Positive Yield Research Articles

Yield Response of Chick Pea (Cicer arietinum L.) Varieties to NPS Fertilizer

Low soil fertility status and reduced biological nitrogen fixation are some of the major constraints in limiting chickpea yield. Thus, an experiment was conducted with the objective of assessing the effect of blended NPS fertilizer rates on the yield and yield components and economic advantages of chickpea varieties. The experiment was done using randomized complete block design with five NPS rates (0, 50, 75, 100 and 125 kg ha-1) and three chick pea varieties (Arerty, Shasho and Teketay) in three replications. The result showed that the main effect of variety had significant effect on days to 50% flowering, days to maturity, plant height, population at harvest, number of secondary branches, number of pods per plant, number of seed per pod, 100 seed weight, biological yield, grain yield and harvest index. Application of NPS significantly influenced number of pod per plant, biological yield, grain yield and harvest index. In addition, the pooled effect of the two factors showed highly significant differences on days to 50% germination, population at emergence and primary plant branches. Hence, Arerty variety showed an increased yield throughout the applied rates and attained its highest yield (3166.70 kg) at 125 kg ha-1 NPS applied along with the highest profit gaining. Shasho variety also showed a positive yield response at all treated plots as compared to the control; but attained maximum yield (2861 kg ha-1) at 100 kg ha-1 NPS applied. However, maximum profit was attained at rate of 75 kg ha-1 NPS. Teketay variety attained highest yield (3138.70 kg ha-1) at 100 kg ha-1 NPS applied; however its highest benefit to cost ratio (1.73) with highest economic benefit was reached at 50 kg ha-1 NPS applied. Thus, based on results obtained from this study, it can be concluded that using 100kg, 75kg and 50kg of NPS fertilizer ha-1 application for Arerty, Shasho, and Teketay varieties respectively improved productivity of chickpea with economically significant amount at the vicinity of the research area.

Comparative Outcomes of Radical Cystectomy in Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis.

Muscle-invasive bladder cancerposes a significant clinical challenge that necessitates effective therapeutic interventions. Radical cystectomy is a primary treatment option, but a comprehensive understanding of its outcomes is crucial for informed clinical decision-making.This systematic review and meta-analysis aimed to investigate and summarize the outcomes associated with radical cystectomy as a primary treatment for muscle-invasive bladder cancer with a focus on survival rates, complications, and quality of life.A systematic search across databases-PubMed, Google Scholar, and others-covered studies from 2017 onwards. Included were studies reporting survival rates, complications, and quality of life post-radical cystectomy in muscle-invasive bladder cancer patients, including randomized controlled trials, cohort, and observational studies. Multidimensional analysis revealed promising findings regarding the efficacy of radical cystectomy in muscle-invasive bladder cancer. Survival outcomes, including overall survival and disease-specific mortality, have demonstrated significant improvements, particularly in recent randomized controlled trials and cohort studies. Complications associated with the surgical procedure, such as positive surgical margins and lymph node yields, were generally acceptable. Quality of life outcomes post-radical cystectomy exhibited positive trends, although variations were noted in the emotional and social domains. This review underscores radical cystectomy's role in enhancing overall survival and reducing disease-specific mortality in muscle-invasive bladder cancer. Despite reported complications, recent studies support its acceptable risk profile. Detailed examination of various factors contributes to a comprehensive understanding of the procedure. These findings emphasize the importance of individualized treatment approaches in the management of muscle-invasive bladder cancer, considering both oncological efficacy and perioperative outcomes.Radical cystectomy remains fundamental in urological oncology, with ongoing advancements refining its significance.

A Single-Center Study of the Utility of Bronchoalveolar Lavage in Critically Ill Patients With Haematological Malignancy or Stem Cell Transplants.

The aim of this study was to evaluate the yield of bronchoscopy-guided bronchoalveolar lavage (BAL) and decisions on management of antimicrobials in critically ill patients with hematological malignancy and/or hematological stem cell transplant (HSCT). The safety and tolerance of bronchoscopy were also reported. A retrospective cohort study was conducted by reviewing health charts of all adult patients with a hematological malignancy and/or an HSCT who were admitted to the intensive care unit and underwent bronchoscopy and BAL over four years from April 2016 to April 2020 at King Abdulaziz Medical City, Riyadh. Results: The cohort included 75 critically ill patients. Of these 75 patients, 53 (70.7%) had HSCT (allogenic 66%, autologous 32.1%, haplogenic 3.8%). Computed tomography of the chest was abnormal in all patients. Predominant findings included airspace abnormalities, ground glass opacities, and others. The positive yield was found to be 20% for bacterial, 22% for viral, 21% for fungal, and other organisms were identified in 2%. Although cytology was not performed in 18 patients, malignant cells were identified on BAL in two patients. While the overall mortality of the cohort was high (46.7%), the vast majority (94.7%) tolerated bronchoscopy and BAL without any complications. However, three patients (4%) developed a pneumothorax and one patient bled and developed the acute respiratory distress syndrome post bronchoscopy. BAL can identify and detect microorganisms directly influencing the clinical care of patients who have received non-invasive diagnostic tests that yielded negative culture results. Bronchoscopy and BAL are generally safe and well tolerated by critically ill patients with hematological malignancy or HSCT.

Impact of introduction of TB LAM in the TB testing algorithm at Levy Mwanawasa University Teaching Hospital on case detection and notifications

Abstract
 
 Introduction
 TB-LAM tests were introduced in the TB program in Zambia in 2019, to aid in diagnosis of TB. We carried out a study to determine the impact that TB lipoarabinomannan (LAM) test has had on case identification and notification at a tertiary hospital in a city with a high prevalence of HIV. We also compared sensitivity, specificity, positive predictive value and negative predictive of TB LAM tests and X-pert MTB RIF test in HIV positive and HIV negative patients.
 
 Method
 Retrospective analysis of the TB laboratory as well as the TB notification registers to determine the number of TB cases identified by TB LAM and Xpert MTB-RIF. We identified patients who had both TB LAM and X-pert MTB RIF tests to determine sensitivity, specificity, positive and negative predictive values of TB LAM and Xpert MTB RIF, using TB notification and commencement of anti-tuberculosis treatment as the gold standard for comparison. 
 
 Results
 Between January 2019 and June 2022, there were a total number of 2353 notified cases of Tuberculosis. A total of 511 cases of Tuberculosis were identified on the basis of positive TB LAM. This accounted for 59% of all bacteriologically confirmed cases of TB. The sensitivity and specificity of TB LAM in diagnosis of TB in the study population was 55.8% and 91.4% respectively. Positive and Negative predictive values for TB LAM were 84.5% and 69.6% respectively. The sensitivity and specificity of Xpert MTB RIF in diagnosis of TB in the study population was 29.2% and 98.2% respectively. Positive and Negative predictive values for Xpert MTB RIF were 93.5% and 60.4% respectively. Positivity yield was higher for TB LAM as compared to Xpert MTB RIF (19% versus 9% in 2019; 36% versus 10% in 2020 and 38% versus 10% in 2021).
 Conclusion
 TB LAM identified 59% of all bacteriologically confirmed cases of tuberculosis at Levy Mwanawasa University Teaching Hospital. Contrary to what has been found in other studies, the sensitivity of TB LAM was much higher than that of Xpert MTB RIF. In addition, the sensitivity of TB LAM was higher in HIV negative as compared to HIV positive, which is contrary to what has been established in similar studies.
 
 
 
 
 

Spatial and temporal crack initiation prediction in steels based on residual stress tensor distribution monitoring

We have developed a method and the corresponding instruments, able to provide the spatial and temporal determination of crack initiation in ferromagnetic steels and their welds. The method is based on the monitoring of the differential magnetic permeability µr along the length of the steel, since a sigmoid monotonical dependence of µr on residual stresses has been determined in the past. Thus, the magnetic stress calibration (MASC) curves can inform on the localized residual stresses. Therefore, the temporal stress monitoring at different areas of interest can inform about the status of residual stresses. Then, the tendency of the residual stress value can inform about reaching the positive (tensile) or negative (compressive) yield point of the steel. As an example, a quasi-parabolic temporal dependence of µr offers the tendency to determine the time, or the time window, required to reach yield point. This way, the temporal prediction of the crack initiation is provided for the given point in space, since reaching the yield point results in crack initiation.

2485. Candida auris Hospital Cluster: Were Our Unwelcome Guests Driven Away by the COVID-19 Delta Surge?

Abstract Background Candida auris (CA) is an MDR pathogen that persists in the environment, causing outbreaks. NUH is an academic medical centre in Singapore. We describe a cluster of CA cases from April 2019 – October 2021. Our last case was during our Delta surge, just before we changed our routine inpatient cleaning to bleach based from quarternary-ammonium. Methods Any CA from the micro lab is escalated to the Infection Prevention Team to initiate isolation, cleaning, and contact tracing (CT) up to 30 days prior to positive cultures. In September 2020, we started enhanced surveillance via NAG (Nasal, axilla and groin) swabs in all new CRE (Carbapenem-Resistant Enterobacterales) patients. Surveillance cultures used sabouraud dulcitol agar with 10% saline incubated at 40°C. Identification and susceptibility testing done using Bruker MALDI Biotyper and Etest (Biomerieux). Hospital onset (HO) is defined as positive cultures sent after day 3 of admission. CA isolates were sent for whole genome sequencing (WGS). Results The 10 cases included 7 from clinical isolates, 2 from enhanced surveillance and 1 from CT. 8 were HO. 7 deaths were during the CA admission, but only 1 due to CA, and 1 occurred > 60 days after positive culture [Table 1]. Of 231 contacts swabbed all were negative, except for Case 8, in whom one contact (Case 9) was positive. Positive yield from enhanced surveillance of CRE patients, was 0.84% (2/239). WGS results indicated all except Case 9 belonged to Clade I with Y132F mutation in ERG111 gene [Table 2]. Cases 2, 3, 5, 6 were closely related with 2-7 SNPs difference, but spaced in years. Cases 7 and 8 differed by 3 SNPs hence, closely related. There were 2 related clones being transmitted, and 4 unrelated sub-types of CA. Case 8 and 9 were not related, though 9 was a contact of 8. Possible links were shared equipment or admission to a common room however, admissions were either non-overlapping or non-successive [Table 3]. Case 5 was admitted to the same room after a long stay by Case 3, with one patient in between. No links found between Cases 7 and 8. Conclusion WGS results suggest that various clones of CA remain in the environment as reservoirs, and related cases are not often spatiotemporally related. There have been no CA cases since Oct 2021, possibly due to the change to bleach-based cleaner during our Delta surge. Disclosures All Authors: No reported disclosures

A meta-analysis of hairy vetch as a previous cover crop for maize

BackgroundThe use of hairy vetch (Vicia villosa Roth.) as cover crop is increasing worldwide. Hairy vetch can contribute as a nitrogen (N) source with potential to impact subsequent high N demanding cereals such as maize (Zea mays L.). Contrasting literature results emphasize the need for a global synthesis analysis to quantify changes in maize yield after hairy vetch. ObjectivesA meta-analysis was conducted to i) quantify maize yield response to hairy vetch as previous crop, ii) explore hairy vetch influence on fertilized and non-N fertilized maize yields, and iii) assess the tillage and environment factors on maize yield response to hairy vetch. MethodsThe global systematic search yielded 23 publications selected by the following criteria, i) hairy vetch dry matter at the end of the season, ii) maize grain yield, and iii) experimental design with (Mzhv) and without (Mzcontrol) hairy vetch treatments. Information such as N fertilization for maize, N accumulation in hairy vetch, organic matter, and tillage before maize sowing were recorded. Hairy vetch effects (effect size) were expressed as a ratio (percentage of grain yield variation in Mzhv/Mzcontrol). ResultsUnder non-N fertilization (n = 9), results revealed hairy vetch had mostly a positive effect, ranging from 13 to 45% (n = 6). In contrast, N-fertilized maize (n = 20) showed a high chance of neutral effects (n = 12), moderate probability of positive yield impact (7 to 38%, n = 6), and a low likelihood of negative effects (−32 and −17%, n = 2). Notably, maize yields improved by 21–25% when the N accumulation in hairy vetch ranged from 95 to 150 kg ha−1 and N rate from 0 to 120 kg ha−1. Non-N-fertilized maize exhibited a 14% increase in response in no-till systems and a 31% increase with conventional tillage. ConclusionThis study summarizes potential benefits of hairy vetch preceding maize. Yet, the heterogeneous outcomes deserve further exploration in terms of environment and management factors.

Genetic abnormalities in sonographically detected heart diseases in antenatal period: A case series

: Recent advances in molecular genetic techniques have found evidence of the role of genetic factors in the development of CHD. Approximately 30% of CHD is thought to be related to genetic syndromes accompanied by extra-cardiac anomalies. We describe the cases of cardiac anomalies detected on prenatal ultrasound, which helped us in suspecting the genetic abnormality in fetus which were later confirmed by definitive testing.: Prospective evaluation and follow up of 10 cases done which showed cardiac and extracardiac findings suspicious of chromosomal disorder. : Definitive testing showed genetic abnormality in (N = 10) cases. We could detect Trisomy 21 in (N = 3), Trisomy 18 in (N=2), Trisomy 13 in (N=2), Triploidy in (N=1) and Monosomy X (Turners) in (N=2) cases in our series. Detection of abnormal cardiac findings can definitely improve the detection rate of genetic disorders and positive yield of genetic testing.

OBTAINING UNSATURATED HYDROCARBONS FROM COAL

The article is devoted to the improvement of the technology of obtaining Liquid Motor Fuels from Coal. Unsaturated hydrocarbons are the most important chemical raw material products and are widely used for producing polymers, alcohols and some other organic substances. The paper considers the proposition of technological process of obtaining Synthetic Fuel from Coal with a positive yield effect of the final product with high quality. It is possible to organize the production of Liquid Fuel is made of Coal conversion. The method of Coal conversion into Liquid Motor Fuel is its gasification and hydrogenation but this is not the only way out. The paper proposes the possibility of creating the small plants for the production of synthetic fuels and components of organic synthesis, which can be used of the capacity of metallurgical factories and shops of machine-building enterprises that are vacated areas. In modern society the need is growing to use alternative liquid fuel technologies, for example, by indirect liquefaction of coal. This is especially important for Ukraine during and after hostilities. Ukraine does not have sufficient oil and gas reserves, but it has coal deposits in the coal basin in the west of the country.
 An important aspect that is insisted on is the achievement of energy independence. Given the historical traditions and the existing structure of energy deposits in Ukraine, one of the ways to solve this strategic task should be the development of the coal industry. In addition, the environmental component of each of these types of security can be an integrator that integrates them into the national security system. This will help to find their optimal ratio in this system. Moreover, today there is no doubt that any aspect of national security, whether economic, technological or defense, loses its meaning in the event of unfitness of the environment for human life and activity. An influential factor in increasing production of coal for processing in the western part of Ukraine is the maximum extraction of coal reserves and at the same time protection of subsoil.

Clinical and histopathological correlation of oral malignancy and potentially malignant disorders based on a screening program at high-risk population in Tamil Nadu, India.

There is a high incidence of oral cancer and oral potential malignant disorder observed in southeast Asian countries such as India. Our study aimed to assess the correlation between screening and histopathological diagnosis and to predict the specificity and sensitivity of chair-side/field-based assessment of the oral lesion. A total of 40,852 subjects aged between 20 and 60 years were screened in the 1st phase of the study, suspected lesions were stained with toluidine blue (Manufactured by Otto Chemicals private limited, India) at two time points, those who stained positively during the two points were taken up for biopsy. Provisional diagnosis was later correlated with histopathological diagnosis. Subjects who underwent biopsy had a mean age of (49.01 ± 9.8 years), Leukoplakia (1.5%) was the most common lesion observed among tobacco users, interestingly it had the least correlation (39.6%) in diagnosis, Overall sensitivity (88%) and a positive predictive value (80%) was high for clinical diagnosis of OPMD in our study. Correlation of clinical and histopathological diagnosis observed in our study confirms higher yield of true positives while screening in remote and vulnerable populations, which would assure a better quality of life for these subjects.

Rising temperatures can negate CO2 fertilization effects on global staple crop yields: A meta-regression analysis

Many meta-analyses have reported increased seed yields in response to rising carbon dioxide concentrations ([CO2]) or decreased yields in response to warming temperatures, but synthesis of their concurrent effects is lacking. We conducted an extensive meta-regression analysis of wheat, rice, soybean, and maize seed yield responses to simultaneous increases in [CO2] and temperature and examined the sensitivity of potential yields to levels projected for mid- and late-century periods using CMIP6 climate model outputs. Positive linear yield responses to increasing [CO2] were observed in maize, rice, and soy, with slopes ranging from +4 % - (100 µmol mol−1) -1 in rice to +10 % - (100 µmol mol−1) -1 in soy. In contrast, wheat yield response to increasing [CO2] was not linear, instead flattening by +200 µmol mol−1 of CO2 elevation. Negative linear yield responses to warming were modeled for the three cereal crops, with slopes of −7.6% -°C −1 in wheat and −9.5% -°C −1 in rice and maize. Soy yield did not decrease with increasing warming treatments in this analysis, but experimental warming treatments did not exceed optimal soy growth temperature ranges. Across the three crops with available observations, yield responses were significantly lower in Free-Air CO2 Enrichment than in studies using other fumigation methods, likely due to the associated rapid fluctuations in [CO2]. Considering potential future eC and eT levels simultaneously, we find that eC fertilization effects on seed yield will likely be greatly reduced or entirely negated in the major crops maize, rice, and wheat. Net yield responses to concurrent [CO2] and temperature increases should not be based on limited observations of responses to either factor in isolation, because the levels of each factor as well as experimental conditions influence responses.

Analysis of Thrombophilia Test Ordering Practices at King Fahad Hospital of the University

Abstract BACKGROUND: Thrombophilia tests are widely performed but often in a nonjustified and inappropriate manner as patients are not properly selected, or test timing is not considered. This study aims to assess the current practice of thrombophilia testing at our institution by determining the indications and the testing characteristics to start an initiative toward the reduction of inappropriate testing. METHODOLOGY: This is a retrospective study of patients who have undergone thrombophilia testing at King Fahad Hospital of the University from January 1, 2019, to December 31, 2020. The data were collected from electronic medical records. RESULTS: A total of 545 patients were included (the median age was 38, 76.4% were females). Of the ordered analyzed, 36.59% were for inappropriate indications. Tests were done in the acute phase of thrombosis in 55.21% of patients. However, 18.89% of patients had thrombophilia tests requested during anticoagulants therapy. Positive results were found in 32.66% of patients and were confirmed in 52.24% of patients. The positive diagnostic yield of thrombophilia testing at our institution was only 14.6%. Of the screened tests that required confirmation for definitive diagnosis, 52.23% was obtained. CONCLUSION: This study highlights the improper practice of thrombophilia testing, which calls for initiatives toward reduction in test request by means of educational intervention, posttest guidance by the laboratory, or restraining ordering to the highly specialized clinicians.

Lymph node level ratio as a predictor of survival in oral cavity squamous cell carcinoma

ObjectiveTo evaluate whether nodal yields and ratios based on level serves as prognostic indicators in patients with oral cavity squamous cell carcinoma undergoing neck dissection. Materials and MethodsA retrospective analysis of 342 patients with oral cavity squamous cell carcinoma treated surgically between 1998 and 2017 were included.Demographics and clinicopathologic data were collated. Disease specific survival and overall survival were analyzed via Kaplan-Meier method and log-rank test as well as univariable and multivariable Cox models. ResultsTotal nodal yield is associated with improved overall and disease specific survival (p < 0.01). Total positive nodal yield (p < 0.01), positive nodal ratio per level (p < 0.001), and identification of <4 lymph nodes/level (p < 0.001) are associated with worse disease specific survival and overall survival. A ratio of at least 4 lymph nodes/level dissected yields the maximal hazard ratio on for both disease specific and overall survival optimizes the Kaplan-Meier split between survival groups. After controlling for sex, age, margin status, disease stage, extranodal extension, perineural invasion, and lymphovascular invasion as fixed covariates in the Cox models, a nodal level ratio of 4 lymph nodes/level provides hazard ratio (95% CI) of 3.59 (1.69, 7.60); p < 0.0006) for disease free survival and 2.90 (1.54, 5.46; p < 0.001) for overall survival. ConclusionNodal level ratio of < 4 lymph nodes/level is associated with worse disease specific and overall survival in oral cavity squamous cell carcinoma. This level-specific metric may prove useful qualitatively and in predicting survival in oral cavity cancer with broader utility to address variations in levels of neck dissection performed.

Modeling one-stop-shop integration of family planning and HIV services in Zimbabwe, 2021

Objectives: In October 2020, the Ministry of Health and Child-care Zimbabwe commenced integrating reproductive health with human immunodeficiency virus (HIV) services. Family planning (FP), sexually transmitted infection (STI) screening and treatment, HIV testing services (HTS), pre-exposure prophylaxis (PrEP), and antiretroviral therapy (ART) services were offered through an integrated one-stop-shop model. The project aimed to address unacceptably high incidences of HIV and STIs among FP clients and demonstrate improved access and uptake of integrated services at dedicated FP centers. Materials and Methods: We conducted an intervention study. A service package of STI symptom screening and HTS (including HIV self-test [HIVST] primary and secondary distribution) was offered to all FP clients by multi-skilled nurses. Service uptake was measured pre and post-introduction of the intervention, before which services were provided by different nurses, in different rooms. HIV-diagnosed clients were linked to ART and eligible negative testers were offered PrEP. Service uptake was measured at 1 year of implementation against the same period before. Results: A total of 20,947 clients were recruited between October 2019 and September 2021, 9386 pre-intervention and 11,561 post-intervention. We observed a 5.2% total increase in clients seen and a 27.1% increase in the average uptake of all integrated services (FP, STI, HTS, PrEP, and ART). Most (93.5%) clients received oral contraception (Progestogen-only pills and combined-oral-contraceptives), while fewer (4.8%) received injectables and implants (1.1%). Following the intervention, STI screening increased by 30.2% (2730 vs. 11,028). HTS delivery increased by 38.9% and PrEP by 44.1%. HIV positivity yield increased significantly (10.1%, 62/615 vs. 16.6%, 813/4910) and linkage to ART improved by 44.4%. HIVST distribution contributed to improved access to HIV testing with 3754 FP clients accepting distribution compared with 4910 receiving HTS by nurses, provider-delivered testing was accessed by reactive self-testers. The project increased (?) improved linkage to preventive and treatment services and reduced missed opportunities associated with fragmented services. Conclusion: The integrated one-stop-shop model demonstrated improved service uptake during the intervention period. This project shows the benefits of integrated FP/STI/HTS/PrEP in Zimbabwe’s high HIV burden settings.

ClinPrior: an algorithm for diagnosis and novel gene discovery by network-based prioritization

BackgroundWhole-exome sequencing (WES) and whole-genome sequencing (WGS) have become indispensable tools to solve rare Mendelian genetic conditions. Nevertheless, there is still an urgent need for sensitive, fast algorithms to maximise WES/WGS diagnostic yield in rare disease patients. Most tools devoted to this aim take advantage of patient phenotype information for prioritization of genomic data, although are often limited by incomplete gene-phenotype knowledge stored in biomedical databases and a lack of proper benchmarking on real-world patient cohorts.MethodsWe developed ClinPrior, a novel method for the analysis of WES/WGS data that ranks candidate causal variants based on the patient’s standardized phenotypic features (in Human Phenotype Ontology (HPO) terms). The algorithm propagates the data through an interactome network-based prioritization approach. This algorithm was thoroughly benchmarked using a synthetic patient cohort and was subsequently tested on a heterogeneous prospective, real-world series of 135 families affected by hereditary spastic paraplegia (HSP) and/or cerebellar ataxia (CA).ResultsClinPrior successfully identified causative variants achieving a final positive diagnostic yield of 70% in our real-world cohort. This includes 10 novel candidate genes not previously associated with disease, 7 of which were functionally validated within this project. We used the knowledge generated by ClinPrior to create a specific interactome for HSP/CA disorders thus enabling future diagnoses as well as the discovery of novel disease genes.ConclusionsClinPrior is an algorithm that uses standardized phenotype information and interactome data to improve clinical genomic diagnosis. It helps in identifying atypical cases and efficiently predicts novel disease-causing genes. This leads to increasing diagnostic yield, shortening of the diagnostic Odysseys and advancing our understanding of human illnesses.

Multi-environment investigations using GGE biplot and regression model for higher spike yield and essential oil content in lavender (Lavandula angustifolia)

Lavender is a highly valuable medicinal and aromatic perennial shrub lacking superior and stable varieties for varied environments in the western Himalayas. In the present experiment, estimates of genotypic effects and their interaction with the environment under various conditions of Himachal Pradesh were investigated to identify superior and stable genotypes. For that, seven selections with a check were evaluated at four different locations in randomized block design with three replications during 2020 and 2021. The pooled analysis of variance showed that genotypic and environmental main effects were highly significant for all the traits under study while, G×E interaction was significant (p≤0.05) for plant height, spike length and spike yield. The highest mean performance for all the traits revealed that location-4 has favourable conditions for lavender cultivation, and LOH15141 followed by LOH15040 were the best performers over all the locations. These high-performing genotypes were clustered together with the check in a major cluster. The stability parameters of the Eberhart and Russell model showed that LOH15141 is stable and superior for both spike yield and essential oil content, further confirmed by GGE biplot analysis. GGE biplot analysis revealed that all the tested locations formed a single mega-environment. The strong positive yield contribution described through Pearson’s correlation coefficients and genotypic path diagram states that plant height, number of spikes and spike length were significant contributors to the spike yield and could be used as selection criteria to improve spike yield due to their high heritability and genetic advance.

Machine learning pipeline for blood culture outcome prediction using Sysmex XN-2000 blood sample results in Western Australia

BackgroundBloodstream infections (BSIs) are a significant burden on the global population and represent a key area of focus in the hospital environment. Blood culture (BC) testing is the standard diagnostic test utilised to confirm the presence of a BSI. However, current BC testing practices result in low positive yields and overuse of the diagnostic test. Diagnostic stewardship research regarding BC testing is increasing, and becoming more important to reduce unnecessary resource expenditure and antimicrobial use, especially as antimicrobial resistance continues to rise. This study aims to establish a machine learning (ML) pipeline for BC outcome prediction using data obtained from routinely analysed blood samples, including complete blood count (CBC), white blood cell differential (DIFF), and cell population data (CPD) produced by Sysmex XN-2000 analysers.MethodsML models were trained using retrospective data produced between 2018 and 2019, from patients at Sir Charles Gairdner hospital, Nedlands, Western Australia, and processed at Pathwest Laboratory Medicine, Nedlands. Trained ML models were evaluated using stratified 10-fold cross validation.ResultsTwo ML models, an XGBoost model using CBC/DIFF/CPD features with boruta feature selection (BFS) , and a random forest model trained using CBC/DIFF features with BFS were selected for further validation after obtaining AUC scores of 0.76 pm 0.04 and 0.75 pm 0.04 respectively using stratified 10-fold cross validation. The XGBoost model obtained an AUC score of 0.76 on a internal validation set. The random forest model obtained AUC scores of 0.82 and 0.76 on internal and external validation datasets respectively.ConclusionsWe have demonstrated the utility of using an ML pipeline combined with CBC/DIFF, and CBC/DIFF/CPD feature spaces for BC outcome prediction. This builds on the growing body of research in the area of BC outcome prediction, and provides opportunity for further research.

Diagnostic Yield of Endoscopy in Upper Gastrointestinal Bleeding in Pediatrics

Introduction Esophagogastroduodenoscopy is currently considered the first-line diagnostic procedure of choice for upper gastrointestinal (GI) bleeding; however, the etiology of bleeding remains unknown in a subset of patients. This study aims to evaluate the diagnostic yield of upper gastrointestinal endoscopy in upper gastrointestinal bleeding in pediatrics and determine the clinical predictors for unreached diagnosis during endoscopy. Methods Cross sectional study, conducted at pediatric endoscopy unit, Ain Shams University, Cairo, Egypt, where 100 patients were recruited, as they were referred for diagnostic upper GI endoscopy due to overt upper GI bleeding in the form of hematemesis and/or melena. Full medical history, examination, laboratory investigations, endoscopic and histopathologic findings were documented. Results :100 patients with ages ranging from 3 months to 15 years, median age 4 years, 47% males and 53% females, 65% presented by hematemesis only, 7% with melena only, and 28 % presented with both hematemesis and melena. In 38 % of cases no endoscopic diagnosis was reached. While patients with a positive diagnostic yield 62%, had variable diagnosis, the most common of which was H pylori gastritis and reflux oesophagitis in 23% and 11% of cases respectively. Followed by nonspecific gastritis (8%), oesophageal varices (4%), and others (16%).. Melena was a negative predictor to reach a diagnosis by upper GI endoscopy. Conclusion Diagnostic yield of upper GI endoscopy in pediatric patients with upper GI bleeding was only 62%. Combining upper GI endoscopy with other tools in cases presenting with melena alone is highly recommended since bleeding from a source in the small bowel or right colon may also be the cause.

Authoritarian Development in Morocco: The ‘Developmental State’ without State Development

Development and authoritarian rule are often viewed as a contradiction in terms, but Morocco exemplifies their confluence in the framework of what could be called ‘authoritarian development’, wherein democracy is divorced from the process and practice of development. This paper examines the contradictory, rocky development path of the Moroccan state. While the state sets the rhythm for the development of society, it itself is impervious to development. As a result, development is a piecemeal practice, confined to the economic and social spheres while neglecting the political sphere, which consequently brings lower positive yields from development. The paper also examines the authoritarian nature of the Moroccan developmental model in light of modernisation theory and developmental authoritarianism, guided by the theory of competitive authoritarianism. It shows that the constraints on citizens’ economic and social empowerment are largely attributable to the fact that the political transformation of the state has been excluded as a possibility. The paper finds that the form of development in Morocco constitutes an extension of political authoritarianism and that the latter is responsible for the failure of economic and social development, concluding that political development geared to dismantling authoritarianism is a prerequisite for the development of the state.

Predictors of Positivity Yield among Index Contacts in Harare and Matabeleland South Provinces, Zimbabwe, 2022

Background: Zimbabwe’s Index Testing programme has failed to achieve targets since its inception in 2017. We determined the index testing implementation modalities to identify and recommend effective contact elicitation, tracking and testing modalities to enhance positivity yield. Subjects dan Method: This study conducted a cross-sectional study on 50 multistage selected health facilities. Dependent variables were all clients, (≥15 years) diagnosed with HIV in 2021, whilst independent variables were contact tracking. The study instrument of variable measure was cascade analysis to identify tracing modalities against yield. Quantitative data were summarized as proportions, odds ratios, and adjusted odds ratios at a 5% significance level. Results: Of 6,308 index cases identified, females constituted 53.9% (n=3,401 and 67.6% (n=4,265) were retests. Index testing was offered to 66.4% (n=4,190), accepted by 93.1% (n=3,899) and the elicitation rate was 1:1.3 (n=5,080). A positivity yield of 27.5% (n=1,736) was achieved from 78.6% (n= 3,991) contacts. Mixed method tracking yielded 46.7% (n=349) positivity from a testing rate of 99.5% (n=748) in an urban setup, with 41.4% (n=1,243) preferring health worker referrals. As high as 202 contacts were not tested following elicitation through client referrals. In a rural setup, client referrals accounted for 53.1%, (n=1,103) yet 122 of these were not tested. The highest positivity yield was obtained from health worker referrals at 65.6% (n=196). Being male (aOR=3.09; 95%CI= 2.74 to 3.49), first tester (aOR=1.65; 95%CI= 1.43 to 1.91), anonymous tracking (aOR=8.46; 95%CI:3.37 to 22.75) and testing contacts within 7 days of elicitation (aOR=2.78; 95%CI=2.44 to 3.18) were identified as high predictors of positivity yield among index contacts. Conclusion: The identified high positivity yield among men, first-time testers and contacts tested within 7 days of elicitation may inform index testing focussing to improve program performance. Implementation fidelity and differentiated contact referrals were recommended to mitigate attritions at each stage of the index cascade to yield the best results on index contact tracing and testing. Keywords: targeted testing, HIV testing services, index contact tracing and testing, index testing cascade Correspondence:Hamufare Dumisani Mugauri. Faculty of Medicine and Health Sciences, Department of Primary Healthcare Sciences, New Health Sciences Building, Parirenyatwa Complex, Mazowe Road, Harare, Zimbabwe. Email: dumiwaboka@gmail.com. Mobile: +263772314894.