Hidden resilience and adaptive dynamics of the global online hate ecology.

Online hate and extremist narratives have been linked to abhorrent real-world events, including a current surge in hate crimes1-6 and an alarming increase in youth suicides that result from social media vitriol7; inciting mass shootings such as the 2019 attack in Christchurch, stabbings and bombings8-11; recruitment of extremists12-16, including entrapment and sex-trafficking of girls as fighter brides17; threats against public figures, including the 2019 verbal attack against an anti-Brexit politician, and hybrid (racist-anti-women-anti-immigrant) hate threats against a US member of the British royal family18; and renewed anti-western hate in the 2019 post-ISIS landscape associated with support for Osama Bin Laden's son and Al Qaeda. Social media platforms seem to be losing the battle against online hate19,20 and urgently need new insights. Here we show that the key to understanding the resilience of online hate lies in its global network-of-network dynamics. Interconnected hate clusters form global 'hate highways' that-assisted by collective online adaptations-cross social media platforms, sometimes using 'back doors' even after being banned, as well as jumping between countries, continents and languages. Our mathematical model predicts that policing within a single platform (such as Facebook) can make matters worse, and will eventually generate global 'dark pools' in which online hate will flourish. We observe the current hate network rapidly rewiring and self-repairing at the micro level when attacked, in a way that mimics the formation of covalent bonds in chemistry. This understanding enables us to propose a policy matrix that can help to defeat online hate, classified by the preferred (or legally allowed) granularity of the intervention and top-down versus bottom-up nature. We provide quantitative assessments for the effects of each intervention. This policy matrix also offers a tool for tackling a broader class of illicit online behaviours21,22 such as financial fraud.

Collective influencers in protein interaction networks.

Recent research increasingly shows the relevance of network based approaches for our understanding of biological systems. Analyzing human protein interaction networks, we determined collective influencers (CI), defined as network nodes that damage the integrity of the underlying networks to the utmost degree. We found that CI proteins were enriched with essential, regulatory, signaling and disease genes as well as drug targets, indicating their biological significance. Also by focusing on different organisms, we found that CI proteins had a penchant to be evolutionarily conserved as CI proteins, indicating the fundamental role that collective influencers in protein interaction networks plays for our understanding of regulation, diseases and evolution.

Traumatic Anterior Dislocation of Hip in a Child - Case Report.

Traumatic hip dislocation in children is relatively rare accounting for about 5% of all hip dislocations. Most of the hip dislocations seen in children are of the posterior type but the much rarer anterior and anterior-inferior (obturator) types have also been described. We present the case of an eight years old girl with an obturator type of hip dislocation following trivial trauma. She was treated with closed reduction and immobilisation in skin traction for three weeks. She was followed up closely for one year and did not develop any complications during that period.

Factors determining non-compliance to mass drug administration for lymphatic filariasis elimination in endemic districts of Nepal.

BACKGROUND: Mass drug administration (MDA) has been implemented in Nepal since 2003 for elimination of Lymphatic Filariasis (LF). The objective of this study was to explore the factors that determine the non-compliance to MDA for Lymphatic Filariasis elimination in endemic districts of Nepal. METHODS: A cross-sectional descriptive study was carried out in three endemic districts namely Dhading, Kapilvastu and Kailali. A total of 900 people were interviewed with structured questionnaire. RESULTS: The result shows that the respondents who knew the DEC contains Albendazole (84.9% vs 42.5%, P<0.001, Adjusted OR=2.89(1.946-4.29) at 95% CI), who were aware of MDA campaign (78.2% vs 33.8% P<0.001, Adjusted OR=2.87(1.73-4.74) at 95% CI), who were visited by health workers at their home during MDA campaign (75.9% vs 24.1% P<0.001, Adjusted OR=4.85(2.448-9.594) at 95% CI) had significantly higher compliance. The respondents who had knowledge of side effects during MDA campaign had lower prevalence of non-compliance as compared who did not have (9.4% vs 33.2%, P<0.001). CONCLUSIONS: Advanced age, primary or below education, ever married, inadequate knowledge on drug, inadequate awareness on MDA, no home visit by health workers during MDA, no belief on MDA drugs were significantly associated with higher non-compliance to MDA. In future, MDA program should focus on awareness campaigns related to composition of drugs, side effects of drugs and compulsory home visit during the campaign.

Reduced susceptibility to vancomycin in methicillin resistant staphylococcus aureus: a time for action.

Infections by Methicillin resistant Staphylococcus aureus (MRSA) is an often encountered therapeutic challenge. The problem is accentuated by the emergence of MRSA strains which are resistant to Vancomycin, the recommended agent for the treatment of MRSA infections. We therefore carried out this study to determine the MIC values ofvancomycin for the MRSA isolated from different clinical specimens in Nepal Medical College. MICs were determined by agar dilution method. Out of the 82 MRSA isolates tested, 18 showed MIC of 2 µg/ml and 29 isolates had MIC of 1 µg/ml and 35 isolates had MIC of 0.5 µg/ml. Although none had a MIC in the intermediate or resistant zone, 18 (2.9%) had MIC in the upper limit of the sensitive zone which is a matter of concern and calls for prompt preventive actions.

Posterior lumbar interbody fusion for the management of spondylolisthesis.

The ideal surgical treatment of spondylolisthesis still remains controversial. There are several methods of treatment and posterior lumbar interbody fusion (PLIF) is one of them. We analyze the results of spondylolisthesis treated by PLIF in term of radiological union, improvement of pre-operative symptoms like back pain, radiating pain and return to normal activities including that of employment, by the review of the medical records. Total of 72 patients, 20 male and 52 female and the age ranges from 15 to 68 years with the mean age being 44.38 years were included in the study. Thirty (41.66%) patients had isthmic spondylolisthesis, 26 (36.12%) had congenital spondylolisthesis, and 16 (22.22%) cases had degenerative spondylolisthesis. There were 38 (52.77%) cases of grade I, 14 (19.44%) cases of grade II and 20 (27.77%) cases of grade III according to the grading criteria of Meyerding. According to the evaluation criteria used by Stauffer and Coventry, 59 patients (81.94%) got good results, eight patients (11.11%) belonged to the fair group and five cases (6.94%) had the poor results. This study showed that PLIF is one of the effective and reliable techniques for the management of spondylolisthesis.

Subperiosteal osteoid osteoma of the neck of talus.

Juxta-articular, subperiosteal osteoid osteomas arising around the ankle are unusual. Tumors arising on the neck of the talus commonly produce symptoms mimicking monoarticular arthritis. Patients are usually treated for arthritis or ankle sprain, which often leads to a delay in definitive diagnosis. Here we present a case of osteoid osteoma of neck of talus which was presented as ankle pain. It puzzled us until MRI was done. Diagnostic dilemma and delay can be avoided by high index of suspicion. The patient was treated with open removal of the tumor. We also present brief review of literature about juxta-articular, subperiosteal osteoid osteoma which is uncommon from the typical osteoid osteoma occurring elsewhere in the body.

Manipulation under local anesthesia in idiopathic frozen shoulder--a new effective and simple technique.

Manipulation under anesthesia has been used to speed up the recovery of frozen shoulder (FS), which is said to be a self-limiting disease. This is a randomized prospective clinical trial performed in a tertiary care hospital. Thirty-one patients with idiopathic unilateral frozen shoulder underwent suprascapular nerve block and intraarticular local anesthesia with Methyl prednisolone acetate followed by manipulation of the glenohumeral joint. Differences in range of motion and pain were assessed before manipulation and at 7 days 6 weeks and 12 weeks. Passive range of motion increased significantly for abduction, external rotation, and internal rotation. Significant decrease in visual analogue pain (VAS) scores between initial and follow-up assessments was observed. Our results revealed that manipulation under suprascapular nerve block and intra-articular local anesthesia is a very simple, safe, cost effective and minimally invasive procedure for shortening the course of an apparently self-limiting disease and can improve shoulder function and symptoms quickly.

Bony hydatid disease of superior pubic ramus with extension into pelvis and proximal thigh.

Hydatid disease is caused by the tapeworm of genus ;Echinococcus. Genus Echinococcus has different species including Echinococcus vogeli, Echinococcus granulosus and Echinococcus multilucularis. Echinococcus granulosus is the most common cause of hydatid disease in humans. This disease can take place either directly through ingestion of parasite eggs from contact with infected dogs or indirectly from the ingestion of contaminated water or food. Infestation of hydatid disease in humans most commonly occurs in the liver (55-70%), followed by the lungs (18-35%). Bone hydatidosis however is very rare,whenever it occurs; it is usually secondary to visceral involvement. We present herein a case of primary hydatid cyst involving superior pubic ramus in a 43 years male patient, which is not a common site for the occurrence of this disease. Diagnosis is usually delayed if high index of suspicion is not there. MRI is a good tool for reaching diagnoses.

Outcome of supracondylar fractures of the humerus in children treated by closed reduction and percutaneous pinning.

Supracondylar fractures of humerus in children are common injuries. Displaced fractures are inherently unstable. Conservative treatment results in malunion. Open reduction and internal fixation (ORIF) is more invasive and recovery is prolonged. From September 2004 to September 2005, 102 displaced supracondylar fractures of humerus, aged between one and half year to 13 years, were treated using close reduction and percutaneous Kirschner (K) wire fixation under c-arm fluoroscopy. Seventy nine patients were treated by cross K-wires and in twenty three cases lateral two K-wires were put. Above elbow plaster of paris back slab was applied in all cases for at least four weeks. Back slab, K-wires were removed after four weeks and elbow range of motion exercise was started. Results were analyzed using Flynn's criteria. All patients were followed up to 14th week postoperatively. In cross K-wire group(N=79) 70.8% had excellent, 22.7% good, 3.8% fair and 2.5% had poor results at eight weeks follow up which was improved to 91.1% excellent, 6.3 good, 1.2% fair and 1.26% poor results at 14 weeks follow up. In lateral K-wire group (N=23) 70% had excellent, 21.7% good, 4.3% fair and 4.3% had poor result at eighth week which was improved to 91.3% excellent, 4.3% good, 4.3% fair and no poor result at 14th week follow up. Eight patients got superficial pin tract infection and seven patients sustained ulnar nerve injury post operatively. We recommend this procedure for displaced supracondylar fractures in children as it is safe and cost effective procedure with acceptable complication rates.

Bilateral slipped capital femoral epiphysis: a case report and review of literature.

Slipped capital femoral epiphysis (SCFE) is a common adolescent problem in the western populations but it is extremely rare in the Asian regions. We report a case management of a teen age boy (16 years old at the time of operation) with bilateral SCFE. After fall injury, the boy sustained SCFE on the left side and was treated. Again after six months with trivial injury he got SCFE on the right side. In both cases the boy was managed by closed reduction and percutaneous cannulated cancelleous screws fixation under c-arm fluoroscopy control. The cannulated screws were removed after one year of insertion confirming of a good fusion in plain x-ray films. During the regular follow up of up to one year the patient had good hip functions and other daily activities. The patient lost to follow up for about three years and suddenly presented to us with restricted hip joints movements and other activities. The x-ray showed tilted pelvis, reduced, incongruent hip joint spaces with malunited femoral physis, widened neck and tilted femoral head along with visible physeal scan on both sides. The patient and patient party are still satisfied with these results and reluctant to go for further surgical intervention.

Histological changes of the skeletal muscle due to muscle tension: a study in rats.

OBJECTIVE: To analyze the influence of muscle tension in the histological changes of the skeletal muscle. METHODS: Fifty-four Sprague-Dawley (SD) rats were randomly divided into 3 groups. The left gastrocnemius muscles of the rats were dissected with only the neurovascular pedicles intact; the tibial nerves were cut and immediately repaired by epineurial suture. Then the Achilles tendons were isolated and treated accordingly; the Achilles tendon were lengthened by 0.5 cm in lengthened group, shortened by 0.5 cm in shortened group and left alone in normal (control) group. In the 2nd, 4th and 8th weeks after operation, the specimens were taken from gastrocnemius muscle for histological study by light and electron microscope. RESULTS: In comparison between the groups, the gastrocnemius muscles in the shortened group showed less severe muscle atrophy and connective tissue proliferation, bigger diameter and cross section area of the muscle fibre than those in the normal and lengthened groups in all the postoperative periods. CONCLUSION: A proper high tension of the muscle may decrease the muscle dystrophy and stops the histological changes of skeletal muscle by having much longer fibre length and bigger cross sectional area. Also increases the muscle function as the muscle active force-generating range is determined by muscle fibre length, while maximum muscle force is determined by physiologic cross-sectional area.