Vitamin C Alleviates the Negative Effects of Heat Stress on Reproductive Processes by Regulating Amino Acid Metabolism in Granulosa Cells.

Heat stress-induced biochemical alterations in ovarian follicles compromise the function of granulosa cells (GCs) and the developmental competence of oocytes. Summer heat stress can have a far-reaching negative impact on overall fertility and reproductive success. Together with the heat stress, the rise of assisted reproductive technologies (ART), potential confounding hazards of in vitro handling and the absence of systemic body support in ART makes it imperative to study the heat stress ameliorative effects of vitamin C under in vitro conditions. Using in vitro heat stress treatment of 43 °C for two hours in bovine GCs, we studied the effects of vitamin C on cell growth, oxidative stress, apoptosis and cell cycle progression together with a comprehensive metabolomics profiling. This study investigates the molecular milieu underlying the vitamin C (VC)-led alleviation of heat-related disruptions to metabolic processes in bovine GCs. The supplementation of VC ameliorated the detrimental effects of heat stress by reducing oxidative stress and apoptosis while restoring cell proliferation. Normal cell function restoration in treated GCs was demonstrated through the finding of significantly high levels of progesterone. We observed a shift in the metabolome from biosynthesis to catabolism, mostly dominated by the metabolism of amino acids (decreased tryptophan, methionine and tyrosine) and the active TCA cycle through increased Succinic acid. The Glutathione and tryptophan metabolism were important in ameliorating the inflammation and metabolism nexus under heat stress. Two significant enzymes were identified, namely tryptophan 2,3-dioxygenase (TDO2) and mitochondrial phenylalanyl-tRNA synthetase (FARS2). Furthermore, our findings provide insight into the significance of B-complex vitamins in the context of heat stress during VC supplementation. This study underscores the importance of VC supplementation in heat stress and designates multiple metabolic intervention faucets in the context of ameliorating heat stress and enhancing reproductive efficiency.

A spatiotemporal atlas of mouse liver homeostasis and regeneration.

The mechanism by which mammalian liver cell responses are coordinated during tissue homeostasis and perturbation is poorly understood, representing a major obstacle in our understanding of many diseases. This knowledge gap is caused by the difficulty involved with studying multiple cell types in different states and locations, particularly when these are transient. We have combined Stereo-seq (spatiotemporal enhanced resolution omics-sequencing) with single-cell transcriptomic profiling of 473,290 cells to generate a high-definition spatiotemporal atlas of mouse liver homeostasis and regeneration at the whole-lobe scale. Our integrative study dissects in detail the molecular gradients controlling liver cell function, systematically defining how gene networks are dynamically modulated through intercellular communication to promote regeneration. Among other important regulators, we identified the transcriptional cofactor TBL1XR1 as a rheostat linking inflammation to Wnt/ß-catenin signaling for facilitating hepatocyte proliferation. Our data and analytical pipelines lay the foundation for future high-definition tissue-scale atlases of organ physiology and malfunction.

Salivary transforming growth factor beta in oral submucous fibrosis: A diagnostic and predictive marker.

CONTEXT: Growth factors and cytokines like transforming growth factor beta (TGF-ß) play a key role in the pathogenesis of oral submucous fibrosis. AIMS: To elucidate the role of Salivary TGF-ß isoforms as a predictive and diagnostic marker for oral submucous fibrosis. SETTINGS AND DESIGN: A total of 30 OSMF and 10 control patients were included in this study, and their clinic-epidemiological data was recorded. METHODOLOGY: The expression of TGF-ß genes-TGF-ß1, TGF-ß2, TGF-ß3-was studied by a real-time polymerase chain reaction in tissue and saliva. Patients were given medicinal intervention for 12 weeks along with jaw-opening exercises. Expression of salivary TGF-ß genes was studied at 12 weeks. STATISTICAL ANALYSIS USED: SPSS software version 20. RESULT: Expression of salivary TGF beta isoforms in OSMF was more than in the control group. There was an increase in salivary TGF-ß1, ß2, ß3 expressions with increasing clinical grades of OSMF and advancing the stage of the disease. Expression of all the TGF beta isoforms was decreased after treatment with statistically significant results. Statistically significant correlations were found between the mean difference of TGF-ß1 and the mean difference between mouth opening and tongue protrusion. CONCLUSION: Salivary TGF-ß isoforms may be used in diagnosis, risk assessment, and screening of the entire population at risk of OSMF after its clinical validation. However, adequate sample size and segmental assessment of the expression of TGF-ß isoforms are needed for further evaluation.

Multi-Locus Microsatellite Typing of Colonising and Invasive Aspergillus fumigatus Isolates from Patients Post Lung Transplantation and with Chronic Lung Disease.

Aspergillus fumigatus can cause different clinical manifestations/phenotypes in lung transplant (LTx) recipients and patients with chronic respiratory diseases. It can also precipitate chronic lung allograft dysfunction (CLAD) in LTx recipients. Many host factors have been linked with the severity of A. fumigatus infection, but little is known about the contribution of different A. fumigatus strains to the development of different phenotypes and CLAD. We used multi-locus microsatellite typing (MLMT) to determine if there is a relationship between strain (i.e., genotype) and phenotype in 60 patients post LTx or with chronic respiratory disease across two time periods (1 November 2006-31 March 2009 and 1 November 2015-30 June 2017). The MLMT (STRAf) assay was highly discriminatory (Simpson's diversity index of 0.9819-0.9942) with no dominant strain detected. No specific genotype-phenotype link was detected, but several clusters and related strains were associated with invasive aspergillosis (IA) and colonisation in the absence of CLAD. Host factors were linked to clinical phenotypes, with prior lymphopenia significantly more common in IA cases as compared with A. fumigatus-colonised patients (12/16 [75%] vs. 13/36 [36.1%]; p = 0.01), and prior Staphylococcus aureus infection was a significant risk factor for the development of IA (odds ratio 13.8; 95% confidence interval [2.01-279.23]). A trend toward a greater incidence of CMV reactivation post-A. fumigatus isolation was observed (0 vs. 5; p = 0.06) in LTx recipients. Further research is required to determine the pathogenicity and immunogenicity of specific A. fumigatus strains.

Association of APO B gene polymorphisms with the development of myocardial infarction in Pakistani population.

Myocardial infarction (MI) is when a blood clot in the coronary artery obstructs blood flow to a specific part of the heart, leading to the death of myocardium in that area. The development of MI is influenced by various environmental factors, genetic components, and their interactions, even though the exact cause has not been fully established. This is the first case-control study examining the possible association between the human Apo B gene and MI in the Punjab region of Pakistan. The study included 100 patients and 50 healthy individuals. Genomic DNA was isolated from blood samples using manual extraction methods. Subsequently, primers were optimized, and genotyping was performed using PCR, followed by DNA sequencing and RFLP analysis. The research focused on two specific APO B gene SNPs, codon 4154 G/A (rs1801701) and codon 2488 G/A (rs1042031). Both SNPs involved the substitution of guanine with adenine. It was found that individuals carrying the minor allele A of SNP rs1801701 (p < 0.001) and the minor allele A of rs1042031 (p < 0.001) had a significantly higher risk of developing MI. Additionally, haplotype analysis revealed that the AA haplotype (comprising both rs1801701 and rs1042031 SNPs) was associated with a substantially increased risk of MI (OR = 3.845). In conclusion, the study provides evidence supporting the association between specific mutations in the APOB gene and the risk of myocardial infarction in the Pakistani population.

Which curve is better? A comparative analysis of trauma scoring systems in a South Asian country.

Objectives: A diverse set of trauma scoring systems are used globally to predict outcomes and benchmark trauma systems. There is a significant potential benefit of using these scores in low and middle-income countries (LMICs); however, its standardized use based on type of injury is still limited. Our objective is to compare trauma scoring systems between neurotrauma and polytrauma patients to identify the better predictor of mortality in low-resource settings. Methods: Data were extracted from a digital, multicenter trauma registry implemented in South Asia for a secondary analysis. Adult patients (≥18 years) presenting with a traumatic injury from December 2021 to December 2022 were included in this study. Injury Severity Score (ISS), Trauma and Injury Severity Score (TRISS), Revised Trauma Score (RTS), Mechanism/GCS/Age/Pressure score and GCS/Age/Pressure score were calculated for each patient to predict in-hospital mortality. We used receiver operating characteristic curves to derive sensitivity, specificity and area under the curve (AUC) for each score, including Glasgow Coma Scale (GCS). Results: The mean age of 2007 patients included in this study was 41.2±17.8 years, with 49.1% patients presenting with neurotrauma. The overall in-hospital mortality rate was 17.2%. GCS and RTS proved to be the best predictors of in-hospital mortality for neurotrauma (AUC: 0.885 and 0.874, respectively), while TRISS and ISS were better predictors for polytrauma patients (AUC: 0.729 and 0.722, respectively). Conclusion: Trauma scoring systems show differing predictability for in-hospital mortality depending on the type of trauma. Therefore, it is vital to take into account the region of body injury for provision of quality trauma care. Furthermore, context-specific and injury-specific use of these scores in LMICs can enable strengthening of their trauma systems. Level of evidence: Level III.

Wide-range and area-selective threshold voltage tunability in ultrathin indium oxide transistors.

The scaling of transistors with thinner channel thicknesses has led to a surge in research on two-dimensional (2D) and quasi-2D semiconductors. However, modulating the threshold voltage (VT) in ultrathin transistors is challenging, as traditional doping methods are not readily applicable. In this work, we introduce a optical-thermal method, combining ultraviolet (UV) illumination and oxygen annealing, to achieve broad-range VT tunability in ultrathin In2O3. This method can achieve both positive and negative VT tuning and is reversible. The modulation of sheet carrier density, which corresponds to VT shift, is comparable to that obtained using other doping and capacitive charging techniques in other ultrathin transistors, including 2D semiconductors. With the controllability of VT, we successfully demonstrate the realization of depletion-load inverter and multi-state logic devices, as well as wafer-scale VT modulation via an automated laser system, showcasing its potential for low-power circuit design and non-von Neumann computing applications.

Greening for greater good: investigating the critical factors for customer satisfaction with sustainable e-banking.

This study investigated the impact of efficiency, reliability, responsiveness, safety, and security on customer satisfaction with sustainable e-banking. The study used a quantitative methodology, with data collected from customers of commercial banks in South Punjab, Pakistan. A Likert scale questionnaire was used to collect cross-sectional data. A sample of 350 was analyzed using the Statistical Package for the Social Sciences (SPSS) for testing descriptive statistics, correlation analysis, and regression results. The study's results revealed that efficiency, reliability, responsiveness, safety, and security significantly impacted customer satisfaction with e-banking services. Efficiency and reliability were the most crucial factors influencing customer satisfaction, followed by safety, security, and responsiveness. The research findings have important implications for commercial banks, as they highlight the critical role of these factors in the development of sustainable e-banking practices. Overall, the study provides valuable insights for commercial banks seeking to improve their e-banking services and ensure customer satisfaction. Commercial banks can enhance their competitiveness and achieve sustainable growth in the highly competitive e-banking sector by prioritizing efficiency, reliability, responsiveness, and safety and security.

Determination of histological and genotoxic parameters of Nile Tilapia, Oreochromis niloticus exposed to lead (Pb).

This study investigates the hazardous effects of lead on the histological and genotoxic parameters of the fish, Oreochromis niloticus. Present work was conducted in a series of three steps. In first step, acute toxicity, LC50 and lethal lead concentration were measured using Probit analysis method. LC50 value and lethal concentration for O. niloticus was measured as 77.673 mgL-1 and 150.924 mgL-1, respectively. In second step, histological changes were assessed by preparing slides of tissues of the gills, liver and kidney of both control and Pb-stressed O. niloticus and examining the respective tissues under the light microscope. The inferences showed significant histological alterations (p<0.05) in the gills of Pb-exposed fish including necrosis, edema, vascular congestion, shortening and curling and lifting of the epithelium of secondary lamella in gills. The cellular degeneration and dilation of sinusoids in liver and loss of hemopoietic tissue, necrosis and edema in kidney was observed. Histomorphometry of the liver showed a decrease in diameter of the central vein and hepatocyte along with an increase in width of sinusoids. The histomorphometry of kidney showed an increase in the diameter of renal corpuscle, glomerulus, proximal and distal convoluted tubules. The nuclear anomalies were studied in the RBCs of fish. Non-parametric Mann-Whitney U-test was conducted to compare nuclear abnormalities and the frequency of micronuclei among the control and lead-treated fish groups. Results declared an increased micronucleus, notched and de-shaped nuclei frequency, in RBCs of fish exposed to lead as compared to control group.

Mathematical modelling and analysis of COVID-19 and tuberculosis transmission dynamics.

In this paper, a mathematical model for assessing the impact of COVID-19 on tuberculosis disease is proposed and analysed. There are pieces of evidence that patients with Tuberculosis (TB) have more chances of developing the SARS-CoV-2 infection. The mathematical model is qualitatively and quantitatively analysed by using the theory of stability analysis. The dynamic system shows endemic equilibrium point which is stable when R 0 < 1 and unstable when R 0 > 1 . The global stability of the endemic point is analysed by constructing the Lyapunov function. The dynamic stability also exhibits bifurcation behaviour. The optimal control theory is used to find an optimal solution to the problem in the mathematical model. The sensitivity analysis is performed to clarify the effective parameters which affect the reproduction number the most. Numerical simulation is carried out to assess the effect of various biological parameters in the dynamic of both tuberculosis and COVID-19 classes. Our simulation results show that the COVID-19 and TB infections can be mitigated by controlling the transmission rate γ .

Bright and Efficient Light-Emitting Devices Based on 2D Transition Metal Dichalcogenides.

2D monolayer transition metal dichalcogenides (TMDCs) show great promise for the development of next-generation light-emitting devices owing to their unique electronic and optoelectronic properties. The dangling-bond-free surface and direct-bandgap structure of monolayer TMDCs allow for near-unity photoluminescence quantum efficiencies. The excellent mechanical and optical characteristics of 2D TMDCs offer great potential to fabricate TMDC-based light-emitting diodes (LEDs) featuring good flexibility and transparency. Great progress has been made in the fabrication of bright and efficient LEDs with varying device structures. In this review, the aim is to provide a comprehensive summary of the state-of-the-art progress made in the construction of bright and efficient LEDs based on 2D TMDCs. After a brief introduction to the research background, the preparation of 2D TMDCs used for LEDs is briefly discussed. The requirements and the corresponding challenges to achieve bright and efficient LEDs based on 2D TMDCs are introduced. Thereafter, various strategies to enhance the brightness of monolayer 2D TMDCs are described. Following that, the carrier-injection schemes enabling bright and efficient TMDC-based LEDs along with the device performance are summarized. Finally, the challenges and future prospects regarding the accomplishment of TMDC-LEDs with ultimate brightness and efficiency are discussed.

Burn Admissions Across Low- and Middle-income Countries: A Repeated Cross-sectional Survey.

Burn injuries have decreased markedly in high-income countries while the incidence of burns remains high in Low- and Middle-Income Countries (LMICs) where more than 90% of burns are thought to occur. However, the cause of burns in LMIC is poorly documented. The aim was to document the causes of severe burns and the changes over time. A cross-sectional survey was completed for 2014 and 2019 in eight burn centers across Africa, Asia, and Latin America: Cairo, Nairobi, Ibadan, Johannesburg, Dhaka, Kathmandu, Sao Paulo, and Guadalajara. The information summarised included demographics of burn patients, location, cause, and outcomes of burns. In total, 15,344 patients were admitted across all centers, 37% of burns were women and 36% of burns were children. Burns occurred mostly in household settings (43-79%). In Dhaka and Kathmandu, occupational burns were also common (32 and 43%, respectively). Hot liquid and flame burns were most common while electric burns were also common in Dhaka and Sao Paulo. The type of flame burns varies by center and year, in Dhaka, 77% resulted from solid fuel in 2014 while 74% of burns resulted from Liquefied Petroleum Gas in 2019. In Nairobi, a large proportion (32%) of burns were intentional self-harm or assault. The average length of stay in hospitals decreased from 2014 to 2019. The percentage of deaths ranged from 5% to 24%. Our data provide important information on the causes of severe burns which can provide guidance in how to approach the development of burn injury prevention programs in LMIC.

Factors Affecting the Transition from Paper to Digital Data Collection for Mobile Tuberculosis Active Case Finding in Low Internet Access Settings in Pakistan.

Between September 2020 and March 2021, Mercy Corps piloted hybrid digital (CAPI) and paper-based (PAPI) data collection as part of its tuberculosis (TB) active case finding strategy. Data were collected using CAPI and PAPI at 140 TB chest camps in low Internet access areas of Punjab and Khyber Pakhtunkhwa provinces in Pakistan. PAPI data collection was performed primarily during the camp and entered using a tailor-performed CAPI tool after camps. To assess the feasibility of this hybrid approach, quality of digital records were measured against the paper "gold standard", and user acceptance was evaluated through focus group discussions. Completeness of digital data varied by indicator, van screening team, and month of implementation: chest camp attendees and pulmonary TB cases showed the highest CAPI/PAPI completeness ratios (1.01 and 0.96 respectively), and among them, all forms of TB diagnosis and treatment initiation were lowest (0.63 and 0.64 respectively). Vans entering CAPI data with high levels of completeness generally did so for all indicators, and significant differences in mean indicator completeness rates between PAPI and CAPI were observed between vans. User feedback suggested that although the CAPI tool required practice to gain proficiency, the technology was appreciated and will be better perceived once double entry in CAPI and PAPI can transition to CAPI only. CAPI data collection enables data to be entered in a more timely fashion in low-Internet-access settings, which will enable more rapid, evidence-based program steering. The current system in which double data entry is conducted to ensure data quality is an added burden for staff with many activities. Transitioning to a fully digital data collection system for TB case finding in low-Internet-access settings requires substantial investments in M&E support, shifts in data reporting accountability, and technology to link records of patients who pass through separate data collection stages during chest camp events.

A novel digital rectoscope for the triage of lower gastrointestinal symptoms in primary care: a prospective multicentre feasibility study.

BACKGROUND: Access to community rectoscopy might help to ease the burden on hospital services and reduce costs for the NHS. To assess this, a prospective multicentre observational phase I feasibility study of a novel digital rectoscope and telestration software for the triage of lower gastrointestinal (GI) symptoms was undertaken. AIM: To determine if digital rectoscopy is feasible, acceptable, and clinically safe. DESIGN & SETTING: Evaluation of clinician case reports and patient questionnaires from patients recruited from five primary care centres. METHOD: Adults meeting 2-week wait (2WW) criteria for suspected lower GI cancer, suspected new diagnosis, or flare-up of inflammatory bowel disease (IBD) were enrolled. Examinations were performed by primary care practitioners using the LumenEye rectoscope. The CHiP platform allowed immediate remote review by secondary care. A prospective analysis was performed of patient and clinician experiences, diagnostic accuracy, and cost. RESULTS: A total of 114 patients were recruited and 110 underwent the procedure (46 [42%] females and 64 [58%] males). No serious adverse events were reported. Eighty-two (74.5%) patients reported that examination was more comfortable than expected, while 104 (94.5%) felt the intervention was most convenient if delivered in the community. Clinicians were confident of their assessment in 100 (87.7%) examinations. Forty-eight (42.1%) patients subsequently underwent colonoscopy, flexible sigmoidoscopy, or computed tomography virtual colonoscopy (CTVC). The overall sensitivity and specificity of LumenEye in identifying rectal pathology was 90.0% and 88.9%. It was 100% and 100% for cancer, and 83.3% and 97.8% for polyps. Following LumenEye examination, 19 (17.3%) patients were discharged, with projected savings of 11 305 GBP. CONCLUSION: Digital rectoscopy in primary care is safe, acceptable, and can reduce referrals. A phase III randomised controlled trial is indicated to define its utility in reducing the burden on hospital diagnostic services.

NLR and PLR Ratios - Accessible and Affordable Predictors of Disease Severity in COPD.

COPD is currently the fourth leading cause of death the world but is projected to be 3rd leading cause of death by 2020. It is characterized by limitation of airflow which is not fully transformable to normal along with increased long term inflammatory response in airways of the tracts of lungs. Acute exacerbations of COPD (AECOPD) are the most common causes of hospitalization and death among COPD patients. CRP, leukocytes, IL-6, IL-8 and fibrinogen are associated with COPD. However, while these biomarkers may be helpful, many of them are time consuming with extra cost, and some of the tests are not readily clinically available. Neutrophil-to-Lymphocyte Ratio (NLR) and platelet lymphocyte ratio (PLR) are effortless and basic parameters that are readily obtained from the simplest and easily obtainable complete blood count, even in peripheral hospitals. Material: Study was conducted at NMCH &RC, Raichur, patients attending NMCH for a duration of 18 months. 100 patients with a confirmed diagnosis of COPD confirmed with pulmonary function test according to GOLD criteria were included in the study. Observation: Mean age of the study population was 67.14±8.03 years. Males were predominant with male to female ratio as 9:1.Mean NLR of the AECOPD patients from stage 1 was 3.73±0.18, stage 2 was 6.07±1.27, stage 3 was 6.02±1.14 and stage 4 was 8.19±2.66. When we compared the mean NLR of the patients between different stages of COPD, the difference was found to be statistically significant (p<0.05). It means mean NLR was higher in stage 4 as compared to other groups. Mean PLR of the AECOPD patients from stage 1 was 12690.48±3978.45, stage 2 was 22219.93±7797.9, stage 3 was 19158.73±5070.88 and stage 4 was 19544.87±10207.59. When we compared the mean PLR of the patients between different stages of COPD, the difference was found to be statistically significant (p<0.05). It means mean PLR was higher in stage 2 followed by stage 4 as compared to other groups Conclusion: The NLR and PLR may be used as a useful and easily accessible tool for evaluating the ongoing inflammation during stable period and the disease severity during acute exacerbations in COPD patients. NLR ratio is more specific to severity of COPD compared to PLR ratio.

Defect Inspection Techniques in SiC.

With the increasing demand of silicon carbide (SiC) power devices that outperform the silicon-based devices, high cost and low yield of SiC manufacturing process are the most urgent issues yet to be solved. It has been shown that the performance of SiC devices is largely influenced by the presence of so-called killer defects, formed during the process of crystal growth. In parallel to the improvement of the growth techniques for reducing defect density, a post-growth inspection technique capable of identifying and locating defects has become a crucial necessity of the manufacturing process. In this review article, we provide an outlook on SiC defect inspection technologies and the impact of defects on SiC devices. This review also discusses the potential solutions to improve the existing inspection technologies and approaches to reduce the defect density, which are beneficial to mass production of high-quality SiC devices.

The Impact of Empowering Leadership on Job Performance of Higher Education Institutions Employees: Mediating Role of Goal Clarity and Self-Efficacy.

Purpose: The main objective of existing research is to assess empowering leadership effects on employees' job performance at the academic level through mediating variables' goal clarity and self-efficacy. Methods: Data were congregated from 400 employees belonging to higher education institutions of Pakistan through research assistants, hired for data collection. Statistical procedures, such as factor analysis via statistical package for the social sciences (SPSS 23), structural equation modeling with bootstrapping via statistical tool analysis of moment structures (AMOS 24), were used to evaluate data and assess the relationship among the constructs. Results: The structural equation modeling analysis uncovered several results. For instance, it shows the positive influence of empowering leadership behaviors on goal clarity, self-efficacy, and employees' job performance. Moreover, the bootstrap investigation showed that goal clarity and self-efficacy mediate empowering leadership behaviors' influence on workers' job performance. Therefore, conferring to existing study results empowering leadership is significantly associated with employees' job performance in the presence of mediators goal clarity and self-efficacy at the academic level of higher education institutions of Sindh, Pakistan. Conclusion: The main research question of existing research is to assess empowering leadership effects on employees' job performance through mediating variables' goal clarity and self-efficacy. To investigate this research question, we have conducted this study and empirically established that empowering leadership can affect employees' job performance with and without mediation. We have also shown empowering leadership as collaborative effects produce advanced levels of self-efficacy, goal clarity, and employees' job performance than either leadership behavior could accomplish by itself.

The mTORC1-eIF4F axis controls paused pluripotency.

Mouse embryonic stem cells (mESCs) can self-renew indefinitely and maintain pluripotency. Inhibition of mechanistic target of rapamycin (mTOR) by the kinase inhibitor INK128 is known to induce paused pluripotency in mESCs cultured with traditional serum/LIF medium (SL), but the underlying mechanisms remain unclear. In this study, we demonstrate that mTOR complex 1 (mTORC1) but not complex 2 (mTORC2) mediates mTOR inhibition-induced paused pluripotency in cells grown in both SL and 2iL medium (GSK3 and MEK inhibitors and LIF). We also show that mTORC1 regulates self-renewal in both conditions mainly through eIF4F-mediated translation initiation that targets mRNAs of both cytosolic and mitochondrial ribosome subunits. Moreover, inhibition of mitochondrial translation is sufficient to induce paused pluripotency. Interestingly, eIF4F also regulates maintenance of pluripotency in an mTORC1-independent but MEK/ERK-dependent manner in SL, indicating that translation of pluripotency genes is controlled differently in SL and 2iL. Our study reveals a detailed picture of how mTOR governs self-renewal in mESCs and uncovers a context-dependent function of eIF4F in pluripotency regulation.

Impact of COVID-19 on global burn care.

BACKGROUND: Worldwide, different strategies have been chosen to face the COVID-19-patient surge, often affecting access to health care for other patients. This observational study aimed to investigate whether the standard of burn care changed globally during the pandemic, and whether country´s income, geographical location, COVID-19-transmission pattern, and levels of specialization of the burn units affected reallocation of resources and access to burn care. METHODS: The Burn Care Survey is a questionnaire developed to collect information on the capacity to provide burn care by burn units around the world, before and during the pandemic. The survey was distributed between September and October 2020. McNemar`s test analyzed differences between services provided before and during the pandemic, χ2 or Fisher's exact test differences between groups. Multivariable logistic regression analyzed the independent effect of different factors on keeping the burn units open during the pandemic. RESULTS: The survey was completed by 234 burn units in 43 countries. During the pandemic, presence of burn surgeons did not change (p = 0.06), while that of anesthetists and dedicated nursing staff was reduced (<0.01), and so did the capacity to manage patients in all age groups (p = 0.04). Use of telemedicine was implemented (p < 0.01), collaboration between burn centers was not. Burn units in LMICs and LICs were more likely to be closed, after adjustment for other factors. CONCLUSIONS: During the pandemic, most burn units were open, although availability of standard resources diminished worldwide. The use of telemedicine increased, suggesting the implementation of new strategies to manage burns. Low income was independently associated with reduced access to burn care.

Blunt abdominal trauma patients presenting to a tertiary care facility of Pakistan: A three years' experience.

Blunt abdominal trauma (BAT) refers to injuries without wounds entering the peritoneal cavity due to road traffic accidents (RTA) and falls, as a result of collision or counter collision. The objective of the present study was to determine the frequency of patients with visceral injuries in blunt abdominal trauma. This study was carried out in the Department of Surgery, including ward-3 of Jinnah Post Graduate Medical Centre, Karachi, from November 2017 till November 2020. The study design was descriptive case series. During the study period, the data of 112 patients was collected, which comprised of 102 males and 10 females. All the patients between 12 to 65 years of age (mean age:31.84±13.14 years) presenting to the emergency with < 24 hours of abdominal trauma, were included in the study. Organs involved during blunt abdominal trauma were observed and frequency was recorded. Liver injuries were found in 48(42.28%) patients, intestinal injuries in 40(35.7%), splenic injuries in 32(28.5%), kidney injuries in 24(21.4%), pancreatic injuries in 8(7.1%) and stomach injuries in 4(3.5%) patients. Grade 4 liver injury was found in 80(71%) patients, Grade 2 and 3 splenic injuries in 56(50%) patients whereas 47(42%) patients had grade 1 kidney injury. Liver was found to be the most frequent organ involved, followed by intestine and spleen.