Results of the eighteenth winter waterbird census in Libya in 2022

Background

Libyan wetlands are diverse; the coastline of Libya, in particular, has different kinds of wetlands, such as salt marshes, bays, lakes, lagoons, and islands. These varieties in habitats provide good shelters and foraging sites for migratory birds during their journeys between Eurasia and Africa. Since the beginning of the Libyan winter census of waterbirds International waterbirds census (Libya IWC) in 2005, which continued regularly until 2012, it has had relatively the same performance in the number of covered sites. However, since 2013, due to the security situation that Libya has experienced due to wars and conflict, which negatively affected the quality of the IWC in Libya, the number of sites has dramatically decreased, reaching only six locations during the middle of the previous decade.

Aim

The IWC 2022 aimed to count the birds along the Libyan coast from January 10 to 29.

Methods

The census activities were conducted from dawn to dusk during the study period by using high-quality Telescopes, binoculars, and digital cameras for the documentation. Point transects method was used to cover the sites.

Results

The results of this year showed that a total of 64 sites were covered, and 68 species of waterbirds were counted, with an abundance of 61,850 individuals. During the census period, a total of 52 non-waterbird species found in Wetlands were recorded, and the number of individuals was 14,836 birds. A total of 18 threatened species were observed during this survey, 12 of them are mentioned in the International Union for Conservation of Nature Red List, and nine species are mentioned in the regional activities center of specially protected areas annex II as threatened in the Mediterranean, where the species; Larus audouinii (Payraudeau, 1826), Larus genei (Breme, 1839), and Puffinus yelkouan (Acerbi, 1827) are mentioned in both of them.

Conclusion

The lack of the number of ornithologists and bird watchers is still one of the factors affecting the quality of the IWC in Libya, as well as lack of funding remains an important factor that plays a major role in the success of the waterbirds census.

Clinical Study on Gonococcal Infection of the Penile Raphe

INTRODUCTION

Gonococcal infection of the penile raphe is rarely encountered in the clinical setting. The study aimed to understand the incidence, sites, clinical manifestations, and treatment of gonococcal infection of the penile raphe.

METHODS

We enrolled men with gonococcal infection of the penile raphe and men with urethral gonorrhea from January 2010 to December 2021. All patients' demographic data and clinical characteristics were recorded. All patients were treated with ceftriaxone. Incision and drainage were performed in patients with non-ruptured abscesses. Nodules and sinus tract-like lesions that did not resolve after 1 month of treatment were excised.

RESULTS

Among 2,736 men who presented with urethral gonorrhea from January 2010 to December 2021, 5 (0.18%) had accompanying gonococcal infection of the penile raphe. An additional two men presented with gonococcal infection of the penile raphe without urethritis. Thus, 7 (0.26%; confidence interval, 0.11-0.56%) of 2,738 men had urethral gonorrhea or gonococcal infection of the penile raphe confirmed both clinically and by laboratory testing. Lesions were present in the frenulum of the prepuce and at the median aspect, proximal end, distal end, and both the proximal and distal ends of the penile raphe. The lesions manifested as abscesses, ulcers, a nodule, and a nodule with a sinus-like lesion. All lesions exhibited tenderness. All seven patients were cured after treatment.

CONCLUSION

Gonococcal infection of the penile raphe is a rare, atypical type of involvement of the male urogenital tract by Neisseria gonorrhoeae. It may be a local complication of urethral gonorrhea or an independent primary infection. The proximal end, distal end, and median aspect of the penile raphe can be infected by N. gonorrhoeae. Cutaneous lesions present as abscesses, ulcers, nodules, and sinus-like lesions. Ceftriaxone is effective, but sinus-like lesions require surgery.

Defining the Patchy Landscape of Esophageal Eosinophilia in Children With Eosinophilic Esophagitis

BACKGROUND & AIMS

Eosinophilic esophagitis (EoE) is a patchy disease of the esophagus with significant variability in intraepithelial eosinophilia. Three biopsies each from distal and proximal esophagus are recommended for identification of active EoE. Recent work suggests 3 biopsy sites are more optimal. We sought to evaluate 2-site vs 3-site esophageal biopsy combinations for utility to identify active EoE.

METHODS

We prospectively obtained 3-site esophageal biopsies based on rigorous endoscopic measurements of the proximal, mid, and distal esophagus and gastroesophageal junction. Biopsies were reviewed by a pathologist, and those with at least 15 eosinophils per high-power field were considered active EoE. The sensitivity of one or more sites to identify active EoE was determined, and endoscopic measurements were correlated to height and age.

RESULTS

Five hundred ninety-six endoscopies were performed in 217 patients; of these, 304 endoscopies in 167 patients had active EoE. Among the initial esophagogastroduodenoscopies with active EoE, distal biopsies had greater than 80% sensitivity, whereas mid and proximal biopsies had sensitivity of 65% and 62%, respectively, and distal + proximal biopsies had the highest diagnostic sensitivity for a 2-site combination. Among the 304 endoscopies with active EoE, 9 had focal eosinophilia restricted to the mid esophagus, and 8 were restricted to the proximal esophagus. For patients with multiple endoscopies with active EoE, nearly one fourth had reduced sites with eosinophilia at the second time point. Endoscopic measurements strongly correlated with height and age.

CONCLUSIONS

This study supports endoscopic measurement-guided 3-site biopsies for optimal disease assessment of active EoE in children.

Development of a TB vaccine trial site in Africa and lessons from the Ebola experience

Tuberculosis is the deadliest infection of our time. In contrast, about 11,000 people died of Ebola between 2014 and 2016. Despite this manifest difference in mortality, there is now a vaccine licensed in the United States and by the European Medicines Agency, with up to 100% efficacy against Ebola. The developments that led to the trialing of the Ebola vaccine were historic and unprecedented. The single licensed TB vaccine (BCG) has limited efficacy. There is a dire need for a more efficacious TB vaccine. To deploy such vaccines, trials are needed in sites that combine high disease incidence and research infrastructure. We describe our twelve-year experience building a TB vaccine trial site in contrast to the process in the recent Ebola outbreak. There are additional differences. Relative to the Ebola pipeline, TB vaccines have fewer trials and a paucity of government and industry led trials. While pathogens have varying levels of difficulty in the development of new vaccine candidates, there yet appears to be greater interest in funding and coordinating Ebola interventions. TB is a global threat that requires similar concerted effort for elimination.

A cross-cutting approach to enhancing clinical trial site success: The Department of Veterans Affairs' Network of Dedicated Enrollment Sites (NODES) model

Background

Recruitment into clinical trials remains a key determinant to study completion and success. While various strategies have been proposed, it is unclear how they apply across different populations, diseases, and/or study goals. The ability to effectively overcome challenges may require different approaches that more broadly focus on addressing obstacles among sites that cannot be overcome by individual studies.

Methods

The Department of Veterans Affairs (VA) Cooperative Studies Program (CSP) established the Network of Dedicated Enrollment Sites (NODES) as a consortium of sites to generate systematic site-level solutions to more efficiently recruit in CSP studies. Initial activities identified priorities and developed approaches through team-based efforts. Metrics were also developed to assess overall network performance.

Results

Network efforts produced several new strategies and best practices for common problems in CSP research. Recruitment strategies included bringing studies to patients and developing data programs using algorithms for finding eligible patients. Efficiency efforts focused on cross-training and standardizing performance reports.

Conclusion

NODES addressed site challenges in clinical trial recruitment and management by taking an overall approach that looked at the system rather than individual studies. Practices and operational changes were implemented for CSP research related to recruitment, staff training and research methodology. The network activities suggest that team-based development of tools and insights may help better identify targets and increase efficiencies for clinical trials recruitment.

Strategies to grow an experiential learning program-The role of administrators

With the newly released ACPE standards, challenges exist in growing experiential learning programs at many schools. The role of administrators in the experiential learning office, practice department, and the dean׳s office is critical for success. This article provides practical tips and strategies to help grow an experiential learning program by emphasizing the role of administrators. In 2012, the administrators of the University of Maryland School of Pharmacy brainstormed and came up with a list of challenges faced by its experiential learning program, provided suggested solutions to each challenge, and began a process of implementing solutions to help grow the program. As of fall 2014, we were able to document increases in the numbers of preceptors and different rotation types, growth in the clinical track program, changes in our learning management system to better accommodate our needs, and increases in satisfaction rates among our preceptors, sites, and students. This article summarizes the challenges faced by University of Maryland Experiential Learning Program, the practical solutions implemented, and the role of leadership in growing the program. Many of the suggestions and lessons learned here can benefit many programs with similar challenges.

Spatial and seasonal influences on culturable endophytic mycobiota associated with different tissues of Eugenia jambolana Lam. and their antibacterial activity against MDR strains

BACKGROUND

Present study focuses on diversity and distribution analysis of endophytic fungi associated with different tissues of Eugenia jambolana. The influence of season and geographical location on diversity and distribution of endophytic fungi has been analyzed. Antibacterial activity of isolated fungal species has also been investigated against MDR bacterial strains.

RESULT

A total of 1896 endophytic fungal isolates were obtained from healthy, surface sterilized tissues of leaf, stem and petiole tissues during summer, monsoon and winter season. Out of 24 fungal species isolated, 20 species belong to class Ascomycetes, 2 to Basidiomycetes and 2 to Zygomycetes. Maximum species diversity was in rainy season whereas colonization frequency was in winter. All the diversity indices showed maximum species diversity at site 5 (Yamunanager), rainy among the seasons and leaf among the tissues studied. Aspergillus genus was most frequently isolated. Aspergillus niger and Alternaria alternata were most dominant species. Three way ANOVA results showed that effect of season was highly significant on species diversity in relation to sites and tissues. 60% endophytic fungal extracts showed significant antibacterial activity against one or more than one MDR bacterial strain.

CONCLUSION

Different fungal species were recovered from different sites but the inter-site comparisons were not significant according to Jaccard similarity coefficient. Diversity of such fungal endophytes indicates that Eugenia jambolana plant acts as an ecosystem facilitating survival of many microbes with impressive antibacterial potential.

[Recurrence sites following definitive intensity-modulated conformational radiotherapy of squamous-cell carcinomas of the upper aerodigestive tract]

PURPOSE

The implementation of intensity-modulated radiotherapy (IMRT) in a centre requires regular critical review of medical practices and feedback to optimize the subsequent management of patients.

PATIENTS AND METHODS

We reviewed and determined through a retrospective single-centre study recurrence sites of 167 consecutive patients treated for head and neck squamous cell carcinoma excluding skin or sinuses. Patients had mostly stage III or IV locally advanced cancer (n=123).

RESULTS

Locoregional control rates at 1 and 2 years were respectively 87.9% (95% confidence interval [95%CI]: 81.6%-92.1%) and 77.6% (95%CI: 70.1%-83.5). Among 55 relapses, 20 patients (36.4%) had treatment failures. Patients treated with 70 Gy relapsed mainly in high risk volume (78%). Those treated with 66 Gy recurred regionally outside the irradiated volume (n=4) or in the irradiated high risk volume (n=3) or had isolated metastatic failure (n=3). Those irradiated with 50 Gy had regional relapse outside the irradiated volume (n=2) or isolated metastatic relapse (n=2). We noticed respectively 5.4%, 10.2% and 4.2% isolated metastatic, local, cervical lymph node relapse.

CONCLUSION

Our results are consistent with data from the literature. Corrective actions were performed to enhance our practices.