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Background and Aim: Informal prescribers (IPs) significantly contribute to the development of antimicrobial resistance and in disseminating pathogens from poultry to humans and other animals through the food chain, posing a serious global health threat. Therefore, this study aimed to assess whether the knowledge of IPs has an impact on their attitude and practice toward antimicrobial use, antibiotic residues, and antimicrobial resistance. Materials and Methods: In this cross-sectional study, we conducted a pre-tested and questionnaire-based survey to investigate the knowledge, attitude, and practice of IPs in selected parts of the Mymensingh division, Bangladesh. Then, we used the linear regression model test with R-squared (R2) to measure the association between the study variables. Results: Our investigation revealed that 70% of the IPs knew about antibiotics and 75% had good knowledge about antibiotic resistance, whereas only 50% were aware of withdrawal periods. Informal prescribers also displayed good attitudes toward the use and sale of antibiotics with withdrawal periods and completion of medication (50%). Analysis of their practice on the sale and prescription of antibiotics showed that 70% and 30% of IPs use antibiotics against bacterial infections and other conditions, respectively. Most of them do not consult a veterinarian before selling or prescribing antibiotics, although 80% claim to do so. This is because 75% of IPs gave other options regarding their consultations. However, 95% of IPs uses antibiotics only for therapeutic purposes. Furthermore, only 10% sell antibiotics based on a veterinarian’s recommendation. Approximately 45% of IPs use single antibiotics at a time, while the rest use multiple antibiotics, individually or combined. Approximately 15% use antibiotics monthly, while 85% use them whenever the need arises. The knowledge and attitude of IPs are significantly affected by their age (p ≤ 0.025). The district of domicile also impacted their knowledge. Surprisingly, IPs from Jamalpur had significantly better knowledge compared to those from Mymensingh and Sherpur (p ≤ 0.01). The attitude of IPs from Jamalpur and Netrokona also differed significantly (p ≤ 0.001) from that of Mymensingh and Sherpur. The knowledge of IPs influenced their attitude up to 80.5% (r2 = 0.628) and their practice up to 75.4% (r2 = 0.545). Conclusion: The knowledge of IPs greatly influenced their attitude and practice, while sociodemographics also influenced their knowledge and attitude toward antimicrobial use, antibiotic residues, and antimicrobial resistance.

To illustrate the challenges encountered when gathering rapidly synthesized evidence in response to the coronavirus disease 2019 (COVID-19) pandemic. In this article, we describe the challenges encountered when we performed a systematic literature review (SLR) of randomized controlled trials (RCTs) on the efficacy and safety of treatments for severe COVID-19. The methods of the SLR are described in full, to show the context of our objectives. Then we use the results of the SLR to demonstrate the problems of producing synthesized evidence in this setting. Various challenges were identified during this SLR. These were primarily a result of heterogeneity in the study methodology of eligible studies. Definitions of the patient populations and outcome measurements were highly variable and the majority of studies demonstrated a high risk of bias, preventing quantitative synthesis of the collated evidence. Consolidating evidence from RCTs evaluating COVID-19 interventions was problematic. Guidance is needed for scenarios with high rapid output in primary research. [ABSTRACT FROM AUTHOR]

The study examines the significant factors affecting the capital structure decisions for banks' in MENA region. An unbalanced panel data comprising of 132 banks operating in fifteen different countries of the MENA region from 2012 to 2017, data was extracted from Bank Scope resulting in 891 bank year observations. Macroeconomic indicators and institutional characteristics data has been taken from World Bank and World Bank governance indicators database and financial freedom data has been collected from heritage foundation. We use the two-step system Generalized Method of Moments (GMM) to explore the relationship between dependent and explanatory variables. The regression outcome between profitability and leverage shows a negative and significant relationship. No significant association between tangibility and leverage is found. Earnings volatility is negatively and significantly related to leverage. The relationship between growth and leverage is negative and significant. Macroeconomic indicators GDP growth and inflation show a positive relationship with leverage. Finally, the institutional factors, that is, government effectiveness, political stability, and rule of law have positive association with leverage. The study results will lend a hand to bank managers to make value-maximizing financing decisions to achieve an optimal capital structure. It will also help the policymakers to articulate an effective regulatory framework in the region. As per our knowledge, this is the first study to explore the determining factors of capital structure for banks operating in the MENA region. Moreover, the findings from MENA region banks could also support the comparative study with other regional blocks. [ABSTRACT FROM AUTHOR]

Objective: To develop faculty consensus of orthodontic learning outcomes associated with knowledge and skills of “Treatment” required for undergraduate students. Study Design: Qualitative study Place and Duration of Study: Islamic International Dental College, Islamabad, 15th January, 2016 to 15th March, 2016. Materials and Methods: A Delphi method was used in two rounds to develop consensus by orthodontic faculty from various dental colleges of Pakistan. Learning outcomes related to skills were formulated in the form of a questionnaire and sent to study participants. A five point likert scale was used to obtain perception of dental faculty. Later, a qualitative approach was adopted by giving open ended questions associated with skills required in “Treatment” part of undergraduate orthodontic course. The quantitative data was analyzed by using SPSS version 20. The qualitative data was obtained and analyzed using NVivo version 11. Results: Twenty participants (N= 20) responded with their feedback to closed-ended first questionnaire and sixteen participants responded to the second open-ended questionnaire. Out of the 28 learning objectives, participants achieved consensus on 21 items particularly on knowledge and skills related to treatment planning for mixed dentition in first round. Whereas in second round, out of seven non consensus items, two learning objectives, three dimensional location of maxillary canine and skill in fabrication of functional appliances could not achieve consensus. Conclusion: The orthodontic faculty agreed that undergraduate students must have skills of history taking, oral examination, x-ray, and removable appliances for orthodontic discipline.

Abstract This paper proposes a numerical approach for predicting residual stresses induced during the additive manufacturing (AM) of polymer composites and their effect on the deformation behavior of the composites. A finite element (FE) model was developed on Abaqus/Standard for 3D printing of layered polymer composite using three polymers: HDPE, PVC, and ABS. The material properties of pure polymers and their blends were measured through tensile testing of injection-molded specimens. These properties were then used as input data in the FE model for the regions of pure polymers and their interfaces. An uncoupled thermo-mechanical analysis was performed, where a heat transfer analysis was realized first using elements birth (activation/deactivation) technique and a moving cylindrical volumetric heat source as a Fortran subroutine (DFLUX). With temperature input from thermal simulation, a mechanical analysis was carried out to deform the polymer composites along and across the print direction, i.e. under isostrain and isostress conditions, respectively. It was observed that the theoretical models existing in the literature underestimate the material properties as they do not consider the residual stresses developed during fabrication. The FE simulations predicted that the estimated material properties were 10 to 50% different from those calculated by the theoretical models, depending upon the residual stress level and the print direction. [ABSTRACT FROM AUTHOR]

Context: There is a growing concern regarding increasing cases of kidney diseases in Jigawa state, with most conditions requiring hemodialysis or other forms of renal replacement therapy. Aim: This study aimed to find the magnitude, distribution, socio-demographic, and other factors associated with hemodialysis in Jigawa state, Northwest Nigeria. Materials and Methods: It was a retrospective multicenter analysis of secondary data from hemodialysis centers of the randomly selected public hospitals in northwest Nigeria. Statistical Analysis: Data were analyzed using IBM SPSS Statistics for Windows, version 22.0, with statistical significance set at P ≤ 0.05. Results: A total of 1,329 patients were enrolled for dialysis in Kano and Jigawa states, between 2019 and 2022, out of which more than one-third (509, 38.3%) were from Jigawa state. Dutse, Jahun, Gumel, and Hadejia local government areas (LGAs) of Jigawa state had 86 (16.8%), 64 (12.6%), 48 (9.4%), and 44 (8.6%) respectively. The respondent's ages ranged from 1 − 100 years with a median age of 48 (interquartile range [IQR] = 31, 60) years. Chronic kidney disease (CKD) was found among 403 (79.2%) patients, acute on chronic kidney disease (AOCCKD) in 87 (17.1%) patients, and acute kidney injury (AKI) in 19 (3.7%) patients. The major risk factors identified were hypertension, diabetes, and chronic glomerulonephritis (CGN) among 329 (64.6%), 69 (13.6%), and 66 (13.0%) patients, respectively. Hypertension was a significantly higher risk factor among patients from Jigawa state compared with other states (46.8%, P < 0.001), hypertensives from Jigawa state were twice more likely to develop kidney disease requiring hemodialysis (adjusted odds ratio [aOR] = 2.2, 95% confidence interval [CI] = 1.7–2.8) compared with non-hypertensive etiologies. Conclusion: The burden of kidney diseases requiring hemodialysis in Jigawa state is high, with hypertension and diabetes being the major risk factors for hemodialysis. The government and other stakeholders should develop strategies for early identification and proper management of the risk factors. [ABSTRACT FROM AUTHOR]

Context: The morbidity and mortality arising from the COVID-19 pandemic in low- and middle-income countries were further worsened by the disruption in health systems and diversion of strained health resources for emergency response. Aim: This study ascertained whether there was an increase in the number of deaths recorded in Kano, Nigeria, during the pandemic, compared to the preceding 3 years and identified the potential causes of these deaths. Materials and Methods: Using a retrospective design, data were collected from a tertiary hospital in Kano from January to June 2020. Data on number and date of deaths, as well as clinical information of the deceased, were retrieved from hospital records. Comparison data were collected on all deaths and admissions in the hospital within a similar period (January–June) of 2017–2019. Results: The age of the deceased ranged from one day to 115 years, with the majority being males (n = 414; 63.2%) and adults (n = 491; 75.0%). The majority did not have history of recent travel (n = 570; 87.0%), contact with COVID-19 suspected cases (n = 622; 95.0%), or confirmed COVID-19 (n = 625; 95.4%). Slightly less than half (n = 262; 46.2%) died within 24h of admission. The majority (n = 452; 79.7%) died within 7 days of admission. The most common cause of death recorded on admission was sepsis (n = 66; 10.1%), while 53 (8.1%) were brought in dead. SARS-CoV-2 infection was the documented cause of death in twelve patients (1.8%). More than half (n = 378; 57.7%) had underlying medical conditions, of which hypertension (n = 172; 45.5%) was the most common. The highest annual average deaths (178) and admissions (2179) were recorded in 2019, while 135 deaths and 1532 admissions were recorded in 2020. Most deaths occurred in April 2020 (208), while the highest number of admissions was recorded in March 2020. Mortality was higher in April of 2020 (14.1%, 95% CI: 12.4%–16.0%) compared to the same month in 2017 (7.6%, 95% CI: 5.9%–9.7%), 2018 (8.4%, 95% CI 7.0%–10.2%), and 2019 (8.5%, 95% CI 7.3–9.8%). Conclusion: In summary, we found excess mortality rates during the COVID-19 pandemic in Kano, Nigeria, consistent with prior studies. [ABSTRACT FROM AUTHOR]

This study examines the effects of shadow banking activities on the financial stability of the Chinese banking system. Moreover, it assesses whether the relation between financial stability and shadow banking activities changes for banks having political connections. The findings suggest a significant positive effect of shadow banking on the credit risk as well as the financial stability of Chinese banks. The growth of shadow banking activities has a significantly positive effect on Chinese commercial banks lowering the default risk and this relationship is incrementally significant for financial institutions having political connections. These findings are robust by controlling for various bank-specific and macroeconomic conditions. [ABSTRACT FROM AUTHOR]

Copyright of Economic Horizons / Ekonomski Horizonti is the property of Economic Horizons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This research aims to evaluate the internal factors influencing the performance of Islamic banks in Pakistan. There are currently five Islamic banks in operation, and data from all five have been used to analyze their performance from 2008 to 2021. The data was collected from the State Bank of Pakistan. To examine financial performance, this study used return on assets (ROA) and returns on equity (ROE) as proxies, and considered both internal attributes (such as liquidity, bank size, asset quality, capital adequacy ratio, operational efficiency, and assets management) and external factors (such as macroeconomic indicators like GDP growth and inflation rate). Ordinary least squares (OLS) estimation is employed to examine the relationship among variables. The estimation findings suggest that all of the internal factors have a strong association with banks' performance. Bank size and asset quality were found to have a positive and significant association with ROA, while asset quality and assets management were associated positively with ROE. Additionally, during the Covid-19 pandemic period, banks' size and liquidity were found to adversely affect ROA of Islamic banks, while operational efficiency had a positive impact. [ABSTRACT FROM AUTHOR]

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Amoebae interact with bacteria in multifaceted ways. Amoeba predation can serve as a selective pressure for the development of bacterial virulence traits. Bacteria may also adapt to life inside amoebae, resulting in symbiotic relationships. Indeed, particular lineages of obligate bacterial endosymbionts have been found in different amoebae. Here, we screened an extensive collection of Dictyostelium discoideum wild isolates for the presence of these bacterial symbionts using endosymbiont specific PCR primers. We find that these symbionts are surprisingly common, identified in 42% of screened isolates (N = 730). Members of the Chlamydiae phylum are particularly prevalent, occurring in 27% of the amoeba isolated. They are novel and phylogenetically distinct from other Chlamydiae. We also found Amoebophilus symbionts in 8% of screened isolates (N = 730). Antibiotic‐cured amoebae behave similarly to their Chlamydiae or Amoebophilus‐infected counterparts, suggesting that these endosymbionts do not significantly impact host fitness, at least in the laboratory. We found several natural isolates were co‐infected with multiple endosymbionts, with no obvious fitness effect of co‐infection under laboratory conditions. The high prevalence and novelty of amoeba endosymbiont clades in the model organism D. discoideum opens the door to future research on the significance and mechanisms of amoeba–symbiont interactions. [ABSTRACT FROM AUTHOR]

Context: Traditional bone setting is a public health concern because of the late hospital presentation and resulting socioeconomic consequences. Aim: This study aimed to determine the prevalence and factors associated with preference of traditional bone setting among patients attending orthopedic clinics in Kano, Nigeria: Design: Descriptive cross-sectional design was used. Materials and Methods: Up to 370 patients were selected using a two-staged sampling technique. Statistical Analysis: Data were collected using interviewer administered questionnaires and analyzed using SPSS version 22.0 with P ≤ 0.05 considered statistically significant. Results: The respondents age ranged 1 − 82 years with a median age of 29 (IQR = 20, 40) years. Majority of the patients (77.6%, n = 287) were older than 24 years of age with more than one-quarter (36.2%, n = 134) engaged in trading activities. Period prevalence (Within the last one year of visiting TBS) was 60.5% (95% CI: 55.4–65.6) while the point prevalence was 2.4% (95% CI: 1.1–4.6). Main reasons highlighted for the preference of traditional bone setting include low costs (8.6%, n = 32) and accessibility (6.5%, n = 24). Patients on admission had less probability of ever visited TBS (aOR: 0.4, 95% CI: 0.2–0.7), and patients with formal education were less likely to currently visit TBS (aOR: 5.0, 95% CI: 1.2–21.7) Conclusion: The prevalence of patronizing traditional bone setters is of significant public health concern despite the reported consequences. Therefore, the stakeholders should ensure regulated practices of the bone setters by providing them with appropriate guidelines including supervision of their practices. [ABSTRACT FROM AUTHOR]

Background: Increasing consumption of vended foods may pose a significant public health threat associated with food-borne illnesses. Context: Increasing consumption of vended foods may pose a significant public health threat associated with food borne illnesses. Aim: To assess and compare the determinants of personal hygiene practices among street food vendors and canteen food handlers in a commercial city of northwestern Nigeria. Settings and design: Using interviewer-administered questionnaire, comparative cross-sectional design was used Materials and Methods: As much as 310 (in each group) street food vendors and canteen food handlers, selected using a multistage sampling technique. Data analysis used: The data was analyzed using SPSS Version 22.0 Results: The proportion of street food vendors practicing correct personal hygiene measures were 214 (70.2%), compared with 213 (74.0%) canteen food handlers, respectively. There was a significant association between street food vendor's sex, ethnicity, educational status, hepatitis A or typhoid vaccination status, and the correct practice of personal hygiene (P < 0.05). Sex was found to be an independent predictor of personal hygiene practice (adjusted odds ratio = 4.7, 95% confidence interval = 1.3–16.7) among street food vendors with female street food vendors being five times more likely to observe correct personal hygiene practice than their male counterparts. Conclusions: Personal hygiene practice was found to be good among both street food vendors and canteen food handlers. However, there is a need for improvement if food-borne diseases are to be controlled; therefore, the government should ensure training and enforcement of all regulations to improve the personal hygiene practice thereby reducing the burden of food-borne illnesses. [ABSTRACT FROM AUTHOR]

Assessment and management of patients with chronic pain is a challenging task due to its complex multidimensional nature and biopsychosocial impact. It requires a collaborative effort by an interdisciplinary team. Evidence showed that in low and middle-income countries (LMICs), 33% patients among general adult population, and 56% of general elderly population, suffer from chronic painful conditions. Women are more likely to report chronic pain than men. In this narrative review, we attempted to search published literature to know the status of assessment and management of patients with chronic pain in low resource countries and to know the most appropriate chronic pain management strategies used in developed countries. We used broad electronic database (January 2010-December 2020) through common search engines. Lack of trained pain physicians and staffs, lack of interest, empathy and lack of integrated multidisciplinary approach are some of the barriers to achieve teamwork in chronic pain management. Authors strongly recommend the need of further research in this area, improvement in training programs for physicians and nursing staff for proper pain assessment and management of patients with chronic pain in low resource countries. [ABSTRACT FROM AUTHOR]

Abstract A 40 year-old female, with a history of cardiac surgery for congenital aortic valve stenosis and von Willebrand's disease (VWD) presented with increasing shortness of breath due to mixed aortic valve dysfunction. With a paucity of such cases in the literature, we describe the successful outcome of a patient with VWD who underwent elective redo-redo aortic root replacement with a mechanical valved conduit. She was given a three-month trial of warfarin pre-operatively to evaluate the extent of bleeding risk. Her post-operative course was uneventful and she was discharged home after six days.

This study investigates how market structure affects the transmission of monetary policy through the policy's effects on the bank lending channel in the Chinese banking system. By using structural and nonstructural measures of market structure, we also examined how bank responses are affected by heterogeneity. An unbalanced panel was constructed for 122 Chinese banks using annual data from 2000 to 2014. A dynamic model using two-step system GMM gave results indicating that, for both structural and nonstructural measures, banks with greater market power and increased concentration in the market tend to weaken the monetary policy transmission via the bank lending channel. This result holds while accounting for different bank characteristics such as size, liquidity, and capitalisation. In the Chinese banking market, banks which are well capitalised and have good liquidity position are much more insulated from any shifts in monetary policy because they have alternative sources of funds and have buffers of capital to meet the bank loan supply needs. Ownership structure also plays an important role in weakening the transmission effect through the bank lending channels of joint-equity and city commercial banks. These results are shown to be robust by considering an alternative measure of monetary policy. [ABSTRACT FROM AUTHOR]

Utilizing a large dataset on Chinese A-Share listed firms comprising 18763 firm-year observation for the period of 2001–2015, we examined whether Confucianism and political connections lessen the stock price crash risk of firms by using geographical-proximity-based Confucianism variables. Our findings point towards the evidence that firms situated in China with higher levels of Confucianism reveal low levels of stock price crash risk and this relationship is incrementally significant for politically connected firms while controlling for a battery of control variables. Our results are robust by using alternate proxies. [ABSTRACT FROM AUTHOR]

This study investigated the role of various factors in the bank lending channel of monetary policy transmission. Using annual data (2000–2012) from the Chinese banking industry, the result of this study suggest that bank lending channel neither operates through balance sheet characteristics nor through bank risk. However, this study provides significant evidence of the lending channel operates through the market structure. The market power undermines the effect of monetary policy on bank lending. The results have important policy implications for the Chinese banking industry. Although higher competition raises concerns about financial stability, however, in this case, higher market power has a detrimental effect on bank lending channel and monetary policy transmission. Such results may argue pro-competitive policy in the Chinese banking market so that the desired objective of monetary policy can be achieved. [ABSTRACT FROM AUTHOR]

Purpose: With the availability of ultra-sensitive PSA assays, early biochemical relapse (eBCR) of prostate cancer is increasingly being detected at values much lower than the conventional threshold of 0.2 ng/ml. Accurate localisation of disease in this setting may allow treatment modification and improved outcomes, especially in patients with pelvis-confined or extra-pelvic oligometastasis (defined as up to three pelvic nodal or distant sites). We aimed to measure the detection rate of [68]Ga-PSMA-HBNED-CC (PSMA)-PET/CT and its influence on patient management in eBCR of prostate cancer following radical prostatectomy (RP). Methods: We retrospectively identified 28 patients who underwent PSMA-PET/CT for post-RP eBCR (PSA < 0.5 ng/ml) at our tertiary care cancer centre. Two nuclear medicine physicians independently recorded the sites of PSMA-PET/CT positivity. Multidisciplinary meeting records were accessed to determine changes in management decisions following PSMA-PET/CT scans. Results: The mean age of patients was 65.6 years (range: 50–76.2 years); median PSA was 0.22 ng/ml (interquartile range: 0.15 ng/ml to 0.34 ng/ml). Thirteen patients (46.4%) had received radiotherapy in the past. PSMA-PET/CT was positive in 17 patients (60.7%). Only one patient had polymetastasis (> 3 sites); the remainder either had prostatectomy bed recurrence (n = 2), pelvic oligometastasis (n = 10), or extra-pelvic oligometastasis (n = 4). PSMA-PET/CT resulted in management change in 12 patients (42.8%), involving stereotactic body radiotherapy (n = 6), salvage radiotherapy (n = 4), and systemic treatment (n = 2). Conclusions: Our findings show that PSMA-PET/CT has a high detection rate in the eBCR setting following RP, with a large proportion of patients found to have fewer than three lesions. PSMA-PET/CT may be of value in patients with early PSA failure, and impact on the choice of potentially curative salvage treatments. [ABSTRACT FROM AUTHOR]

The establishment of symbioses between eukaryotic hosts and bacterial symbionts in nature is a dynamic process. The formation of such relationships depends on the life history of both partners. Bacterial symbionts of amoebae may have unique evolutionary trajectories to the symbiont lifestyle, because bacteria are typically ingested as prey. To persist after ingestion, bacteria must first survive phagocytosis. In the social amoeba Dictyostelium discoideum, certain strains of Burkholderia bacteria are able to resist amoebal digestion and maintain a persistent relationship that includes carriage throughout the amoeba's social cycle that culminates in spore formation. Some Burkholderia strains allow their host to carry other bacteria, as food. This carried food is released in new environments in a trait called farming. To better understand the diversity and prevalence of Burkholderia symbionts and the traits they impart to their amoebae hosts, we first screened 700 natural isolates of D. discoideum and found 25% infected with Burkholderia. We next used a multilocus phylogenetic analysis and identified two independent transitions by Burkholderia to the symbiotic lifestyle. Finally, we tested the ability of 38 strains of Burkholderia from D. discoideum, as well as strains isolated from other sources, for traits relevant to symbiosis in D. discoideum. Only D. discoideum native isolates belonging to the Burkholderia agricolaris, B. hayleyella, and B. bonniea species were able to form persistent symbiotic associations with D. discoideum. The Burkholderia–Dictyostelium relationship provides a promising arena for further studies of the pathway to symbiosis in a unique system. [ABSTRACT FROM AUTHOR]

This study is focused on the impact of religion on the electoral pattern of the people of Punjab. Religion as a determinant of voting behavior is best expressed in the votes secured by the religious parties. Thus, religious parties vote in Pakistan and Punjab is studied to build an argument. Religion has a strong impact on human life. It influences each act and attitude of the individual especially in developing countries. In Pakistan; religion has a solid affect in shaping the political attitudes and beliefs of the individuals. It is one of the key elements of politics.2018 general elections saw a sudden rise in the vote bank of religious political parties. It witnessed a 2.17 % increase in the religious vote country wide and 1.32% increase in Punjab. Tahreek Labbaik Pakistan appeared on the scene as a radical Sunni Islamic party, it mobilized the barelvi vote bank to great effect. And it emerged as the third largest party of Punjab, in terms of votes polled. 2018 general elections also witnessed the rise of Milli Muslim League which was a political wing of Jamaat-ud-Dawa, who were previously rejecting the parliamentary form of government and were critical of voting in elections. The increase in the influence of the various spiritual gaddi nasheen in the electoral politics of Punjab was also a prominent factor during the 11th general election. [ABSTRACT FROM AUTHOR]

A small subset of bacteria in soil interact directly with eukaryotes. Which ones do so can reveal what is important to a eukaryote and how eukaryote defenses might be breached. Soil amoebae are simple eukaryotic organisms and as such could be particularly good for understanding how eukaryote microbiomes originate and are maintained. One such amoeba, Dictyostelium discoideum , has both permanent and temporary associations with bacteria. Here we focus on culturable bacterial associates in order to interrogate their relationship with D. discoideum. To do this, we isolated over 250 D. discoideum fruiting body samples from soil and deer feces at Mountain Lake Biological Station. In one-third of the wild D. discoideum we tested, one to six bacterial species were found per fruiting body sorus (spore mass) for a total of 174 bacterial isolates. The remaining two-thirds of D. discoideum fruiting body samples did not contain culturable bacteria, as is thought to be the norm. A majority (71.4%) of the unique bacterial haplotypes are in Proteobacteria. The rest are in either Actinobacteria, Bacteriodetes, or Firmicutes. The highest bacterial diversity was found in D. discoideum fruiting bodies originating from deer feces (27 OTUs), greater than either of those originating in shallow (11 OTUs) or in deep soil (4 OTUs). Rarefaction curves and the Chao1 estimator for species richness indicated the diversity in any substrate was not fully sampled, but for soil it came close. A majority of the D. discoideum -associated bacteria were edible by D. discoideum and supported its growth (75.2% for feces and 81.8% for soil habitats). However, we found several bacteria genera were able to evade phagocytosis and persist in D. discoideum cells through one or more social cycles. This study focuses not on the entire D. discoideum microbiome, but on the culturable subset of bacteria that have important eukaryote interactions as prey, symbionts, or pathogens. These eukaryote and bacteria interactions may provide fertile ground for investigations of bacteria using amoebas to gain an initial foothold in eukaryotes and of the origins of symbiosis and simple microbiomes. [ABSTRACT FROM AUTHOR]

Background: Successful tuberculosis (TB) treatment is essential to effective TB control. TB-HIV coinfection, social determinants and access to services influenced by rural residence can affect treatment outcome. We examined the separate and joint effects of rural residence and HIV infection on poor treatment outcome among patients enrolled in a large TB treatment centre in Kano, Nigeria. Methods: We retrospectively analysed a cohort of patients with TB enrolled in a large urban TB clinic in northern Nigeria, from January 2010 to December 2014. Poor treatment outcome was defined as death, default or treatment failure. We used Poisson regression to model rates and determine the relative risks (and 95% confidence intervals, CI) of poor treatment outcomes. Results: Among 1381 patients included in the analysis, 28.4% were rural residents; 39.8% were HIV-positive; and 46.1% had a poor treatment outcome. Approximately 65 and 38% of rural and urban residents, respectively, had a poor treatment outcome. Rural residents had 2.74 times (95% CI: 2.27-3.29) the risk of having a poor treatment outcome compared to urban residents. HIV-positive patients had 1.4 times (95% CI: 1.16-1.69) the risk of poor treatment outcome compared to HIV-negative patients. The proportion of poor treatment outcome attributable to rural residence (population attributable fraction, PAF) was 25.6%. The PAF for HIV infection was 11.9%. The effect of rural residence on poor treatment outcome among HIV-negative patients (aRR:4.07; 95%CI:3.15-5.25) was more than twice that among HIV-positive patients (aRR:1.99; 95%CI:1.49-2.64). Conclusion: Rural residents attending a large Nigerian TB clinic are at increased risk of having poor treatment outcomes, and this risk is amplified among those that are HIV-negative. Our findings indicate that rural coverage of HIV services may be better than TB services. These findings highlight the importance of expanding coverage of TB services to ensure prompt diagnosis and commencement of treatment, especially among rural-dwellers in resource-limited settings. [ABSTRACT FROM AUTHOR]