Evaluation of Clostridium autoethanogenum protein as a new protein source for broiler chickens in replacement of soybean meal.

OBJECTIVE: The object of this study was to investigate the effect of replacing soybean meal with Clostridium autoethanogenum protein (CAP) in broiler diets on growth performance, blood indicators, antioxidant capacity, and immune function. METHODS: A total of 180 Arbor Acres broilers were randomly divided into three treatments, each treatment with six replicates and 10 broilers per replicate for a 42-day feeding trial. The control group (CON) was fed corn-soybean meal based diet. The CAP-1 and CAP-2 groups were considered to use CAP to replace 25% or 50% of soybean meal in the diet, respectively. The average daily gain and average daily feed intake of broilers at 1 to 21 d, 22 to 42 d, and 1 to 42 d were measured, and the feed conversion ratio was calculated. At the 42nd day of age, two broilers with similar weights and fasted for 12 h were selected in each replicate for blood collection from the brachial wing vein. The blood routine indicators, serum biochemical indicators, serum antioxidant capacity, and immunoglobulin content of broiler chickens were measured. RESULTS: Replacement of soybean meal with 25% (CAP-1) and 50% (CAP-2) CAP significantly increased the average daily gain of 22 to 42 d and 1 to 42 d and decreased the average daily feed intake and feed conversion rate (p<0.05). The CAP-1 group, and CAP-2 group significantly increased hemoglobulin in the blood of broilers, while the CAP-2 group increased hematocrit content (p<0.05). Compared with the control group, the contents of superoxide dismutase and immunoglobulin A in serum of the CAP-2 group were significantly increased, while the contents of malondialdehyde in CAP group were significantly decreased (p<0.05). CONCLUSION: Replacing soybean meal with CAP led to significant improvements in the growth performance, antioxidant capacity, and immunoglobulin content of broilers.

Management of Tacrolimus-Induced Toxicity With Normal Serum Levels After Liver Transplant.

Drug-induced liver injury after liver transplant occurs in 1.7% of patients. Tacrolimus is an effective immunosuppressant that is used to treat acute rejection. Although rare, it can cause toxicity, which is demonstrated by cholestatic liver injury. Here, we present a case of a young male patient who was diagnosed with Wilson disease, had penicillaminechelating therapy, and underwent living related liver transplant. Within 1 month posttransplant, he developed deranged, predominantly cholestatic pattern liver function tests. Laboratory parameters showed total bilirubin of 1.12 mg/ dL, alanine aminotransferase of 553 IU/L, gammaglutamyltransferase of 624 IU/L, and tacrolimus level of 10.2 ng/mL. After thorough evaluation, a liver biopsy was performed. Liver biopsy showed hepatocellular necrosis with centrilobular cholestasis without any evidence of graft rejection. However, with normal level of tacrolimus, the biopsy was suggestive of drug-induced liver injury. Thus, tacrolimus dose was reduced, resulting in improved liver function tests and patient discharge from the hospital. Tacrolimus is an effective immunosuppressant after liver transplant and has the ability to treat early acute rejection. The patient's liver biopsy showed hepatocellular necrosis with centrilobular cholestasis without any evidence of graft rejection. Cholestatic liver injury after tacrolimus usually resolves after dose reduction or by switching to another agent. With demonstrated tacrolimus-induced toxicity in liver transplant recipients, despite normal serum levels, transplant physicians should keep high index of suspicion regarding toxicity in the posttransplant setting.

Enhancing the Production Performance and Nutrient Utilization of Laying Hens by Augmenting Energy, Phosphorous and Calcium Deficient Diets with Fungal Phytase (Trichoderma reesei) Supplementation.

A ten-week trial was conducted to evaluate the enhancement of production performance and nutrient utilization of laying hens through augmenting energy, phosphorous, and calcium deficient diets with fungal phytase (Trichoderma reesei) supplementation. 720 Hy-line Brown hens aged 28 weeks were randomly divided into 5 groups; each group had 8 replicates of 18 hens. Five experimental diets were prepared and fed to corresponding groups. A positive control (PC) diet contained 3.50% of calcium (Ca), 0.32% of non-phytate phosphorus (NPP), and apparent metabolic energy (AME) of 11.29MJ/kg, while a negative control (NC) diet contained 3.30% of Ca, 0.12% of NPP, and lower AME of 300 kJ/kg. The other three diets were supplemented with 250 FTU/kg phytase (PHY-250), 1000 FTU/kg phytase (PHY-1000), and 2000 FTU/kg phytase (PHY-2000) in addition to a regular NC diet. Results indicated that the positive control (PC) diet group had higher body weight gain, egg weight, and average daily feed intake. However, laying rate, egg mass, and FCR were most improved in the PHY-2000 group, followed by the PHY-1000 and PHY-250 groups (p < 0.05). Improved yolk color was most notable in laying hens fed the diet with PHY-1000 as opposed to the PC and NC groups (p < 0.05), but no overall difference was found among all of the phytase treated groups. The apparent availability of dry matter, energy, phosphorus, and phytate P was significantly higher in the PHY-2000 group than in the PC and NC groups (p < 0.05). Compared to the PC group, nitrogen retention was significantly higher in the PHY-1000 group, while calcium availability was higher in the PHY-250 group. The results suggested that the addition of phytase to diets with low P, Ca, and AME improved laying performance and apparent availability of dietary nutrients. Thus, it was concluded that the laying hen diet could be supplemented with 1000-2000 FTU/kg phytase for improving laying production and nutrient availability and mitigating the negative impact of reduced nutrient density in laying hen diets.

A patient-specific functional module and path identification technique from RNA-seq data.

With the advancement of new technologies, a huge amount of high dimensional data is being generated which is opening new opportunities and challenges to the study of cancer and diseases. In particular, distinguishing the patient-specific key components and modules which drive tumorigenesis is necessary to analyze. A complex disease generally does not initiate from the dysregulation of a single component but it is the result of the dysfunction of a group of components and networks which differs from patient to patient. However, a patient-specific network is required to understand the disease and its molecular mechanism. We address this requirement by constructing a patient-specific network by sample-specific network theory with integrating cancer-specific differentially expressed genes and elite genes. By elucidating patient-specific networks, it can identify the regulatory modules, driver genes as well as personalized disease networks which can lead to personalized drug design. This method can provide insight into how genes are associating with each other and characterized the patient-specific disease subtypes. The results show that this method can be beneficial for the detection of patient-specific differential modules and interaction between genes. Extensive analysis using existing literature, gene enrichment and survival analysis for three cancer types STAD, PAAD and LUAD shows the effectiveness of this method over other existing methods. In addition, this method can be useful for personalized therapeutics and drug design. This methodology is implemented in the R language and is available at https://github.com/riasatazim/PatientSpecificRNANetwork.

Radiotherapy and Limb-Sparing Surgery in the Management of Localized Soft Tissue Sarcomas: Tertiary Care Center Experience From Pakistan.

PURPOSE: When combined with radiotherapy, limb salvage surgery is an alternative to amputation. This study sought to determine the limb-sparing treatment outcomes in patients diagnosed with soft tissue extremity sarcomas treated at our institution. MATERIALS AND METHODS: All adult patients with extremity soft tissue sarcoma treated with the radical limb salvage strategy at Shaukat Khanum Memorial Cancer Hospital and Research Canter, Lahore, Pakistan, between January 2017 and December 2019 were retrospectively assessed. RESULTS: A total of 122 patients were included in the study. The mean age was 42 years (range 19-82), and 64 (52.5%) were males. The majority of patients, 65 (53.3%), were diagnosed with stage III and grade III disease according to American Joint Committee on Cancer TNM classification (Eighth edition). The most common surgical modality was wide local excision that was performed in 106 (86.9%) patients. Adjuvant radiation treatment was given in 111 (91%) patients, whereas 11 (9%) patients received neoadjuvant radiation treatment. The mean dose was 58 Gy (range: 46-66 Gy). Eighty-two (67.2%) of the patients were disease-free on post-treatment radiologic scans with disease recurrence observed in 40 (32.8%) patients. The median disease-free survival was 8 months (95% CI, 5.45 to 10.55). Local recurrence and distant metastases developed in 16 (13%) and 24 (20%) patients, respectively. CONCLUSION: About two thirds of patients with extremity soft tissue sarcoma were successfully treated with limb salvage strategy, surgery, and radiation therapy. However, high rate of relapse warrants further novel strategies in this patient population.

Effect of Lipase and Lysolecithin Supplementation with Low Energy Diet on Growth Performance, Biochemical Attributes and Fatty Acid Profile of Breast Muscle of Broiler Chickens.

This study aimed to investigate the effect of dietary lysolecithin (LYSO) and lipase supplementation on productive performance, nutrient retention, and meat quality of broiler chicken fed a low energy diet. For this purpose, a total of 360 chicks were randomly alienated into six treatments, having six replicates (no = 10) birds each replicate. The dietary treatments were followed as control (CON fed as normal energy diet), LE (CON-100 kcal/kg from BD. basal diet), LIP 0.04 (LE + 0.04% lipase), LYSO 0.04 (LE + 0.04% lysolecithin), LIP + LYSO 0.04 (LE + 0.04% lipase and lysolecithin), and LIP + LYSO 0.08 (LE. + 0.08% lipase and lysolecithin). The birds fed with LIP + LYSO 0.04 exhibited higher weight gain than LYSO 0.08 and CON (p < 0.05), and higher feed intake (F.I.) was also observed in LIP + LYSO 0.04 than CON. However, lipase and emulsifier dietary effects were non-significant on FCR. (p > 0.05). Effects of experimental diets on dry matter (DM), crude protein (CP), and fat digestibility were also non-significant (p > 0.05). Similarly, the blood biochemical profile (total cholesterol, triglycerides, LDL, HDL) of the broiler showed no significant difference (p > 0.05) by dietary treatments. Similarly, liver enzymes, AST and A.L.T., were also not statistically significant (p > 0.05) among all dietary treatments. Similarly, supplementation of LIP and LYSO had a non-significant (p > 0.05) effect on breast meat fatty acids composition. Conclusively, adding LIP + LYSO 0.08 to a low energy diet could demonstrate better growth performance and reduce the negative impact of a low-energy diet.

A Novel Low-Cost Compact High-Performance Flower-Shaped Radiator Design for Modern Smartphone Applications.

This manuscript examines the design principle and real-world validation of a new miniaturized high-performance flower-shaped radiator (FSR). The antenna prototype consists of an ultracompact square metallic patch of 0.116λ0 × 0.116λ0 (λ0 is the free space wavelength at 3.67 GHz), a rectangular microstrip feed network, and a partial metal ground plane. A novel, effective, and efficient approach based on open circuit loaded stubs is employed to achieve the antenna's optimal performance features. Rectangular, triangular, and circular disc stubs were added to the simple structure of the square radiator, and hence, the FSR configuration was formed. The proposed antenna was imprinted on a low-cost F4B laminate with low profile thickness of 0.018λ0, relative permittivity εr = 2.55, and dielectric loss tangent δ = 0.0018. The designed radiator has an overall small size of 0.256λ0 × 0.354λ0. The parameter study of multiple variables and their influence on the performance results has been extensively studied. Moreover, the impact of different substrate materials, impedance bandwidths, resonance tuning, and impedance matching has also been analyzed. The proposed antenna model has been designed, simulated, and fabricated. The designed antenna exhibits a wide bandwidth of 5.33 GHz ranging from 3.67 to 9.0 GHz at 10 dB return loss, which resulted in an 83.6% fractional impedance bandwidth; a maximum gain of 7.3 dBi at 8.625 GHz; optimal radiation efficiency of 89% at 4.5 GHz; strong intensity current flow across the radiator; and stable monopole-like far-field radiation patterns. Finally, a comparison between the scientific results and newly published research has been provided. The antenna's high-performance simulated and measured results are in a good agreement; hence, they make the proposed antenna an excellent choice for modern smartphones' connectivity with the sub-6 GHz frequency spectrum of modern fifth-generation (5G) mobile communication application.

The Outcome of Extremity Soft Tissue Sarcomas in Terms of Resection Margins: A Study From a Cancer Dedicated Center.

Introduction Extremity soft-tissue sarcomas are uncommon malignancies of mesenchymal tissue, it accounts for <1 % of cancers and has a high recurrence rate with positive resection margins and unplanned excision. This study aims to determine the influence of unplanned excision and resection margins on local recurrence, metastasis, and overall survival in soft tissue sarcoma of the extremities. Methods A retrospective review was conducted from January 2005 to December 2015 on all the patients with soft tissue sarcoma of the extremities. Age, sex, histopathology, site, tumor grade, biopsy type, recurrence, metastasis, and end outcome were analyzed. Kaplan-Meir curves were used for Survival analysis, and log-rank or the Cox proportional-hazards regression model was used for Significance analysis. The data were entered into SPSS version 20, and Statistical significance was set at a p-value ≤0.05. Results One hundred forty-five patients with soft tissue sarcoma of extremities were managed with a mean follow-up of 76.3+/-6.7 months. Undifferentiated pleomorphic sarcoma 47 (32.4%) was the most common pathology found in this cohort, followed by Synovial sarcoma 34 (23.4%) and Liposarcoma 19 (13.1%). The most common site of occurrence was lower extremity 102 (70.3%). All the patients had residual disease after unplanned excisions; 107 underwent R0 resection, while 38 underwent R1 resection. Five-year overall survival was 70.2 & 71.1 % for R1 & R0 resections, respectively, and 71.3% for excisional and 74.2% for incisional biopsy. The tumor grade significantly influences overall survival, while other variables were not found to affect Recurrence-free survival and metastasis-free survival. Conclusion The data indicates that the high-grade tumor has a negative influence on overall survival, while resection margins width and unplanned excision have no significant effect on local recurrence, Metastasis free survival, and overall survival; however, before excision, adequate planning and awareness among general surgeons is necessary to improve the surgical morbidity and financial burden over the health care facilities.

CDSImpute: An ensemble similarity imputation method for single-cell RNA sequence dropouts.

BACKGROUND: Single-cell RNA-sequencing enables the opportunity to investigate cell heterogeneity, discover new types of cells and to perform transcriptomic reconstruction at a single-cell resolution. Due to technical inadequacy, the presence of dropout events hinders the downstream and differential expression analysis. Therefore, it demands an efficient and accurate approach to recover the true gene expression. To fill the gap, we present a novel Single-cell RNA dropout imputation method to retrieve the original gene expression of the genes with excessive zero and near-zero counts. RESULT: Here we have developed CDSImpute (Correlation Distance Similarity Imputation) to identify dropouts induced in scRNA-seq data rather than biological zeros and recover true gene expression. By taking into consideration correlation and negative distance between cells, a similar cell list has been created and by borrowing the gene expression from similar cells dropout has been detected and corrected simultaneously. The improvement is consistent with simulation data and several publicly available scRNA-seq datasets. The clustering accuracy of CDSImpute is evaluated by adjusted rand index on Kolod, Pollen and Usoskin datasets are 1.00, 0.79 and 0.34 respectively. CDSImpute achieves improved performance compared to the three existing methods evaluated by precise cell-type identification and differentially expressed gene detection from scRNA-seq Data. CONCLUSION: CDSImpute is a novel effective method to impute the dropout events of a scRNA-seq expression matrix. The package is implemented in the R language and is available at https://github.com/riasatazim/CDSImpute.

A novel compact broadband and radiation efficient antenna design for medical IoT healthcare system.

This paper investigates and develops a novel compact broadband and radiation efficient antenna design for the medical internet of things (M-IoT) healthcare system. The proposed antenna comprises of an umbrella-shaped metallic ground plane (UsMGP) and an improved radiator. A hybrid approach is employed to obtain the optimal results of antenna. The proposed solution is primarily based on the utilization of etching slots and a loaded stub on the ground plane and rectangular patch. The antenna consists of a simple rectangular patch, a 50 Ƹ microstrip feed line, and a portion of the ground plane printed on a relatively inexpensive flame retardant material (FR4) thick substrate with an overall compact dimension of 22 × 28 × 1.5 mm3. The proposed antenna offers compact, broadband and radiation efficient features. The antenna is carefully designed by employing the approximate calculation formulae extracted from the transmission line model. Besides, the parameters study of important variables involved in the antenna design and its influence on impedance matching performance are analyzed. The antenna shows high performance, including impedance bandwidth of 7.76 GHz with a range of 3.65Ƀ11.41 GHz results in 103% wider relative bandwidth at 10 dB return loss, 82% optimal radiation efficiency in the operating band, reasonable gain performance, stable monopole-shaped radiation patterns and strong current distribution across the antenna lattice. The suggested antenna is manufactured, and simulation experiments evaluate its performance. The findings indicate that the antenna is well suited for medical IoT healthcare systems applications.

Clinical Characteristics and Comparison of Different Prognostic Scores in Wilson's Disease.

Aim: Wilson's disease (WD) is a rare autosomal recessive disease, that can involve any organ of the body, the main ones being the liver and the brain. These patients can have varied presentations, ranging from having no symptoms to having neurological manifestations to features of chronic liver disease (CLD). Those patients that end up having CLD are prognosticated via the Child-Turcotte-Pugh (CTP) score and the Model for End-stage Liver Disease (MELD) score. However, two specific scores exist for prognostication in patients having WD, namely, the Nazar score and the Dhawan score. However, these are yet to be validated nor has their use been implemented in clinical practice. Materials and methods: Our study involved 65 patients with WD, comprising both the pediatric and the adult population. We aimed at evaluating the clinical manifestations the lab parameters and the management of these patients. Furthermore, we tried validating the Nazar and the Dhawan score and later compared them with the CTP and the MELD score, which are well-known prognostic tools in CLD. Results: Our patients were subdivided into the pediatric (more than 50%) and the adult group. The most common presenting complaint noted in both groups was abdominal distension. Values of the urine copper and serum ceruloplasmin did not defer between the pediatric and adult patients. Hepatic involvement is frequently seen in the pediatric age-group. Also, CTP class C was chiefly seen in pediatrics 17/33 (51.5%), while CTP class B was in adults 13/32 (40.6%). The mean Nazar score was 3 ± 3, while the mean Dhawan score was 5 ± 4. The main treatment offered for both groups was zinc along with penicillamine. Conclusion: Our study showed the Dhawan score was comparable to the CTP and the MELD score in terms of predicting the disease severity of WD in our patient population. How to cite this article: Majid Z, Abrar G, Laeeq SM, et al. Clinical Characteristics and Comparison of Different Prognostic Scores in Wilson's Disease. Euroasian J Hepato-Gastroenterol 2022;12(2):69-72.

The Use of Albumin-to-bilirubin Score in Predicting Variceal Bleed: A Pilot Study from Pakistan.

Variceal hemorrhage is a serious consequence of patients having chronic liver disease (CLD). Various scores exist that predict the outcome for non-variceal bleed. However, only a few scores evaluate patients with variceal bleed. We, in our study, evaluated 48 cirrhotics who presented with variceal gastrointestinal (GI) bleed over a period of 3 months. Majority of these were males and the most common etiology was hepatitis C infection. The main presenting complaints were hematemesis seen in 39.6% followed by hematemesis and melena in 31.25%. Most bleeding episodes were secured via banding in 62.5% followed by injection of histoacryl in 12.5%. Finally, Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), albumin-to-bilirubin (ALBI), and the ABC score were applied and none correlated with the presence of esophageal varices. However, the ALBI score did correlate with the presence of tachycardia in our study, a pertinent sign of upper GI bleed. How to cite this article: Majid Z, Khan SA, Akbar N, et al. The Use of Albumin-to-bilirubin Score in Predicting Variceal Bleed: A Pilot Study from Pakistan. Euroasian J Hepato-Gastroenterol 2022;12(2):77-80.

Effect of Azomite on growth performance, immune function and tibia breaking strength of broiler chickens during starter period.

This study was examined to investigate the effect of Azomite (AZO) on the growth performance, immune function, and bone mineralization of broiler chickens. A total of 240-d old male chicks were randomly assigned into four treatments with six replicates (n = 10), which included control (basal diet), basal diet +0.25% AZO, basal diet + 0.50% AZO and basal diet + kitasamycin as antibiotic growth promoter (AGP). The results indicate that live body weight (LBW), average daily gain (ADG) and feed conversion ratio (FCR) were significantly (p < .05) improved in AZO 0.25% and 0.50% than the control. The weight of bursa of Fabricus was significantly (p < .05) higher in AZO-0.25% and AZO-0.50% than control. Total protein (TP), globulin, IgA and IgG levels were significantly (p < .05) increased with AZO supplemented treatments. Tibia diameter tibia breaking strength was significantly (p < .05) increased in AZO- 0.25% and AZO-0.50% treatment. In conclusion, the results indicated that addition of AZO at the doses of 0.25% and 0.50% in the diet had beneficial effects on growth performance, immune functions and tibia breaking strength.

TSInsight: A Local-Global Attribution Framework for Interpretability in Time Series Data.

With the rise in the employment of deep learning methods in safety-critical scenarios, interpretability is more essential than ever before. Although many different directions regarding interpretability have been explored for visual modalities, time series data has been neglected, with only a handful of methods tested due to their poor intelligibility. We approach the problem of interpretability in a novel way by proposing TSInsight, where we attach an auto-encoder to the classifier with a sparsity-inducing norm on its output and fine-tune it based on the gradients from the classifier and a reconstruction penalty. TSInsight learns to preserve features that are important for prediction by the classifier and suppresses those that are irrelevant, i.e., serves as a feature attribution method to boost the interpretability. In contrast to most other attribution frameworks, TSInsight is capable of generating both instance-based and model-based explanations. We evaluated TSInsight along with nine other commonly used attribution methods on eight different time series datasets to validate its efficacy. The evaluation results show that TSInsight naturally achieves output space contraction; therefore, it is an effective tool for the interpretability of deep time series models.

Antibiogram and molecular characterization of multi-drug resistant microorganisms isolated from urinary tract infections.

Bacteria are the commonest etiological factor among the microbes that cause UTIs. The most prevalent bacteria identified in the lab are Escherichia coli, Klebsiella pneumonia and Pseudomonas aeruginosa. Antibiotics are the empiric therapy for such infections but the reoccurrence rate is becoming high owing to the development of resistance due to their irrational and indiscriminate use across the globe. This study was designed on UTI cases of OPD, Medical, Nephrology, Surgical, Main OT, Urology and ICU wards of Allied hospital Faisalabad. 11 antibiotics were used which showed that E. coli is sensitive to Amikacin, Gentamicin, Imipenem, Piperacillin tazobactam, and Polymyxin B. Klebsiella pneumonia showed sensitivity for Amikacin, Gentamicin, Nitrofurantoin, Imipenem, Polymyxin B, Piperacillin tazobactam and Trimethoprim-sulfamethoxazole. While Pseudomonas aurignosa showed resistance to Amikacin, Ciprofloxacin, Gentamicin, Piperacillin tazobactam, Imipenem, and Polymyxin B. E. coli exhibited the highest sensitivity for Piperacillin tazobactam, Klebsiella pneumonia for Imipenem and Pseudomonas aurignosa for Ciprofloxacin. Further, the isolated DNA samples of these microorganisms were confirmed by gel electrophoresis and subjected to molecular characterization by performing trace file and phylogenetic tree analysis.

Molecular mechanisms of growth depression in broiler chickens (Gallus Gallus domesticus) mediated by immune stress: a hepatic proteome study.

BACKGROUND: Immunological stress decreases feed intake, suppresses growth and induces economic losses. However, the underlying molecular mechanism remains unclear. Label-free liquid chromatography and mass spectrometry (LC-MS) proteomics techniques were employed to investigate effects of immune stress on the hepatic proteome changes of Arbor Acres broilers (Gallus Gallus domesticus) challenged with Escherichia coli lipopolysaccharide (LPS). RESULTS: Proteomic analysis indicated that 111 proteins were differentially expressed in the liver of broiler chickens from the immune stress group. Of these, 28 proteins were down-regulated, and 83 proteins were up-regulated in the immune stress group. Enrichment analysis showed that immune stress upregulated the expression of hepatic proteins involved in defense function, amino acid catabolism, ion transport, wound healing, and hormone secretion. Furthermore, immune stress increased valine, leucine and isoleucine degradation pathways. CONCLUSION: The data suggests that growth depression of broiler chickens induced by immune stress is triggered by hepatic proteome alterations, and provides a new insight into the mechanism by which immune challenge impairs poultry production.

Determinants of SARS-CoV-2 Vaccine Engagement in Algeria: A Population-based Study with Systematic Review of Studies from Arab Countries of the MENA Region

BackgroundThe Algerian COVID-19 vaccination campaign, which started by the end of January 2021, is marked by a slowly ascending curve despite the deployed resources. To tackle the issue, we assessed the levels and explored determinants of engagement towards the COVID-19 vaccine among the Algerian population. MethodsA nationwide, online-based cross-sectional study was conducted between March 27 and April 30, 2021. A two-stage stratified snowball sampling method was used to include an equivalent number of participants from the four cardinal regions of the country. A vaccine engagement scale was developed, defining vaccine engagement as a multidimensional parameter (5 items) that combined self-stated acceptance and willingness with perceived safety and efficacy of the vaccine. An Engagement score was calculated and the median was used to define engagement versus nonengagement. Sociodemographic and clinical data, perceptions about COVID-19 and levels of adherence to preventive measures were analyzed as predictors for nonengagement. ResultsWe included 1,019 participants, 54% were female and 64% were aged 18-29 years. Overall, there were low rates of self-declared acceptance (26%) and willingness (21%) to take the vaccine, as well as low levels of agreement regarding vaccine safety (21%) and efficacy (30%). Thus, vaccine engagement rate was estimated at 33.5%, and ranged between 29.6-38.5% depending on the region (p>0.05). Nonengagement was independently associated with female gender (OR=2.31, p<0.001), low adherence level to preventive measures (OR=6.93p<0.001), private sector jobs (OR=0.53, p=0.038), perceived COVID-19 severity (OR=0.66, p=0.014), and fear from contracting the disease (OR=0.56, p=0.018). Concern about vaccine side effects (72.0%) and exigence for more efficacy and safety studies (48.3%) were the most commonly reported barrier and enabler for vaccine acceptance respectively; whereas beliefs in the conspiracy theory were reported by 23.4%. ConclusionsThe very low rates of vaccine engagement among the Algerian population probably explain the slow ascension of the vaccination curve in the country. Vaccine awareness campaigns should be implemented to address the multiple misconceptions and enhance the levels of knowledge and perception both about the disease and the vaccine, by prioritizing target populations and engaging both healthcare workers and the general population.

Total maxillary arch distalization with modified C-palatal plates in adolescents: A long-term study using cone-beam computed tomography.

INTRODUCTION: The aims of this study were to evaluate the long-term skeletodental effects, the volume of maxillary tuberosity, and airway space changes after maxillary molar distalization using modified C-palatal plate (MCPP) in adolescents with Class II malocclusion. METHODS: The sample consisted of 20 adolescent patients (MCPP group; mean age, 12.9 ± 1.0 year) who underwent bilateral distalization of their maxillary dentition and 20 subjects as a control group. In the MCPP group, cone-beam computed tomography images were taken before distalization, at the end of the treatment, and during retention with a minimum of a 3-year posttreatment follow up period. Repeated measures ANOVA followed by post-hoc analysis with the Bonferroni test were used to identify significant differences between time points. RESULTS: After the long-term observation period, sagittal skeletal and dental relationships were maintained (there were no significant changes in ANB, occlusal plane angle, and overjet postretention). The vertical skeletal dimension did not change during treatment and was stable at the long-term follow-up (the mandibular plane angle and ANS-Me were relatively well maintained). The volume of the maxillary tuberosity showed no significant change during long-term retention. However, the volume was significantly smaller in the treatment group than in the control group (P <0.0001). There were no significant airway space changes after distalization and the postretention period. In addition, there was no significant difference between the MCPP and control groups. CONCLUSIONS: Improved sagittal skeletal and dental relationships because of treatment were maintained in the long-term evaluation. There was no negative long-term effect on airway space associated with the maxillary arch distalization. Therefore, these findings might be beneficial for clinicians in diagnosis and treatment planning for Class II malocclusion in adolescents.

An analysis on determinants of farmers' willingness for resource utilization of livestock manure.

The increased manure produced in animal husbandry, especially in beef cattle farming, pose a great threat to the environment. Resource utilization of the manure is an effective way to solve the problem and is conducive to the sustainable development of animal husbandry. Based on the theory of planned behavior, this paper attempts to construct a model of farmers' willingness to utilize livestock manure from behavioral attitude, subjective norm and cognitive behavioral control, and makes an empirical test through a questionnaire on beef cattle farmers. As the findings show, farmers' behavioral attitude, subjective norm and cognitive behavioral control have a significantly positive impact on the resource utilization of the manure. Among them, behavioral attitude exerts the greatest impact, followed by cognitive behavioral control and subjective norm. Farmers surveyed share almost the same attitude towards the effects of resource utilization, who may actively or passively take into consideration the corresponding economic, social and ecological benefits. The pressure from the government plays an important role in farmers' subjective norm, while less pressure comes from village cadres and neighbors. Finally, time or labor endowment and economic strength are the core constraints on the resource utilization of livestock manure by farmers, with relatively little constraint on skill acquisition.