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Odontogenic bone tumor (OT) is a rare pathology in the world, but it is very common in developing countries; its etiology is still unknown, and it causes serious deformities of the mandible and maxilla if it is not operated upon soon. Lassa virus (LASV) belongs to the Arenaviridae family, and its reservoir is a rodent of the genus Mastomys. The transmission of the LASV to humans can occur through ingestion or inhalation by contact with dirty objects, the consumption of contaminated food, or exposure to wounds, as rodents shed the virus in their urine and excrement. In this observational study, we aim to evaluate the presence of LASV in OT patient tissues collected in the Democratic Republic of the Congo. For this purpose, a group of nine patients affected by OT were enrolled, and the tissues derived from the surgery were collected. In total, 81.5% of the tissues were positive for LASV presence. Interestingly, we found that not only was the tumor LASV-positive, but in some cases, the bone was close to the tumor and the oral mucosa lining. These preliminary data could suggest the hypothesis that LASV may be involved with the onset of OT.

ABSTRACTArthropod-borne (arbo) viruses cause emerging diseases that affect the livelihoods of people around the world. They are linked to disease outbreaks resulting in high morbidity, mortality, and economic loss. In sub-Saharan Africa, numerous arbovirus outbreaks have been documented, but the circulation and magnitude of illness caused by these viruses during inter-epidemic periods remains unknown in many regions. In Rwanda, there is limited knowledge on the presence and distribution of arboviruses. This study aimed at determining the occurrence and distribution of selected arboviruses, i.e., chikungunya virus (CHIKV), o’nyong-nyong virus (ONNV), dengue virus (DENV), West Nile virus (WNV), Zika virus (ZIKV), Rift Valley fever virus (RVFV) and Crimean-Congo haemorrhagic fever virus (CCHFV), among febrile patients visiting health centres in Rwanda. A total of 2294 dry blood spots (DBS) were collected on filter papers during August 2019 – December 2020. Reverse-transcription polymerase chain reaction (RT-PCR) was performed on samples in pools of ten, using both quantitative (DENV, ZIKV, RVFV) and conventional PCR (CHIKV, ONNV, WNV, CCHFV) with virus specific primers, followed by sequencing. Demographic data and clinical manifestations of illness were analysed. ONNV infection was detected in 12 of 230 pools (5.2%) and ZIKV in three pools (1.3%). The other arboviruses were not detected. All ONNV cases were found in the Rwaniro health centre, while ZIKV infection was found among patients visiting the Kirinda and Zaza health centres. There was temporal variability in ONNV infections with most cases being recorded during the long dry season, while ZIKV infection occurred during both dry and wet seasons. Patients with ONNV were older and more were females. In conclusion, ONNV and ZIKV infection were detected in acute patients and can explain some of the feverish diseases in Rwanda.

The current research on integrating phase change materials (PCMs) into building envelopes is driven by the need to optimize thermal performance while preserving material properties. Integrating PCM into cement mortar faces challenges in balancing heat storage capacity and material strength. Using higher PCM content may compromise strength, but smaller content may limit heat storage capacity. To overcome these hurdles, integrating high-conductive SSPCM at lower percentages can enhance thermal performance without compromising material integrity. Yet, research in this domain is lacking. This study investigates integrating a shape-stable PCM into plaster to ascertain the ideal PCM content while maintaining vital characteristics. Experimental analysis of five composites, with PCM percentages ranging from 3% to 10%, showed that all met physical property criteria except the 10% PCM composite. Despite a slight decrease in mechanical strength, it remained within acceptable standards for mortar materials. The composites exhibited improved thermal conductivity, specific heat capacity, thermal diffusivity, and heat storage capacity significantly with increasing PCM content. This study convincingly demonstrates the feasibility of maintaining thermal effectiveness even with low PCM content, offering crucial insights for developing energy-efficient building designs and promoting sustainable practices in the construction industry.

Abstract Provenance studies demonstrate the important control of plate boundary mountain building on continental sediment routing systems. Less well understood is if subsidence and uplift in cratons also has the potential to affect the organization of sediment routing systems on continental scales. New detrital zircon provenance data from the Michigan Basin in the Midcontinent of North America preserve evidence of intrabasin provenance heterogeneity in Cambrian, Ordovician, and middle Devonian strata. These results suggest that cratonic basins serve as effective sediment barriers that prevent mixing within and across basins from 10 to 100 s of millions of years. Internal sediment mixing, sorting, and dispersal may be achieved by a combination of sedimentary processes and inherited low relief topography. These observations are consistent with provenance data sets from eastern Laurentian Midcontinent basins that show locally and regionally variable provenance signatures during the early Paleozoic. By the late Devonian, provenance signatures throughout the basins homogenized, consistent with the emergence of transcontinental sediment transport systems associated with Appalachian orogenesis at the plate margin. These results demonstrate the importance of cratonic basins on local and regional sediment routing systems suggesting that these features may impede the integration of continental-scale sediment routings systems, particularly during periods of plate margin quiescence.

Ketamine has been shown to produce analgesia in various acute and chronic pain states; however, abuse liability concerns have limited its utility. The ketamine metabolite (2R,6R)-hydroxynorketamine (HNK) has been shown to produce antidepressant-like effects similar to ketamine without abuse liability concerns. (2R,6R)-HNK produces sustained analgesia in models of chronic pain, but has yet to be evaluated in models of acute pain. The present study evaluated the efficacy of acute (2R,6R)-HNK administration (one injection) in assays of pain-stimulated (52- and 56-degree hot plate test and acetic acid writhing) and pain-depressed behavior (locomotor activity and rearing) in male and female C57BL/6 mice. In assays of pain-stimulated behaviors, (2R,6R)-HNK (1-32 mg/kg) failed to produce antinociception in the 52- and 56-degree hot plate and acetic acid writhing assays. In assays of pain-depressed behaviors, 0.56% acetic acid produced a robust depression of locomotor activity and rearing that was not blocked by pretreatment of (2R,6R)-HNK (3.2-32 mg/kg). The positive controls morphine (hot plate test) and ketoprofen (acetic acid writhing, locomotor activity, and rearing) blocked pain-stimulated and pain-depressed behaviors. Finally, the effects of intermittent (2R,6R)-HNK administration were evaluated in 52-degree hot plate and pain-depressed locomotor activity and rearing. Intermittent administration of (2R,6R)-HNK also did not produce antinociceptive effects in the hot plate or pain-depressed locomotor activity assays. These results suggest that (2R,6R)-HNK is unlikely to have efficacy in treating acute pain; however, the efficacy of (2R,6R)-HNK in chronic pain states should continue to be evaluated.

Objective: Pulmonary artery reconstruction during comprehensive stage 2 (CS2) procedure can be challenging. Since 2017, we have employed preemptive left pulmonary artery (LPA) stenting. We hypothesized that LPA stenting promotes adequate growth and without compromising Fontan candidacy. Herewith, we report our midterm results. Methods: From 2002 to 2020, 159 patients underwent CS2. Patients were divided as follows: no stent (n = 122; Group 1) and perioperative LPA stent (n = 37; Group 2). Group 2 was subdivided according to unplanned stent (n = 17; Group 2a) or preemptive stent (n = 20; Group 2b). Relevant perioperative data was reviewed. Nonparametric statistics were utilized. Results: Median age and weight at surgery and hospital length of stay after CS2 did not differ between groups. Median cardiopulmonary bypass and crossclamp times were significantly greater in Group 1 (265 vs 243 minutes [P = .021] and 46 vs 26 minutes [P = .008]). In-hospital mortality was similar between Groups 1 and 2 (9.0% vs 18.9%, respectively [P = .1348]). Group 2b demonstrated a superior survival compared to Group 2a (P = .0335) but not Group 1 (P > .9999). Preemptive stenting significantly increased median hilar LPA diameter at CS2 exit angiogram compared with no stenting (P

Abstract Rail and road infrastructure is essential for economic growth and development but can cause a gradual loss in biodiversity and degradation of ecosystem function and services. We assessed the influence of underpass dimensions, fencing, proximity to water and roads, Normalized Difference Vegetation Index (NDVI), presence of other species and livestock on underpass use by large and medium-sized mammals. Results revealed hyenas and leopards used the underpasses more than expected whereas giraffes and antelopes used the underpasses less than expected. Generalized linear mixed-effects models revealed that underpass height influenced use by wildlife, with several species preferring to use taller underpasses. Electric fencing increased underpass use by funneling species towards underpasses, except for elephants and black-backed jackal for which it reduced underpass passage. We also found that the use of underpasses by livestock reduced the probability of use by nearly 50% for wildlife species. Carnivore species were more likely to cross underpasses used by their prey. Buffalo, livestock, and hyenas used underpasses characterized by vegetation with higher NDVI and near water sources while baboons, dik-diks and antelope avoided underpasses with high NDVI. Our findings suggest a need for diverse and comprehensive approaches for mitigating the negative impacts of rail on African wildlife.

Viral hepatitis remains one of the largest public health concerns worldwide. Especially in Central Africa, information on hepatitis virus infections has been limited, although the prevalence in this region has been reported to be higher than the global average. To reveal the current status of hepatitis B and C virus (HBV and HCV) infections and the genetic diversity of the viruses, we conducted longitudinal surveillance in Gabon. We detected 22 HBV and 9 HCV infections in 2047 patients with febrile illness. Genetic analyses of HBV identified subgenotype A1 for the first time in Gabon and an insertion generating a frameshift to create an X-preC/C fusion protein. We also revealed that most of the detected HCVs belonged to the “Gabon-specific” HCV subtype 4e (HCV-4e), and the entire nucleotide sequence of the HCV-4e polyprotein was determined to establish the first reference sequence. The HCV-4e strains possessed resistance-associated substitutions similar to those of other HCV-4 strains, indicating that the use of direct-acting antiviral therapy may be complex. These results provide a better understanding of the current situation of hepatitis B and C virus infections in Central Africa and will help public health organizations develop effective countermeasures to eliminate chronic viral hepatitis in this region.

Upper Ordovician hardgrounds display a spectrum of complexity reflecting a range of local to global-scale processes. Hardgrounds are cemented seafloor surfaces typically marked by the presence of encrusting taxa and borings. Many hardgrounds show evidence for successive episodes of colonization by hard substrate specialists and are associated with localized evidence of seafloor erosion such as overhangs and reworked concretions. They commonly show trace amounts of pyrite and dolomite cements indicating an association with sulfate reduction. The most widespread hardgrounds are highly complex and unravelling their history provides insights into global biogeochemical events. The Curdsville and Kirkfield hardgrounds in the Appalachian Basin (Kentucky and Ontario) represent relatively simple end members of the hardground spectrum. They covered 10s to 100s km2 and formed relatively quickly during the early Katian. They display both planar to subplanar and hummocky to topographically complex surfaces (cm-scale) and contain highly diverse encrusting echinoderm faunas. Study of these surfaces yields important insights into the evolutionary history of encrusting communities. By contrast, the slightly younger hardground at the top of the Galena Group (Ka1) is a surface that is present throughout most of the Midcontinent Basin (>7.5 à 105km2). It is an example of a highly complex surface that was repeatedly modified by erosion and mineralization. Near the eastern margin of the basin in Indiana, the capping Galena hardground is pinnacled with cavity-filling sharpstone clasts, phosphate grains and bored crusts, iron ooids, and pyritic impregnated surfaces. It is onlapped by graptolitic shales of the Kope Formation (Fm) (Ka1) indicating an unconformity of approximately 1 m.y. To the west, in Illinois, the Kope Fm is erosionally truncated and the hardground is directly overlain by graptolitic shales of the Waynesville Fm (Ka3), where the unconformity expands to nearly 4 m.y. Toward Iowa, the hardground is onlapped by meters of phosphorite. Taken together, these observations reveal that the capping Galena Group hardground reflects a complicated history of repeated subaerial exposure, karsting, and marine flooding by a dysoxic to anoxic water mass with fluctuating redox conditions, similar to the age equivalent hardground at the base of the Fjäcka Shale in the Baltic Basin. Thus, hardground studies provide important insights for resolving the temporal continuity of the Upper Ordovician rock record and unravelling processes that controlled carbonate precipitation and dissolution and the evolution of sea floor communities. Some simple hardgrounds may have formed through random exhumation of cemented sediments on the sea floor through the effects of storm scour. However, their clustering into certain portions of the Upper Ordovician suggests that processes that affected sea water chemistry may also be involved. The most complex surfaces reflect major environmental perturbations with large amplitude sea level oscillations and redox changes that in some cases generated rare-earth enriched phosphorites.

The late Katian Elkhorn event is a biogeochemical perturbation preceding the Late Ordovician mass extinction (LOME) with an exceptional record in the United States (U.S.). Results of our recent studies in this interval allow revised temporal ordering to strata across multiple basins providing insights into the magnitude of environmental disturbance and associated processes and feedbacks. The record of the Elkhorn event spans portions of the Appalachian and Midcontinent basins in the eastern U.S. and the Williston Basin and Cordilleran margin in the west. Our work focuses heavily on the Midcontinent Basin in particular, as it shares many characteristics of size, tectonic setting, and lithofacies with the Baltic Basin, providing the potential for resolving global signatures of the event. In its type-area, the Cincinnatian Series ends with the Elkhorn event. The succession is marked by shallowing from subtidal to marginal marine facies, capped by a karstic sequence boundary. Our new conodont data demonstrate that an overlying white to pink crinoidal grainstone package, previously assigned to the basal Silurian âwhiteâ Brassfield Formation near the Ohio-Indiana state line, is in fact Upper Ordovician. Further, δ13Ccarb values in this unit are elevated, in line with later phases of the Elkhorn event (2â° more positive than reported Rhuddanian values). These findings support a correlation of the grainstone interval with the Fernvale Formation of central Tennessee. To the east, much of the northern Appalachian Basin was overfilled with widespread marginal marine to terrestrial red beds by the onset of the Elkhorn event, while the Midcontinent Basin to the west remained relatively sediment starved. In the southern Midcontinent, the mid-Elkhorn event sequence boundary was onlapped by ironstone deposition (lower Fernvale Formation). The ironstones are overlain by sparry and hematitic grainstones with localized bioherms. In Arkansas, where the Fernvale is thickest (>30 m), the sparry phase gives way upward to manganese carbonates and bioherms. Across the region, the Fernvale is, in turn, cut by a sequence boundary, suggesting a yet higher Katian sequence, and is perforated by paleokarst pockets that are filled and overlain by upper Katian (Ka4) sediments. This sequence boundary is onlapped by black shales and the thickest (>10 m) phosphorite of the Ordovician at the end of the Elkhorn event. Previous studies have suggested age equivalence of the Elkhorn and Paroveja δ13Ccarb excursions in Laurentia and Baltica. Despite the attraction of aligning the latest Richmondian and Pirgu regional stages, our data sets demonstrate that this is a miscorrelation. Critical to this revision are new integrated biostratigraphic and chemostratigraphic data sets in a transect from the margin of the Appalachian Basin into the Midcontinent Basin. The new data reveal that the Elkhorn Shale and Fernvale Formation are overlain by the Brainard and laterally equivalent Sylvan, and Mannie shales. These shale successions contain graptolites of the complanatusand pacificus zones. Thus, the Elkhorn event occurred in the latest manitoulinensis Zone, suggesting correlation with the Baltic Moe δ13Ccarb excursion. Our extensive new data sets provide regional chronostratigraphic correlation of strata deposited during the Elkhorn event. When temporally ordered, these records provide evidence for high amplitude sea level oscillations, major redox fluctuations, and reef pulses that demonstrate the waxing and waning of continental ice sheets on Gondwana and the spread of oceanic anoxia only a few million years before the LOME. These findings further call into question traditional models of rapid glaciation during a long-lived greenhouse state as the sole driver of the LOME and emphasize the need for new integrated Upper Ordovician research initiatives to better characterize Katian events.

Study of a subsurface core (named F688) from northern Indiana provides integrated data sets linking Katian chronostratigraphic records of the Appalachian and Midcontinent basins. The F688 core shows a variety of shallow- and deep-water facies containing numerous, well-preserved and zonally significant fossil species and diagnostic chemostratigraphic patterns. The succession belonging to the Cincinnatian Regional Stage in the F688 core is 210 m thick. Detailed benchtop examination of the succession revealed several phosphatic intervals, rich brachiopod faunas, multiple graptolitic horizons, and at least two tephras. Elemental analysis was conducted at 60 cm spacing quantifying lithofacies composition. Based on these results, the succession was assigned to six previously defined lithostratigraphic units (Kope, Waynesville, Liberty, Whitewater, Elkhorn, and Fort Atkinson formations). This lithostratigraphic succession shares components with both the Appalachian and Midcontinent basins, suggesting deposition near their shared margin. Twenty samples yielded abundant, well-preserved, low-diversity conodont assemblages with long-ranging taxa that clearly demarcate the position of the OrdovicianâSilurian boundary at the top of the succession in the core. More than fifty palynologic samples, targeting graptolite-bearing intervals, were processed for chitinozoans and produced important new insights. The Kope Formation contains the chitinozoan species Belonechitina kjellstromi, Hercochitina downiei, and Clathrochitina sp. nov., co-occurring with a graptolite assemblage suggestive of the Geniculograptus pygmaeus Zone. Samples from the overlying Waynesville Formation produced graptolites indicative of the upper G. pygmaeus to Paraorthograptus manitoulinensis zones co-occurring with the long-ranging chitinozoan species Belonechitina micracantha and Plectochitina spongiosa as well as several new species of the genera Tanuchitina and Hercochitina. Higher in the core, the Liberty, Whitewater, Elkhorn, and Fort Atkinson formations yielded chitinozoan species characteristic of the upper Katian biozones of Anticosti Island and Nevada, such as Tanuchitina anticostiensis, Hercochitina longi, and Eisenackitina ripae. Results of δ13Ccarb analysis reveal partial preservation of the Kope, Waynesville, and Elkhorn excursions. A tephra in the rising limb of the Waynesville Excursion yielded needle-shaped clear zircons that will provide a high-precision U-Pb age. The Fort Atkinson Formation is overlain by the Brassfield Formation containing Silurian conodonts and δ13Ccarb values suggesting an Aeronian age. Chronostratigraphic data from our study of the F688 core resolves longstanding uncertainty about correlations between strata of Katian Age in the Appalachian and Midcontinent basins. Integration of core F688 with our other regional chronostratigraphic data in the Midcontinent Basin demonstrates that the Fort Atkinson Formation of the Indiana and Illinois subsurface is age equivalent to the Fernvale Formation of Tennessee, Arkansas, and Oklahoma. Across this area, the Fernvale is overlain by graptolitic shales of the uppermost P. manitoulinensis to basal Dicellograptus complanatus graptolite zones. By contrast, the type Fort Atkinson Formation of Iowa is interpreted to occur completely within the younger D. complanatus Zone. These regional correlations taken as a whole suggest that the uppermost Katian (all of Ka4) and all but the uppermost Hirnantian are missing throughout much of the Appalachian Basin. By contrast, the Midcontinent Basin contains a much more complete upper Katian and Hirnantian succession. Our comprehensive approach is correcting temporal miscorrelation and providing robust chronostratigraphic context for study of biogeochemical events, which will further enable us to disentangle proxy data and identify the processes that drove the Katian diversity peak and culminated in the Late Ordovician mass extinction.

New data on 52 non-indigenous mollusks in the Eastern Mediterranean Sea is reported. Fossarus sp. (aff. aptus sensu Blatterer 2019), Coriophora lessepsiana Albano, Bakker & Sabelli, sp. nov., Cerithiopsis sp. aff. pulvis, Joculator problematicus Albano & Steger, sp. nov., Cerithiopsis sp., Elachisina sp., Iravadia aff. elongata, Vitrinella aff. Vitrinella sp. 1 (sensu Blatterer 2019), Melanella orientalis, Parvioris aff. dilecta, Odostomia cf. dalli, Oscilla virginiae, Parthenina cossmanni, Parthenina typica, Pyrgulina craticulata, Turbonilla funiculata, Cylichna collyra, Musculus coenobitus, Musculus aff. viridulus, Chavania erythraea, Scintilla cf. violescens, Iacra seychellarum and Corbula erythraeensis are new records for the Mediterranean. An unidentified gastropod, Skeneidae indet., Triphora sp., Hypermastus sp., Sticteulima sp., Vitreolina cf. philippi, Odostomia (s.l.) sp. 1, Henrya (?) sp., and Semelidae sp. are further potential new non-indigenous species although their status should be confirmed upon final taxonomic assessment. Additionally, the status of Dikoleps micalii, Hemiliostraca clandestina comb. nov. and H. athenamariae comb. nov. is changed to non-indigenous, range extensions for nine species and the occurrence of living individuals for species previously recorded from empty shells only are reported. Opimaphora blattereri Albano, Bakker & Sabelli, sp. nov. is described from the Red Sea for comparison with the morphologically similar C. lessepsiana Albano, Bakker & Sabelli, sp. nov. The taxonomic part is followed by a discussion on how intensive fieldwork and cooperation among institutions and individuals enabled such a massive report, and how the poor taxonomic knowledge of the Indo-Pacific fauna hampers non-indigenous species detection and identification. Finally, the hypothesis that the simultaneous analysis of quantitative benthic death assemblages can support the assignment of non-indigenous status to taxonomically undetermined species is discussed.

Summary: Infrastructure professionals (N = 261) were randomly assigned to either a future or present-framed project description and asked to recommend design attributes for an infrastructure project. The future-framed condition led professionals to propose a significantly longer infrastructure design life, useful life to the community, and acceptable return on financial investment. The findings suggest a straightforward and inexpensive way to lessen present bias in various design contexts

Abstract Background The dynamics of helminth infection in African elephant populations are poorly known. We examined the effects of age, sex, social structure and the normalized difference vegetation index (NDVI) as primary drivers of infection patterns within and between elephant populations. Methods Coprological methods were used to identify helminths and determine infection patterns in distinct elephant populations in Maasai Mara National Reserve, Tsavo East National Park, Amboseli National Park and Laikipia-Samburu Ecosystem. Gaussian finite mixture cluster analyses of egg dimensions were used to classify helminth eggs according to genera. Generalized linear models (GLM) and Chi-square analyses were used to test for variation in helminth infection patterns and to identify drivers in elephant populations. Results Helminth prevalence varied significantly between the studied populations. Nematode prevalence (96.3%) was over twice as high as that of trematodes (39.1%) in elephants. Trematode prevalence but not nematode prevalence varied between populations. Although we found no associations between helminth infection and elephant social groups (male vs family groups), the median helminth egg output (eggs per gram, epg) did vary between social groups: family groups had significantly higher median epg than solitary males or males in bachelor groups. Young males in mixed sex family groups had lower epg than females when controlling for population and age; these differences, however, were not statistically significant. The average NDVI over a three-month period varied between study locations. Cluster analyses based on egg measurements revealed the presence of Protofasciola sp., Brumptia sp., Murshidia sp., Quilonia sp. and Mammomonogamus sp. GLM analyses showed that the mean epg was positively influenced by a three-month cumulative mean NDVI and by social group; female social groups had higher epg than male groups. GLM analyses also revealed that epg varied between elephant populations: Samburu-Laikipia elephants had a higher and Tsavo elephants a lower epg than Amboseli elephants. Conclusions Elephants had infection patterns characterized by within- and between-population variation in prevalence and worm burden. Sociality and NDVI were the major drivers of epg but not of helminth prevalence. Gastrointestinal parasites can have a negative impact on the health of wild elephants, especially during resource scarcity. Thus, our results will be important when deciding intervention strategies.

Objectives: Dengue outbreaks, mainly caused by dengue virus serotype 2 (DENV-2), occurred in 2007 and in 2010 in Gabon, Central Africa. However, information on DENV infections has been insufficient since 2010. The aim of this study was to investigate the current DENV infection scenario and the risk of repeated infections in Gabon. Methods: During 2015–2017, serum samples were collected from enrolled febrile participants and were tested for DENV infection using RT-qPCR. DENV-positive samples were analyzed for a history of previous DENV infection(s) using ELISA. The complete DENV genome was sequenced to analyze the phylogeny of Gabonese DENV strains. Results: DENV-3 was exclusively detected, with a high rate of anti-DENV IgG seropositivity among DENV-3-positive participants. DENV-3 showed higher infection rates in adults and the infection was seasonal with peaks in the rainy seasons. Phylogenetic analysis revealed that Gabonese DENV-3 originated from West African strains and has been circulating continuously in Gabon since at least 2010, when the first DENV-3 case was reported. Conclusions: These findings indicate stable DENV-3 circulation and the risk of repeated DENV infections in Gabon, highlighting the need for continuous monitoring to control DENV infections. Keywords: Dengue, Dengue virus, Gabon, Africa, Phylogeny, Surveillance

Anthrax, an acute disease of homeotherms caused by soil-borne Bacillus anthracis is implicated in dramatic declines in wildlife mainly in sub-Saharan Africa. Anthrax outbreaks are often localized in space and time. Therefore, understanding predictors of the spatial and temporal occurrence of anthrax in wildlife areas is useful in supporting early warning and improved response and targeting measures to reduce the impact of epizootic risk on populations. Spatial localization of anthrax is hypothesized to be driven by edaphic factors, while the temporal outbreaks are thought to be driven by extreme weather events including temperature, humidity, rainfall, and drought. Here, we test the role of select edaphic factors and normalized difference vegetation index (NDVI) metrics driven by vegetation structure and climate variability on the spatial and temporal patterns of wildlife mortality from anthrax in key wildlife areas in Kenya over a 20-year period, from 2000 to 2019. There was a positive association between the number of anthrax outbreaks and the total number of months anthrax was reported during the study period and the nitrogen and organic carbon content of the soil in each wildlife area. The monthly occurrence (timing) of anthrax in Lake Nakuru (with the most intense outbreaks) was positively related to the previous month’s spatial heterogeneity in NDVI and monthly NDVI deviation from 20-year monthly means. Generalized linear models revealed that the number of months anthrax was reported in a year (intensity) was positively related to spatial heterogeneity in NDVI, total organic carbon and cation exchange capacity of the soil. These results, examined in the light of experimental studies on anthrax persistence and amplification in the soil enlighten on mechanisms by which these factors are driving anthrax outbreaks and spatial localization.

Many fungi in the Ophiostomatales are vectored by bark beetles that introduce these fungi directly into their tree hosts. Most of these fungal associates have little effect on their hosts, but some can cause serious diseases. One such fungus, Leptographium wageneri, causes an economically and ecologically important tree disease known as black stain root disease (BSRD). For this study, 159 full genome sequences of L. wageneri were analyzed using a population genomics approach to investigate the epidemiology, dispersal capabilities, and reproductive biology of this fungus. Analyses were performed with SNP haplotypes from 155 isolates of L. wageneri var. pseudotsugae collected in 16 Douglas-fir stands in Oregon and 4 isolates of L. wageneri var. wageneri collected in pinyon pine stands in southern California. These two host-specific varieties appear to be evolutionarily divergent, likely due a combination of factors such as host differentiation and geographic isolation. We analyzed gene flow and population structure within and among Douglas-fir plantations in western Oregon to infer the relative importance of local vs. long distance dispersal in structuring populations of L. wageneri var. pseudotsugae. Long-distance gene flow has occurred between Douglas-fir plantations, contributing to diversity and population structure within stands, and likely reflecting the behavior of an important insect vector. Genetic clustering analyses revealed the presence of unique local clusters within stands and plantations in addition to those common among multiple stands or plantations. Although populations of L. wageneri var. pseudotsugae are primarily asexual, two mating types were present in many stands, suggesting that recombination is at least possible and may contribute to genetic diversity.

Abstract The environment has a strong influence on the abundance and distribution of plant pathogenic organisms and plays a major role in plant disease. Climatological factors may also alter the dynamics of the interactions between plant pathogens and their hosts. Nothophaeocryptopus (=Phaeocryptopus) gaeumannii, the causal agent of Swiss needle cast (SNC) of Douglas‐fir, is endemic to western North America where it exists as two sympatric, reproductively isolated lineages. The abundance of this fungus and the severity of SNC are strongly influenced by climate. We used statistical and population genetic analyses to examine relationships between environment, pathogen population structure, and SNC severity. Although N. gaeumannii Lineage 2 in western Oregon and Washington was most abundant where SNC symptoms were most severe, we did not detect a significant relationship between Lineage 2 and disease severity. Warmer winter temperatures were inversely correlated with foliage retention (AFR) and positively correlated with the relative abundance of Lineage 2 (PL2). However when distance inland, which was strongly correlated with both AFR and PL2, was included in the model, there was no significant relationship between Lineage 2 and AFR. Spring/early summer dew point temperatures also were positively associated with total N. gaeumannii abundance (colonization index (CI)) and inversely correlated with AFR. Warmer summer mean temperatures were associated with lower CI and higher AFR. Our results suggest that the two lineages have overlapping environmental optima, but slightly different tolerance ranges. Lineage 2 was absent from more inland sites where winters are colder and summers are warm and dry, while Lineage 1 occurred at most sites across an environmental gradient suggesting broader environmental tolerance. These relationships suggest that climate influences the abundance and distribution of this ecologically important plant pathogen and may have played a role in the evolutionary divergence of these two cryptic fungal lineages.

Roadkill is one of the highest causes of wildlife mortality and is of global conservation concern. Most roadkill studies have focused on wildlife in developed countries such as the United States of America and temperate biomes, but there are limited data for the impacts of roads on wildlife in the African tropics, where road infrastructure development is projected to grow rapidly in natural environments and conservation areas. The Tsavo Conservation Area is an important biodiversity hotspot in eastern Kenya and is bisected by a major highway and railways that connect the port of Mombasa to the interior. Along this infrastructure corridor, roadkill was recorded for 164 days over an 11-year period (2007–2018). In total, 1,436 roadkill were recorded from 13,008 km driven of a 164.42 km Nairobi-Mombasa road representing 0.11 collisions per kilometer. The majority of roadkill were small to medium sized mammals (15kg). Of the 460 birds recorded, 264 were identifiable represented by 62 species. All large mammals comprising 10 species were identified, including the African elephant, Loxodonta africana and the endangered African wild dog, Lycaon pictus. Thirteen species of small mammal were also identified dominated by Kirk's dik-dik (Madoqua kirkii). Reptiles were represented by 11 species which were identified to the species level. Roadkill hotspots were identified using a kernel density method. The spatial distribution of roadkill was associated with adjacent shrub vegetation and proximity to permanent and seasonal rivers, and differences in seasonality and habitats were observed. Roadkill was lowest on road sections that traversed settled areas as opposed to roads adjacent to the protected areas. The results demonstrate that roadkill for two of the taxonomic groups - mammals and birds - appear high with numerous species detected in the Tsavo Conservation Area. These results can be used to focus efforts to reduce wildlife mortality by guiding future mitigation efforts.

Button batteries (BBs) are found in many households and are a source of esophageal foreign body in the pediatric population. Upon ingestion, significant caustic injury can occur within 2 hours leading to tissue damage and severe, potentially fatal sequelae. Aortoesophageal fistula (AEF) is a rare complication that nearly always results in mortality. We report a rare case of a toddler who developed an AEF after BB ingestion and survived following staged aortic repair. There should be a high index of suspicion for this complication with the history of BB ingestion and presence of hematemesis, hemoptysis, or melena.

Several arenaviruses are highly pathogenic to humans, causing hemorrhagic fever. Discovery of anti-arenavirus drug candidates is urgently needed, although the molecular basis of the host- and organ-specific pathogenicity remains to be fully elucidated. The arenavirus Z protein facilitates production of virus-like particles (VLPs), providing an established method to assess virus budding. In this study, we examined the efficiency of VLP production by solely expressing Z protein of several different arenaviruses. In addition, we analyzed the role of the late (L)-domain of the arenavirus Z protein, which is essential for the interaction with ESCRT proteins, in VLP production among different cell lines. VLP assay was performed using Z proteins of Junín virus (JUNV), Machupo virus (MACV), Tacaribe virus (TCRV), Latino virus (LATV), Pichinde virus (PICV), and Lassa virus (LASV) in six different cell lines: HEK293T, Huh-7, A549, Vero76, BHK-21, and NIH3T3 cells. JUNV, MACV, and LASV Z proteins efficiently produced VLPs in all tested cell lines, while the efficiencies of VLP production by the other arenavirus Z proteins were cell type-dependent. The contribution of the L-domain(s) within Z protein to VLP production also highly depended on the cell type. These results suggested that each arenavirus has its own particle-production mechanism, which is different among the cell types.

A 62-year-old male with type 2 diabetes mellitus presented to our nationally accredited breast center with bilateral breast masses present for 7 years and new-onset pink nipple discharge for several months. Mammography and ultrasound demonstrated a left 2.7 retroareolar cystic lesion and a right 2.1 cm retroareolar solid lesion. Given the suspicious nature of the bilateral breast discharge, core needle biopsies were performed to rule out underlying malignancy. The biopsies revealed benign results, but the discordance between the biopsy, imaging, and suspicious discharge led to the decision to perform bilateral excisional biopsies. Intraoperatively, a small organism resembling a larva was encountered. The abnormal tissue was sent for histopathological examination, along with the organism, which was identified as the larvae of Musca domestica , or common house fly.

Abstract Answering questions before a learning episode—“prequestions”—can enhance memory for that information. A number of studies have explored this effect in the laboratory; however, few studies have examined prequestions in a classroom setting. In the current study, the effects of prequestions were examined in an undergraduate course in chemical engineering. At the start of several class meetings, students were provided with a prequestion to answer about the upcoming lesson, and then were asked to provide ratings of confidence in their answers, familiarity with the content in the prequestion, and how much of the assigned reading they had completed. At the end of class, students were given the same question again (postquestion), along with a different question from the same lesson (new question). On a quiz at the end of each week, students were given the postquestions and new questions again, in addition to never-before-seen questions (quiz-only questions) from the same lessons. Performance on questions at the end of class revealed no difference in performance for postquestions vs. new questions. Although weekly quiz performance revealed an effect of retrieval practice—superior memory for material tested at the end of class (postquestions and new questions) compared to material not tested (quiz-only questions)—there was no difference in weekly quiz performance on postquestions vs. new questions. These results suggest that retrieval practice is beneficial to learning in the classroom. However, prequestions do not appear to enhance learning, nor to enhance the effects of retrieval practice.

The use of biopsy darts for remote collection of tissue samples from free-ranging terrestrial and aquatic animal species has gained popularity in the recent past. The success of darting is very important since scientists may not have many chances to re-dart the same animal, especially with the free-ranging elusive wildlife species. We used wildebeest (Connochaetes taurinus) as a model to estimate the optimum shooting distance, pressure and the shot part of the body through which a researcher can optimize the success and amount of tissue collected from similar wild land mammalian species. Wildebeests were darted at six categories of distances ranging between 10 and 45 m and dart gun pressures of 5–14 millibar. The number of failed darts increased by increasing the darting distance: 0% (10 m), 0% (20 m), 6% (30 m), 20% (35 m), 71% (40 m), and 67% (45 m). There was a notable effect of the distances on the amount of tissue collected 20 m offered the best results. Dart gun pressure had no effect on the amount of tissue samples obtained. The amount of tissue obtained from successful darts was the same whether the animal was darted on the shoulder or thigh. In this paper, we present a practical guideline for remote biopsy darting of wildebeest to obtain optimum amount of tissue samples, which could be generalized for similar wild land mammalian species.

Although historical records indicate the presence of Ehrlichia and Babesia in African elephants, not much is known about their prevalence and diversity in elephants and their ticks, Amblyomma thollonii and Rhipicephalus humeralis. We amplified and sequenced the hypervariable V4 region of the 18S rRNA gene of Babesia and Theileria and the heat shock protein gene (groEL) of Ehrlichia/Anaplasma in DNA extracted from elephant blood (n = 104) and from elephant ticks (n = 52). Our results showed that the African elephants were infected with a novel Babesia spp. while A. thollonii was infected with Theileria bicornis and Theileria cf. velifera. This is the first record of T. bicornis; a protozoan that is linked to fatal infection in rhinoceros in a tick. Elephants and their ticks were all infected with a species of Ehrlichia like that identified in Japanese deer. The prevalence of Babesia spp., Theileria spp. and Ehrlichia spp. in ticks was higher than that of their elephant hosts. About 13.5% of elephants were positive for Theileria or Babesia while 51% of A. thollonii ticks and 27% of R. humeralis ticks were positive for Theileria or Babesia. Moreover, 5.8% of elephants were positive for Ehrlichia or Anaplasma compared to 19.5% in A. thollonii and 18% in R. humeralis. There was no association between the positive result in ticks and that of their elephant hosts for either Babesia spp., Theileria spp. or Ehrlichia spp. Our study reveals that the African elephants are naturally infected with Babesia spp and Ehrlichia spp and opens up an opportunity for further studies to determine the role of elephant as reservoirs of tick-borne pathogens, and to investigate their potential in spreading these pathogens as they range extensively. The presence of T. bicornis in A. thollonii also suggests a need for experiments to confirm its vector competence.

Objective: Periodontal diseases are treated using nonsurgical treatment methods and surgical treatment methods. There is a paucity of information on surgical periodontal treatment in Nigerian periodontal healthcare settings. The objective of the study was to determine the indications and pattern of surgical periodontal treatment in the University of Benin Teaching Hospital, Benin City, Nigeria. Materials and Methods: This retrospective review of patients that had surgical periodontal treatment at University of Benin Teaching Hospital, Benin City, Nigeria, over a 37 month period (January 2013–2016) was done using a self developed proforma as the data collection tool. A total of 52 patients out of the 5111 patients treated within the period had surgical periodontal treatment and were subsequently analyzed using SPSS version 20.0. Results: The patients aged between 16 and 81 years with a mean age of 44.15 ± 18.99 years and a median age of 45 years had surgical periodontal treatments. The majority of the patients were older adults (57.7%) (middle-age adults [34.6%] and elderly [23.1%]) and females (75.0%). The indications for the surgical periodontal treatment were mainly periodontal abscess and gingival enlargement. The gingival enlargement was majorly pyogenic granuloma in 41.2% (7/17) and fibrous epulis in 23.5% (4/17). Incision and drainage and gingivectomy constituted the main surgical periodontal treatments among the patients in this study. Age and gender were found to be significantly associated with the indications for surgical periodontal treatment and the pattern of surgical periodontal treatment among the patients. Conclusion: Periodontal abscess and gingival enlargement constituted the main indications for surgical periodontal treatment while incision and drainage and gingivectomy were the main surgical periodontal treatments in this study.

Most biology undergraduates learn about mutations in multiple classrooms throughout their college career. Understanding personalised genome test results, genome editing controversies, and the appearance of new variants of viruses or antibiotic resistant bacteria all require foundational knowledge about mutations. However, the abstract nature of molecular processes surrounding mutations makes them one of the more difficult topics for students to understand and apply. Instructors need valid assessment tools to document student understanding and tailor their instructional methods to address student knowledge gaps. We describe here the development and validation of the Mutations Criterion Referenced Assessment (MuCRA). This formative assessment was developed through an iterative process involving expert feedback and student responses to both open-ended and multiple-choice questions. The final MuCRA is composed of 10 multiple-choice questions aligned with three learning objectives. The item difficulty for each question was between 0.32-0.65, while the discrimination index ranged from 0.31-0.75 and the reliability (KR20) for the MuCRA was 0.69. The congruence analyses demonstrated distractors are capturing student misconceptions in 9/10 questions. These data indicate that the MuCRA can be used to reliably assess student learning and common misconceptions about mutations.

Background: Rift Valley fever (RVF) is a fatal arthropod-borne zoonotic disease of livestock and humans. Since the identification of RVF in Kenya in the 1930s, repeated epizootics and epidemics coinciding with El Niño events have occurred in several locations in Africa and Saudi Arabia, causing mass deaths of livestock and humans. RVF is of great interest worldwide because of its negative effect on international livestock trade and its potential to spread globally. The latter is due to the increasing incidence of extreme climatic phenomena caused by global warming, as well as to the increase in global trade and international travel. How RVF is maintained and sustained between epidemics and epizootics is not clearly understood, but it has been speculated that wildlife reservoirs and trans-ovarian transmission in the vector may be important. Several studies have examined the role of wildlife and livestock in isolation or in a limited geographical location within the one country over a short time (usually less than a year). In this study, we examined the seroprevalence of anti-RVF antibodies in cattle and several wildlife species from several locations in Kenya over an inter-epidemic period spanning up to 7 years. Methods: A serological survey of immunoglobulin G (IgG) antibodies to RVF using competitive ELISA was undertaken on 297 serum samples from different wildlife species at various locations in Kenya. The samples were collected between 2008 and 2015. Serum was also collected in 2014 from 177 cattle from Ol Pejeta Conservancy; 113 of the cattle were in close contact with wildlife and the other 64 were kept separate from buffalo and large game by an electric fence. Results: The seroprevalence of RVF virus (RVFV) antibody was 11.6% in wildlife species during the study period. Cattle that could come in contact with wildlife and large game were all negative for RVFV. The seroprevalence was relatively high in elephants, rhinoceros, and buffalo, but there were no antibodies in zebras, baboons, vervet monkeys, or wildebeest. Conclusions: Diverse species in conservation areas are exposed to RVFV. RVFV exposure in buffalo may indicate distribution of the virus over wide geographical areas beyond known RVFV foci in Kenya. This finding calls for thorough studies on the epizootology of RVFV in specific wildlife species and locations.

Lilly PCSK9 antibody LY3015014 (LY) is a monoclonal antibody (mAb) that neutralizes proprotein convertase subtilisin-kexin type 9 (PCSK9). LY decreases LDL cholesterol in monkeys and, unlike other PCSK9 mAbs, does not cause an accumulation of intact PCSK9 in serum. Comparing the epitope of LY with other clinically tested PCSK9 mAbs, it was noted that the LY epitope excludes the furin cleavage site in PCSK9, whereas other mAbs span this site. In vitro exposure of PCSK9 to furin resulted in degradation of PCSK9 bound to LY, whereas cleavage was blocked by other mAbs. These other mAbs caused a significant accumulation of serum PCSK9 and displayed a shorter duration of LDL-cholesterol lowering than LY when administered to mice expressing the WT human PCSK9. In mice expressing a noncleavable variant of human PCSK9, LY behaved like a cleavage-blocking mAb, in that it caused significant PCSK9 accumulation, its duration of LDL lowering was reduced, and its clearance (CL) from serum was accelerated. Thus, LY neutralizes PCSK9 and allows its proteolytic degradation to proceed, which limits PCSK9 accumulation, reduces the CL rate of LY, and extends its duration of action. PCSK9 mAbs with this property are likely to achieve longer durability and require lower doses than mAbs that cause antigen to accumulate.

Background: Retention of patients in HIV care is crucial to ensure timely treatment initiation, viral suppression, and to avert AIDS-related deaths. We did a randomised trial to determine whether a text-messaging intervention improved retention during the first year of HIV care. Methods: This unmasked, randomised parallel-group study was done at two clinics in informal settlements in Nairobi, Kenya. Eligible participants were aged 18 years or older, HIV-positive, had their own mobile phone or access to one, and were able to use simple text messaging (or have somebody who could text message on their behalf). Participants were randomly assigned (1:1), with random block sizes of 2, 4, and 6, to the intervention or control group. Participants in the intervention group received a weekly text message from the automated WelTel service for 1 year and were asked to respond within 48 h. Participants in the control group did not receive text messages. Participants in both groups received usual care, which comprised psychosocial support and counselling; patient education; CD4 cell count; treatment; screening for tuberculosis, opportunistic infections, and sexually transmitted infections; prevention of mother-to-child transmission and family planning services; and up to two telephone calls for missed appointments. The primary outcome was retention in care at 12 months (ie, clinic attendance 10–14 months after the first visit). Participants who did not attend this 12-month appointment were traced, and we considered as retained those who were confirmed to be active in care elsewhere. The data analyst and clinic staff were masked to the group assignment, whereas participants and research nurses were not. We analysed the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01630304. Findings: Between April 4, 2013, and June 4, 2015, we screened 1068 individuals, of whom 700 were recruited. 349 people were allocated to the intervention group and 351 to the control group. Participants were followed up for a median of 55 weeks (IQR 51–60). At 12 months, 277 (79%) of 349 participants in the intervention group were retained, compared with 285 (81%) of 351 participants in the control group (risk ratio 0·98, 95% CI 0·91–1·05; p=0·54). There was one mild adverse event related to the intervention, a domestic dispute that occurred when a participant's partner became suspicious of the weekly messages and follow-up calls. Interpretation: This weekly text-messaging service did not improve retention of people in early HIV care. The intervention might have a modest role in improving self-perceived health-related quality of life in individuals in HIV care in similar settings. Funding: National Institutes of Health and Canadian Institutes of Health Research Canadian HIV Trials Network

Background: Three device-assisted deep endoscopic platforms presently exist and are available for clinical use: double-balloon enteroscopy, single-balloon enteroscopy (SBE), and spiral enteroscopy (SE). In a retrospective study, SE was associated with a greater depth of maximal insertion (DMI) with similar diagnostic yields and procedure time as compared with SBE. Aims: This was a prospective, randomized comparison of SE and SBE with respect to DMI, diagnostic yield, procedure time, and rate of adverse events. Methods: Patients were prospectively randomized to undergo either anterograde SE or SBE. Patient demographics, indication for procedure, DMI, procedure time, therapeutic procedure time, adverse event, diagnostic findings, and therapeutic interventions were prospectively recorded. The primary outcome was DMI. Secondary outcomes included: procedure time; diagnostic yield; therapeutic yield and adverse event rates. Results: During the study period, 30 patients underwent deep enteroscopy (SE 13, SBE 17). The most common indication was gastrointestinal bleeding in both groups. There was no significant difference in the DMI between SE and SBE (330.0 ± 88.2 cm vs 285.3 ± 80.8 cm, P = .16). There was no difference between SE and SBE in procedure time (37.0 ± 10.5 vs 38.3 ± 12.4, P = .76), diagnostic yield (SE = 9 [69%] vs SBE = 7 [41%], P = .16), or therapeutic yield (SE = 6 [46%] vs SBE = 4 [24%], P = .26). There were no major adverse events in either group. Conclusions: Spiral enteroscopy and SBE are similar with respect to DMI, diagnostic yield, therapeutic yield, procedure time, and rate of adverse events. Small numbers prevent giving a definitive judgment and future adequately powered prospective study is required to confirm these findings.

Introduction. Anastomotic biliary strictures (ABS) are a significant clinical problem associated with decreased survival post-liver transplantation (LT). Contributing to the morbidity of ABS is the need for early (i.e. emergent or unplanned) repeat endoscopic retrograde cholangiopancreatographies (ER-ERCPs). Our aim was to determine clinical, operative, and endoscopic predictors of ER-ERCP in patients with ABS.Material and methods. Medical records of 559 patients who underwent LT at our institution from 2000-2012 were retrospectively reviewed for pertinent data. The primary endpoint was need for ER-ERCP. Seventeen potential predictors of ER-ERCP were assessed in bivariate analyses, and those with p < 0.20 were included in multivariate regression models.Results. Fifty-four LT patients developed ABS and underwent a total of 200 ERCPs, of which 40 met criteria for ER-ERCP. Predictors of ER-ERCP in bivariate analyses included balloon dilation within 3 months post-LT and donation after cardiac death (both p < 0.05). Balloon dilation within 3 months post-LT was also associated with shorter ER-ERCP-free survival (p = 0.02). Moreover, a significantly higher proportion (67%) of patients who underwent balloon dilation within 3 months post-LT subsequent experienced ≥ 1 ER-ERCP (p = 0.03), and those who experienced ≥ 1 ER-ERCP had lower stricture resolution rates at the end of endoscopic therapy compared to those who did not (79 vs. 97%, p = 0.02). In multivariate analyses, balloon dilation within 3 months post-LT was the strongest predictor of ER-ERCP (OR 3.8, 95% CI 1.7-8.6, p = 0.001).Conclusions. Balloon dilation of ABS within 3 months post-LT is associated with an increased risk of ER-ERCP, which itself is associated with lower ABS resolution rates. Prospective studies are needed to confirm these findings and their implications for endoscopic management and follow-up of post-LT ABS.

Proprotein convertase subtilisin-kexin type 9 (PCSK9) is a secreted protein which regulates serum LDL cholesterol. It circulates in human and rodent serum in an intact form and a major truncated form. Previous in vitro studies involving the expression of human PCSK9 genetic variants and in vivo studies of furin knockout mice suggest that the truncated form is a furin cleavage product. However, the circulating truncated form of PCSK9 has not been isolated and characterized. Utilizing antibodies which bind to either the catalytic domain or the C-terminal domain of PCSK9, the truncated PCSK9 was isolated from serum. MS was used to determine that this form of PCSK9 is a product of in vivo cleavage at Arg218 resulting in pyroglutamic acid formation of the nascent N terminus corresponding to Gln219 of intact PCSK9. We also determined that the truncated PCSK9 in serum lacked the N-terminal segment which contains amino acids critical for LDL receptor binding. A truncated PCSK9, expressed and purified from HEK293 cells with identical composition as the circulating truncated protein, was not active in inhibition of LDL uptake by HepG2 cells. These studies provide a definitive characterization of the composition and activity of the truncated form of PCSK9 found in human serum.

Background. Consensus guidelines recommend that patients at high risk for choledocholithiasis undergo endoscopic retrograde cholangiopancreatography (ERCP) without additional imaging. This study evaluates factors and outcomes associated with performing magnetic resonance cholangiopancreatography (MRCP) prior to ERCP among patients at high risk for choledocholithiasis. Methods. An institutional administrative database was searched using diagnosis codes for choledocholithiasis, cholangitis, and acute pancreatitis and procedure codes for MRCP and ERCP. Patients categorized as high risk for choledocholithiasis were evaluated. Results. 224 patients classified as high risk, of whom 176 (79%) underwent ERCP only, while 48 (21%) underwent MRCP prior to ERCP. Patients undergoing MRCP experienced longer time to ERCP (72 hours versus 35 hours, p

Objective: To determine the tooth brushing, tongue cleaning and snacking behaviour of dental technology and therapist students. Methods: A descriptive cross-sectional study of students of Federal School of Dental Therapy and Technology Enugu, Nigeria. Self-administered questionnaire was used to obtain information on demography, frequency, duration and technique of tooth brushing and tongue cleaning as well as information on consumption of snacks. Results: A total of 242 students responded. Dental technology students made up 52.5% of the respondents and dental therapist in training made up 47.5%. Majority (63.2%) of the respondents considered the strength of tooth brush when purchasing a tooth brush and 78.9% use tooth brushes with medium strength. Seven-tenth (71.9%) of the respondents brush their teeth twice daily and 52.1% brush for 3–5 minutes. About one-third (30.2%) brush their teeth in front of a mirror. Chewing stick was used by 51.7% of respondents in addition to the use of tooth brush. Tongue cleaning was done by 94.2% with only 9.5% using a tongue cleaner. Only 20.2% reported regular snacks consumption. Nine-tenth (90.4%) of respondents were previously involved in educating others, apart from their colleagues, on tooth brushing. Conclusion: This survey revealed that most of the dental therapy and technology students had satisfactory tooth-brushing behaviour. The zeal to educate others about proper tooth brushing revealed in this study suggests that the students may be helpful in oral health promotion.

Objective: To determine the perceived oral health status and treatment needs of Nigerian dental therapists in training and dental technology students. Methods: A descriptive cross-sectional study of students from Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted using self-administered questionnaire to obtain information on demography, self-reported oral health status, knowledge of impact of oral health on daily life activity, dental attendance and perceived dental need. Results: The perception of oral health status and treatment need of the two groups of dental auxiliaries was the same. Fewer respondents (27.3%) rated their oral health as excellent, while 50.4% rated their oral health as good. Majority (95.5%) agreed that oral health is a part of general health and 94.6% agreed that oral health has a role in daily life.Out of 81.4% that had previous dental treatment, scaling and polishing accounted for 66.1%. Presently, 48.8% think they need dental treatment ranging from scaling and polishing (33.9%), tooth restoration (10.3%), to extraction (1.2%). Conclusion: This survey revealed that most of the students are aware that oral health is a component of general health and that it has an impact on an individual's daily life. More than half of the students perceived their oral health as good, but only a few knew that there is a need for a preventive approach to oral health as evident by the percentage that perceived scaling and polishing as a treatment need.