Correlation of Malondialdehyde (MDA) and C-reactive Protein (CRP) Level to Neurodevelopmental Outcome in Children After the Episode of Convulsive Type Status Epilepticus

Refractory and mortality associated with status epilepticus (SE) were correlated with the degree of inflammation-induced neuronal cell death. This study was aimed to investigate the correlation of oxidative stress (Malondialdehyde, MDA) and inflammation (C-reactive protein, CRP) process with neurodevelopmental outcome in children after the episode of convulsive type SE. This study was designed as cross sectional which included 26 convulsive type SE subjects and 15 control subjects. MDA level was measured by thiobarbituric acid (TBA) method, while CRP level was measured by ELISA method. Neurodevelopmental outcome was measured by Bayley-III Scale of Infant and Toddler Development 3 month after the convulsive type SE episode. Results showed that both MDA (independent t-test, p < 0.05) and CRP (Mann-Whitney test, p < 0.05) level was significantly higher in convulsive type SE group as compared to control group. Further analysis also showed that MDA (Spearman correlation test, p = 0.000, r = 0.756) and CRP (Spearman correlation test, p = 0.000, r = 0.835) level was positively correlated with convulsive type SE. In convulsive type SE group, MDA level was negatively correlated with neurodevelopmental outcome but CRP was not. We concluded that MDA level was negatively correlated with neurodevelopmental outcome in children with convulsive type SE, but CRP was not

Rancangan Dan Implementasi Sekolah Lapang Pengelolaan Tanaman Terpadu Padi

EnglishField School-Integrated Crop Management (FS-ICM) was one of components withinthe National Rice Production Enhancement Program implemented by the Ministry of Agriculture in the period of 2009−2014. With the support of a large amount of budget, FS-ICM implementation was expected to have a significant impact on the increase offood production. This study aims to assess planning design and the implementation of FS-ICM on rice. This study used primary and secondary data included all information related to planning design and the implementation ofFS-ICM program at national and regional levels. Data collection was carried out by interviewing the leaders of agricultural institutions associated with activities of FS-ICM and from Focus Group Discussion (FGD) among the group and individual rice farmers at provincial and regency levels in West Java Province in the period of September−October 2014. The data and information were processed descriptively and qualitatively. The results of this study indicated that annual planning of the FS-ICM program wasin fact not based on the results of annual evaluation of the implementation and the performance of FS-ICM. During five-yearperiod, annual target of the FS-ICM had been arranged to be increased at a very high rate, regardless of the limited capacity and the unsuccessful implementation of the program. This study had also indicated that planning and implementation of FS-ICM in the field was not fully in accordance with the basic concept of ICM. The rate of adoption of ICM technology components among the rice farmers was quite low, besides the limited number and quality of agriculture extension workers to support this program.It is suggested reporting systems and socialization program improvement, well-functioning LL, encouraging the mobilization of extension, fostering local growers, establishing better coordination between central and local governments as well as implementers in the field, and also building and repairing aspects of processing, marketing and farmers groupsIndonesiaSekolah Lapang Pengelolaan Tanaman Terpadu (SL-PTT) merupakan salah satu komponen dalam program Peningkatan Produksi Beras Nasional yang dilaksanakan Kementerian Pertanian pada tahun 2009−2014. Dengan dukungan anggaran yang besar, pelaksanaan SL-PTT diharapkan dapat berdampak nyata pada peningkatan produksi pangan. Kajian ini bertujuan untuk mengkaji perencanaan dari implementasi kegiatan SLPTT padi sawah. Data yang digunakan dalam kajian ini adalah data primer dan sekunder, meliputi informasi tentang perencanaan dan implementasi SL-PTT di pusat dan daerah. Pengumpulan data dilakukan melalui wawancara dengan pimpinan instansi pertanian yang terkait dengan kegiatan SL-PTT serta focus group discussion (FGD) di antara kelompok tani/petani padi sawah pada tingkat provinsi dan kabupaten di Provinsi Jawa Barat yang dilaksanakan pada bulan September−Oktober 2014. Pengolahan data dan informasi dilakukan dengan metode deskriptif kualitatif. Hasil kajian menunjukkan bahwa kegiatan perencanaan tahunan SL-PTT tidak didasarkan pada hasil evaluasi pelaksanaan dan kinerja implementasi SL-PTT di lapangan. Selama periode lima tahun, target tahunan SL-PTT terus ditambah dengan tingkat kenaikan yang tinggi, tanpa memperhatikan kemampuan daya dukung keberhasilan program. Kajian ini juga menunjukkan perencanaan dan implementasi SL-PTT di lapangan tidak mengacu sepenuhnya pada konsep dasar PTT, tingkat adopsi komponen teknologi PTT masih rendah, dan jumlah serta kualitas penyuluh pertanian terbatas untuk mendukung keberhasilan program SL-PTT ini. Implikasi kebijakan yang disarankan ialah perbaikan sistem pelaporan dan sosialisasi program, memfungsikan LL secara baik, mendorong mobilisasi penyuluh, menumbuhkan penangkar-penangkar lokal, membangun koordinasi yang baik antara pemerintah pusat, daerah, dan pelaksana di lapangan, serta membangun dan memperbaiki aspek pengolahan, pemasaran, dan kelembagaan kelompok tani

Malaria protection due to sickle haemoglobin depends on parasite genotype

Host genetic factors can confer resistance against malaria1, raising the question of whether this has led to evolutionary adaptation of parasite populations. Here we searched for association between candidate host and parasite genetic variants in 3,346 Gambian and Kenyan children with severe malaria caused by Plasmodium falciparum. We identified a strong association between sickle haemoglobin (HbS) in the host and three regions of the parasite genome, which is not explained by population structure or other covariates, and which is replicated in additional samples. The HbS-associated alleles include nonsynonymous variants in the gene for the acyl-CoA synthetase family member2-4 PfACS8 on chromosome 2, in a second region of chromosome 2, and in a region containing structural variation on chromosome 11. The alleles are in strong linkage disequilibrium and have frequencies that covary with the frequency of HbS across populations, in particular being much more common in Africa than other parts of the world. The estimated protective effect of HbS against severe malaria, as determined by comparison of cases with population controls, varies greatly according to the parasite genotype at these three loci. These findings open up a new avenue of enquiry into the biological and epidemiological significance of the HbS-associated polymorphisms in the parasite genome and the evolutionary forces that have led to their high frequency and strong linkage disequilibrium in African P. falciparum populations

Germline mosaicism in Rett syndrome identified by prenatal diagnosis

Rett syndrome is an X-linked neurodevelopmental dominant disorder that affects almost exclusively girls. The vast majority of cases are sporadic and are caused by de novo mutations in the MECP2 gene, located in Xq28. Only few familial cases have been reported: in four cases, the mother was an asymptomatic carrier and in other four cases, the germline mosaicism in the mother was postulated. Owing to the above reported cases of germline mosaicism, we decided to offer prenatal diagnosis to all expectant mothers with a Rett daughter despite the absence of the causative mutation in parents' blood. We describe here the outcome of the first nine cases of prenatal diagnosis followed by our center. In eight cases, the fetus did not carry the mutation. In one case, the female fetus did carry the same mutation of the affected sister. The couple decided to interrupt the pregnancy and to devolve fetal tissues for research purposes. Our results indicate that prenatal diagnosis should be proposed to all couples with a Rett daughter, even when the mutation is apparently de novo. Moreover, one positive prenatal test among the first nine cases indicates that germline mosaicism may be seriously considered for the assessment of recurrence risk during genetic counseling

Indonesian first national suicide prevention strategy: key findings from the qualitative situational analysis

The reduction of suicide is a priority within the United Nations’ Sustainable Development Goals. However, Indonesia—the fourth most populous country globally—does not have a national suicide prevention strategy. Thus, in 2021, we began developing such a strategy, starting with a situational analysis recommended by the WHO LIVE-LIFE framework.1 This nationwide effort was led by a leadership committee advised by the Ministry of Health and WHO Indonesia

Assessing transmissibility of SARS-CoV-2 lineage B.1.1.7 in England

The SARS-CoV-2 lineage B.1.1.7, designated variant of concern (VOC) 202012/01 by Public Health England1, was first identified in the UK in late summer to early autumn 20202. Whole-genome SARS-CoV-2 sequence data collected from community-based diagnostic testing for COVID-19 show an extremely rapid expansion of the B.1.1.7 lineage during autumn 2020, suggesting that it has a selective advantage. Here we show that changes in VOC frequency inferred from genetic data correspond closely to changes inferred by S gene target failures (SGTF) in community-based diagnostic PCR testing. Analysis of trends in SGTF and non-SGTF case numbers in local areas across England shows that B.1.1.7 has higher transmissibility than non-VOC lineages, even if it has a different latent period or generation time. The SGTF data indicate a transient shift in the age composition of reported cases, with cases of B.1.1.7 including a larger share of under 20-year-olds than non-VOC cases. We estimated time-varying reproduction numbers for B.1.1.7 and co-circulating lineages using SGTF and genomic data. The best-supported models did not indicate a substantial difference in VOC transmissibility among different age groups, but all analyses agreed that B.1.1.7 has a substantial transmission advantage over other lineages, with a 50% to 100% higher reproduction number

Emerging Monogenic Complex Hyperkinetic Disorders

PURPOSE OF REVIEW: Hyperkinetic movement disorders can manifest alone or as part of complex phenotypes. In the era of next-generation sequencing (NGS), the list of monogenic complex movement disorders is rapidly growing. This review will explore the main features of these newly identified conditions. RECENT FINDINGS: Mutations in ADCY5 and PDE10A have been identified as important causes of childhood-onset dyskinesias and KMT2B mutations as one of the most frequent causes of complex dystonia in children. The delineation of the phenotypic spectrum associated with mutations in ATP1A3, FOXG1, GNAO1, GRIN1, FRRS1L, and TBC1D24 is revealing an expanding genetic overlap between epileptic encephalopathies, developmental delay/intellectual disability, and hyperkinetic movement disorders,. SUMMARY: Thanks to NGS, the etiology of several complex hyperkinetic movement disorders has been elucidated. Importantly, NGS is changing the way clinicians diagnose these complex conditions. Shared molecular pathways, involved in early stages of brain development and normal synaptic transmission, underlie basal ganglia dysfunction, epilepsy, and other neurodevelopmental disorders

Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

Background: Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure. Methods: The SELECT trial was a randomised, double-blind, multicentre, placebo-controlled, event-driven phase 3 trial in 41 countries. Adults aged 45 years and older, with a BMI of 27 kg/m2 or greater and established cardiovascular disease were eligible for the study. Patients were randomly assigned (1:1) with a block size of four using an interactive web response system in a double-blind manner to escalating doses of once-weekly subcutaneous semaglutide over 16 weeks to a target dose of 2·4 mg, or placebo. In a prespecified analysis, we examined the effect of semaglutide compared with placebo in patients with and without a history of heart failure at enrolment, subclassified as heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, or unclassified heart failure. Endpoints comprised MACE (a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death); a composite heart failure outcome (cardiovascular death or hospitalisation or urgent hospital visit for heart failure); cardiovascular death; and all-cause death. The study is registered with ClinicalTrials.gov, NCT03574597. Findings: Between Oct 31, 2018, and March 31, 2021, 17 604 patients with a mean age of 61·6 years (SD 8·9) and a mean BMI of 33·4 kg/m2 (5·0) were randomly assigned to receive semaglutide (8803 [50·0%] patients) or placebo (8801 [50·0%] patients). 4286 (24·3%) of 17 604 patients had a history of investigator-defined heart failure at enrolment: 2273 (53·0%) of 4286 patients had heart failure with preserved ejection fraction, 1347 (31·4%) had heart failure with reduced ejection fraction, and 666 (15·5%) had unclassified heart failure. Baseline characteristics were similar between patients with and without heart failure. Patients with heart failure had a higher incidence of clinical events. Semaglutide improved all outcome measures in patients with heart failure at random assignment compared with those without heart failure (hazard ratio [HR] 0·72, 95% CI 0·60-0·87 for MACE; 0·79, 0·64-0·98 for the heart failure composite endpoint; 0·76, 0·59-0·97 for cardiovascular death; and 0·81, 0·66-1·00 for all-cause death; all pinteraction>0·19). Treatment with semaglutide resulted in improved outcomes in both the heart failure with reduced ejection fraction (HR 0·65, 95% CI 0·49-0·87 for MACE; 0·79, 0·58-1·08 for the composite heart failure endpoint) and heart failure with preserved ejection fraction groups (0·69, 0·51-0·91 for MACE; 0·75, 0·52-1·07 for the composite heart failure endpoint), although patients with heart failure with reduced ejection fraction had higher absolute event rates than those with heart failure with preserved ejection fraction. For MACE and the heart failure composite, there were no significant differences in benefits across baseline age, sex, BMI, New York Heart Association status, and diuretic use. Serious adverse events were less frequent with semaglutide versus placebo, regardless of heart failure subtype. Interpretation: In patients with atherosclerotic cardiovascular diease and overweight or obesity, treatment with semaglutide 2·4 mg reduced MACE and composite heart failure endpoints compared with placebo in those with and without clinical heart failure, regardless of heart failure subtype. Our findings could facilitate prescribing and result in improved clinical outcomes for this patient group. Funding: Novo Nordisk