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Five billion people lack access to surgery, with the highest burden being in sub-Saharan Africa. As the surgical workforce is crucial in closing this gap, the University of British Columbia collaborated with Médecins Sans Frontières to create and launch the Essential Surgical Skills (ESS) task-sharing program, which consists of online learning modules and hands-on surgical training. Our study aimed to evaluate this pilot program. This is a mixed-method prospective cohort study to evaluate the effectiveness of the ESS program in South Sudan. Quantitative data included patient outcomes (complications, re-operation, and mortality), surgical proficiency of the trainees (quiz, entrustable professional activity (EPA), and logbook data), and electronic surveys. We used semi-structured interviews to collect qualitative data. From July 2019 to February 2021, three trainees performed 385 operations. The most common procedures were skin graft (14.8%) and abscess drainage (9.6%). A total of 172 EPAs were completed, of which 136 (79%) demonstrated the independence of the trainees. During the training, surgical mortality (0.56% vs. 0.13%, p = 0.0541) and morbidity (17% vs. 12%, p = 0.1767) remained unchanged from the pretraining phase. Interviews and surveys revealed that surgical knowledge and interprofessional teamwork improved throughout the training. The program empowered trainees to develop surgical career paths and increased their local acceptance among patients and other healthcare providers. This study confirmed the feasibility of a surgical task-sharing program in South Sudan. This program evaluation will hopefully inform Ministries of Health and their partners for the development of a training pillar of National Surgical, Obstetric, and Anesthesia Plans in the sub-Saharan African region.

In sustainable construction and packaging, the development of novel bio-based materials is crucial, driving a re-evaluation of traditional components. Lightweight, biodegradable materials, including xerogels, have great potential in architectural and packaging applications. However, reinforcing these materials to improve their mechanical strength remains a challenge. Alginate is a promising matrix material that may be compatible with inorganic fibrous or particulate materials. In this study, biocomposite xerogel-structured foam materials based on an alginate matrix with expanded perlite reinforcement are improved using certain additives in different weight ratios. The plasticizers used include glycerol and gum arabic, while chitosan was added as an additional reinforcement, and iota carrageenan was added as a stabilizer. The tested specimens, with varying weight ratios of the added components, showed good mechanical behavior that highlights their potential use as packaging and/or architectural materials. The influence of the presence of different components in the composite material specimens on the modulus of elasticity was investigated using SEM images and FTIR analyses of the specimens. The results show that the specimen with the largest improvement in the elastic modulus contained a combination of chitosan and glycerol at a lower percentage (1.96 MPa), and the specimen with the largest improvement in tensile strength was the specimen containing chitosan with no plasticizers (120 kPa), compared to cases where combinations of other materials are present.

Deep proteomic analyses identified, in total, 159 master proteins (with 1% FDR and 2 unique peptides) from 26 protein families in the venom of Vipera ammodytes ammodytes (Vaa). Data are available via ProteomeXchange with the identifier PXD056495. The relative abundance of PLA2s is 11.60% of the crude venom, of which 4.35% are neurotoxic Ammodytoxins (Atxs). The neurotoxicity of the venom of Vaa and the neutralizing effect of the antivenom were tested on the neuromuscular preparation of the diaphragm (NPD) of rats. The activity of PLA2 in the venom of Vaa and its neutralization by the antivenom were determined under in vitro conditions. The Vaa venom leads to a progressive decrease in NPD contractions. We administered pre-incubated venom/antivenom mixtures at various ratios of 1:2, 1:10 and 1:20 (w/w) and observed the effects of these mixtures on NPD contractions. The results show that the mean effective time (ET50) for NPD contractions with the 1:20 mixture is highly significantly different (p < 0.001) from the ET50 for the venom and the ET50 for the 1:2 and 1:10 mixture ratios. We also found a highly significant (p < 0.001) reduction in Na+/K+-ATPase activity in the NPD under the influence of the venom. The reduction in the activity of this enzyme was reversible by the antivenom. Under in vitro conditions, we have achieved the complete neutralization of PLA2 by the antivenom. In conclusion, the antivenom abolished the venom-induced progressive decrease in NPD contractions in a concentration-dependent manner. Antivenom with approximately the same mass proportion almost completely restores Na+/K+-ATPase activity in the NPD and completely neutralizes the PLA2 activity of the venom in vitro.

Notwithstanding prevalence gaps in micronutrients supporting immune functions, the significance of their deficits/supplementation for the efficacy of vaccines is underinvestigated. Thus, the influence of supplementation combining vitamins C and D, zinc, selenium, manganese, and N-acetyl cysteine on immune correlates/surrogates of protection conferred by a quadrivalent influenza vaccine (QIV) in mice was investigated. The supplementation starting 5 days before the first of two QIV injections given 28 days apart increased the serum titres of total and neutralizing IgG against each of four influenza strains from QIV. Accordingly, the frequencies of germinal center B cells, follicular CD4+ T helper (Th) cells, and IL-21-producing Th cells increased in secondary lymphoid organs (SLOs). Additionally, the supplementation improved already increased IgG response to the second QIV injection by augmenting not only neutralizing antibody production, but also IgG2a response, which is important for virus clearance, through favoring Th1 differentiation as indicated by Th1 (IFN-γ)/Th2 (IL-4) signature cytokine level ratio upon QIV restimulation in SLO cell cultures. This most likely partly reflected antioxidant action of the supplement as indicated by splenic redox status analyses. Thus, the study provides a solid scientific background for further research aimed at repurposing the use of this safe and inexpensive micronutrient combination to improve response to the influenza vaccine.