonally. The present study was conducted at Kaghan and Siran Valleys, District Mansehra, Khyber Pakhtunkhwa, Pakistan to assess habitat of black bear. Line transect method was used for observation of bear signs. Twelve meter circular radius plots were selected for the concern vegetations i.e. (trees, shrubs and herbs) and three to six plots were placed in each transect. At the result of sign survey, thirteen different categories of bear signs were recorded and encounter rate was calculated for each sign. A total of 1858 signs were observed during field surveys. Total (81%) coniferous species were recoded among trees, with the highest appearance of Pinus wallichiana (34.22%) and Spruce spp (27.76%), similarly broad leaves trees (18.56%) were also recoded from habitat plots. Most of the signs were encountered in bushy areas, whereas high number of Viburnum Spp (60.29%) was present. It is indicated that black bear prefers blend of Coniferous Trees, Viburnum and Ferns Species; probably because these plants provide enough food, protection, and meticulous shelter because more than 80% of habitat composed of these three species. Currently habitat destruction and increase in human population are the up-growing issues for wild animals (especially Asiatic black bear), which is highly sensitive to such problems. High levels of conservation efforts are recommended for the protection of black bear habitat and to avoid human interference in their territory.

Resumo O urso-negro asiático está presente em uma variedade de habitats, como folhas largas e florestas de coníferas, estendendo-se do nível do mar até 4.300 m de altitude e mudando seu habitat para fins alimentares sazonalmente. O presente estudo foi conduzido nos vales Kaghan e Siran, distrito de Mansehra, Khyber Pakhtunkhwa, Paquistão, para avaliar o habitat do urso preto. O método de transecto linear foi usado para a observação de sinais do urso. Parcelas de raio circular de 12 m foram selecionadas para a vegetação de preocupação, ou seja, árvores, arbustos e ervas, e 3 a 6 parcelas foram colocadas em cada transecto. No resultado da pesquisa de sinais, 13 categorias diferentes de sinais de urso foram registradas e a taxa de encontro foi calculada para cada sinal. Um total de 1858 sinais foi observado durante os levantamentos de campo. O total (81%) de espécies de coníferas foi recodificado entre as árvores, com maior aparecimento de Pinus wallichiana (34,22%) e Spruce spp (27,76%); árvores de folhas largas (18,56%) também foram recodificadas em parcelas de habitat. A maioria dos sinais foi encontrada em áreas com arbustos, enquanto um alto número de Viburnum spp (60,29%) estava presente. É indicado que o urso-negro prefere a mistura de árvores coníferas, espécies de viburnos e samambaias; provavelmente porque essas plantas fornecem alimento suficiente, proteção e abrigo meticuloso porque mais de 80% do habitat é composto por essas três espécies. Atualmente, a destruição do habitat e o aumento da população humana são questões crescentes para os animais selvagens, especialmente o urso-negro asiático, que é altamente sensível a esses problemas. Altos níveis de esforços de conservação são recomendados para a proteção do habitat do urso-negro e para evitar a interferência humana em seu território.

Paratype: a genotyping tool for Salmonella Paratyphi A reveals its global genomic diversity.

Salmonella Paratyphi A, the primary etiology of paratyphoid, is estimated to cause 3.4 million infections annually, worldwide. With rising antimicrobial resistance and no licensed vaccines, genomic surveillance is key to track and monitor transmission, but there is currently no reliable genotyping framework for this pathogen. Here, we sequence 817 isolates from South Asia and add 562 publicly available genomes to build a global database representing 37 countries, covering 1917-2019. We develop a single nucleotide polymorphism-based genotyping scheme, Paratype, that segregates Salmonella Paratyphi A population into three primary and nine secondary clades, and 18 genotypes. Each genotype is assigned a unique allele definition located on an essential gene. Using Paratype, we identify spatiotemporal genomic variation and antimicrobial resistance markers. We release Paratype as an open-access tool that can use raw read files from both Illumina and Nanopore platforms, and thus can assist surveillance studies tracking Salmonella Paratyphi A across the globe.

Correlation between blood pressure and lung function in Malaysian adult population.

INTRODUCTION: The correlation between pulmonary function and hypertension remains ambiguous. This study therefore determined the relationship between pulmonary function and hypertension among adult subgroup in Malaysia. MATERIALS AND METHODS: Data for this study were obtained from an ongoing Prospective Urban Rural Epidemiology- Rural Urban Study (PURE RUS) , which is a prospective cohort study done by MARA University of Technology (UiTM) Medical Faculty research team to track risk factors, changing lifestyles, and chronic diseases in rural and urban population. The inclusion criteria included: Malaysian citizen, age 18-80 years, not on any anti-hypertensive agents, and able to perform lung function test. 1640 participants satisfied the criteria and were recruited in this study. RESULTS: From the studied population, males comprised 43.5% of them and female comprised 56.5%. A significant inverse relationship was found between pulmonary function and systolic blood pressure in both sexes measured by forced vital capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1). A substantial inverse relationship was also found between pulmonary function and age, and there was a profound positive association between blood pressure and age. No major disparities were significant in pulmonary function between hypertensive and age-matched normotensive participants. CONCLUSION: Even though a substantial inverse relationship was evident between systolic blood pressure and pulmonary function, its precise clinical importance needs to be further explored particularly when age can influence both pulmonary function and blood pressure. Clearly, the impact of age has to be removed before FVC can be used as a prognosticator of hypertension.

Formative Evaluation of Using Action Learning in a Master of Medical Education Assessment and Measurement Course.

BACKGROUND: The future success of any graduate or professional degree program is dependent upon continuous feedback provided by instructors and students. Various teaching models used by medical educators include didactics, problem/case-based learning, small/large group work, distance/online education, simulation, labs, and service/experiential learning. Action Learning is a process "that involves a small group working on real problems, taking action, and learning as individuals, as a team, and as an organization." Medical school curricula usually begin with a mostly knowledge-based approach to learning the relevant science courses. While it may include some experiential learning, there is limited organized reflection. The idea inherent in Action Learning is "learn while doing" and "reflect on the experience." This paper reports the process and outcomes of using the Action Learning Model (ALM) in teaching a master's level assessment and measurement medical education class. OBJECTIVE: The objective of this quality improvement education study was to ascertain students' knowledge, skills, and attitudes demonstrated in conducting substantive evaluations using the ALM in a graduate medical education assessment and measurement course. METHOD: This study was a formative evaluation of a 16-week master's level medical education assessment and measurement course. The curriculum included teaching the traditional knowledge, skills, and attitudes (KSAs) to conduct formative and summative evaluations in medical education. In addition, students learned applicable quality improvement skills. Specifically, they learned how to identify and work with valid customer (student) requirements, how to map and improve processes, and how to collect and analyze process data. Students were taught the KSAs while conducting a formative evaluation of the class as their major project. They evaluated the class they were taking while reflecting on the experience. In addition to the ALM, the course incorporated both the Bloom Taxonomy (a hierarchical framework for cognition and learning objectives) and the Kirkpatrick Model (a globally recognized method of evaluating the results of training and learning programs). The one-sample significance test was used to evaluate the median of the difference between the pre-and post-test groups. Descriptive statistics were also performed. RESULTS: Nine students who were medical students, dental students, physicians, and simulation lab technicians participated in the course. Students learned medical education assessment and measurement of knowledge, skills, and attitudes (KSAs) and experienced the process of performing a formative evaluation. The post-test results for all students combined revealed that 277 of the 450 (61.6%) data points were greater than zero. A total of 139 data points showed no improvement and 34 results were worse than the pretest.  Discussion: The ALM for teaching assessment and measurement in medical education can be challenging, but it may provide a more realistic and rewarding educational experience. The students gained a greater appreciation of the positive and negative aspects of using an experiential approach. Finally, the weekly formative surveys provided regular feedback that led to instructional improvements. With regards to medical education, action learning is best suited for students during the clinical phase of their education.

Bayesian estimation of sensitivity and specificity of fecal culture, fecal PCR and serum ELISA for diagnosis of Mycobacterium avium subsp. paratuberculosis infections in sheep.

The objective of the present study was to evaluate the diagnostic accuracy of the individual fecal culture (IFC), fecal PCR (FPCR), and serum ELISA for the detection of Mycobacterium avium subsp. paratuberculosis (MAP) infections in sheep from four governorates in Egypt, using a latent class model (LCM) fitted within a Bayesian framework. Furthermore, the within-governorate prevalence of MAP infection in sheep was estimated as a secondary objective. Fecal and blood samples were collected from 370 sheep in four Egyptian governorates. Fecal samples were analyzed by IFC and RT-PCR based on ISMav2 gene, while ELISA was performed on serum samples. The sensitivity (Se) and specificity (Sp) of the three diagnostic tests were estimated using a three-tests-four-populations Bayesian LCM to obtain posterior estimates [medians and 95% Bayesian credible intervals (95% BCI)] for each parameter. The median Se estimates (95% BCI) for IFC, FPCR, and serum ELISA were 31.8% (22.8-41.4), 49.7% (31.8-79.9), and 61.2% (39.8-81.4), respectively. The median Sp estimates (95% BCI) for IFC, FPCR, and serum ELISA were 97.7% (96.1-98.9), 97.7% (95.6-99.5), and 98.4% (96.9-99.3), respectively. The median within-governorate paratuberculosis prevalence (95% BCI) was 5.2% (1.1-13.6), 8.4% (2.9-17.7), 9.4% (3.0-20.7), and 18.2% (10.5-29.5) for the Gharbia, Menoufia, Qalyubia, and Kafr El-Sheikh governorates, respectively. In conclusion, at a ratio of the optical density (OD) sample/OD positive control threshold of > 45%, ELISA showed the highest Se among the three tests and comparable Sp to IFC and FPCR. The test ELISA evaluated in this study is an interesting alternative for detecting MAP in sheep due to its higher Se, lower cost, and shorter turnaround laboratory time compared to IFC and FPCR.

A DNA barcode survey of insect biodiversity in Pakistan.

Although Pakistan has rich biodiversity, many groups are poorly known, particularly insects. To address this gap, we employed DNA barcoding to survey its insect diversity. Specimens obtained through diverse collecting methods at 1,858 sites across Pakistan from 2010-2019 were examined for sequence variation in the 658 bp barcode region of the cytochrome c oxidase 1 (COI) gene. Sequences from nearly 49,000 specimens were assigned to 6,590 Barcode Index Numbers (BINs), a proxy for species, and most (88%) also possessed a representative image on the Barcode of Life Data System (BOLD). By coupling morphological inspections with barcode matches on BOLD, every BIN was assigned to an order (19) and most (99.8%) were placed to a family (362). However, just 40% of the BINs were assigned to a genus (1,375) and 21% to a species (1,364). Five orders (Coleoptera, Diptera, Hemiptera, Hymenoptera, Lepidoptera) accounted for 92% of the specimens and BINs. More than half of the BINs (59%) are so far only known from Pakistan, but others have also been reported from Bangladesh (13%), India (12%), and China (8%). Representing the first DNA barcode survey of the insect fauna in any South Asian country, this study provides the foundation for a complete inventory of the insect fauna in Pakistan while also contributing to the global DNA barcode reference library.

Determination of hormoligosis of organophosphate insecticides against Phenacoccus solenopsis.

Cotton mealybug is a highly invasive pest of agricultural crops worldwide. Major agriculturists most rely on the use of insecticides for the control of pesticides. So, the indiscriminate use of insecticides leads to resistance development in recent years. For this purpose, an experiment was conducted using different concentrations of the three insecticides (profenfos chlorpyrifos and triazophos) to check the hormoligosis effects against cotton mealybug (CMB) in laboratory conditions. Investigation of variations for % mortality of adults of CMB after three days revealed that all treatments had statistically significant (P ˂ 0.05). The highest mortality was observed at the highest concentrations of profenofos 2.4% (38.55%). After 7 days, all the treatments were significant with difference in means (P ˂ 0.05). The highest mortality was recorded at the highest dilution of pesticide profenofos 2.4% (77.11%). The values of fecundity and longevity exposed a valid difference among treatments (P ˂ 0.05). Maximum fecundity was observed at the concentration 2.4% (181.41%) and longevity showed (38.46%). The highest mortality was observed at a concentration of triazophos 4% (27.98%). For chlorpyriphos the highest mortality was examined at concentration 4% (24.79%). The fecundity showed a statistically significant difference for different concentrations of triazophos and chlorpyriphos (P ˂ 0.05). The results of the recent study provide valuable information regarding the selection of insecticides and hormoligosis effects. The study can be helpful in the implications of integrated pest management of P. solenopsis.