TRANSCOV cohort protocol: an epidemiological study assessing the impact of critically ill COVID-19 patients long distance transfers between intensive care units

IntroductionDuring spring 2020, four regions of France faced a surge of severe COVID-19 patients which threatened to overflow local intensive care units (ICU) capacities. As an emergency response, between 13 March 2020 and 10 April 2020, an estimated 661 patients were transferred from overcrowded ICUs to eight other French regions and four neighbouring countries. The intensity, geographical spread and the diversity of vectors used are unprecedented. The study aims at assessing the impact of these inter-ICU transfers on the short-term and medium-term physical and psychological outcomes in this population of severe COVID-19 patients.Methods and analysisThe TRANSCOV cohort is a multicentre observational retrospective study. All transferred patients between ICUs outside the origin region will be invited to take part. For each transfer, up to four control patients will be selected among those admitted in the same ICU during the same period (±4 days of transfer date). Clinical data will be extracted from medical records and will include haemodynamic and respiratory parameters, as well as clinical severity scores before, during and after transfer. Data linkage with medicoadministrative data will enrich the clinical database and allow follow-up up to 1 year after initial admission.Ethics and disseminationThe study has been approved by the French Ethics and Scientific Committee on the 16 July 2020 (file no. 2046524). The results will be disseminated via publication of scientific articles and communications in national and international conferences.Trial registration number20 CO 015 CZ.

Competitive binding of MatP and topoisomerase IV to the MukB hinge domain

Structural Maintenance of Chromosomes (SMC) complexes have ubiquitous roles in compacting DNA linearly, thereby promoting chromosome organization-segregation. Interaction between the Escherichia coli SMC complex, MukBEF, and matS-bound MatP in the chromosome replication termination region, ter, results in depletion of MukBEF from ter, a process essential for efficient daughter chromosome individualisation and for preferential association of MukBEF with the replication origin region. Chromosome-associated MukBEF complexes also interact with topoisomerase IV (ParC2E2), so that their chromosome distribution mirrors that of MukBEF. We demonstrate that MatP and ParC have an overlapping binding interface on the MukB hinge, leading to their mutually exclusive binding, which occurs with the same dimer to dimer stoichiometry. Furthermore, we show that matS DNA competes with the MukB hinge for MatP binding. Cells expressing MukBEF complexes that are mutated at the ParC/MatP binding interface are impaired in ParC binding and have a mild defect in MukBEF function. The data highlight competitive binding as a means of globally regulating MukBEF-topoisomerase IV activity in space and time.

Factors influencing maternal healthcare seeking in a highland region of Madagascar: a mixed methods analysis

Background In Madagascar, maternal mortality remains stable and high (426 deaths per 100,000 live births). This situation is mainly due to a delay or lack of use of maternal healthcare services. Problems related to maternal healthcare services are well documented in Madagascar, but little information related to maternal healthcare seeking is known. Thus, this paper aims to identify and analyze the factors that influence the utilization of maternal services, specifically, the use of antenatal care (ANC) during pregnancy and the use of skilled birth attendants (SBAs) at delivery. Method We used quantitative and qualitative approaches in the study. Two communes of the Vakinankaratra region, which are located in the highlands, were the settings. Data collection occurred from October 2016 to July 2017. A total of 245 pregnant women were included and followed up in the quantitative survey, and among them, 35 participated in in-depth interviews(IDIs). Logistic regressions were applied to explore the influencing factors of antenatal and delivery healthcare seeking practices through thematic qualitative analysis. Results Among the 245 women surveyed, 13.9% did not attend any ANC visits. School level, occupation and gravidity positively influenced the likelihood of attending one or more ANC visits. The additional use of traditional caregivers remained predominant and was perceived as potentially complementary to medical care. Nine in ten (91%) women expressed a preference for delivery at healthcare facilities (HFs), but 61% of births were assisted by a skilled birth attendant (SBA).The school level; the frequency of ANCs; the origin region; and the preference between modern or traditional care influenced the use of SBAs at delivery. A lack of preparation (financial and logistics problems) and women’s low involvement in decision making at delivery were the main barriers to giving birth at HFs. Conclusion The use of maternal healthcare services is starting to gain ground, although many women and their relatives still use traditional caregivers at the same time. Relatives play a crucial role in maternal healthcare seeking. It would be necessary to target women’s relatives for awareness-raising messages about ANC and childbirth in healthcare facilities and to support and formalize collaborations between traditional healers and biomedical caregivers.

ANALISIS KEBIJAKAN PENGENDALIAN URBANISASI KOTA BERASTAGI KABUPATEN KARO SUMUT

ABSTRAK This study aims at analyzing the factors driving and pulling the occurrence of urbanization in Berastagi and the efforts made by the Karo district government to control it. The method used is descriptive qualitative with primary data sources from interviews and field observations, while secondary data is from literary studies, social media and documentation. The data analysis used is the Delphi analysis to equalize the perceptions of the informants, the analysis of pull and support factors as well as policy analysis on efforts to control urbanization in the City of Berastagi.The conclusion from the results of this study is that the main driving factor for urbanites from their hometowns for those who are not married is shy to live in the village, while for those who are already married are limited employment opportunities in the village. The main draw factor for urbanites from the destination area is for those who do not have family, invite friends who are already in the city while those who are already married are looking for a new job. Efforts made by the Government in the Origin Region are Encouraging and Facilitating: Soft Loans, MSME Empowerment Program Assistance (especially Micro Enterprises) and Building Village Facilities through APBD. Efforts made by the Government in the urbanization destination of Berastagi City are to make a new settlement plan consisting of a. Agricultural Zone on Jl. Air (Column Monument towards Simpang Empat District); b. Office Zone On Jl. Djamin Ginting (from Tugu Kol to Kec. Kaban Jahe); . and c. Tourism Zone Jl. Djamin Ginting starting from the monument mejuah Juah towards Tahura).

Spoligotype-specific risk of finding lesions in tissues from cattle infected by Mycobacterium bovis

Background Although the pathogenic effect of members of the Mycobacterium tuberculosis complex in susceptible hosts is well known, differences in clinical signs and pathological findings observed in infected animals have been reported, likely due to a combination of host and pathogen-related factors. Here, we investigated whether Mycobacterium bovis strains belonging to different spoligotypes were associated with a higher risk of occurrence of visible/more severe lesions in target organs (lungs and/or lymph nodes) from infected animals. A large collection of 8889 samples belonging to cattle were classified depending on the presence/absence of tuberculosis-like lesions and its degree of severity. All samples were subjected to culture irrespective of the presence of lesions, and isolates retrieved were identified and subjected to spoligotyping. The association between the presence/severity of the lesions and the isolation of strains from a given spoligotype was assessed using non-parametric tests and Bayesian mixed multivariable logistic regression models that accounted for origin (region and herd) effects. Results Results suggested a difference in severity in lesioned samples depending on the strain’s spoligotype. An association between specific spoligotypes and presence of lesions was observed, with a higher risk of finding lesions in animals infected with strains with spoligotypes SB0120, SB0295 and SB1142 compared with SB0121, and in those coming from certain regions in Spain. Conclusions Our results suggest that strains belonging to certain spoligotypes may be associated with a higher probability in the occurrence of gross/macroscopic lesions in infected cattle, although these observational findings should be confirmed in further studies that allow accounting for the effect of other possible confounders not considered here, and ultimately through experimental studies.

Data Identification of Cirebon Batik West Java Source of Strength Geographical Indication

In the history of batik in Indonesia, We used to know that batik is identified with Javanese culture. In addition, the use of batik cloth is limited to the royal court with a variety of very strict rules. But in its development, batik is no longer owned by Javanese, batik has now become one of the "national clothes" of Indonesia that is used by Indonesians throughout the archipelago on various occasions. In West Java batik has grown and developed in 27 regencies/cities spread from the eastern part of the Cirebon district to the western of West Java, Depok. There are potential characteristics and excellences from each region in West Java that people could not find in other regions. The uniqueness and characteristics of batik in certain area are part of the protection system of geographical indications that identify an area of the country, as the origin region of the product, where the reputation, quality and characteristics of related products are largely determined by geographical factors in the region. The need for a complete and accurate identification in the protection of Geographical Indications is very important considering batik products in West Java have enormous potential that can be protected as part of Geographical Indications (IG) which can be used as marketing tools in the world of commerce, both at the national and international level.Keywords: Cirebon Batik, Geographical Indication, Identification

Identification of the unwinding region in the Clostridioides difficile chromosomal origin of replication

Faithful DNA replication is crucial for viability of cells across all kingdoms of life. Targeting DNA replication is a viable strategy for inhibition of bacterial pathogens. Clostridioides difficile is an important enteropathogen that causes potentially fatal intestinal inflammation. Knowledge about DNA replication in this organism is limited and no data is available on the very first steps of DNA replication. Here, we use a combination of in silico predictions and in vitro experiments to demonstrate that C. difficile employs a bipartite origin of replication that shows DnaA-dependent melting at oriC2, located in the dnaA-dnaN intergenic region. Analysis of putative origins of replication in different clostridia suggests that the main features of the origin architecture are conserved. This study is the first to characterize aspects of the origin region of C. difficile and contributes to our understanding of the initiation of DNA replication in clostridia.

Consumers' Preferences for Locally Produced Honey in Hungary

Sustainability is considered in relation to the consumption of local food. Consumers have recently become more concerned about food safety, including potential impurities in Asian honey. Some consumers believe that eating local honey products might be a way to avoid food safety risks. Food security is also guaranteed by certification marks that create confidence in consumers, and help their decisions in buying. The aim of the paper is to identify the main characteristics of Hungarian consumer preferences when buying honey. In this article we analyse the consumer behaviour of Hungarian hive products. This study was supported by the data from a nationwide consumer survey carried out in 2016. A total of 1584 subjects participated in this survey, the sample is representative for gender, age and highest level of education in Hungary. The results of our study show the actual potential consumers of the Hungarian honey products. Based on the results, the consumers we interviewed consider the consumption of honey of Hungarian origin very important, and they prefer to purchase these products directly or indirectly from the beekeepers. Well-informed consumers in terms of honey certification marks consider some features of honey (Hungarian origin; region of origin; brand, producer name; certification marks) significantly more important than uninformed consumers. Awareness of the certification marks helps consumer decisions which are confirmed by the fact that consumers who are informed about honey certification marks were not affected by honey counterfeits.

Human Trafficking in North Sulawesi Indonesia

The aims of this research are to identify the factors that cause human trafficking, to describe the map of origin region and destination of delivery, to analyze the modes used by the traffickers. The method used is the Qualitative Descriptive Method. The results showed that there were seven main factors causing human trafficking in North Sulawesi. Those were lifestyle, lack of knowledge and capacity, potential employability as commercial sex workers, demand of commercial sex workers, youth marriage and limited employment in formal sectors and secullarism. Most of the victims came from Manado City, Minahasa, South Minahasa and North Minahasa Regency. The largest destination areas of the victims were Papua, West Papua, Southeast Sulawesi and Batam (the Province of Riau Islands). The modes used by the perpetrators are persuading victims to work outside the area with high incomes, cheated with debt bondage, offering scholarship programs, adopted as children, fraudulent and abducting. The efforts that need to be done to eliminate human trafficking are changing the lifestyles from consumptive to productive by increasing self-resilience (changing the paradigm of thinking to be realistic and not regarding material wealth as a source of self-esteem or avoiding hedonism) and improving self-capacity through continuous knowledge enhancement. Local governments need to enlighten the publics through various programs/activities such as socialization with emphasis on human trafficking modes, to train of members of the task force on prevention of human traffics, to cooperate and to form partnerships with other institutions and local/regional governments, to build cooperation on the prevention and handling of human traffics with non-government institutions, to break the links of sexual trafficking and other types of unlawful businesses, to prevent young marriages to stimulate job creations, especially in the formal sectors and to increase the roles of parents and education institutions