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Heavy metal contamination usually causes depletion in feed utilization in fish, and such disturbance may result in reduced metabolic rate and hence causing reduction in their growth. The present study assessed theharmful effect of sublethal concentrations of four different heavy metal mixturesi.e., Mix-I (Mn+Ni), Mix-II(Mn+Ni+Pb), Mix-III (Mn+Pb+Zn+Fe), and Mix-IV (Mn+Ni+Pb+Zn+Fe) on five fish species including Labeorohita, Catla catla, Cirrhinamrigala, Hypophthalmichthys molitrix, and Ctenopharyngodonidella. The experiment was carried out in triplicate for each species separately in glass aquarium for 12 weeks. The results showed a significant(p < 0.001)effect on the treated group as compared to the control group. The average weight gain was as C. catla>L. rohita>C. mrigala>C. idella>H. molitrix. The condition factor was as C. idella>C. mrigala>L. rohita>C. catla>H. molitrix. Similarly, the feed intake also reduced significantly (p>0.001) in the treated group, and the feed conversion efficiency showed significant (p>0.05) effect of metal mixtures on fish metabolism and growth activity. The current study concluded that the studied heavy metals are toxic to different fish species, even at sub-lethal concentrations, and affect different biological parameters of fish growth. [ABSTRACT FROM AUTHOR]

Introduction: Hemorrhage is a leading cause of death. Blood products are used for the treatment of hemorrhagic shock. The use of low titer group O whole blood (LTOWB) has become more common., Methods: Data from patients ≥15 years of age in the Trauma Quality Improvement Program (TQIP) database that received ≥10 units of packed red cells and/or LTOWB within the first 4-h of hospital arrival were included. The proportion of LTWOB of total blood products administered was correlated to 6- and 24-h mortality., Results: 12,763 met inclusion, 3827 (30 %) received LTOWB. On multivariable logistic regression (MVLR), there was no difference in survival at 6 h with a LTOWB. When assessing 24-h survival, there was improved survival with LTOWB ≥10 % (OR 1.18, 1.08-1.28)., Conclusions: In this analysis of TQIP data, patients receiving ≥10 units of PRBC or LTOWB, we found that higher proportions of LTOWB transfusion relative to the total volume of blood products transfused during the first 4 h were associated with improved 24-h, but not 6-h survival., Competing Interests: Declaration of competing interest ADF, MDA, FLW, MJC, TMG, and SGS have all received funding from the Department of Defense in the form of grants to their institution. We have no other conflicts of interest to report., (Published by Elsevier Inc.)

Background: Delayed stent grafting for blunt thoracic aortic injuries (BTAIs) is current standard of care. However, given the heterogeneity of pseudoaneurysm presentations, it is currently unclear which severe BTAIs require more urgent intervention. We hypothesize that a Traumatic Aortic Disruption Index (TADI) calculation based on sagittal computed tomography angiography imaging measurements would correlate with urgency of stent grafting., Methods: All patients at a level-1 trauma center with BTAIs over a 12-year period were identified. A TADI score was then calculated using the length of pseudoaneurysm (L), maximum width of pseudoaneurysm (W), and normal adjacent aortic diameter (NA). Patient presentation, injury characteristics, timing of stent grafting, and outcomes were then evaluated., Results: Forty-two patients were diagnosed with BTAIs. Mean age was 37.6 years, with a median injury severity score (ISS) of 29. Overall mortality was 11.9%. TADI scores ranged from 3.6 to 158.6. Compared to patients with a TADI <28, patients with TADI >28 had similar median ISS scores (34 vs. 29, P = 0.16), and rates of both traumatic brain injury (TBI; 33.3% vs. 42.0%, P = 0.53) and nonaortic hemorrhage control procedures (44.4% vs. 33.3%, P = 0.3). TADI >28 patients had a lower initial mean systolic BP (98.5 vs. 121.9, P = 0.003), more severe hypotension (lowest systolic 77.0 vs. 91.2, P = 0.034), lower initial Glasgow Coma Scale (6 vs. 13, P = 0.039), higher mean admission lactate (4.6 vs. 3.3, P = 0.036), and higher overall mortality (23.8% vs. 0%, P = 0.048). Patients with TADI >28 received stent grafting at significantly shorter median time intervals from injury identification (median 4 hrs vs. 14 hrs, P = 0.001). Overall causes of mortality were aortic hemorrhage related (n = 3, 60%) and TBI (n = 2, 40%)., Conclusions: This simple-to-calculate index is independently correlated with mortality and urgency of stent grafting in blunt trauma patients with similar ISS. Patients with TADI scores >28 were more likely to undergo urgent stent grafting, thereby suggesting a trend in practice patterns with higher scores representing injuries that should be considered for expedited operative management. The TADI score should be validated in a larger sample of blunt trauma patients as an injury prioritization tool in the multisystem injured patient., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Sex disparities have previously been identified in surgical academia. This study examines sex differences in the top-cited contemporary general surgery articles and compares Altimetric Attention Score (AAS) and other impact metrics between male and female corresponding authors (CAs)., Methods: We conducted a bibliometric analysis of the 100 most cited articles published between 2019 and 2021 in each of the top 10 general surgery journals based on the 2021 Journal Impact Factor. Impact metrics included AAS, citation count, and H-index of the CA. We used multivariable regression analyses to investigate whether the sex of the CA or first author (FA) was independently associated with AAS and citation count., Results: Among 1000 articles, 23.1% had female CAs and 27.4% female FAs. Female CA articles had higher AAS (13.0 [2.0-63.0] vs. 8.0 [1.0-28.5]; p < 0.001) and lower H-indices (24.0 [11.0-45.0] vs. 31.0 [17.0-50.0]; p = 0.015). Although median citation count did not differ by CA sex, articles with Level 1 evidence and a female CA were cited more often (35.5 [24.0-85.0] vs. 25.0 [16.0 vs. 46.0]; p < 0.05). In multivariable regression, female CA articles had higher AAS (OR: 1.002 [95% CI: 1.001-1.004]) and lower H-index (OR: 0.987 [95% CI: 0.977-0.997])., Conclusion: Despite having similar citation counts, articles authored by female CAs exhibit higher AAS scores compared to those authored by their male counterparts. While it is heartening that research authored by female surgeons achieves significant visibility, it remains to be understood how this translates into academic impact and scholarly recognition., (© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)

Background: Dense inflammation obscuring the hepatocystic anatomy can hinder the ability to perform a safe standard laparoscopic cholecystectomy in severe cholecystitis, requiring use of a bailout procedure. We compared clinical outcomes of laparoscopic and open subtotal cholecystectomy against the traditional standard of open total cholecystectomy to identify the optimal bailout strategy for the difficult gallbladder., Methods: A multicenter, multinational retrospective cohort study of patients who underwent bailout procedures for severe cholecystitis. Procedures were compared using one-way analysis of variance/Kruskal-Wallis tests and χ 2 tests with multiple pairwise comparisons, maintaining a family-wise error rate at 0.05. Multiple multivariate linear/logistical regression models were created., Results: In 11 centers, 727 bailout procedures were conducted: 317 laparoscopic subtotal cholecystectomies, 172 open subtotal cholecystectomies, and 238 open cholecystectomies. Baseline characteristics were similar among subgroups. Bile leak was common in laparoscopic and open fenestrating subtotal cholecystectomies, with increased intraoperative drain placements and postoperative endoscopic retrograde cholangiopancreatography(P < .05). In contrast, intraoperative bleeding (odds ratio = 3.71 [1.9, 7.22]), surgical site infection (odds ratio = 2.41 [1.09, 5.3]), intensive care unit admission (odds ratio = 2.65 [1.51, 4.63]), and length of stay (Δ = 2 days, P < .001) were higher in open procedures. Reoperation rates were higher for open reconstituting subtotal cholecystectomies (odds ratio = 3.43 [1.03, 11.44]) than other subtypes. The overall rate of bile duct injury was 1.1% and was not statistically different between groups. Laparoscopic subtotal cholecystectomy had a bile duct injury rate of 0.63%., Conclusion: Laparoscopic subtotal cholecystectomy is a feasible surgical bailout procedure in cases of severe cholecystitis where standard laparoscopic cholecystectomy may carry undue risk of bile duct injury. Open cholecystectomy remains a reasonable option., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these., Method: We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and > 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality., Results:  1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4-2), (OR = 4.7, 95% CI 3.1-7.6)], female gender [(OR = 1.8, 95% CI 1.4-2.3), (OR = 1.9, 95% CI 1.3-2.9)], shock on admission [(OR = 2.1, 95% CI 1.7-2.7), (OR = 4.8, 95% CI 3.2-7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9-3.2), (OR = 3.9), 95% CI 2.7-5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1-1.6], but not mortality., Conclusions: This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality., (© 2024. Crown.)

Introduction: Inflammation in acute cholecystitis may cause a cholecystectomy to be more challenging. Due to the difficult dissection, conversion to subtotal cholecystectomy via laparoscopic or open procedure may be required. This is done to reduce the risk of bile duct injury and hemorrhage. We sought to describe the incidence and risk factors, safety, morbidity, and outcomes associated with bailout procedures., Methods: A single academic center, retrospective review of laparoscopic cholecystectomies that resulted in bailout procedures performed between January 2015 and December 2020. Data collected from the chart review included demographics, comorbidities, length of presenting symptoms, vital signs, laboratory and imaging, intraoperative findings, length of surgery, and outcome., Results: A total of 1892 cholecystectomies were performed with 147 bailout procedures. For bailout 92 (63.4%) were converted to open, with 66% resulting in complete cholecystectomy. Hypertension and diabetes were the most common comorbidities. The median duration of symptoms was 4 days. Difficult anatomy in the hepatocystic triangle (66%) and dense adhesions (31%) were the most common reasons for bailout. The mean duration of surgery was 145.76 (SD 102.94) minutes. There were 2 bile duct injuries, both in open total cholecystectomy subgroup. Bile leak occurred in 23.8% with majority in subtotal cholecystectomy group. There was no difference in hospital length of stay, surgical site infection, or mortality among different bailout procedures., Conclusions: Subtotal cholecystectomy represents a safe alternative to total cholecystectomy during challenging cases to avoid damaging surrounding structures. The choice of laparoscopic or open subtotal approach is dependent on the surgeons' expertise., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Effective mentorship plays a crucial role in the professional development of surgical residents by providing guidance, support, networking, and facilitating personal, and career growth. This is particularly significant for female and underrepresented minority residents who often encounter additional challenges due to discrimination and historical lack of representation. Our objective is to present a framework for structuring a progressive and inclusive formal mentorship program- Surgery IMPACT- which embodies a panoramic perspective of surgery residency., Design: A holistic mentorship program was created through the conceptualization of WISE Domains (Work-Life Balance, Interpersonal and cultural proficiency, Scholarly and career advancement, Effective learning and study techniques). Mentor-Mentee partnerships were created between current surgical faculty and general surgery residents. The foundation of the program is built upon four essential mentor roles: Core faculty mentor, research mentor, fellowship mentor, alongside a concurrent incorporation of peer mentorship. Over the academic year, we encouraged at least 3 formal mentorship meeting prefaced by a reflective exercise by the residents., Conclusions: The implementation of Surgery IMPACT has been successful in formalizing mentorship opportunities at our institution. By incorporating WISE domains, structured meeting centered on well-defined objectives, we have effectively created an all-inclusive mentorship program to foster resident growth and equal opportunities. Our ongoing commitment is to further refine and expand this innovative program with the aspiration of galvanizing similar mentorship models across diverse surgical programs., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: This study aimed to assess 30-day morbidity and mortality rates following cholecystectomy for benign gallbladder disease and identify the factors associated with complications., Summary Background Data: Although cholecystectomy is common for benign gallbladder disease, there is a gap in the knowledge of the current practice and variations on a global level., Methods: A prospective, international, observational collaborative cohort study of consecutive patients undergoing cholecystectomy for benign gallbladder disease from participating hospitals in 57 countries between January 1 and June 30, 2022, was performed. Univariate and multivariate logistic regression models were used to identify preoperative and operative variables associated with 30-day postoperative outcomes., Results: Data of 21,706 surgical patients from 57 countries were included in the analysis. A total of 10,821 (49.9%), 4,263 (19.7%), and 6,622 (30.5%) cholecystectomies were performed in the elective, emergency, and delayed settings, respectively. Thirty-day postoperative complications were observed in 1,738 patients (8.0%), including mortality in 83 patients (0.4%). Bile leaks (Strasberg grade A) were reported in 278 (1.3%) patients and severe bile duct injuries (Strasberg grades B-E) were reported in 48 (0.2%) patients. Patient age, ASA physical status class, surgical setting, operative approach and Nassar operative difficulty grade were identified as the five predictors demonstrating the highest relative importance in predicting postoperative complications., Conclusion: This multinational observational collaborative cohort study presents a comprehensive report of the current practices and outcomes of cholecystectomy for benign gallbladder disease. Ongoing global collaborative evaluations and initiatives are needed to promote quality assurance and improvement in cholecystectomy., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Because the use of hydrofluoric acid (HF) poses health risks if handled improperly, many clinicians prefer to have the ceramic restorations pre-etched in dental laboratories. However, during the try-in procedure, the pre-etched glass-ceramic restorations may be contaminated with saliva resulting in reduced bond strength. This in-vitro study aimed to investigate the effect of different surface treatments on the bond strength of lithium disilicate (LD) glass-ceramic restorations (IPS e.max Press, Ivoclar Vivadent) to two resin cements. One-hundred eighty blocks (4X4X3mm) of LD glass-ceramic were divided into twelve groups (n = 15), of which six received Variolink Esthetic DC (VE) cement and six received RelyX Ultimate (RU) cement, following the surface treatments: G1) Control: Hydrofluoric Acid + Silane (HF + Sil); G2) Hydrofluoric Acid + Saliva + Silane (HF + S + Sil); G3) Hydrofluoric Acid + Saliva + Ivoclean + Silane (HF + S + IC + Sil); G4) Hydrofluoric Acid + Saliva + Phosphoric Acid + Silane (HF + S + P + Sil); G5) Hydrofluoric Acid + Saliva + Monobond Etch & Prime (HF + S + EP); G6) Monobond Etch & Prime (EP). Following treatment, a resin-cement cylinder (2.3 mm diameter) was built on the glass-ceramic surface, photocured (20 s), stored in distilled water (37 °C, 24 h) and submitted to the shear bond strength test. Bond strength data (MPa) were subjected to two-way ANOVA and Tukey (α = 0.01). Cement type and surface treatment had a significant effect on the bond strength (p < 0.001) (Table 4). Single-step Monobond Etch & Prime (EP) significantly improved the bond strength of resin-cements to glass-ceramic with and without saliva contamination., (© 2023. The Author(s), under exclusive licence to The Society of The Nippon Dental University.)

Medical ethics underpin the moral framework that delineates the professional relationship between physicians and their patients and thereby is an integral part of making patient-centric healthcare decisions. The concept of ethics is deeply embedded in the field of surgery as surgeons confront a myriad of dilemmas as a part of their routine, whether it be in a preoperative or postoperative environment. The current review aims to describe the state of surgical ethics in Pakistan, with the intent of encouraging dialogues about the ethical considerations relevant to the field surgery that will identify actionable areas for improvement. While most surgeons are aware of the traditional principles of ethics and their practice, their surgical and clinical decisions may fall short of these standards because of time constraints and prevailing cultural and religious beliefs and taboos. The rigorous application of ethical principles in areas of patient-related communication, such as consenting, trainee education, palliative and end-of-life care, and surgical innovation and research, will have significant implications for patients, surgeons, and society. Our review has identified the lack of formal bioethics education and insufficient oversight and ethical regulations to be at the core of inadequate ethical practices in Pakistan and has highlighted actionable areas to be addressed in the future., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Zakaria et al.)

Introduction: Ethics education in surgical residencies is often delivered in an informal and nonstructured manner as part of a "hidden curriculum", leading to few residencies routinely including it in their core curriculum. This systematic review aimed to summarize the delivery modes, curriculum, structure, and effectiveness of ethics educational interventions for surgical trainees., Methods: We performed a comprehensive database search including MEDLINE, Embase, Scopus and CENTRAL to search for articles describing the implementation of ethics educational interventions for general surgery or subspecialty trainees., Results: A total of 14 studies were included. Only 2 centers performed targeted needs assessment. Curricula covered included informed consent, the doctor-patient relationship, breaking bad news, decision-making, end-of-life care, conflicts of interest, considering patients' personal contexts, and surgical research ethics. Modes of delivery varied across studies, including case-based learning, group discussions, didactic lectures, reading material, role-playing, simulated patients, and ethics morbidity and mortality (M&M) meetings. Evaluations were most commonly via surveys exploring knowledge and self-reported confidence, with only 3 studies measuring actual trainee performance using objective structured clinical examinations. In general, the educational interventions increased trainees' confidence/preparedness in handling ethical dilemmas., Conclusion: We recommend comprehensive local needs assessment to guide curricular development and designing specific learning objectives and measurable milestones to ensure evaluation. Educational interventions are best delivered in a graduated manner with the complexity of the topic mirroring residents' real-life clinical responsibilities and experiences. Teaching modalities should be tailored according to the nature of the curricular content being taught to make the learning experience more interactive and effective., (Copyright © 2023 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Introduction: The American Association for the Surgery of Trauma Colon Organ Injury Scale (OIS) was updated in 2020 to include a separate OIS for penetrating colon injuries and included imaging criteria. In this multicenter study, we describe the contemporary management and outcomes of penetrating colon injuries and hypothesize that the 2020 OIS system correlates with operative management, complications, and outcomes., Methods: This was a retrospective study of patients presenting to 12 Level 1 trauma centers between 2016 and 2020 with penetrating colon injuries and Abbreviated Injury Scale score of <3 in other body regions. We assessed the association of the new OIS with surgical management and clinical outcomes and the association of OIS imaging criteria with operative criteria. Bivariate analysis was done with χ 2 , analysis of variance, and Kruskal-Wallis, where appropriate. Multivariable models were constructed in a stepwise selection fashion., Results: We identified 573 patients with penetrating colon injuries. Patients were young and predominantly male; 79% suffered a gunshot injury, 11% had a grade V destructive injury, 19% required ≥6 U of transfusion, 24% had an Injury Severity Score of >15, and 42% had moderate-to-large contamination. Higher OIS was independently associated with a lower likelihood of primary repair, higher likelihood of resection with anastomosis and/or diversion, need for damage-control laparotomy, and higher incidence of abscess, wound infection, extra-abdominal infections, acute kidney injury, and lung injury. Damage control was independently associated with diversion and intra-abdominal and extra-abdominal infections. Preoperative imaging in 152 (27%) cases had a low correlation with operative findings ( κ coefficient, 0.13)., Conclusion: This is the largest study to date of penetrating colon injuries and the first multicenter validation of the new OIS specific to these injuries. While imaging criteria alone lacked strong predictive value, operative American Association for the Surgery of Trauma OIS colon grade strongly predicted type of interventions and outcomes, supporting use of this grading scale for research and clinical practice., Level of Evidence: Prognostic and Epidemiological; Level III., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

With increasing environmental regulation (ER), the requirements for green technology innovation (GTI) in enterprises are also rising. However, there are relatively few systematic summaries of the themes of ER-affecting GTI. Adopting the method of bibliometrics and visual analysis, this research discusses the status of research and development trends of ER-affecting GTI and summarizes the research in this field. The paper takes 738 papers from 2001 to 2021 in the core database of Web of Science as the research sample. Based on CiteSpace, this paper makes a visual analysis of the number of published papers, institutions, authors, keywords, countries (regions) and journals. The study found that to some extent, favorable collaboration between authors and institutions in this field needs to be strengthened. Research hotspots in this field include innovation, technology, performance, policy and environmental regulation. Renewable energy consumption, the pollution haven hypothesis, sustainable development, carbon dioxide emission, energy technology and environmental Kuznets curve are the current research frontiers in this field. In terms of the number of published papers, research in this field has been conducted in a national (regional) layout with China as the core force, and Italy, America, Britain, Germany and other European countries as important forces. This field covers three main research areas: enterprise performance, policy instruments and research methods, going through the start-up phase (2001-2011), the growth phase (2012-2018) and the development phase (2019-2021). Future research can further incorporate the digital economy and synergy of multiple environmental regulation policies into this field, which will continuously enrich the theoretical research system in this field. The content, methods and conclusions of research in this field are becoming increasingly diverse., Competing Interests: The authors declare no competing interest.

Objective: To share institutional experience of transcatheter device closure of secundum atrial septal defect in children and adults., Methods: The descriptive cross-sectional study was conducted at the Department of Paediatric Cardiology, Institute of Cardiology, Multan, Pakistan, from February 2011 to September 2019, and comprised patients with moderate to large secundum atrial septal defect without severe pulmonary hypertension. All procedures were performed under general anaesthesia and trans-oesophageal echo guidance. Success and safety of procedure were evaluated. Data was analysed using SPSS 16., Results: Of the 75 patients, 26(34.6%) were males and 49(65.3%) were females. The overall mean age was 25±1.53 years (range: 4 -54 years). Mean defect was 20.38±0.58mm (range: 9-32mm). Large defects >25mm were 17(22.7%). Significant pulmonary stenosis was observed in 3(4%) patients and valvuloplasty was performed. Device size was selected on the basis of trans-oesophageal echo measurement +4-5mm. Balloon sizing was performed in only 3(4%) patients. Amplatzer septal occluder was used in 60(80%) patients. Balloon-assisted technique was used in 9(12%) patients. All the procedures were successful except 2(2.7%) where device was embolised and retrieved by surgery. Transient arrhythmias were observed in 6(8%) patients and small pericardial effusion in 1(1.3%) patient who was managed conservatively. There was no procedure-related mortality., Conclusion: Transcatheter closure of moderate to large secundum atrial septal defect in children and adults was found to be a safe procedure.

Mitochondria is a cellular source of energy, appears to play an essential role in dealing with cellular stress induced by environmental stimuli. The genetic diversity of mitochondrial genes involved in oxidative phosphorylation affecting the production of cellular energy and regional adaptation to various ecological (climatic) pressures affecting amino acid sequences (variants of protein). However, little is known about the combined effect of protein changes on cell-level metabolic alterations in simultaneous exposure to various environmental conditions, including mitochondrial dysfunction and oxidative stress induction. The present study was designed to address this issue by analyzing the mitochondrial proteins in Fasciola species including Cytochrome oxidase (COX1, COX2, COX3, and CYTB) and NADH dehydrogenase (ND1, ND2, ND3, ND4, ND5, and ND6). Mitochondrial proteins were used for detailed computational investigation, using available standard bioinformatics tools to exploit structural and functional relationships. These proteins in Fasciola hepatica, Fasciola gigentica, and Fasciola jacksoni were functionally annotated using public databases. The results showed that the protein of COX1 of F. hepatica, F. gigantica, and F. jacksoni consist of 510, 513, and 517 amino acids, respectively. The alignment of proteins showed that these proteins are conserved in the same regions at ten positions in COX and CYTB proteins while at twelve locations in NADH. Three-dimensional structure of COX, CYTB, and NADH proteins were compared and showed differences in additional conserved and binding sites in COX and CYTB proteins as compared to NADH in three species of Fasciola. These results based on the amino acid diversity pattern were used to identify sites in the enzyme and the variations in mitochondrial proteins among Fasciola species. Our study provides valuable information for future experimental studies, including identification of therapeutic, diagnostic, and immunoprophylactic interests with novel mitochondrial proteins., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Pseudorabies is an important infectious disease of swine, and immunization using attenuated pseudorabies virus (aPrV) vaccine is a routine practice to control this disease in swine herds. This study was to evaluate a saline solution containing ginseng stem-leaf saponins (GSLS) and sodium selenite (Se) as a vaccine adjuvant for its enhancement of immune response to aPrV vaccine. The results showed that aPrV vaccine diluted with saline containing GSLS-Se (aP-GSe) induced significantly higher immune responses than that of the vaccine diluted with saline alone (aP-S). The aP-GSe promoted higher production of gB-specific IgG, IgG1, and IgG2a, neutralizing antibody titers, secretion of Th1-type (IFN- γ , IL-2, IL-12), and Th2-type (IL-4, IL-6, IL-10) cytokines, and upregulated the T-bet/GATA-3 mRNA expression when compared to aP-S. In addition, cytolytic activity of NK cells, lymphocyte proliferation, and CD4 + /CD8 + ratio was also significantly increased by aP-GSe. More importantly, aP-GSe conferred a much higher resistance of mice to a field virulent pseudorabies virus (fPrV) challenge. As the present study was conducted in mice, further study is required to evaluate the aP-GSe to improve the vaccination against PrV in swine., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Yong Wang et al.)

The present study evaluated soybean oil (SO) containing vitamin E (VE) and ginseng saponins (GS) (SO-VE-GS) for their adjuvant effect on foot-and-mouth disease (FMD) vaccine. Since mineral oil ISA 206 is a common adjuvant used in the FMD vaccine, it was used as a control adjuvant in this study. VE and GS were found to have a synergistic adjuvant effect. When mice were immunized with the FMD vaccine emulsified in SO with VE and GS, significantly higher serum IgG, IgG1, and IgG2a were found than VE and GS used alone. SO-VE-GS and ISA 206 behaved differently in adjuvant activities. When mice were immunized with the FMD vaccine adjuvanted with SO-VE-GS, significantly higher and earlier production of serum IgG was found than that adjuvanted with ISA 206. Although both adjuvants significantly increased the number of bone marrow plasma cells, a stimulation index of lymphocytes (SI) as well as the production of IL-4 and IL-6, SO-VE-GS promoted significantly higher SI and the ratio of CD4 + /CD8 + T cells with production of increased IFN-γ and decreased TGF-β1 as compared with the ISA 206 group. The data suggested that SO-VE-GS activated Th1/Th2 immune responses. Transcriptome analysis of splenocytes showed that differentially expressed genes (DEGs), immune-related gene ontology (GO) terms, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were significantly enriched in the SO-VE-GS group. Therefore, the potent adjuvant effect of SO-VE-GS on the FMD vaccine may be attributed to the immune-related gene profile expressed in lymphocytes. Due to its plant origin and due to being much cheaper than imported mineral oil ISA 206, SO-VE-GS deserves further study in relation to vaccines used in food animals.

Pseudorabies, a herpesvirus infection, is mainly controlled by using attenuated live vaccines. In this study, the effect of ginseng stem and leaf saponins (GSLS) in combination with selenium (Se; in the form of sodium selenite) on vaccination against attenuated pseudorabies virus (aPrV) was evaluated. It was found that GSLS and Se have an adjuvant effect and that a combination of GSLS and Se stimulates significantly enhanced immune responses than does GSLS or Se alone. Following oral administration of GSLS, mice immunized with an attenuated PrV vaccine diluted in Se-containing physiological saline solution (PSS) provoked a significantly stronger gB-specific serum antibodies response (IgG, IgG1 and IgG2a), enhanced lymphocyte proliferation and cytolytic activity of NK cells, along with higher production of cytokines (IFN-γ, IL-12, IL-5 and IL-10) by splenocytes. Notably, the combination of GSLS and Se conferred a much higher resistance to fPrV challenge after immunization of the mice with aPrV vaccine. This study offers convincing experimental evidence that an injection of Se with oral GSLS is a promising adjuvant combination that improves the efficacy of vaccination against PrV and deserves further study regarding improvement of responses to other animal vaccines., (© 2019 The Societies and John Wiley & Sons Australia, Ltd.)

A young soldier was brought to the emergency of Combined Military Hospital (CMH), Multan in a collapsed state with two day's history of chest pain. He was resuscitated and placed on ventilator. While the rest of examinations were normal, ultrasound examination of the abdomen revealed a cystic mass in liver most likely to be hydatid. The patient was fully conscious the next day and was put on tab albendazole (200 mg BID). CT scan of the abdomen revealed a large cystic mass having inner undulating wall with watery content diagnosed as hydatid cyst in right lobe of liver. Since anaphylaxis was considered consequent to hydatid cyst perforation, surgery was carried out. Approximately 100 ml of haemorrhagic fluid was aspirated and 10% hypertonic saline instilled. After re-aspiration, cyst cavity was opened and endocyst completely removed. Portion of ectocyst projecting away from the liver edge was also excised. He made an uneventful postoperative recovery and was discharged with the advice to continue tab albendazole 200mg BID for four weeks and weekly follow-up in surgical OPD. He is doing well now.

Three oat ( Avena sativa L.) cultivars have been successfully transformed using an efficient and reproducible in vitro culture system for differentiation of multiple shoots from shoot apical meristems. The transformation was performed using microprojectile bombardment with two plasmids (pBY520 and pAct1-D) containing linked ( hva1-bar) and non-linked ( gus) genes. The hva1 and bar genes cointegrated with a frequency of 100% as expected, and 61.6% of the transgenic plants carried all three genes. Molecular and biochemical analyses in R0, R1 and R2 progenies confirmed stable integration and expression of all transgenes. Localization of the GUS protein in R0 and R1 plants revealed that high-expression of gus occurred in vascular tissues and in the pollen grains of mature flowers. The constitutive expression of HVA1 protein was observed at all developmental stages of transgenic plants, and was particularly stronger during the early seedling stages. R2 progeny of five independent transgenic lines was tested in vitro for tolerance to osmotic (salt and mannitol) stresses. As compared to non-transgenic control plants, transgenic plants maintained a higher growth and showed significantly ( P < 0.05) increased tolerance to stress conditions. Less than 10% of transgenic plants showed symptoms of wilting or death of leaves and, when these symptoms present were delayed in transgenic plants as compared to 80% of non-transgenic plants, either wilted or died. These symptoms confirmed the increased in vitro tolerance in hva1-expressing transgenic plants to non-transgenic plants, providing strong evidence that the HVA1 protein may play an important role in the protection of oats against salinity and possible water-deficiency stress conditions.