Comparative evolutionary analyses of eight whitefly Bemisia tabaci sensu lato genomes: cryptic species, agricultural pests and plant-virus vectors.

BACKGROUND: The group of > 40 cryptic whitefly species called Bemisia tabaci sensu lato are amongst the world's worst agricultural pests and plant-virus vectors. Outbreaks of B. tabaci s.l. and the associated plant-virus diseases continue to contribute to global food insecurity and social instability, particularly in sub-Saharan Africa and Asia. Published B. tabaci s.l. genomes have limited use for studying African cassava B. tabaci SSA1 species, due to the high genetic divergences between them. Genomic annotations presented here were performed using the 'Ensembl gene annotation system', to ensure that comparative analyses and conclusions reflect biological differences, as opposed to arising from different methodologies underpinning transcript model identification. RESULTS: We present here six new B. tabaci s.l. genomes from Africa and Asia, and two re-annotated previously published genomes, to provide evolutionary insights into these globally distributed pests. Genome sizes ranged between 616-658 Mb and exhibited some of the highest coverage of transposable elements reported within Arthropoda. Many fewer total protein coding genes (PCG) were recovered compared to the previously published B. tabaci s.l. genomes and structural annotations generated via the uniform methodology strongly supported a repertoire of between 12.8-13.2 × 103 PCG. An integrative systematics approach incorporating phylogenomic analysis of nuclear and mitochondrial markers supported a monophyletic Aleyrodidae and the basal positioning of B. tabaci Uganda-1 to the sub-Saharan group of species. Reciprocal cross-mating data and the co-cladogenesis pattern of the primary obligate endosymbiont 'Candidatus Portiera aleyrodidarum' from 11 Bemisia genomes further supported the phylogenetic reconstruction to show that African cassava B. tabaci populations consist of just three biological species. We include comparative analyses of gene families related to detoxification, sugar metabolism, vector competency and evaluate the presence and function of horizontally transferred genes, essential for understanding the evolution and unique biology of constituent B. tabaci. s.l species. CONCLUSIONS: These genomic resources have provided new and critical insights into the genetics underlying B. tabaci s.l. biology. They also provide a rich foundation for post-genomic research, including the selection of candidate gene-targets for innovative whitefly and virus-control strategies.

Microbial contamination of packaged drinking water in Nigeria.

OBJECTIVES: About 18% of urban households in Nigeria depend on packaged sachet water as the primary source of drinking water. This review assessed microbial contamination of these products with an emphasis on total coliforms and the faecal indicator bacteria (FIB) - Escherichia coli (E. coli) and thermotolerant coliforms (TTC). METHODS: PubMed/Medline, African Index Medicus, AfroLib, Global Health Library, Embase and the ISI Web of Science databases were searched to identify original research published up to October 2020. The literature findings were synthesised narratively in line with the review objectives. To assess prevalence of microbial contamination, a random effects meta-analysis, was also conducted using the R metafor package in RStudio. The protocol for this review is registered on PROSPERO with reference number CRD 42019128474. RESULTS: Fifty-two of 429 studies were identified for inclusion. At 53.27%, contamination prevalence was higher for total coliforms (95% CI: 39.05-66.98, I2  = 81%, p < 0.01, 42 studies) than FIB (12.38%, 95% CI: 7.92-18.85, I2  = 61%, p < 0.01, 33 studies) suggesting that treatment failure is a major contributor to the poor microbial quality reported in the included studies. Within the FIB group, the prevalence of contamination with E. coli was 13.30% (95% CI: 8.23-20.80, I2  = 65%, p < 0.01, 27 studies) versus 6.24% (95% CI: 1.12-28.06, I2  = 72%, p < 0.01, six studies) for TTCs. Other microbial contaminants reported were Pseudomonas aeruginosa, Klebsiella and Enterococcus faecalis and these showed multidrug antibiotic resistance. CONCLUSIONS: The findings of this review highlight the need for improved regulatory oversight with more stringent monitoring of the microbial quality of sachet water products in Nigeria.

Metals in vegetables from markets in Zaria, Nigeria and risk assessment.

This study, investigated the concentrations of cadmium, lead and arsenic in vegetables grown with irrigation and sold in Sabon gari and Samaru markets in Zaria, Nigeria. Cadmium was absent in amaranthus, pepper and tomatoes purchased from Samaru market. Nevertheless, amaranthus and lettuce had higher concentrations of these toxic metals than pepper. Total arsenic concentrations in the investigated vegetables were higher than the maximum levels set by the World Health Organization. Total daily intake of the metals was higher than the maximum levels for consuming vegetables from these markets. Therefore, individuals who consume these foods may be at risk. These results indicate the possibility of toxic metal contamination in vegetables purchased from Zaria markets.

Knowledge and Perception of Paediatric Drug Dosing: Impact of Paediatric Drug Dosing Workshop.

BACKGROUND: Paediatric patients frequently encounter medication errors caused by the requirement for individualised drug dose estimates based on weight, age variance, and drug pharmacokinetics. One thing contributing to drug dosing errors is the lack of healthcare personnel's knowledge of paediatric drug dosing. The present study aimed to evaluate the knowledge and perception regarding the workshop on paediatric drug dosing among undergraduate pharmacy students. METHOD: A prospective pre-post study was conducted. A virtual workshop on paediatric drug dosing was designed and developed by the clinical pharmacy lecturer from Universiti Sultan Zainal Abidin (UniSZA) for pharmacy students. An online questionnaire with 15 questions regarding knowledge of paediatric drug dosing and perception of the virtual workshop on paediatric drug dosing was used to evaluate pharmacy students' knowledge pre- and post-workshop. RESULT: Twenty-six students took part in the study (100%). In the pre-workshop on paediatric drug dosing calculation, most students had poor knowledge of the paediatric drug dosing calculation, scored 8 out of 15, 26.92% between 9 to 11 and only 11.54% scored ≥ 12. There was a statistically significant difference in median knowledge score between pre- and post-workshop (p< 0.05). Among the students, 73.08% stated that they strongly agreed that the online workshop attracted their attention and 76.92% of students strongly agreed that they were able to calculate paediatric drug dosing after joining the online workshop. CONCLUSION: Results demonstrate that pharmacy students have insufficient knowledge of paediatric drug dosing calculations. Virtual workshop is one strategy that could improve the pharmacy students' knowledge.

An Elbow Patch Reconstruction Technique for Narrowed Remnant Portal Veins during Right Lobe Living Donor Hepatectomy: A Rescue Surgery.

Background: Treatment of established portal vein narrowing after living donor hepatectomy is challenging. We aimed to present a new approach termed the "elbow patch reconstruction technique" to correct the narrowed remnant portal vein just or late after right lobe living donor hepatectomy. Methods: Demographic and clinical data of 12 living liver donors with narrowed remnant portal veins and treated with the "elbow patch reconstruction technique" were prospectively collected and retrospectively evaluated. Anatomic variation of the portal vein was defined in accordance with the Nakamura classification; six of the living liver donors had type A, three had type B, and the remaining three had type C. In eight of the living liver donors with a narrowed remnant portal vein, diagnosis was detected by intraoperative Doppler ultrasonography and visual inspection by experienced transplant surgeons in the living donor hepatectomy procedure. In the remaining four living liver donors, diagnosis was performed postoperatively when elevation of liver enzymes was noticed during the routine liver function test and Doppler US. The diagnosis was confirmed by multidetector computed tomography. Results: Data from nine males and three females aged 18 to 54 years were analyzed. All of the living liver donors were followed up for a median of 1710 days (min-max: 1178-4447 days; IQR: 1516 days), and none of the living liver donors had any structural or functional complications in the portal vein. Conclusions: Narrowing remnant portal veins are rare, but they are a life-threatening complication in living liver donors, and this condition requires urgent management. Image guided interventions and narrowed segment resection with end-to-end anastomosis using a vascular graft carried a potential risk for thrombosis and restenosis. To avoid these complications, we shared a technique named "elbow patch reconstruction technique". This technique can be very effective in relieving the narrowing of the remnant portal vein after right lobe living donor hepatectomy.

Computational models for improving surveillance for the early detection of direct introduction of cassava brown streak disease in Nigeria.

Cassava is a key source of calories for smallholder farmers in sub-Saharan Africa but its role as a food security crop is threatened by the cross-continental spread of cassava brown streak disease (CBSD) that causes high yield losses. In order to mitigate the impact of CBSD, it is important to minimise the delay in first detection of CBSD after introduction to a new country or state so that interventions can be deployed more effectively. Using a computational model that combines simulations of CBSD spread at both the landscape and field scales, we model the effectiveness of different country level survey strategies in Nigeria when CBSD is directly introduced. We find that the main limitation to the rapid CBSD detection in Nigeria, using the current survey strategy, is that an insufficient number of fields are surveyed in newly infected Nigerian states, not the total number of fields surveyed across the country, nor the limitation of only surveying fields near a road. We explored different strategies for geographically selecting fields to survey and found that early and consistent CBSD detection will involve confining candidate survey fields to states where CBSD has not yet been detected and where survey locations are allocated in proportion to the density of cassava crops, detects CBSD sooner, more consistently, and when the epidemic is smaller compared with distributing surveys uniformly across Nigeria.

Knowledge of Medical Students Towards the Re-emergence of Human Monkeypox Virus.

INTRODUCTION: Declaration of human monkeypox(HMPX) virus as Public Health Emergency of International Concern (PHEIC) by World Health Organisation (WHO) has raised concerns among the public andlack of knowledge is a prominent challenge in curbing this outbreak. Therefore, assessment ofknowledge level on this outbreak among the medical students is also necessary due to the fact that they are the future healthcare practitioners who will be directly involved in the disease management as well as a major source of knowledge dissemination to the public. AIM: The main objective of this study is to assess the knowledge level of medical students at Universiti Sultan Zainal Abidin (UniSZA) regarding the emergence of HMPX. Additionally, the study aims to investigate potential associations between socio-demographic characteristics and knowledge levels, while also identifying factors that predict a high level of knowledge in this context.. METHODS: A descriptive cross-sectional study was conducted among UniSZA undergraduatemedical students from Year 1 to Year 5. A validated questionnaire comprising six socio-demographic variables and 27 knowledge items was shared online. Descriptive statistics, non-parametric tests and multivariate logistic regression were performed using SPSS software. RESULTS: A total of 138 medical students out of 300 participated in this study. Overall, the average knowledge score was 73.95% ±4.43, which indicates that the medical students have moderate knowledge level. Nearly half of them had good knowledge level (n= 68; 49.3%), 43 of them had moderate knowledge level (31.2%), and 27 of them had poor knowledge level (19.6%). There was a significant association between knowledge level and two factors: receiving information on HMPX during their education and seniority (P-value < 0.01 and P-value < 0.05, respectively). Besides, received information on HMPX during their education was a significant predicting factor of good knowledge level (P-value = 0.002). CONCLUSION: The knowledge level among the medical students was relatively inadequate.

Does mtori base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials.

Recurrence is still a problem after liver transplant for hepatocellular carcinoma (HCC). We performed an updated systematic review and meta-analysis of randomized controlled trials comparing tumor recurrence of mammalian target of rapamycin inhibitors (mTORi) versus Calcineurin inhibitor-based immunosuppression after liver transplantation for HCC. A systematic search was conducted in the following databases: MEDLINE, EMBASE, and Cochrane Central Register of Control Trials databases. The Medical Subject Headings used in the search included: "sirolimus," "everolimus," "mTORi," "HCC," "mTORi," "hepatic transplantation" "randomized controlled trials," and "liver transplantation (LT)". Seven randomized controlled trials were included for meta-analysis. There were a total of 1,365 patients, with 712 of these patients receiving calcineurin inhibitors (CNIs) while 653 had received mTORi. Our meta-analysis revealed that patients that received mTORi-based immunosuppression had superior recurrence-free survival (RFS) at 1 year and 3 years with a hazard ratio of 2.02 and 1.36, respectively. Meta-analysis also showed that within the first 3 years after LT for HCC, patients receiving CNIs-based immunosuppression have a higher recurrence than those receiving mTORi-based immunosuppression. Our meta-analysis revealed that recipients of mTORi-based immunosuppression had a superior OS at 1 year and 3 years. mTORi-based immunosuppression is associated with decreased early recurrence and improved RFS and overall survival.

Outcome of split liver transplantation vs living donor liver transplantation: A systematic review and meta-analysis.

BACKGROUND: The outcomes of liver transplantation (LT) from different grafts have been studied individually and in combination, but the reports were conflicting with some researchers finding no difference in both short-term and long-term outcomes between the deceased donor split LT (DD-SLT) and living donor LT (LDLT). AIM: To compare the outcomes of DD-SLT and LDLT we performed this systematic review and meta-analysis. METHODS: This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The following databases were searched for articles comparing outcomes of DD-SLT and LDLT: PubMed; Google Scholar; Embase; Cochrane Central Register of Controlled Trials; the Cochrane Database of Systematic Reviews; and Reference Citation Analysis (https://www.referencecitationanalysis.com/). The search terms used were: "liver transplantation;" "liver transplant;" "split liver transplant;" "living donor liver transplant;" "partial liver transplant;" "partial liver graft;" "ex vivo splitting;" and "in vivo splitting." RESULTS: Ten studies were included for the data synthesis and meta-analysis. There were a total of 4836 patients. The overall survival rate at 1 year, 3 years and 5 years was superior in patients that received LDLT compared to DD-SLT. At 1 year, the hazard ratios was 1.44 (95% confidence interval: 1.16-1.78; P = 0.001). The graft survival rate at 3 years and 5 years was superior in the LDLT group (3 year hazard ratio: 1.28; 95% confidence interval: 1.01-1.63; P = 0.04). CONCLUSION: This meta-analysis showed that LDLT has better graft survival and overall survival when compared to DD-SLT.

Screening, Surveillance, and Management of Hepatocellular Carcinoma During the COVID-19 Pandemic: a Narrative Review.

PURPOSE: The COVID-19 pandemic has been a burden to the global community as a whole but the healthcare community had bore the brunt of it. The pandemic resulted in policy changes that interfered with effective healthcare delivery. The healthcare community attempted to cope with the pandemic by triaging and prioritizing emergency conditions especially COVID related, ahead of elective conditions like cancer care. There was also fear that patients with cancer were at an increased risk of sever COVID-19 with increased mortality. Hepatocellular carcinoma (HCC) was also affected by these policies. METHODS: We reviewed the modified measures adopted in screening, surveillance, and management of HCC during the pandemic using PubMed, Medline, Index Medicus, EMBASE, SCOPUS, and Google Scholar databases. RESULT: The main modification in surveillance and screening for HCC during the pandemic includes limiting the surveillance to those with very high risk of HCC. The interval between surveillan was also delayed by few months in some cases. The adoption of teleconferencing for multidisciplinary team meetings and patient consultation is one of the highlights of this pandemic all in an effort to reduce contact and spread of the virus. The treatment of early-stage HCC was also modified as needed. The role of ablative therapy in the management of early HCC was very prominent during the pandemic as the surgical therapy was significantly affected by the lacks of ventilators and intensive care unit space resulting from the pandemic. Transplantation, especially living donor liver transplantation, was suspended in few centers because of the risk of infection to the living donors. CONCLUSION: As we gradually recover from the pandemic, we should prepare for the fallout from the pandemic as we may encounter increased presentation of those patients deferred from screening during the pandemic.

Liver Transplantation for Hepatocellular Carcinoma in Patients with Inherited Metabolic Liver Diseases: A Single-Center Analysis.

BACKGROUND/AIMS: Liver transplantation is an acceptable treatment for some selected hepatocellular carcinoma. We report our experience of 6 patients with liver transplantation for hepatocellular carcinoma with background inherited metabolic disease. MATERIALS AND METHODS: This is a single-center retrospective, descriptive study. Consecutive patients who underwent liver transplantation for hepatocellular carcinoma with background inherited metabolic disease were included in the study. The record of the patients was accessed, and the following data were extracted: sociodemographic variables, type of metabolic disease, date of liver transplantation, tumor characteristics, laboratory parameters, Model for End-Stage Liver Disease score, immediate- and long-term outcome after transplantation, disease-free survival, and overall survival. Data were analyzed using Statistical Package for the Social Sciences version 25.0. RESULTS: Six patients received liver transplantation for hepatocellular carcinoma with background inherited metabolic liver disease. The median age was 4.5 years. The median Model for End-Stage Liver Disease score was 29.30. The median maximum tumor diameter was 2.15 cm. Three patients had multiple tumor nodules. Half of the patients had microvascular invasion. Four of the patients had a moderately differentiated tumor. Progressive familial intrahepatic cholestasis type II is the commonest inherited metabolic disease seen in 3 patients. Median follow-up is 46.1 months. Half of the patients are currently more than 5 years post liver transplantation with no features of recurrence. The estimated survival rates at 1, 3, and 5 years are 100%, 83.3%, and 83.3%, respectively. CONCLUSION: Liver transplant for these categories of patients is associated with good disease-free and overall survival, even in the presence of some seemingly poor prognostic features.

Evaluation of the coexistence of pilonidal sinus disease and hirsutism in female patients: a retrospective cross-sectional study.

This study aimed to investigate the coexistence of pilonidal sinus disease (PSD) and hirsutism in female patients. Materials and methods: The demographic and clinical data of 164 female patients who underwent surgery for PSD between January 2007 and May 2014 were evaluated for this retrospective cross-sectional study. Data collected for this study were age, BMI, the modified Ferriman and Gallwey scale (mFGS) for hirsutism, main symptoms, type of surgery, early postoperative complications (wound infection, wound dehiscence), recurrence, and follow-up. The independent variables are hirsutism (mFGS scores) and BMI. Dependent variables are early postoperative complications and recurrence. Results: The median age was 20 years (95% CI for median: 19-21 years). According to the BMI, 45.7, 50.6, and 3.7% of patients were considered normal, overweight, and obese, respectively. According to the mFGS, 11, 9.8, 52.4, and 26.8% of patients were considered to have none, mild, moderate, or severe hirsutism, respectively. Fourteen (8.5%) patients had developed recurrence. Recurrence developed in six patients with primary closure, five patients with Limberg flaps, two patients with Karydakis, and one with marsupialization. There was no statistical difference between recurrent and nonrecurrent patients in terms of BMI (P=0.054) and mFGS (P=0.921). On the other hand, BMI was statistically significantly higher in those who developed early postoperative complications than in those who did not (P<0.001). Conclusion: PSD is no longer a 'men's only disease'. BMI increases the risk of early postoperative complications, but this association was not found between BMI and recurrence. Prospective multicenter studies are needed on the relationship between PSD and hirsutism.

Effect of Pre-Transplant Covid-19 Exposure on Post-Liver Transplant Clinical Outcomes.

BACKGROUND: COVID-19 has led to an unprecedented global health crisis. This situation caused an immediate reduction in solid organ transplantation activity. This study aimed to present the follow-up results of patients with chronic liver disease who underwent liver transplantation (LT) after a history of COVID-19 infection. METHODS: Sociodemographic characteristics and clinicopathological data of 474 patients who underwent LT at Inonu University Liver Transplant Institute between March 11, 2020 and March 17, 2022 were prospectively recorded and analyzed retrospectively. Among these, the data of 35 patients with chronic liver disease who were found to be exposed to COVID-19 infection in the pre-LT period were analyzed for this study. RESULTS: The median body mass index, Child score, and Model for end-stage liver disease/ Pediatric end-stage liver disease scores of the 35 patients were calculated as 25.1 kg/m2 (IQR: 7.4), 9 points (IQR: 4), and 16 points (IQR: 10), respectively. Graft rejection occurred in 4 patients at a median of 25 days post-transplant. Five patients underwent retransplantation at a median of 25 days post-transplant. The most common cause of retransplantation is early hepatic artery thrombosis. There were 5 deaths during postoperative follow-up. Mortality developed in 5 (14.3%) patients exposed to COVID-19 infection in the pretransplant period, whereas mortality occurred in 56 (12.8%) patients not exposed to COVID-19 infection. There was no statistically significant difference in mortality between the groups (P = .79). CONCLUSIONS: The results of this study showed that exposure to COVID-19 before LT does not affect post-transplant patients and graft survival.

Histopathological Features of Gallbladder Specimens Obtained From Liver Recipients.

BACKGROUND: To evaluate the histopathological features of gallbladder specimens obtained from liver transplantation (LT) recipients and to find the correlation between these findings with the clinical features of patients. METHODS: The 1985 patients who underwent LT in our institute between March 2002 and January 2021 and whose data regarding pathologic analysis of gallbladder could retrospectively be obtained were included in the study. The data of the patients including age, gender, the reason for LT (fulminant or nonfulminant), presence of ascites, macroscopic characteristics of gallbladder (the length, diameter, and wall thickness), and microscopic findings were all obtained and analyzed in the present study. RESULTS: A total of 1985 patients (men = 1300 and women = 685) with a median age of 39.4 years were included in this study. LT was performed in 249 patients because of fulminant liver failure, and abdominal ascites were detected in 933 patients during LT. There were statistical differences in terms of age (P < .001), gallbladder length (P < .001). and width (P < .001) among the both gender, but there was no difference in terms of histopathologic characteristics and presence of gallstones. On the other hand, there were significant differences in terms of age (P < .001), gallbladder length (P < .001), width (P < .001), wall thickness (P = .021), presence of gallstones (P < .001), and histopathologic characteristics (P < .001) between the patients with fulminant and nonfulminant liver failure etiologies. Similar results were obtained when characteristics of patients with and without ascites were compared. CONCLUSIONS: This the first study analyzing the histopathological analysis of gallbladder specimens in LT recipients. Chronic liver disease, presence of ascites and gender are the factors affecting the macroscopic and microscopic features of the gallbladder.

Measurement of Heavy Metal and Antioxidant-Oxidant Levels in Tissues Obtained From Three Different Localizations of Explant Hepatectomy of Patients With Hepatocellular Carcinoma.

BACKGROUND: To reveal any difference in terms of heavy metal and antioxidant/oxidant levels of liver tissues obtained from 3 different locations of hepatectomy specimens of patients with hepatocellular carcinoma (HCC). METHODS: Total hepatectomy materials of patients who underwent liver transplantation for HCC were objects of this study. Three liver tissue samples were obtained from each material, one from HCC tissue, one adjacent from the border of HCC, and one at least 3 cm distant from HCC, each 10 × 10 mm in diameter. Samples are preserved at -70°C. Levels of heavy metals (As, Cd, Cu, Mn, Pb, Se, and Zn) and oxidant-antioxidant parameters (catalase, glutathione peroxidase [GSHPx], superoxide dismutase [SOD], nitric oxide, prolidase, glutathione, malondialdehyde, total oxidant status, antioxidant status, oxidative stress index, total-thiol, native thiol, and disulphid) are measured. RESULTS: This study included 22 patients (18 men, 4 women with an age range of 3 to 66 years. There were significant differences in terms of Cd, Pb, Zn, GSHPx, SOD, nitric oxide, and native thiol levels between liver tissues derived from 3 different locations. Cd, Pb, and Zn levels were significantly different in tumor tissues, whereas GSHPx and SOD levels were significantly different in tumor and neighboring tissues. Nitric oxide levels were relatively different in tumor tissues compared with tumor-neighboring tissues. Native thiol levels differed significantly in tumor tissues compared with tissues distant from tumor. CONCLUSIONS: The aim of this study is unique in medical literature, which reveals that the amount of heavy metals and antioxidant/oxidant accumulation are variable in the same liver tissue in different locations because of multiple and yet unknown factors.

Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation Because of Hepatocellular Carcinoma.

BACKGROUND AND AIM: Many clinical studies have shown that the COVID-19 case fatality rate is higher in older patients, those with comorbidities, those with immunosuppressive conditions, and those who stay in the intensive care unit. This study aims to evaluate the clinical outcomes of 66 liver transplant (LT) patients with primary liver cancer who were exposed to COVID-19 infection. METHODS: Demographic and clinical data of 66 patients with primary liver cancer (hepatocellular carcinoma = 64, hepatoblastoma = 1, cholangiocarcinoma = 1) who underwent LT in our institute and were exposed to COVID-19 infection between March 2020 and November 2021 were analyzed in this cross-sectional study. The following data of the patients were recorded: age, sex, body mass index (kg/m2), blood group, underlying primary liver disease, smoking, tumor characteristics, post-transplant immunosuppressive agents, COVID-19 symptoms, hospitalization, intensive care unit stay, intubation, and other clinical features. RESULTS: There were 55 (83.3%) male and 11 (16.7%) female patients, with a median age of 58 years. Sixty-four patients were exposed to COVID-19 only once, whereas the remaining 2 patients were exposed 2 and 4 times, respectively. After exposure to COVID-19, it was determined that 37 patients used antiviral drugs, 25 were hospitalized, 9 were followed in the intensive care unit, and 3 were intubated. One intubated patient was under hospital follow-up because of biliary complications before exposure to COVID-19, and this patient died from sepsis. CONCLUSION: The low mortality rate of LT patients with primary liver cancer exposed to COVID-19 infection can be attributed to background immunosuppression that prevents cytokine storm. However, it is appropriate to support this study with multicenter studies to make strong comments on this issue.

Evaluation of Bone Mineral Metabolism After Liver Transplantation by Bone Mineral Densitometry and Biochemical Markers.

AIM: This study aimed to evaluate the course of bone and mineral metabolism after liver transplantation (LT) in patients with chronic liver disease. METHODS: One hundred four patients who had undergone LT and had a minimum of 6 months of follow-up after LT were included in this prospective cohort study. The following parameters were evaluated for each patient: preoperative and postoperative (postoperative day [POD]30, POD90, POD180) osteocalcin, bone-specific alkaline phosphatase (BALP), type 1 collagen, beta-C-terminal end telopeptide (ß-CTx), vitamin D, parathyroid hormone (PTH), ALP, calcium, phosphate, sedimentation, and bone mineral densitometer scores (L2, L4, L total, and F total). The parameters were compared in terms of sex, presence of liver tumor (hepatocellular carcinoma [HCC; n = 19] vs non-HCC [n = 85]), and presence of autoimmune liver disease (autoimmune liver disease [ALD; n = 8] vs non-ALD [n = 96]). RESULTS: The median age of the patients (n = 81 men and n = 23 women) was 52 years (95% CI, 50-56). There was a significant change in the defined time intervals in parameters such as osteocalcin (P < .001), BALP (P < .001), ß-CTx (P < .001), vitamin D (P < .001), PTH (P < .001), ALP (P = .001), calcium (P < .001), phosphate (P = .001), L2 (P = .038), L total (P = .026), and F total (P < .001) scores. There was a significant difference in POD90 ALP (P = .033), POD180 calcium (P = .011), POD180 phosphate (P = .011), preoperative sedimentation (P = .032), and POD180 F total (P = .013) scores between both sexes. There was a significant difference in POD180 osteocalcin (P = .023), POD180 ß-CTx (P = .017), and preOP calcium (P = .003) among the HCC and non-HCC groups. Furthermore, we found significant differences in preoperative ALP (P = .008), preoperative sedimentation (P = .019), POD90 (P = .037) and POD180 L2 (P = .005) scores, preoperative (P = .049) and POD180 L4 (P = .017), and POD180 L total (P = .010) and F total (P = .022) scores between the patients with and without ALD. CONCLUSION: This study shows that the bone and mineral metabolism of the LT recipients was negatively affected after LT. In addition, we showed that bone and mineral metabolism was more prominent in patients with HCC, and bone mineral density scores were higher in patients with ALD.

Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study.

BACKGROUND: In liver transplant (LT) recipients, immunosuppressive therapy may potentially increase the risk of severe COVID-19 and may increase the mortality in patients. However, studies have shown conflicting results, with various studies reporting poor outcomes while the others show no difference between the LT recipients and healthy population. The aim of this study is to determine the impact of the COVID-19 pandemic on survival of LT recipients. METHODS: This is a retrospective cohort study analyzing the data from 387 LT recipients diagnosed with COVID-19. LT recipients were divided into two groups: survival (n = 359) and non-survival (n = 28) groups. A logistic regression model was used to determine the independent risk factors for mortality. Machine learning models were used to analyze the contribution of independent variables to the mortality in LT recipients. RESULTS: The COVID-19-related mortality rate in LT recipients was 7.2%. Multivariate analysis showed that everolimus use (p = 0.012; OR = 6.2), need for intubation (p = 0.001; OR = 38.4) and discontinuation of immunosuppressive therapy (p = 0.047; OR = 7.3) were independent risk factors for mortality. Furthermore, COVID-19 vaccination reduced the risk of mortality by 100 fold and was the single independent factor determining the survival of the LT recipients. CONCLUSION: The effect of COVID-19 infection on LT recipients is slightly different from the effect of the disease on the general population. The COVID-19-related mortality is lower than the general population and vaccination for COVID-19 significantly reduces the risk of mortality.

Development of Hausa dataset a baseline for speech recognition.

The Hausa language read-speech dataset was created by recording native Hausa speakers. The recording took place at Nile university of Nigeria audio studio and radio broadcasting studio. The recorded dataset was segmented into unigram and bigram. The Hausa speech dataset contain 47hr of recorded audio speech. The dataset can be used for automatic speech recognition, speech synthesis, Text-to-Speech and speech-to-text application.

Assessment of head CT protocol to reduce the radiation dose in eye lens in some selected hospital in Kaduna State, Nigeria.

The lens of the eye are very sensitive to radiation and mostly exposed to scattered radiation during the Computed Tomography (CT) procedure. The study measures the absorbed doses to the lens of the eye and proposed a diagnostic reference level for head examination by comparing the current research result with the international standard. The incurred doses of 62 patients who undergone head and neck CT procedure were measure using thermoluminescent dosimeters (TLD-100), the protocols adopted in the study were brain (sequential and spiral), sinus (sequential and spiral), and neck-brain (spiral). The scanning parameters were CT dose index (CTDI), dose length product (DLP), tube current-exposure time product (mAs), kilovoltage peak (kVp), pitch factor, for each patient were recorded. The patients were divided into two age groups (½ to 17) years for Pediatric and >18 years for adult patient, TLD chips were placed on the patient's skin surface at two different locations to measure the absorbed dose of the lens of the eye. The mean dose and standard deviation to left and right eye lens for Hospital A, for Paediatrics Patients were (left 5.29 ± 7.32 mGy, right 5.73 ± 8.9O mGy), Adult Patients (left 5.74 ± 9.23 mGy, right 4.78 ± 6.11 mGy), Hospital B Paediatrics (left 5.08 ± 9.06 mGy, right 2.82 ± 2.67 mGy) Adult (left 0.26 ± 0.07 mGy, right 0.48 ± 0.08 mGy), Hospital C Paediatrics (left 8.95 ± 15.20 mGy, right 7.32 ± 6.14 mGy) Adult (left 6.41 ± 4.15 mGy, right 7.24 ± 5.69 mGy). Threshold recommended by International Commission on Radiological Protection (ICRP) for lens of the eye damage, it appears to be clinically safe. While CT scan remains a crucial tool, further dose reduction can be achieved by controlling different factors affecting patient doses.