A Fatal Case of Severe Acute Organophosphorus Pesticide Poisoning Complicated with Secondary Hemophagocytic Lympho-Histiocytosis, Severe Lower Intestinal Hemorrhage and Intestinal Mucormycosis

A man in his 50’s, under influence of alcohol, accidentally ingested a pesticide, and was referred for further management and admitted to our hospital. An empty can of Curacron® was found at the site in his farm where he took the alleged pesticide. This raised the suspicion of organophosphorus pesticide poisoning and he was managed at two medical centres before getting admitted to our hospital. His hospital course was complicated with multiorgan dysfunction, shock, respiratory failure and intermediate syndrome. On day five he developed secondary hemophagocytic lymphohistiocytosis (sHLH) and had hematochezia on day six. Colonoscopy revealed multiple circumferential ulcerations in descending and sigmoid colon with luminal narrowing. Biopsy of colonic tissue showed evidence of intestinal Mucormycosis. The clinical presentation of organophosphorus pesticide poisoning in this patient was complicated with multiple issues and included sHLH, chemical gastroenteritis, hemorrhagic ulcers and intestinal zygomycosis. The organophosphorus pesticide ingested by the patient was a 50% emulsifiable concentrate of profenofos along with vegetable oil, soyabean oil and polyglycol ether alkyl aryl sulphate calcium salt 5.25% w/w as an emulsifier/spreading agent. The management of the patient is discussed. Due to the possibility of the emulsifier adhering to the gastrointestinal tract and causing mucosal injury, it is necessary to identify the drug composition and ingredients of the pesticide as soon as possible when managing organophosphorus poisoning.

CHEATING DURING ONLINE EXAMINATIONS – LITERATURE REVIEW

The COVID-19 pandemic forced the closure of many human activities. As a result, education quickly shifted from a classroom setting to an online one, challenging educators and students alike. Multiple issues that had barely been known to educators surfaced: technophobia, lack of rules or guidelines regarding online learning, politeness in a virtual environment, limited social interaction, but some of the greatest challenges remain cheating, and academic integrity concerns during online examinations. Technological and software advances can oftentimes identify cases of academic dishonesty. However, with mass education and faculty unpreparedness it is rather problematic to combat and avoid cheating during online assessment. This mixed-methods review based on the limited empirical research on the topic of cheating during online examinations will identify the factors that lead to cheating and will discuss the best ways of combating and avoiding academic dishonesty.

HIV and Aging: Overcoming Challenges in Existing HIV Guidelines to Provide Patient-Centered Care for Older People with HIV

With advances in antiretroviral therapy and subsequent increase in life expectancy, People with HIV (PWH) now experience multiple geriatric syndromes in the setting of advanced aging and increased multimorbidity. HIV clinicians bear the responsibility of delivering geriatric care to this vulnerable population, despite limited geriatric medicine training and limited support from HIV service networks that were not traditionally designed to care for an aging population. Although HIV clinicians reported formal guidelines specific to older PWH to be among the most helpful interventions, current HIV guidelines present multiple issues in their applicability to the care of older PWH, including multifactorial nature of conditions in older adults, difficulty measuring patient-centered outcomes, lack of representation of older PWH in clinical trials, limited guidelines addressing geriatric syndromes, and the use of chronological age as criteria for inclusion despite advanced aging in PWH. Understanding that updated guidelines addressing above challenges may take many years to develop, we offer strategies on the application of current guidelines, including using baseline attributes, time to benefit, and the Geriatrics 5M model to aid in shared decision making and improve outcomes among older PWH.

Emerging Pillars for IWRM Implementation In Bangladesh

Since the early 1990s, the IWRM approach has been performing for improving the water sector through minimising the water crisis in Bangladesh. Therefore, Bangladesh has developed three pillars (e.g., enabling environment, institutional arrangement, management instruments, etc.) favouring IWRM to meet the desired goal. Despite the ability to adequately address the cross-cutting and multiple issues of the water sector of Bangladesh, the IWRM approach is getting more complex day by day because the steps taken under the pillars may not work correctly. Given above, an attempt has been made to analyse how the existing contradictions in IWRM pillars (designed by Bangladesh) affect IWRM effectiveness. Using document analysis and semi-structured interviews, this paper provides an understanding of existing inconsistencies of IWRM pillars and the necessity of enhancing IWRM pillars for increasing IWRM implementation effectiveness in Bangladesh. The implementation challenges of the policy networks (policy, plan, strategy etc.) and implementation networks (water projects) made to ensure enabling environment affect IWRM effectiveness. Institutional power and responsibility are not defined in the policy rules and regulations correctly, causing problems in the institutional arrangement, which has affected IWRM effectiveness. Database related issues about the management instruments are also responsible in this regard. Necessary strategies and measures as per network management are recommended to enhance IWRM tools by resolving irregularities and improving IWRM effectiveness in Bangladesh.

Why morphology matters: the negative consequences of hasty descriptions of putative novelties in asexual ascomycetes

ABSTRACTRecent progress in the discovery of fungal diversity has been enabled by intensive mycological surveys in centres of global biodiversity. Descriptions of new fungal species have been almost routinely based on phenotypic studies coupled with single or multigene phylogenetic analyses of DNA sequence data. However, high accessibility of sequencing services together with an increasing amount of available molecular data are providing easier and less critical support for taxonomic novelties without carefully studying the phenotype, particularly morphology. As a result, the accelerated rate of species descriptions has been unfortunately accompanied by numerous cases of overlooking previously described and well documented species, some of them that have been known for more than a century. Here, we critically examined recent literature, phenotypic and molecular data, and detected multiple issues with putative novelties of asexual Ascomycota traditionally known as hyphomycetes. In order to fix these taxonomic problems, three new combinations within the genera Pleopunctum, Camposporium and Sporidesmium, and two new names in Camposporium are proposed. Moreover, three genera, Aquidictyomyces, Fusiconidium and Pseudohelminthosporium, together with nine species are reduced to synonymy. The examples outlined here clearly show the relevance of morphology in modern phylogenetic studies and the importance of more stringent ‘quality controls’ during biodiversity studies documenting the extensive fungal diversity in a speedy manner.

Предварительная обработка данных системного мониторинга для анализа профиля загрузки высокопроизводительных вычислительных систем

HPC systems are complex in architecture and contain millions of components. To ensure reliable operation and efficient output, functioning of most subsystems should be supervised. This is done on the basis of collected data from various logging and monitoring systems. This means that different data sources are used, and accordingly, data analysis can face multiple issues processing this data. Some of the data subsets can be incorrect due to the malfunctioning of used sensors, monitoring system data aggregation errors, etc. This is why it is crucial to preprocess such monitoring data before analyzing it, taking into the consideration the analysis goals. The aim of this paper is, being based on the MSU HPC Center monitoring data, to propose an approach to data preprocessing of HPC monitoring systems, giving some real life examples of issues that may be faced, and recommendations for further analysis of similar datasets. Высокопроизводительные вычислительные системы сложны по архитектуре и содержат миллионы компонент. Чтобы обеспечить надежную работу и эффективную отдачу, необходимо контролировать работу всех их подсистем. Это делается на основе данных, собранных различными системами журналирования и мониторинга. Это означает, что используются разные источники данных, и, соответственно, анализ данных может столкнуться с множеством проблем, связанных с обработкой этих данных. Некоторые из подмножеств данных могут быть неверными из-за неисправности используемых датчиков, ошибок агрегирования данных системы мониторинга и т.д. Вот почему крайне важно проводить предварительную обработку таких данных мониторинга перед их анализом, принимая во внимание цели анализа. Цель этой работы, описать подход к предварительной обработке данных суперкомпьютерных систем мониторинга на основе опыта работы СКЦ МГУ, привести некоторые реальные примеры проблем, с которыми можно при этом столкнуться, а также рекомендации по дальнейшему анализу подобных наборов данных.

COVID-19 Transmission in Children: Implications for Schools

The COVID-19 pandemic poses multiple issues of importance to child health including threats to physical health and disruption of in-school learning. This chapter reviews what is currently known about COVID-19 epidemiology, presentation, pathophysiology, case definitions, therapies, and in-school transmission in children. COVID-19 has some unique characteristics in children including the rare yet severe Multisystem Inflammatory Syndrome in Children (MIS-C) that may be related to acquired immune responses. There are limited studies to date to define therapeutic guidelines in children, however consensus recommendations from multiple organizations are summarized including the use of immunomodulatory therapies (intravenous immunoglobulin, steroids, anakinra and tocilizumab), antiplatelet (aspirin) and anti-coagulant (low molecular weight heparin) therapies. Finally, considerations for safe return to the classroom are discussed including strategies for optimized student to teacher ratios, hand washing, social distancing, sibling pairing and staged re-opening strategies.

Ethical and Social Challenges in Research with Children Exposed to Forced labour, Exploitation, and Trafficking

This article explores the ethical and social challenges in research with children exposed to forced labour, exploitation, and trafficking. It examines whether the participation of children in evidence generation has the potential to affect them and how the researcher avoids potential discomfort. This requires investigating the multiple issues and contexts that affect the children. Essentially, conducting a child-centred evidence generation is ethically reasonable based on how such investigation is carried out and on how a child is affected by the research activities. The process of recruiting participants, avoiding potential harm, ensuring privacy, anonymity and confidentiality corresponds to the best possible regulation, in full respect of the interests of children. What is pursued is a child-centred evidence generation, capable of responding in an acceptable way, from an ethical point of view to the question about the methodology of the research itself. In addition, child-centred research enhances the sharing of perspectives and insights, which break down the barriers of exclusion. Against this background, this article contributes to the identification, interpretation, and clarification of ethical and social questions that arise in relation to child-centred evidence generation. Similarly, it furthers awareness on the significance of ethical reflection and in making informed decisions and choices to mitigate against potential harm to participants during and after the research.

Agroforestry, Indigenous Tree Cover and Biodiversity Conservation: A Case Study of Mount Elgon in Uganda

Addressing interconnected social and environmental issues, including poverty, food security, climate change, and biodiversity loss, requires integrated solutions. Agroforestry is a sustainable land use approach with the potential to address multiple issues. This study examined the tree cultivation behavior of smallholder farmers in the Mt. Elgon region of Uganda. We examined the proportion of indigenous tree species added to or removed from agricultural land and the reasons for farmers’ decisions in this regard. We found that farmers overwhelmingly planted exotic species, limiting the possible benefits for the conservation of biodiversity from a suggested re-greening of the region. Indigenous trees were cultivated in low numbers and dominated by a handful of species. Opportunities to help farmers increase the number and variety of indigenous trees on their land were found among smaller-scale coffee farmers and in the protection of natural forests from which indigenous trees propagate into the wider landscape.

UK ruling on Venezuela gold will raise multiple issues

Significance The ruling will follow a protracted legal battle between incumbent President Nicolas Maduro and opposition leader Juan Guaido -- the latter recognised as legitimate president by the UK government. Impacts Lack of oversight of the Guaido team’s use of resources could raise questions over any handover. A ruling in favour of Guaido could set a precedent in allowing ‘parallel’ authorities to claim control of UK-held sovereign resources. US and UK positions on Venezuela appear to be moving apart.