Post-operative nonketotic hyperglycemic induced focal motor status epilepticus related to treatment with corticosteroids following standard anterior temporal lobectomy

•Complications from standard ATL are uncommon and the use of post-operative corticosteroids may reduce complications.•Following standard ATL, FMSE was present after treatment with corticosteroids that resolved after blood sugar control.•After epilepsy surgery, corticosteroids should be used cautiously in people with comorbid diabetes mellitus

Alkhurma Hemorrhagic Fever Virus in Ornithodoros savignyi Ticks

Evidence for the tickborne nature of Alkhurma hemorrhagic fever virus (AHFV) is indirect because AHFV has not been detected in arthropods. One Ornithodoros savignyi tick from Saudi Arabia contained AHFV RNA. This is the first direct evidence that AHFV is a tickborne flavivirus and confirms the association between human AHFV cases and tickbite history

Activin A is Not a Reliable Prognostic Biomarker For Bilirubin Induced Neurotoxicity in Neonates

Background: Bilirubin induced neurological dysfunction (BIND) remains an important cause of disability in developing countries. Although high total serum bilirubin (TSB) is the main instigator for BIND, different babies may have different neurological outcomes at the same TSB level. This reflects the need for a more specific predictive factor for the neurological outcome, which would allow prompt intervention and prevention of kernicterus. Aim of the Work: To assess the value of serum activin A as a predictor for acute bilirubin neurotoxicity and adverse neurodevelopmental outcomes at one year of life. Materials and Methods: The study enrolled 84 term/near-term infants admitted with indirect hyperbilirubinemia requiring intervention to the Neonatal Intensive Care Unit of Cairo University Children’s Hospital. Clinical examination, BIND score and laboratory tests including activin A were performed. Neurodevelopmental outcome was assessed at 3, 6 and 12 months using the Bayley scale of Infant Development II. Correlations between serum activin A, TSB, BIND scores and Bayley scores were studied. Results: Mean TSB level at admission was 25.92±7.14 mg/dL. BIND score at admission ranged from 0-7, and mean serum activin A level was 109.92±55 pg/ml. Activin A did not show significant correlations with TSB or BIND scores. A negative correlation between activin A level and psychomotor developmental index (PDI) at 3 months was detected however all other neurodevelopmental outcomes showed no significant correlation with activin A. Conclusion: In cases of neonatal hyperbilirubinemia, activin A is not a reliable biomarker for predicting acute or chronic bilirubin induced neurotoxicity

PEMAHAMAN MASYARAKAT PEDESAAN TERHADAP MANFAAT ASURANSI KESEHATAN DI INDONESIA: LITERATURE REVIEW

Masih minimnya pengetahuan masyarakat yang tinggal di daerah pedesaan terhadap asuransi kesehatan, sehingga masyarakat pedesaan tersebut cenderung kurang untuk menggunakan asuransi daripada masyarakat perkotaan. Masalah pemahaman ini tidak lepas dari karakteristik masyarakat pedesaan itu sendiri yang masih kental unsur agamanya dalam melihat aspek hukum asuransi. Penelitian ini bertujuan untuk menganalisis dan mengetahui sosialisasi seperti apa yang dapat dilakukan secara efektif dan efisien untuk menjangkau semua kelompok dan lapisan masyarakat. Penelitian ini merupakan literature review yang bersumber dari beberapa situs online seperti Google Scholar dan Garuda dengan memasukkan kata kunci “Pemahaman Masyarakat Desa”, “Asuransi Kesehatan”, dan “Manfaat Asuransi”. Kriteria inklusi yang digunakan adalah pemahaman masyarakat pedesaan terhadap manfaat asuransi kesehatan. Hasil yang ditemukan dari peneliti bahwa pemahaman masyarakat terkait asuransi berbeda-beda, beberapa masyarakat pedesaan telah paham tetapi banyak juga yang masih belum paham dan belum menyadari akan pentingnya manfaat asuransi kesehatan. Hal tersebut terjadi karena dipengaruhi oleh beberapa faktor seperti karakteristik individu, lingkungan sekitar, dan minimnya akses pelayanan kesehatan. Sehingga perlu adanya peningkatan edukasi dan sosialisasi kepada masyarakat desa mengenai manfaat asuransi kesehatan guna meningkatkan derajat kesehatan masyarakat

Comparison of the efficacy of a neutral wrist splint and wrist splint with lumbrical unit for the treatment of patients with carpal tunnel syndrome

Purpose: The purpose of this study was to compare the effect of a neutral wrist splint or a wrist splint with an additional metacarpophalangeal (MCP) unit on pain, function, grip and pinch strength in patients with mild-to-moderate carpal tunnel syndrome (CTS). Methods: Twenty four patients received conservative treatment using either the neutral wrist splint or wrist splint with the MCP unit for a period of 6 weeks. Primary outcome measures were pain, function, grip and pinch strength. Data was collected immediately before and after using the two types of splints at baseline (0 weeks) and 6 weeks. Statistical analysis was performed using the paired t-test and independent T-test. Results: Compared to baseline, both the neutral wrist splint and the wrist splint with an MCP unit significantly decreased pain, increased function and pinch and grip strength. Comparisons of the two types of splints for grip (P =0.675) and pinch strength (P =0.650) revealed that there were no significant differences between the two after 6 weeks of wear. However, there were significant differences in pain levels (P =0.022) and the DASH score (P =0.027) between the two types of splints from baseline to 6 weeks. Conclusion: The wrist splint with an MCP unit was more effective than the neutral wrist splint in pain reduction and improvement of function

In‐person interventions to reduce social isolation and loneliness: An evidence and gap map

BackgroundSocial isolation and loneliness can occur in all age groups, and they are linked to increased mortality and poorer health outcomes. There is a growing body of research indicating inconsistent findings on the effectiveness of interventions aiming to alleviate social isolation and loneliness. Hence the need to facilitate the discoverability of research on these interventions.ObjectivesTo map available evidence on the effects of in-person interventions aimed at mitigating social isolation and/or loneliness across all age groups and settings.Search MethodsThe following databases were searched from inception up to 17 February 2022 with no language restrictions: Ovid MEDLINE, Embase, EBM Reviews—Cochrane Central Register of Controlled Trials, APA PsycInfo via Ovid, CINAHL via EBSCO, EBSCO (all databases except CINAHL), Global Index Medicus, ProQuest (all databases), ProQuest ERIC, Web of Science, Korean Citation Index, Russian Science Citation Index, and SciELO Citation Index via Clarivate, and Elsevier Scopus.Selection CriteriaTitles, abstracts, and full texts of potentially eligible articles identified were screened independently by two reviewers for inclusion following the outlined eligibility criteria.Data Collection and AnalysisWe developed and pilot tested a data extraction code set in Eppi-Reviewer. Data was individually extracted and coded. We used the AMSTAR2 tool to assess the quality of reviews. However, the quality of the primary studies was not assessed.Main ResultsA total of 513 articles (421 primary studies and 92 systematic reviews) were included in this evidence and gap map which assessed the effectiveness of in-person interventions to reduce social isolation and loneliness. Most (68%) of the reviews were classified as critically low quality, while less than 5% were classified as high or moderate quality. Most reviews looked at interpersonal delivery and community-based delivery interventions, especially interventions for changing cognition led by a health professional and group activities, respectively. Loneliness, wellbeing, and depression/anxiety were the most assessed outcomes. Most research was conducted in high-income countries, concentrated in the United States, United Kingdom, and Australia, with none from low-income countries. Major gaps were identified in societal level and community-based delivery interventions that address policies and community structures, respectively. Less than 5% of included reviews assessed process indicators or implementation outcomes. Similar patterns of evidence and gaps were found in primary studies. All age groups were represented but more reviews and primary studies focused on older adults (≥60 years, 63%) compared to young people (≤24 years, 34%). Two thirds described how at-risk populations were identified and even fewer assessed differences in effect across equity factors for populations experiencing inequities

A Web-Based Global Educational Model for Training in Semen Analysis during the COVID-19 Pandemic

Infertility affects between 2.5% and 12% of couples worldwide, with male factor infertility solely accounting for 20% to 30% and contributing to 50% of the overall infertility cases [1]. In the United States alone, infertility affects 9.5% of men [2]. The clinical evaluation of male infertility is based on the semen analysis where the results can significantly influence the diagnostic interpretation and management. While many clinicians rely on semen parameters as a surrogate marker of a man’s ability to father a child, the results of semen analysis should, however, be interpreted with caution considering its inherent limitations [3,4]. A properly performed semen analysis and an adequate clinical examination of the male along with questions regarding current medical conditions and lifestyle circumstances that could affect sample quality, can provide valuable information related to a man’s fertility potential. This information facilitates a better understanding of the physiology of the reproductive organs and the underlying causes of dysfunction [5- 7]. However, manual semen analysis has its inherent challenges associated with high subjectivity, lack of standardization, inadequate quality control and quality assurance, as well as inadequate assessment of competency, and training of laboratory personnel performing the test [7,8]. Unlike sperm concentration and motility, sperm morphology has even more subjectivity in reporting the results, with increased intra- and intervariability [8-10]. Therefore, quality control is imminent in preventing such variations and retaining uniformity in all assessments by all operators. This includes preanalytical (test requisition, correct sample collection, delivery of sample), analytical (mixing and loading of sample, correct preparation of smears or calculation of results), and post-analytical (correct reporting of results to the clinician) indicators. To minimize errors, daily, weekly, or monthly quality control of reagents and equipment is imperative

Multiscale interactome analysis coupled with off-target drug predictions reveals drug repurposing candidates for human coronavirus disease

The COVID-19 pandemic has highlighted the urgent need for the identification of new antiviral drug therapies for a variety of diseases. COVID-19 is caused by infection with the human coronavirus SARS-CoV-2, while other related human coronaviruses cause diseases ranging from severe respiratory infections to the common cold. We developed a computational approach to identify new antiviral drug targets and repurpose clinically-relevant drug compounds for the treatment of a range of human coronavirus diseases. Our approach is based on graph convolutional networks (GCN) and involves multiscale host-virus interactome analysis coupled to off-target drug predictions. Cell-based experimental assessment reveals several clinically-relevant drug repurposing candidates predicted by the in silico analyses to have antiviral activity against human coronavirus infection. In particular, we identify the MET inhibitor capmatinib as having potent and broad antiviral activity against several coronaviruses in a MET-independent manner, as well as novel roles for host cell proteins such as IRAK1/4 in supporting human coronavirus infection, which can inform further drug discovery studies.We gratefully acknowledge funding that supported this research support from the Ryerson University Faculty of Science (CNA), as well as funding support in the form of a CIFAR Catalyst Grant (JPJ and CNA), an NSERC Alliance Grant (CNA) and the Ryerson COVID-19 SRC Response Fund award (CNA). BW is partly supported by CIFAR AI Chairs Program. This work was also supported by a Mitacs award (BW), the European Union’s Horizon 2020 research and innovation program under a Marie Sklodowska-Curie grant (ER), by the CIFAR Azrieli Global Scholar program (JPJ), by the Ontario Early Researcher Awards program (JPJ and CNA), and by the Canada Research Chairs program (JPJ). We also thank Dr. James Rini (University of Toronto) for the kind gift of the 9.8E12 antibody used to detect the 229E Spike protein, and Dr. Scott Gray-Owen (University of Toronto) for the kind gift of the NL63 human coronavirus.Peer reviewe

Transmission and evolution of the Middle East respiratory syndrome coronavirus in Saudi Arabia:a descriptive genomic study

BACKGROUND: Since June, 2012, Middle East respiratory syndrome coronavirus (MERS-CoV) has, worldwide, caused 104 infections in people including 49 deaths, with 82 cases and 41 deaths reported from Saudi Arabia. In addition to confirming diagnosis, we generated the MERS-CoV genomic sequences obtained directly from patient samples to provide important information on MERS-CoV transmission, evolution, and origin. METHODS: Full genome deep sequencing was done on nucleic acid extracted directly from PCR-confirmed clinical samples. Viral genomes were obtained from 21 MERS cases of which 13 had 100%, four 85-95%, and four 30-50% genome coverage. Phylogenetic analysis of the 21 sequences, combined with nine published MERS-CoV genomes, was done. FINDINGS: Three distinct MERS-CoV genotypes were identified in Riyadh. Phylogeographic analyses suggest the MERS-CoV zoonotic reservoir is geographically disperse. Selection analysis of the MERS-CoV genomes reveals the expected accumulation of genetic diversity including changes in the S protein. The genetic diversity in the Al-Hasa cluster suggests that the hospital outbreak might have had more than one virus introduction. INTERPRETATION: We present the largest number of MERS-CoV genomes (21) described so far. MERS-CoV full genome sequences provide greater detail in tracking transmission. Multiple introductions of MERS-CoV are identified and suggest lower R0 values. Transmission within Saudi Arabia is consistent with either movement of an animal reservoir, animal products, or movement of infected people. Further definition of the exposures responsible for the sporadic introductions of MERS-CoV into human populations is urgently needed. FUNDING: Saudi Arabian Ministry of Health, Wellcome Trust, European Community, and National Institute of Health Research University College London Hospitals Biomedical Research Centre

Sustainable food security decision-making : an agent-based modelling approach.

Ensuring a consistent and regular availability of food is crucial for food security. Food markets, supplied through both domestic production and international trade, are governed by several risks emerging from unpredictable supply chain disruptions, volatility of commodity prices, along with other unforeseen circumstances such as natural disasters. To mitigate the challenges threatening the stability of food systems, decision-making within the food sector should be enhanced and robust to accommodate any changes that might cause food shortages. Dynamic models, that can predict the behavior of food systems in order to avoid potential future knock-on effects and deficits, are incumbent to ensure the sustainable performance of food systems. This study proposes a dynamic decision-making scheme that simulates strategies of the perishable food market under different circumstances. An agent-based model (ABM) is developed and implemented using python MESA library for a case study in Qatar, illustrating the potential performance of tomato under three different scenarios to be considered, namely: (a) baseline scenario - aiming to reflect current production and market conditions; (b) water resource efficiency scenario - basing decisions on crop water requirement (CWR) depending on weather conditions; and (c) economic risk scenario - applying the concept of forward contracts to hedge against future uncertainties in crop prices. The findings of this study demonstrate that under the baseline conditions, a tomato crop can be supplied through a combination of domestic production and imports depending on the available inventories and prices imposed by exporters. The results obtained for the CWR scenario suggest the need for total reliance on imports in order to meet domestic demand, as there is potentially high-water loss, which amounts to an average of 4.9 Billion m3 per year, if tomato is grown locally. In contrast, the results from the forward contract scenario recommend a 57% dependency on local production in order to mitigate the effects of volatility in global food prices, which contributes to a 63% reduction in environmental emissions. Findings of this research provide insight into the factors that influence strategic decision making by the food sector to enhance its economic and environmental performances under diverse circumstances