Search results for: P. Intra

Authors: Sharon Sibanda, Benny Motileng

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The World Health Organisation (WHO) identified the Sars-Cov-2 (COVID-19) as a pandemic on the 12ᵗʰ of March 2020, with South Africa recording its first case on the 5ᵗʰ of March 2020. The rapidly spreading virus led the South African government to implement one of the strictest nationwide lockdowns globally, resulting in the closing down of all institutions of higher learning effective March 18ᵗʰ 2020. Thus, this qualitative study primarily aimed to explore whether post-graduate psychology students were in a state of a depleted or cohesive self, post the psychological isolation of COVID-19 risk-adjusted level 5 lockdown. Semi-structured interviews from a qualitative interpretive approach comprising N=6 psychology post-graduate students facilitated a rich understanding of their intra-psychic experiences of the self. Thematic analysis of data gathered from the interviews illuminated how students were forced into the self by the emotional isolation of hard lockdown, with the emergence of core psychic conflict often defended against through external self-object experiences. The findings also suggest that lockdown stripped off this sample of psychology post-graduate students’ defensive escape from the inner self through external self-object distractions. The external self was stripped to the core of the internal self by the isolation of hard lockdown, thereby uncovering the psychic function of roles and defenses amalgamated throughout modern cultural consciousness that dictates self-functioning. The study suggests modelling reflexivity skills in the integration of internal and external self-experience dynamics as part of a training model for continued personal and professional development for psychology students.

Keywords: COVID-19, fragmentation, self-object experience, true/false self

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Authors: Mojtaba Barzegar, Alireza Shirazi, Saied Rabi Mahdavi

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Intraoperative radiation therapy (IORT) is an innovative treatment modality that the delivery of a large single dose of radiation to the tumor bed during the surgery. The radiotherapy success depends on the absorbed dose delivered to the tumor. The achievement better accuracy in patient treatment depends upon the measured dose by standard dosimeter such as ionization chamber, but because of the high density of electric charge/pulse produced by the accelerator in the ionization chamber volume, the standard correction factor for ion recombination Ksat calculated with the classic two-voltage method is overestimated so the use of dose/pulse independent dosimeters such as chemical Fricke and ethanol chlorobenzene (ECB) dosimeters have been suggested. Dose measurement is usually calculated and calibrated in the Zmax. Ksat calculated by comparison of ion chamber response and ECB dosimeter at each applicator degree, size, and dose. The relative output factors for IORT applicators have been calculated and compared with experimentally determined values and the results simulated by Monte Carlo software. The absorbed doses have been calculated and measured with statistical uncertainties less than 0.7% and 2.5% consecutively. The relative differences between calculated and measured OF’s were up to 2.5%, for major OF’s the agreement was better. In these conditions, together with the relative absorbed dose calculations, the OF’s could be considered as an indication that the IORT electron beams have been well simulated. These investigations demonstrate the utility of the full Monte Carlo simulation of accelerator head with ECB dosimeter allow us to obtain detailed information of clinical IORT beams.

Keywords: intra operative radiotherapy, ethanol chlorobenzene, ksat, output factor, monte carlo simulation

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Authors: Vyacheslav Furtak, Merja Roivainen, Olga Mirochnichenko, Majid Laassri, Bella Bidzhieva, Tatiana Zagorodnyaya, Vladimir Chizhikov, Konstantin Chumakov

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Molecular epidemiology and environmental surveillance are parts of a rational strategy to control infectious diseases. They have been widely used in the worldwide campaign to eradicate poliomyelitis, which otherwise would be complicated by the inability to rapidly respond to outbreaks and determine sources of the infection. The conventional scheme involves isolation of viruses from patients and the environment, followed by their identification by nucleotide sequences analysis to determine phylogenetic relationships. This is a tedious and time-consuming process that yields definitive results when it may be too late to implement countermeasures. Because of the difficulty of high-throughput full-genome sequencing, most such studies are conducted by sequencing only capsid genes or their parts. Therefore the important information about the contribution of other parts of the genome and inter- and intra-species recombination to viral evolution is not captured. Here we propose a new approach based on the rapid concentration of sewage samples with tangential flow filtration followed by deep sequencing and reconstruction of nucleotide sequences of viruses present in the samples. The entire nucleic acids content of each sample is sequenced, thus preserving in digital format the complete spectrum of viruses. A set of rapid algorithms was developed to separate deep sequence reads into discrete populations corresponding to each virus and assemble them into full-length consensus contigs, as well as to generate a complete profile of sequence heterogeneities in each of them. This provides an effective approach to study molecular epidemiology and evolution of natural viral populations.

Keywords: poliovirus, eradication, environmental surveillance, laboratory diagnosis

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Authors: Maryam Nazari, Atefeh Ghanbari, Saghar Noorinia

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Obesity, as an abnormal or excessive accumulation of fat, is caused by genetic, behavioral and environmental factors. Recently, obesity surgeries, such as bariatric surgery, as the last measure to control obesity, have attracted experts and society, especially women, attention, so knowing the possible complications of this major surgery and their control in reproductive age is of particular importance due to its effects on pregnancy outcomes. Bariatric surgery reduces the risk of diabetes and high blood pressure associated with pregnancy, premature birth, macrosomia, stillbirth and dumping syndrome. Although in the first months after surgery, nausea and vomiting caused by changes in intra-abdominal pressure are associated with an increased risk of malabsorption of micronutrients such as folic acid, iron, vitamin B1, D, calcium, selenium and phosphorus and finally, fetal growth disorder. Moreover, serum levels of micronutrients such as vitamin D, calcium, and iron in mothers who used to have bariatric surgery and their babies have been shown to be lower than in mothers without a history of bariatric surgery. Moreover, vitamin A deficiency is shown to be more widespread in pregnancies after bariatric surgery, which leads to visual problems in newborns and premature delivery. However, complications such as the duration of hospitalization of newborns in the NICU, disease rate in the first 28 days of life and congenital anomalies are not significantly different in babies born to mothers undergoing bariatric surgery compared to the control group. In spite of the vast advantages following obesity surgeries, due to the catabolic conditions and severe weight loss followed by such major intervention and the probability of nutrients malnutrition in a pregnant woman and her baby, after having surgery, at least 12 to 18 months should be considered to get pregnant as a recovery period. In addition, taking essential supplements before and at least 6 months after this approach is recommended.

Keywords: bariatric surgery, pregnancy, malnutrition, vitamin and mineral deficiency

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Authors: Rameesha Javaid

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Balochistan, the largest landmass named after and dominated by the 55% Baloch population, which has had a difficult anti-center history like their brothers the Kurds of Middle East, reluctantly acceded to Pakistan in 1947. The region, which attained the status of a province after two decades of accession, has lagged behind in social development and economic growth as compared to the other three federating units. The province has seen the least financial autonomy and administrative decentralization both in autocratic and democratic dispensations under geostrategic and security considerations. Significant corrections have been recently made in the policy framework through changing the formula for intra-provincial National Finance Award, curtailing the number of subjects under federal control, and reactivating the Council of Common Interests. Yet policymaking remains overwhelmingly bureaucratic under a weak parliamentary oversight. The provincial coalition governments are unwieldy and directionless. The government machinery has much less than the optimal capability, character, integrity, will, and opportunity to perform. Decentralization further loses its semblance in the absence of local governments for long intervals and with the hold of hereditary tribal chiefs. Increased allocations failed to make an impact in the highest per capita cost environment due to long distances and scattered settlements. Decentralization, the basic ingredient of federalism has remained mortgaged to geo-strategic factors, internal security perceptions, autocratic and individualistic styles of governments, bureaucratic policymaking structures, bad governance, non-existent local governments, and feudalistic tribal lords. This suboptimal federalism speaks for the present underdevelopment in Balochistan and will earmark the milestones in the future.

Keywords: Balochistan, economic development, federalism, political economy

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Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: Y. Cochet, A. Achim, Tom Flatman, J-C. Domec, J. Ogée, L. Wingate, Ram Oren

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It is accepted that atmospheric CO2 concentration will increase in the future. For the past 30 years, researchers have used FACE (Free-Air Carbon Dioxide Enrichment) facilities to study the development of terrestrial ecosystems under elevated CO2 (eCO2). Forest responses to eCO2 are likely to impact timber industries with potential feedbacks towards the atmosphere. The main objectives of this study were to examine whether eCO2 alone or in combination with N-fertilization alter wood properties and to identify changes in wood anatomy related to water transport. Wood disks were sampled at breast height from mature loblolly pine trees (Pinus taeda L.) harvested at the Duke FACE site (NC, USA). By measuring ring width and intra-ring changes in density (X-ray densitometry) and tracheid size (lumen and cell wall thickness) from pith to bark, the following hypotheses were tested: 1) eCO2 and N-fertilization interact positively to increase significantly above-ground primary productivity; 2) eCO2 and N-fertilization lead to a decrease in density; 3) eCO2 and N-fertilization increase lumen diameter and decrease cell wall thickness, thus affecting water transport capacity. Our results revealed a boost in earlywood tracheid production induced by eCO2 lasting a few years. The following decrease seemed to be buffered by N-fertilization. X-ray profiles did not show a marked decrease in wood density under eCO2 or N-fertilization, although there were changes in cell anatomical properties such as a reduction in cell-wall thickness and an increase in lumen diameter. If such effects of eCO2 are confirmed, forest management strategies for example N-fertilization should be redesigned.

Keywords: wood density, Duke FACE (free-air carbon dioxide enrichment), N fertilization, tree ring

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Authors: Carmela Perta

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Among the studies flourished in the field of historical sociolinguistics, mainly in the strand devoted to English history, during its Medieval and early modern phases, multilingual texts had been analysed using theories and models coming from contact linguistics, thus applying synchronic models and approaches to the past. This is true also in the case of contact phenomena which would transcend the writing level involving the language systems implicated in contact processes to the point of perceiving a new variety. This is the case for medieval administrative-commercial texts in which, according to some Scholars, the degree of fusion of Anglo-Norman, Latin and middle English is so high a mixed code emerges, and there are recurrent patterns of mixed forms. Interesting is a collection of multilingual business writings by John Balmayn, an Englishman overseeing a large shipment in Tuscany, namely the Cantelowe accounts. These documents display various analogies with multilingual texts written in England in the same period; in fact, the writer seems to make use of the above-mentioned patterns, with Middle English, Latin, Anglo-Norman, and the newly added Italian. Applying an atomistic yet dynamic approach to the study of contact phenomena, we will investigate these documents, trying to explore the nature of the switching forms they contain from an intra-writer variation perspective. After analysing the accounts and the type of multilingualism in them, we will take stock of the assumed mixed code nature, comparing the characteristics found in this genre with modern assumptions. The aim is to evaluate the possibility to consider the switching forms as core elements of a mixed code, used as professional variety among merchant communities, or whether such texts should be analysed from a switching perspective.

Keywords: historical sociolinguistics, historical code switching, letters, medieval england

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Authors: Marialuisa Gennari, Giancarlo Tamanza, Ilaria Montanari

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Identity development in adolescence is characterized by many risks and challenges, and becomes even more complex by the situation of migration and deafness. In particular, the condition of the second generation of migrant adolescents involves the comparison between the family context in which everybody speaks a language and deals with a specific culture (usually parents’ and relatives’ original culture), the social context (school, peer groups, sports groups), where a foreign language is spoken and a new culture is faced, and finally in the context of the “deaf” world. It is a dialectic involving unsolved differences that have to be treated in a discontinuous process, which will give complex outcomes and chances depending on the process of elaboration of the themes of growth and development, culture and deafness. This paper aims to underline the problems and opportunities for each issue which immigrant deaf adolescents must deal with. In particular, it will highlight the importance of a multifactorial approach for the analysis of personal resources (both intra-psychic and relational); the level of integration of the family of origin in the migration context; the elaboration of the migration event, and finally, the tractability of the condition of deafness. Some psycho-educational support objectives will be also highlighted for the identity development of deaf immigrant adolescents, with particular emphasis on the construction of the adolescents’ useful abilities to decode complex emotions, to develop self-esteem and to get critical thoughts about the inevitable attempts to build their identity. Remarkably, and of importance, the construction of flexible settings which support adolescents in a supple, “decentralized” way in order to avoid the regressive defenses that do not allow for the development of an authentic self.

Keywords: immigrant deaf adolescents, identity development, personal and social challenges, psycho-educational support

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Authors: Laurin Zemmrich, Nicolai Stickler

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With the ongoing debate over how to incorporate sustainability, resilience, and value creation into business strategies, many procurement departments are put under pressure by governments, consumers, non-governmental organizations, and other stakeholders to disclose more information about their supply chains. According to practitioners and experts, procurement benefits the supply chain by increasing transparency and accountability, recruiting new suppliers, and supporting sustainable and ethical sourcing strategies. While most procurement departments establish these objectives, the bulk of activities are not carried out or are not regularly monitored. With the full potential of targeted sourcing still to be realized, procurement executives, in particular, are seeking for short-term cost-cutting impacts to appease external shareholders. We overcome this limitation by using an abductive approach to research and integrating empirical data from a Gioia methodology study design with relevant literature. Our analysis demonstrates that the procurement department has six essential levers aligned with sustainability, resilience, and value creation objectives and contributes to developing a new intra- and interorganizational purpose within the supply chain. Three enablers are identified as having a value-creating effect on supply chain interactions. Additionally, we discovered two impacts that alter the power balance between buyers and suppliers during transactions and have a cost-cutting or cost-avoiding effect. While cost-cutting, cost-avoidance, and dependency-reduction impacts are desirable, redistributing power may also have negative consequences. The article establishes a first strategy framework for evaluating the influence of the procurement department on supply chain transactions, allowing managers to understand better and apply the sourcing function inside a supply chain and embed it throughout the business.

Keywords: supply chain management, resilience, sustainability, value creation, purpose

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Authors: Arbolino Roberta, Boffardi Raffaele

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Achieving the highest effectiveness for the National Plans for Recovery and Resilience (NPRR) while strengthening the objectives of cohesion and reduction of intra-EU unbalances is only possible by means of strategic, coordinated, and coherent policy planning. Therefore, the present research aims at assessing and quantifying the potential impact of NPRRs across the twenty-seven European Member States in terms of economic convergence, considering disaggregated data on industrial, construction, and service sectors. The first step of the research involves a performance analysis of the main macroeconomic indicators describing the trends of twenty-seven EU economies before the pandemic outbreak. Subsequently, in order to define the potential effect of the resources allocated, we perform an impact analysis of previous similar EU investment policies, estimating national-level sectoral elasticity associated with the expenditure of the 2007-2013 and 2014-2020 Cohesion programmes funds. These coefficients are then exploited to construct adjustment scenarios. Finally, convergence analysis is performed on the data used for constructing scenarios in order to understand whether the expenditure of funds might be useful to foster economic convergence besides driving recovery. The results of our analysis show that the allocation of resources largely mirrors the aims of the policy framework underlying the NPRR, thus reporting the largest investments in both those sectors most affected by the economic shock (services) and those considered fundamental for the digital and green transition. Notwithstanding an overall positive effect, large differences exist among European countries, while no convergence process seems to be activated or fostered by these interventions.

Keywords: NPRR, policy evaluation, cohesion policy, scenario Nalsysi

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Authors: Chahrazed Zouaoui

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In recent years, the volume of geospatial information is increasing due to the evolution of communication technologies and information, this information is presented often by geographic information systems (GIS) and stored on of spatial databases (BDS). The classical data mining revealed a weakness in knowledge extraction at these enormous amounts of data due to the particularity of these spatial entities, which are characterized by the interdependence between them (1st law of geography). This gave rise to spatial data mining. Spatial data mining is a process of analyzing geographic data, which allows the extraction of knowledge and spatial relationships from geospatial data, including methods of this process we distinguish the monothematic and thematic, geo- Clustering is one of the main tasks of spatial data mining, which is registered in the part of the monothematic method. It includes geo-spatial entities similar in the same class and it affects more dissimilar to the different classes. In other words, maximize intra-class similarity and minimize inter similarity classes. Taking account of the particularity of geo-spatial data. Two approaches to geo-clustering exist, the dynamic processing of data involves applying algorithms designed for the direct treatment of spatial data, and the approach based on the spatial data pre-processing, which consists of applying clustering algorithms classic pre-processed data (by integration of spatial relationships). This approach (based on pre-treatment) is quite complex in different cases, so the search for approximate solutions involves the use of approximation algorithms, including the algorithms we are interested in dedicated approaches (clustering methods for partitioning and methods for density) and approaching bees (biomimetic approach), our study is proposed to design very significant to this problem, using different algorithms for automatically detecting geo-spatial neighborhood in order to implement the method of geo- clustering by pre-treatment, and the application of the bees algorithm to this problem for the first time in the field of geo-spatial.

Keywords: mining, GIS, geo-clustering, neighborhood

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Authors: Shang-Yu Chiang, Yu-Shan Tsai, Shih-Hsien Sung, Chung-Ming Lo

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Mitral regurgitation (MR) is a heart disorder which the mitral valve does not close properly when the heart pumps out blood. MR is the most common form of valvular heart disease in the adult population. The diagnostic echocardiographic finding of MR is straightforward due to the well-known clinical evidence. In the determination of MR severity, quantification of sonographic findings would be useful for clinical decision making. Clinically, the vena contracta is a standard for MR evaluation. Vena contracta is the point in a blood stream where the diameter of the stream is the least, and the velocity is the maximum. The quantification of vena contracta, i.e. the vena contracta width (VCW) at mitral valve, can be a numeric measurement for severity assessment. However, manually delineating the VCW may not accurate enough. The result highly depends on the operator experience. Therefore, this study proposed an automatic method to quantify VCW to evaluate MR severity. Based on color Doppler ultrasound, VCW can be observed from the blood flows to the probe as the appearance of red or yellow area. The corresponding brightness represents the value of the flow rate. In the experiment, colors were firstly transformed into HSV (hue, saturation and value) to be closely align with the way human vision perceives red and yellow. Using ellipse to fit the high flow rate area in left atrium, the angle between the mitral valve and the ultrasound probe was calculated to get the vertical shortest diameter as the VCW. Taking the manual measurement as the standard, the method achieved only 0.02 (0.38 vs. 0.36) to 0.03 (0.42 vs. 0.45) cm differences. The result showed that the proposed automatic VCW extraction can be efficient and accurate for clinical use. The process also has the potential to reduce intra- or inter-observer variability at measuring subtle distances.

Keywords: mitral regurgitation, vena contracta, color doppler, image processing

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Authors: Sarah Almuhayya, Andrew Mcbain, Gavin Humphreys

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Background. The microbiome of the upper respiratory tract (URT) has received less research attention than other body sites. This study aims to investigate the microbial ecology of the human URT with a focus on the antagonism between the corynebacteria and staphylococci. Methods. Mucosal swabs were collected from the anterior nares and nasal turbinates of 20 healthy adult subjects. Genomic DNA amplification targeting the (V4) of the 16Sr RNA gene was conducted and analyzed using QIIME. Nasal swab isolates were cultured and identified using near full-length sequencing of the 16S rRNA gene. Isolates identified as corynebacteria or staphylococci were typed using (rep-PCR). Antagonism was determined using an agar-based inhibition assay. Results. Four major bacterial phyla (Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria) were identified from all volunteers. The typing of cultured staphylococci and corynebacteria suggested that intra-individual strain diversity was limited. Analysis of generated nasal microbiota profiles suggested an inverse correlation in terms of relative abundance between staphylococci and corynebacteria. Despite the apparent antagonism between these genera, it was limited when investigated on agar. Of 1000 pairwise interactions, observable zones of inhibition were only reported between a single strain of C.pseudodiphtheriticum and S.aureus. Imaging under EM revealed this effect to be bactericidal with clear lytic effects on staphylococcal cell morphology. Conclusion. Nasal microbiota is complex, but culturable staphylococci and corynebacteria were limited in terms of clone type. Analysis of generated nasal microbiota profiles suggested an inverse correlation in terms of relative abundance between these genera suggesting an antagonism or competition between these taxonomic groups.

Keywords: nasal, microbiota, S.aureus, microbioal interaction

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Authors: S. H. Jang

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Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurologic symptoms (visual loss, headache, altered mentality and seizures) and by typical imaging findings (bilateral subcortical and cortical edema with predominatly posterior distribution). Nephrotic syndrome is a syndrome comprising signs of proteinuria, hypoalbuminemia, and edema. It is well known that hypertension predispose patient with nephrotic syndrome to PRES. A 45-year old male was referred for suddenly developed vertigo, disequilibrium. He had previous history of nephrotic syndrome. His medical history included diabetes controlled with medication. He was hospitalized because of generalized edema a few days ago. His vital signs were stable. On neurologic examination, his mental state was alert. Horizontal nystagmus to right side on return to primary position was observed. He showed good grade motor weakness and ataxia in right upper and lower limbs without other sensory abnormality. Brain MRI showed increased signal intensity in FLAIR image, decreased signal intensity in T1 image and focal enhanced lesion in T1 contrast image at whole midbrain, pons and cerebellar peduncle symmetrically, which was compatible with vasogenic edema. Laboratory findings showed severe proteinuria and hypoalbuminemia. He was given intravenous dexamethasone and diuretics to reduce vasogenic edema and raise the intra-vascular osmotic pressure. Nystagmus, motor weakness and limb ataxia improved gradually over 2 weeks; He recovered without any neurologic symptom and sign. Follow-up MRI showed decreased vasogenic edema fairly. We report a case of brain stem PRES in normotensive, nephrotic syndrome patient.

Keywords: posterior reversible encephalopathy syndrome, MRI, nephrotic syndrome, vasogenic brain edema

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Authors: Ena Arora, Rong Fan, Aleksandr Fuks, Kolawole Felix Akinnawonu

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Introduction: Leiomyomas are benign tumors that are derived from the overgrowth of uterine smooth muscle cells. Women with symptomatic leiomyomas who desire future fertility, myomectomy should be the standard surgical treatment. Perioperative hemorrhage is a common complication in myomectomy. We performed the study to investigate blood transfusion rate in abdominal myomectomies, risk factors influencing blood loss and modalities to improve perioperative blood loss. Methods: Retrospective chart review was done for patients who underwent myomectomy from 2016 to 2022 at Queens hospital center, New York. We looked at preoperative patient demographics, clinical characteristics, intraoperative variables, and postoperative outcomes. Mann-Whitney U test were used for parametric and non-parametric continuous variable comparisons, respectively. Results: A total of 159 myomectomies were performed between 2016 and 2022, including 1 laparoscopic, 65 vaginal and 93 abdominal. 44 patients received blood transfusion during or within 72 hours of abdominal myomectomy. The blood transfusion rate was 47.3%. Blood transfusion rate was found to be twice higher than the average documented rate in literature which is 20%. Risk factors identified were black race, preoperative hematocrit<30%, preoperative blood transfusion within 72 hours, large fibroid burden, prolonged surgical time, and abdominal approach. Conclusion: Preoperative optimization with iron supplements or GnRH agonists is important for patients undergoing myomectomy. Interventions to decrease intra operative blood loss should include cell saver, tourniquet, vasopressin, misoprostol, tranexamic acid and gelatin-thrombin matrix hemostatic sealant.

Keywords: myomectomy, perioperative blood loss, cell saver, tranexamic acid

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Authors: Muhammad Anjum Aqueel, Muhammad Jaffar Hussain, Abu Bakar Muhammad Raza

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Diaeretiella rapae (M’Intosh) attack most of the aphid species. However, it is specialized in feeding on crucifer aphid, Brevicoryne brassicae. Biological potential of parasitoid is its density-dependency due to sharing of limited resources in few cases. The present study was carried out to check the biotic potential of D. rapae at its different densities (1, 2, 4, 8 and 10 pairs) on fixed number of B. brassicae (100 in number) as a host. The present study was performed under laboratory conditions (25 ± 2 ºC temperature and 65-70 % R.H.). Different biological parameters for parasitoid (e.g. percent parasitism, adult emergence, adult longevity and per pair parasitism) were evaluated to check its biotic potential. The present findings showed that maximum parasitism (43.09 % ± 0.63) was observed in highest density (10 pairs) and minimum parasitism (16.59 % ± 1.28) in lowest density (1 pair) of the parasitoid. Maximum adult emergence (80.31 % ± 1.33) was observed in highest density (10 pairs) and minimum parasitism (45.99 % ± 1.27) in lowest density (1 pair) of the parasitoid. In the case of adult longevity, highest (8.2 days ± 0.38) and lowest (6 days ± 0.32) longevity were observed in lowest (1 pair) and highest (10 pairs) densities of parasitoids respectively. However, per pair parasitism rate decreased with the increase in parasitoid densities due to intra-specific competition, developed between the parasitoids for parasitism. The positive but close relationship was observed between percent parasitism and adult emergence. The increase in parasitoid densities increased the percent parasitism and adult emergence of the parasitoid. So, we conclude that an inter-specific competition negatively affected the efficacy of parasitoids and may reduce the fitness of the emerging parasitoid.

Keywords: Diaeretiella rapae, Parasitoid densities, Percent parasitism, adult emergence

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Authors: Dilek Saritas Atalar, Cansu Alsancak Akbulut, İrem Metin Orta, Feyza Yön, Zeynep Yenen, Joan Grusec

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Objective: The aim of this study was to develop semi-structured Domains of Socialization Interview and its coding manual and to test their psychometric properties. Domains of Socialization Interview was designed to assess maternal awareness regarding effective parenting in five socialization domains (protection, mutual reciprocity, control, guided learning, and group participation) within the framework of the domains-of-socialization approach. Method: A series of two studies were conducted to develop and validate the interview and its coding manual. The pilot study, sampled 13 mothers of preschool-aged children, was conducted to develop the assessment tools and to test their function and clarity. Participants of the main study were 82 Turkish mothers (Xage = 34.25, SD = 3.53) who have children aged between 35-76 months (Xage = 50.75, SD = 11.24). Mothers filled in a questionnaire package including Coping with Children’s Negative Emotions Questionnaire, Social Competence and Behavior Evaluation-30, Child Rearing Questionnaire, and Two Dimensional Social Desirability Questionnaire. Afterward, interviews were conducted online by a single interviewer. Interviews were rated independently by two graduate students based on the coding manual. Results: The relationships of the awareness of effective parenting scores to the other measures demonstrate convergent, discriminant, and predictive validity of the coding manual. Intra-class correlation coefficient estimates were ranged between 0.82 and 0.90, showing high interrater reliability of the coding manual. Conclusion: Taken as a whole, the results of these studies demonstrate the validity and reliability of a new and useful interview to measure maternal awareness regarding effective parenting within the framework of the domains-of-socialization approach.

Keywords: domains of socialization, parenting, interview, assessment

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Authors: Gabrielle O'Donoghue

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Background: Pre-operative radiographs facilitate assessment and treatment planning in minor oral surgery. Quality assurance for dental radiography advocates the As Low As Reasonably Achievable (ALARA) principle in collecting accurate diagnostic information. Aims: To audit the quality of digital intraoral periapicals (IOPAs) taken prior to dental extractions in a metropolitan general dental practice setting. Standards: The National Radiological Protection Board (NRPB) guidance outlines three grades of radiograph quality: excellent (Grade 1 > 70% of total exposures), diagnostically acceptable (Grade 2 <20%), and unacceptable (Grade 3 <10%). Methodology: A study of pre-operative radiographs taken prior to dental extractions across 12 private general dental practices in a large metropolitan area by 44 practitioners. A total of 725 extractions were assessed, allowing 258 IOPAs to be reviewed in one audit cycle. Results: First cycle: Of 258 IOPAs: 223(86.4%) scored Grade 1, 27(10.5%) Grade 2, and 8(3.1%) Grade 3. The standard was met. 35 dental extractions were performed without an available pre-operative radiograph. Action Plan & Recommendations: Results were distributed to all staff and a continuous professional development evening organized to outline recommendations to improve image quality. A second audit cycle is proposed at a six-month interval to review the recommendations and appraise results. Conclusion: The overall standard of radiographs met the published guidelines. A significant improvement in the number of procedures undertaken without pre-operative imaging is expected at a six-month interval period. An investigation into undiagnostic imaging and associated adverse patient outcomes is being considered. Maintenance of the standards achieved is predicted in the second audit cycle to ensure consistent high quality imaging.

Keywords: audit, oral radiology, oral surgery, periapical radiographs, quality assurance

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Authors: Sara Javanmardi, Sepehr Aziziz, Baharak Divband, Masoumeh Firouzamandi

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Post-operative adhesions are the most common cause of intestinal obstruction, female infertility and chronic abdominal pain. We developed a novel approach for preventing post-operative peritoneal adhesions using a biodegradable and thermosensitive curcumin hydrogel in rats. Thirteen male Sprague-Dawley rats were assigned randomly into five groups of six animals each: In SHAM group, the cecum was exteriorized, gently manipulated and sent back into the abdomen. In CONTROL group, the surgical abrasion was performed with no further treatment. In Hydrogel group, surgical abrasion was performed with local application of blank hydrogel (1 mL). In Curcumin group, surgical abrasion was performed with local application of curcumin (1 mL). In CUR/HGEL group, surgical abrasion was performed with local application of curcumin hydrogel (1 mL). On day 10, adhesions were assessed using a standardized scale (Evans model), and samples were collected for the Real-time PCR. Real-time PCR was performed to determine mRNA levels of VCAM-1, ICAM-1 and GAPDH. The macroscopic adhesion intensity showed statistically significant differences between the CUR/HGEL and other groups (P=0.0005). The findings of the present study revealed there were statistically significant differences between the groups regarding adhesion band length and numbers (P<0.0001). The protein and mRNA expression of VCAM-1 and ICAM-1 in secal tissues were significantly down regulated due to curcumin-hydrogel application in CUR/HGEL compared to other groups (p<0.05). The thermosensitive hydrogel could reduce the severity and even prevent formation of intra-abdominal adhesion. Curcumin hydrogel could serve as a potential barrier agent to prevent post-operative peritoneal adhesion in rats.

Keywords: peritoneal adhesion, hydrogel, curcumijn, ICAM-1, VCAM-1

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Authors: Quoc Ngoc Phan, Hieu Van Nguyen, Minh Hong Nguyen

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This study presents an integrated approach using Mercury Injection Capillary Pressure (MICP) and petrographic analysis to assess the seal quality of the inter-bedded shale formations which are considered the intra-formation top seals of hydrocarbon bearing zones in Green Dragon structure. Based on the hydrocarbon column height (HCH) at leak point derived from capillary pressure data, four seal types were identified. Furthermore, the results of scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis were interpreted to clarify the influence of clay minerals on seal capacity. The result of the study indicated that the inter-bedded shale formations are the good sealing quality with a majority of analyzed samples ranked type A and B seals in the sample set. Both seal types occurred mainly in mudstones with pore radius estimated less than 0.251 µm. Overall, type A and B seals contained a large amount of authigenic clay minerals such as illite, chlorite which showed the complexity of morphological arrangement in pore space. Conversely, the least common seal type C and D were presented in moderately compacted sandstones with more open pore radius. It is noticeable that there was a reduction of illite and chlorite in clay mineral fraction of these seal type. It is expected that the integrated analysis approach using Mercury Injection Capillary Pressure and petrographic data employed in this study can be applied to assess the sealing quality of future well sites in Green Dragon or other structures.

Keywords: seal capacity, hydrocarbon height column, seal type, SEM, XRD

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Authors: Ziyad S. Haidar

Abstract:

Millions of teeth are removed annually, and dental extraction is one of the most commonly performed surgical procedures globally. Whether due to caries, periodontal disease or trauma, exodontia and the ensuing wound healing and bone remodeling processes of the resultant socket (hole in the jaw bone) usually result in serious deformities of the residual alveolar osseous ridge and surrounding soft tissues (reduced height/width). Such voluminous changes render the placement of a proper conventional bridge, denture or even an implant-supported prosthesis extremely challenging. Further, most extractions continue to be performed with no regard for preventing the onset of alveolar osteitis (also known as dry socket, a painful and difficult-to-treat/-manage condition post-exodontia). Hence, such serious resorptive morphological changes often result in significant facial deformities and a negative impact on the overall Quality of Life (QoL) of patients (and oral health-related QoL), alarming, particularly for the geriatric with compromised healing and in light of the thriving longevity statistics. Opportunity: Despite advances in tissue/wound grafting, serious limitations continue to exist, including efficacy and clinical outcome predictability, cost, treatment time, expertise and risk of immune reactions. For cases of dry sockets, specifically, the commercially-available and often-prescribed home remedies are highly lacking. Indeed, most are not recommended for use anymore. Alveogyl is a fine example. Hence, there is a great market demand and need for alternative solutions. Solution: Herein, SockGEL/PLUG (patent pending), an all-natural, drug-free and injectable stimuli-responsive hydrogel, was designed, formulated, characterized and evaluated as an osteogenic, angiogenic, anti-microbial and pain-soothing suture-free intra-alveolar dressing, safe and efficacious for use in several oro-dental and cranio-maxillo-facial interventional applications; for example: in fresh dental extraction sockets, immediately post-exodontia. It is composed of FDA-approved, biocompatible and biodegradable polymers, self-assembled electro-statically to formulate a scaffolding matrix to (a) prevent the onset of alveolar osteitis via securing the fibrin-clot in situ and protecting/sealing the socket from contamination/infection; and (b) endogenously promote/accelerate wound healing and bone remodeling to preserve the volume of the alveolus. Findings: The intrinsic properties of the SockGEL/PLUG hydrogel were evaluated physico-chemico-mechanically for safety (cell viability), viscosity, rheology, bio-distribution and essentially, capacity to induce wound healing and osteogenesis (small defect, in vivo) without any signaling cues from exogenous cells, growth factors or drugs. The performed animal model of cranial critical-sized and non-vascularized bone defects shall provide vitally critical insights into the role and mechanism of the employed natural bio-polymer blend and gel product in endogenous reparative regeneration of soft tissues and bone morphogenesis. Alongside, the fine-tuning of our modified formulation method will further tackle appropriateness, reproducibility, scalability, ease and speed in producing stable, biodegradable and sterilizable stimuli (thermo-sensitive and photo-responsive) matrices (3-dimensional interpenetrating yet porous polymeric network) suitable for an intra-socket application, and beyond. Conclusions and Perspective: Findings are anticipated to provide sufficient evidence to translate into pilot clinical trials and validate the bionanomaterial before engaging the market for feasibility, acceptance and cost-effectiveness studies. The SockGEL/PLUG platform is patent pending: SockGEL is a bio-inspired drug-free hydrogel; SockPLUG is a drug-loaded hydrogel designed for complex indications.

Keywords: hydrogel, injectable, dentistry, craniomaxillofacial complex, bioinspired, nanobiotechnology, biopolymer, sol-gel, stimuli-responsive, matrix, tissue engineering, regenerative medicine

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Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

Abstract:

In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

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Authors: Nissim Avissar

Abstract:

This paper aims to question the practice of bringing together people belonging to groups in conflict with the aim of bridging differences through universal empathy and interpersonal connections. It is argued that in cases where one group has the power, and the other is in a struggle to change the balance assuming universal equality between the groups and encouraging emphatic understanding is a non-emphatic practice. Accordingly, a new concept is posited–justice-sensitive empathy, conditioning empathy in such situations on the acknowledgement of an imbalance of power/injustice. With this reframing in mind, educational practices promoting social justice are discussed. In order to create conditions for justice-seeking or politically sensitive empathy, we need to go beyond the conventional definitions of empathy and offer other means and possibilities. Three possibilities are discussed. The first focuses on intra-group (as opposed to inter-group) processes within each group. It means temporary and tactical separation that may allow each group to focus on its own needs and values and perhaps to return to the dialogue more confidently. The second option emphasizes the notion of "constructive conflict," which means that each side still aspires to promote his own interests but without demolishing the other side (which is a rival but also an unwanted and forced partner). Here, alongside the "obligation to resist" and to act to promote justice as we view and understand it, we have to take into account the other side. The third and last option relates to the practice of Restorative Justice. This practice originated in the Truth and Reconciliation committees in South Africa, but it is now widely used in other contexts. Those committees had the authority to punish (or pardon) people; however, their main purpose was to seek truth and, from there, nourish reconciliation. This is the main idea of restorative justice; it seeks justice for the sake of restoring relationships. All the above options involve action and are aware of power relations (i.e., politics). They all seek justice. They may create conditions for the more conventional empathic practice to evolve, but no less than that, they are examples of justice-seeking and politically sensitive empathetic practice.

Keywords: education, empathy, justice, reconciliation

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Authors: Moh’d A. AL-Shboul

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Recently, and due to Arab spring and terrorism around the globe, pushing and driving most governments potentially to harmonize their border measures particularly the regional and an international transit trade within and among Customs Unions. The main purpose of this study is to investigate and provide an insight for monitoring and controlling the trade supply chain within and among different countries by using technological advancement (i.e. an electronic tracking system, etc.); furthermore, facilitate the local and intra-regional trade among countries through reviewing the recent trends and practical implementation of an electronic transit traffic and cargo that related to customs measures by introducing and supporting some case studies of several international and landlocked transit trade countries. The research methodology employed in this study was described as qualitative by conducting few interviews with managers, transit truck drivers, and traders and reviewing the related literature to collect qualitative data from secondary sources such as statistical reports, previous studies, etc. The results in this study show that Jordan and other countries around the globe that used an electronic tracking system for monitoring transit trade has led to a significant reduction in cost, effort and time in physical movement of goods internally and crossing through other countries. Therefore, there is no need to escort transit trucks by customs staff; hence, the rate of escort transit trucks is reduced by more than ninety percent, except the bulky and high duty goods. Electronic transit traffic has been increased; the average transit time journey has been reduced by more than seventy percent and has led to decrease in rates of smuggling up to fifty percent. The researcher recommends considering Jordan as regional and international office for tracking electronically and monitoring the transit trade for many considerations.

Keywords: electronic tracking system, facilitation system, regional and international corridor, supply chain security, transit trade

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Authors: Nurunnaher Nurunnaher

Abstract:

This paper examines the impact of women’s participation in microcredit on women’s decision making in the slum areas of Dhaka city, Bangladesh. There is confusion in the literature about whether women’s empowerment is or is not a trickle down impact of poverty alleviation or household well-being, and the studies use more or less similar indicators to measure the status of household and the status of women. Studies very rarely conceptualize and operationalize the term ‘empowerment’ as the word is often used without proper care by policy makers and development practitioners instead of household wellbeing. Currently, decision making in many studies has been used as an indicator of women’s empowerment when assessing the impact of microcredit programs on women. Based on a qualitative and feminist study this paper operationalizes women’s empowerment through the development of a conceptual framework, the identification of assessment criteria and the development of proper indicators that guided the whole study. The testimonies of participants, both men and women, were the basis of exploration of women’s lived experiences, which is the most appropriate method to explore the impact of such programs on women’s empowerment. The study considers empowerment as a process that affects various levels of life and gender relationships. The study found that there is a positive change in women’s position in decision making when women have developed an independent economic base with credit money. However, predominantly, women’s decision making is shared with men with the final decision still in the men’s hands. It can be said that women’s microcredit participation has not significantly challenged the social norms, therefore it is not surprising that women who hand over credit to their husband rarely have any power in intra-household bargaining process. Nevertheless, overall it is evident that women are continuously struggling toward the freedom to have the authority over household, economic and personal matters. It is concluded that while making strategic choices or gaining empowerment requires several steps, women’s participation in decision-making has several implications on their lives and potentially challenges patriarchy.

Keywords: women, gender inequality/equality, decision making, empowerment, microcredit, slums, Dhaka, Bangladesh

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Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

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Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

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Authors: M. A. Rashed, A. S. Mansour, H. Faris, W. Afify

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The calcarenites carbonate rocks of the Quaternary ridges, which extend along the northwestern Mediterranean coastal plain of Egypt, represent an excellent model for the transformation of loose sediments to real sedimentary rocks by the different stages of meteoric diagenesis. The depositional and diagenetic fabrics of the rocks, in addition to the strata orientation, highly affect their ultimate compressive strength and other geotechnical properties. There is a marked increase in the compressive strength (UCS) from the first to the fourth ridge rock samples. The lowest values are related to the loose packing, weakly cemented aragonitic ooid sediments with high porosity, besides the irregularly distributed of cement, which result in decreasing the ability of these rocks to withstand crushing under direct pressure. The high (UCS) values are attributed to the low porosity, the presence of micritic cement, the reduction in grain size and the occurrence of micritization and calcretization processes. The strata orientation has a notable effect on the measured (UCS). The lowest values have been recorded for the samples cored in the inclined direction; whereas the highest values have been noticed in most samples cored in the vertical and parallel directions to bedding plane. In case of the inclined direction, the bedding planes were oriented close to the plane of maximum shear stress. The lowest and highest anisotropy values have been recorded for the first and the third ridges rock samples, respectively, which may attributed to the relatively homogeneity and well sorted grain-stone of the first ridge rock samples, and relatively heterogeneity in grain and pore size distribution and degree of cementation of the third ridge rock samples, besides, the abundance of shell fragments with intra-particle pore spaces, which may produce lines of weakness within the rock.

Keywords: compressive strength, anisotropy, calcarenites, Egypt

Procedia PDF Downloads 349

Authors: Ahmed Elbeltagy, Francesca Bertolini, Damarius Fleming, Angelica Van Goor, Chris Ashwell, Carl Schmidt, Donald Kugonza, Susan Lamont, Max Rothschild

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The major factor in shaping genomic variation of the African indigenous rural chicken is likely natural selection drives the development genetic footprints in the chicken genomes. To investigate such a hypothesis of a selection footprint, a total of 292 birds were randomly sampled from three indigenous ecotypes from East Africa (Uganda, Rwanda) and North Africa (Egypt) and two registered Egyptian breeds (Fayoumi and Dandarawi), and from the synthetic Kuroiler breed. Samples were genotyped using the Affymetrix 600K Axiom® Array. A total of 526,652 SNPs were utilized in the downstream analysis after quality control measures. The intra-population runs of homozygosity (ROH) that were consensuses in > 50% of individuals of an ecotype or > 75% of a breed were studied. To identify inter-population differentiation due to genetic structure, FST was calculated for North- vs. East- African populations in addition to population-pairwise combinations for overlapping windows (500Kb with an overlap of 250Kb). A total of 28,563 ROH were determined and were classified into three length categories. ROH and Fst detected sweeps were identified on several autosomes. Several genes in these regions are likely to be related to adaptation to local environmental stresses that include high altitude, diseases resistance, poor nutrition, oxidative and heat stresses and were linked to gene ontology terms (GO) related to immune response, oxygen consumption and heme binding, carbohydrate metabolism, oxidation-reduction, and behavior. Results indicated a possible effect of natural selection forces on shaping genomic structure for adaptation to local environmental stresses.

Keywords: African Chicken, runs of homozygosity, FST, selection footprints

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Authors: Vinod Kumar Gupta, Narendrakumar M. Chaudhari, Suchismitha Iskepalli, Chitra Dutta

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Background-The community composition of the human microbiome is known to vary at distinct anatomical niches. But little is known about the nature of variations if any, at the genome/sub-genome levels of a specific microbial community across different niches. The present report aims to explore, as a case study, the variations in gene repertoire of 28 Prevotella reference draft genomes derived from different body-sites of human, as reported earlier by the Human Microbiome Consortium. Results-The analysis reveals the exclusive presence of 11798, 3673, 3348 and 934 gene families and exclusive absence of 17, 221, 115 and 645 gene families in Prevotella genomes derived from the human oral cavity, gastro-intestinal tracts (GIT), urogenital tract (UGT) and skin, respectively. The pan-genome for Prevotella remains “open”. Distribution of various functional COG categories differs appreciably among the habitat-specific genes, within Prevotella pan-genome and between the GIT-derived Bacteroides and Prevotella. The skin and GIT isolates of Prevotella are enriched in singletons involved in Signal transduction mechanisms, while the UGT and oral isolates show higher representation of the Defense mechanisms category. No niche-specific variations could be observed in the distribution of KEGG pathways. Conclusion-Prevotella may have developed distinct genetic strategies for adaptation to different anatomical habitats through selective, niche-specific acquisition and elimination of suitable gene-families. In addition, individual microorganisms tend to develop their own distinctive adaptive stratagems through large repertoires of singletons. Such in situ, habitat-driven refurbishment of the genetic makeup can impart substantial intra-lineage genome diversity within the microbes without perturbing their general taxonomic heritage.

Keywords: body niche adaptation, human microbiome, pangenome, Prevotella

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