Measures of Adrenal and Gonadal Hormones in Relation to Biological and Management Factors among Captive Red Pandas in Indian Zoos.

Animals in human care are affected by stressors that can ultimately reduce fitness. When reproduction is affected, endangered species conservation programs can be severely compromised. Thus, understanding factors related to stress and reproduction, and related hormones, is important to ensure captive breeding success. Red pandas (Ailurus fulgens) are endangered, and populations in the wild are threatened with extinction. A global captive breeding program has been launched to conserve the species with the goal of reintroduction. However, there is little information on how stressors impact physiological aspects of the species. This study measured fecal glucocorticoid (fGCM), progestagen (fPM), and androgen (fAM) metabolite concentrations in 12 female and 8 male red pandas at 3 zoos in India to determine predictors of adrenal and gonadal steroid activity, and the influence of fGCM on reproduction. Based on the generalized linear mixed model (GLMM), fGCM concentrations were positively correlated with the number of visitors, number of nests and enclosure areas, and negatively related to frequency of feedings, log density, and social time, while fPM concentrations were negatively associated with enclosure areas. A confounder for enclosure areas and number of nests was the fact that these spaces were relatively barren, with limited hiding spaces, compared to the smaller enclosures. By contrast, no significant relationships were found for fAM, perhaps due to the smaller sample size. A negative relationship between fGCM and fPM was observed, indicating increasing adrenal hormones may decrease reproductive function among female red pandas. Results suggest that zoo management should consider increasing feeding frequency, providing larger enclosures with more enrichment and more nests in larger spaces, and regulating visitor numbers to support good welfare and potentially improve reproductive fitness of red pandas in captivity.

Pediatric Mortality and Acute Kidney Injury Are Associated with Chloride Abnormalities in Intensive Care Units in the United States: A Multicenter Observational Study.

Our objective was to determine in children in the intensive care unit (ICU) the incidence of hyperchloremia (>110 mmol/L) and hypochloremia (<98 mmol/L), the association of diagnoses with chloride abnormalities, and the associations of mortality and acute kidney injury (AKI) with chloride abnormalities. We analyzed the initial, maximum, and minimum chloride measurements of 14,684 children in the ICU with ≥1 chloride measurement in the Health Facts database between 2009 and 2016. For hyperchloremia and hypochloremia compared with normochloremia, mortality rates increased three to fivefold and AKI rates increased 1.5 to threefold. The highest mortality rate (7.7%; n = 95/1,234) occurred with hyperchloremia in the minimum chloride measurement group and the highest AKI rate (7.7%; n = 72/930) occurred with hypochloremia in the initial chloride measurement group. The most common diagnostic categories associated with chloride abnormalities were injury and poisoning; respiratory; central nervous system; infectious and parasitic diseases; and endocrine, nutritional, metabolic, and immunity disorders. Controlled for race, gender, age, and diagnostic categories, mortality odds ratios, and AKI odds ratios were significantly higher for hyperchloremia and hypochloremia compared with normochloremia. In conclusion, hyperchloremia and hypochloremia are independently associated with mortality and AKI in children in the ICU.

Predictors of psychological stress and behavioural diversity among captive red panda in Indian zoos and their implications for global captive management.

At high elevations, biodiversity is at elevated risk from extinctions due to rapid environmental changes. In the most of its range in Himalayas, the red panda, an endangered species, is struggling to survive in the wild, and a global captive breeding programme has been launched to conserve the species. Because captivity can have negative impacts on animals, reducing the chance of successful reintroduction, we investigated the predictors of stereotyped behaviour and behavioural diversity of red panda (n = 26), and the effect of stereotypy on their behavioural diversity in three Indian zoos. Multivariate analysis showed that stereotypy increased with density of logs on the ground, age and higher among pandas in zoo 3 compared to zoo 2, but decreased with number of nests, sociality, tree density and tree height used. Similarly, behavioural diversity increased with log density, but decreased among pandas in zoo 2 compared to zoo 1, during summer compared to winter, and also with ambient temperature, stereotypy, tree density, and tree height used. The relationship between stereotypy and behavioural diversity was negative, but not significant. Provision of a greater density of trees was associated with higher levels of daytime inactivity. Findings from this study have global relevance, as the captive red panda experiences similar welfare issues around the world, and our data provide empirical support for some existing guidelines for red panda husbandry.

C5b-9-activated, K(v)1.3 channels mediate oligodendrocyte cell cycle activation and dedifferentiation.

Voltage-gated potassium (K(v)) channels play an important role in the regulation of growth factor-induced cell proliferation. We have previously shown that cell cycle activation is induced in oligodendrocytes (OLGs) by complement C5b-9, but the role of K(v) channels in these cells had not been investigated. Differentiated OLGs were found to express K(v)1.4 channels, but little K(v)1.3. Exposure of OLGs to C5b-9 modulated K(v)1.3 functional channels and increased protein expression, whereas C5b6 had no effect. Pretreatment with the recombinant scorpion toxin rOsK-1, a highly selective K(v)1.3 inhibitor, blocked the expression of K(v)1.3 induced by C5b-9. rOsK-1 inhibited Akt phosphorylation and activation by C5b-9 but had no effect on ERK1 activation. These data strongly suggest a role for K(v)1.3 in controlling the Akt activation induced by C5b-9. Since Akt plays a major role in C5b-9-induced cell cycle activation, we also investigated the effect of inhibiting K(v)1.3 channels on DNA synthesis. rOsK-1 significantly inhibited the DNA synthesis induced by C5b-9 in OLG, indicating that K(v)1.3 plays an important role in the C5b-9-induced cell cycle. In addition, C5b-9-mediated myelin basic protein and proteolipid protein mRNA decay was completely abrogated by inhibition of K(v)1.3 expression. In the brains of multiple sclerosis patients, C5b-9 co-localized with NG2(+) OLG progenitor cells that expressed K(v)1.3 channels. Taken together, these data suggest that K(v)1.3 channels play an important role in controlling C5b-9-induced cell cycle activation and OLG dedifferentiation, both in vitro and in vivo.

First documented reinfection of SARS-COV-2 in second wave from Pakistan.

Little is known about the pathophysiology and immunology of Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). It is not yet clear whether SARS-CoV-2 infection produces long-term immune protection, or a short-lived immunity that would fade with the passage of time. We report a first case of SARS-CoV-2 reinfection in second wave from Pakistan. A 41-year-old male, health care worker developed flu-like illness, tested positive on 6th June 2020 and became PCR negative on 19th June 2020 with reactive antibodies. After 4 months and 13 days of negative PCR, he developed symptoms again and tested positive for SARS-CoV-2 with non-reactive antibodies.

Emergency room endotracheal intubation in children with bronchiolitis: A cohort study using a multicenter database.

BACKGROUND AND AIMS: Bronchiolitis and asthma have a clinical overlap, and it has been shown that pediatric intensive care unit (PICU) patients with asthma undergoing endotracheal intubation in a community hospital emergency room (ER) have a shorter duration of mechanical ventilation (MV) and PICU length of stay (LOS) vs children undergoing intubation in a children's hospital. We aimed to determine if the setting of intubation (community vs children's hospital ER) is associated with the duration of MV and PICU LOS among children with bronchiolitis. METHODS: With IRB approval, data in the Virtual Pediatric Systems (VPS, LLC) database were queried for bronchiolitis patients <24 months of age admitted to one of 103 predominantly North American PICUs between 1/2009 and 1/2016 who had an endotracheal tube in place at PICU admission. There were no exclusion criteria. Extracted data included ER type (community/external or children's hospital/internal), demographics, and reported comorbidities. Outcomes analyzed were duration of MV and PICU LOS. Multivariable linear regression was used to evaluate if intubation location was independently associated with the outcomes of interest. RESULTS: Among 1934 patients, median age was 2.0 (IQR: 1.0-4.8) months, 51% were admitted from an external ER, 41% were White, 61% were male, and 28% had ≥1 comorbidity. Median duration of MV was 6.6 (4.6-9.5) days and the median PICU LOS was 7.0 (4.6-10.6) days. Children who underwent endotracheal intubation in a children's hospital ER had a modestly longer duration of MV (6.7 [4.4-9.4] vs 6.5 [5.2-9.6] days, P < .001, Mann-Whitney U) and longer PICU LOS (7.2 [4.8-10.8] vs 6.9 [4.2-10.1] days, P = .004, Mann-Whitney U). After adjusting for confounding variables, we did not observe a significant association between the location of endotracheal intubation and duration of MV or PICU LOS. CONCLUSION: In this cohort, and unlike outcomes of near-fatal asthma, we observed that clinical outcomes of critical bronchiolitis were similar regardless of location of endotracheal intubation.

Low-Cost Carbon Fillers to Improve Mechanical Properties and Conductivity of Epoxy Composites.

In recent years, low-cost carbons derived from recycled materials have been gaining attention for their potentials as filler in composites and in other applications. The electrical and mechanical properties of polymer composites can be tuned using different percentages and different kind of fillers: either low-cost (e.g., carbon black), ecofriendly (e.g., biochar), or sophisticated (e.g., carbon nanotubes). In this work, the mechanical and electrical behavior of composites with biochar and multiwall carbon nanotubes dispersed in epoxy resin are compared. Superior mechanical properties (ultimate tensile strength, strain at break) were noticed at low heat-treated biochar (concentrations 2⁻4 wt %). Furthermore, dielectric properties in the microwave range comparable to low carbon nanotubes loadings can be achieved by employing larger but manageable amounts of biochar (20 wt %), rending the production of composites for structural and functional application cost-effective.

Spaghetti wrist: management and outcome.

OBJECTIVE: To determine the outcome of emergency management of the spaghetti wrist. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of General Surgery, Sir Ganga Ram Hospital Lahore, Pakistan, from January 2000 to December 2003. PATIENTS AND METHODS: During this period, all patients of more than 12 years, with sharp clean cut volar forearm lacerations (spaghetti wrist) of <6 hours were included, with a follow-up of one year, clinically and with nerve conduction studies, where appropriate. Sensory and motor recovery was evaluated according to S0-S4 and MRC (medical research council) scale respectively. The power of first dorsal interosseous and adductor pollicis was used to monitor the recovery of ulnar nerve; and abductor pollicis brevis and opponens pollicis for the median nerve. The tendon recovery was evaluated by Strickland Adjusted System Score. RESULTS: This study comprised of 10 patients (M:F, 4:1), of 14 to 38 years (mean 22.9 years). Injury was accidental in 70%; due to broken glass in 50% and kite string in 40%; involving right hand in 70%. 8.2 (4-12) structures per patient were involved. The injury involved median nerve in 70%, ulnar nerve in 60%, (30% had both nerves involved), flexor carpi ulnaris in 70%. There was predilection of injury for medial structures. In 80%, wrist flexors were involved, and all wrist joints recovered to the full range of movements and power. The ulnar nerve showed less total motor and sensory recovery than median nerve. However, sensory and motor recovery was good. Overall functional results were good and did not correlate with neurophysiological studies. CONCLUSION: Immediate primary repair is safe and has good outcome, which also depends upon good physiotherapy, close follow-up and patients' compliance. Overall clinical and functional assessment is more appropriate than series of individual observations and neurophysiological studies.

Non-academic attributes of hidden curriculum in medical schools.

OBJECTIVE: To identify the non-academic attributes developed during 5 years of training in medical school. STUDY DESIGN: Sequential mixed method. PLACE AND DURATION OF STUDY: The study was conducted on final year medical students of four medical colleges in the city of Lahore, from March to September 2010. METHODOLOGY: Probability random sampling was employed to identify public sector medical colleges for inclusion in the study through Lottery method. In the first phase, survey was done with the help of questionnaires, distributed amongst 280 students, selected on the basis of convenience sampling. It was triangulated with data collected by in-depth structured interviews on 46 students selected using purposive sampling after formal informed consent. For quantitative data percentages of the categorical variables were calculated through SPSS version 10. For qualitative data, themes and patterns were identified using Content Analysis technique. RESULTS: Majority of the medical students (80%) learn the attributes of integrity, self-reliance, tolerance and independence during their schooling. Sixty five percent students thought that the values of humanity, forbearance, righteous attitude in face of adversities and sympathetic behaviour towards peers and patients helped them in being better medical students. Thirty five percent said they faced the negative influences of gender bias and gender discrimination which has led to their impaired professional growth. Eighty percent of the students believe that the teaching methodology employed is teacher centric which does not let them become problem solvers, team players, reflective learners and hampers development of effective communication skills. CONCLUSION: Medical schooling in our part of the world helps in developing untaught attributes such as integrity, selfreliance, tolerance, independence, sympathetic attitude and good communication skills which are the same as are developed in the medical students of advanced countries, which can be fostered further by formally addressing them in the curriculum.