Sigmoid sinus thrombosis presenting with posterior alexia in a patient with Behçet's disease and polycythaemia: a case report

<p>Abstract</p> <p>Introduction</p> <p>A 59-year-old Caucasian woman presented with an acute onset of alexia, noticed whilst driving. She described how while she could read car number plates, she had lost the ability to read and understand words on roadside advertisements and car window stickers.</p> <p>Case presentation</p> <p>Neurological examination was unremarkable apart from the inability to read full words or sentences. Imaging of the brain, initially computed tomography, followed by magnetic resonance venography, confirmed a diagnosis of sigmoid sinus thrombosis with associated venous infarction. The patient's past medical history revealed that she had suffered an ischemic stroke and following investigation for this, had undergone a nephrectomy for renal cell carcinoma. This was complicated by postoperative deep venous thrombosis. She had a persistent polycythaemia that was managed with venesection, and recently she had been diagnosed with Behçet's disease. Prior to this presentation, she had recently stopped her prophylactic antiplatelet medication as she was due to undergo a total knee replacement for osteoarthritis. She was managed with weight-adjusted, low molecular weight heparin followed by oral anticoagulation, and made a good recovery from her symptoms.</p> <p>Conclusion</p> <p>This case illustrates a classical neurological syndrome, highlights the importance of cerebral venous and sinus thrombosis as a cause of stroke, and the importance of remaining vigilant to a person's changing risk of venous thrombosis with evolving comorbidity.</p

SOME THOUGHTS ON FUTURE OF OTHER STATE FORESTS IN SRI LANKA

The agricultural frontier in the country has been expanding in recent years, primarilythrough the alienation and leasing out of large extents of forested state land to landlesspersons and also through encroachments. The remaining unutilized state lands also carryforests, and the demand for agricultural land in the future will have to be met by selectingfrom these areas, lands that are best suited for agricultural development.State land available for agriculture and other development purposes are currentlydesignated as Other State Forests (OSF). A part of the OSF is under the jurisdiction of theConservator of Forests and a part under the Divisional Secretaries. Much of this land inthe Wet Zone has either been distributed or encroached upon and hence the bulk of theOSF is to be found in the Dry and Intermediate Zones. The forest cover on these landshave been denuded because of widespread chena cultivation and therefore what remainstoday is sparse forest.As population increases, the demand for land from various users will increase and thisdemand will have to be met by the OSF. It is therefore very essential that all of the OSF inthe country are evaluated and divided into different land use categories. Initially, landssuitable for forestry should be separated and devoted exclusively to forestry development.The balance area will represent the lands available for other uses.The paper is in two parts. Part I will examine the need for catergorising OSF. Part II willpresents a methodology for categorising these lands based on 2 case studies undertaken inthe Anuradhapura and Ratnapura districts.

Stabilization of a-conotoxin AuIB: influences of disulfide connectivity and backbone cyclization

a-Conotoxins are peptides isolated from the venom ducts of cone snails that target nicotinic acetylcholine receptors (nAChRs). They are valuable pharmacological tools and have potential applications for treating a range of conditions in humans, including pain. However, like all peptides, conotoxins are susceptible to degradation, and to enhance their therapeutic potential it is important to elucidate the factors contributing to instability and to develop approaches for improving stability. AuIB is a unique member of the a-conotoxin family because the nonnative &quot;ribbon&quot; disulfide isomer exhibits enhanced activity at the nAChR in rat parasympathetic neurons compared with the native &quot;globular&quot; isomer. Here we show that the ribbon isomer of AuIB is also more resistant to disulfide scrambling, despite having a nonnative connectivity and flexible structure. This resistance to disulfide scrambling does not correlate with overall stability in serum because the ribbon isomer is degraded in human serum more rapidly than the globular isomer. Cyclization via the joining of the N- and C-termini with peptide linkers of four to seven amino acids prevented degradation of the ribbon isomer in serum and stabilized the globular isomers to disulfide scrambling. The linker length used for cyclization strongly affected the relative proportions of the disulfide isomers produced by oxidative folding. Overall, the results of this study provide important insights into factors influencing the stability and oxidative folding of a-conotoxin AuIB and might be valuable in the design of more stable antagonists of nAChRs

Sex education and self-poisoning in Sri Lanka: an explorative analysis

BACKGROUND: Self-harm and suicide are important causes of morbidity and mortality in Sri Lanka, but our understanding of these behaviours is limited. Qualitative studies have implicated familial and societal expectations around sex and relationships. We conducted an explorative analysis using case-control data to investigate the association between sex education and self-poisoning in Sri Lanka. METHODS: Cases (N=298) were self-poisoning inpatients on a toxicology ward, Teaching Hospital Peradeniya. Controls (N=500) were sex and age frequency matched to cases and were outpatients/visitors to the same hospital. Participants were asked whether they had received sex education, and to rate the quality and usefulness of any sex education received. Logistic regression models adjusted for age, sex, and religion quantified the association between receipt, quality and usefulness of sex education and self-poisoning. We tested whether the associations differed by sex. RESULTS: Roughly 1-in-3 cases and 1-in-5 controls reported having not received sex education. Individuals who did not receive sex education were nearly twice as likely to have self-poisoned than those who did (OR 1.68 (95% CI 1.11-2.55)). Those who reported the sex education they received as not useful were more likely to have self-poisoned compared to those who reported it useful (OR 1.95 (95% CI 1.04-3.65)). We found no evidence of an association between self-poisoning and the self-rated quality of sex education, or that associations differed by participant sex. CONCLUSION: As sex education is potentially modifiable at the population-level, further research should aim to explore this association in more depth, using qualitative methods and validated measurement tools. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-12374-4

INdigenous Systems and Policies Improved and Reimagined for Ear and hearing care (INSPIRE): A multi-method study protocol

Introduction Otitis media (middle ear disease) severity and chronicity among Aboriginal and Torres Strait Islander people, as well as gaps in socioeconomic outcomes related to hearing loss, indicates a breakdown in the current ear and hearing care system. The ear and hearing care system spans multiple sectors due to long-term impacts of otitis media and hearing loss in health, education and employment, necessitating a multi-disciplinary cross-sectorial approach to ear and hearing care. Public policies shape the current ear and hearing care system and here it is argued that a critical public policy analysis across different sectors is needed, with strong Aboriginal and Torres Strait Islander leadership and guidance. The current study aims to establish consensus-based ear and hearing care policy solutions for Aboriginal and Torres Strait Islander people in Australia. Methods and analysis This multi-method study will be guided by a Brains Trust with strong Aboriginal and Torres Strait Islander leadership. Public policies in hearing health, social services, and education will be scoped to identify policy gaps, using the World Health Organization framework. Qualitative data will be collected through a culturally specific process of yarning circles to identify policy challenges and/or limitations in enabling accessible ear and hearing care programs/services for Aboriginal and Torres Strait Islander people, using dimensions of Morestin's public policy appraisal tool as an interview guide for stakeholders. Themes from the yarning circles will be used to inform an expert Delphi process to establish consensus-based policy solutions for optimising the ear and hearing care system for Aboriginal and Torres Strait Islander people. Ethics and dissemination This study has approval from the Australian Institute of Aboriginal and Torres Strait Islander Studies Ethics Committee. Study findings will be disseminated to community through Brains Trust members and study participants, as well as through publications in peer-reviewed journals and research forum presentations

Ear and hearing care programs for First Nations children: a scoping review

Background: Ear and hearing care programs are critical to early detection and management of otitis media (or middle ear disease). Otitis media and associated hearing loss disproportionately impacts First Nations children. This affects speech and language development, social and cognitive development and, in turn, education and life outcomes. This scoping review aimed to better understand how ear and hearing care programs for First Nations children in high-income colonial-settler countries aimed to reduce the burden of otitis media and increase equitable access to care. Specifically, the review aimed to chart program strategies, map the focus of each program against 4 parts of a care pathway (prevention, detection, diagnosis/management, rehabilitation), and to identify the factors that indicated the longer-term sustainability and success of programs. Method: A database search was conducted in March 2021 using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Programs were eligible or inclusion if they had either been developed or run at any time between January 2010 to March 2021. Search terms encompassed terms such as First Nations children, ear and hearing care, and health programs, initiatives, campaigns, and services. Results: Twenty-seven articles met the criteria to be included in the review and described a total of twenty-one ear and hearing care programs. Programs employed strategies to: (i) connect patients to specialist services, (ii) improve cultural safety of services, and (iii) increase access to ear and hearing care services. However, program evaluation measures were limited to outputs or the evaluation of service-level outcome, rather than patient-based outcomes. Factors which contributed to program sustainability included funding and community involvement although these were limited in many cases. Conclusion: The result of this study highlighted that programs primarily operate at two points along the care pathway—detection and diagnosis/management, presumably where the greatest need lies. Targeted strategies were used to address these, some which were limited in their approach. The success of many programs are evaluated as outputs, and many programs rely on funding sources which can potentially limit longer-term sustainability. Finally, the involvement of First Nations people and communities typically only occurred during implementation rather than across the development of the program. Future programs should be embedded within a connected system of care and tied to existing policies and funding streams to ensure long term viability. Programs should be governed and evaluated by First Nations communities to further ensure programs are sustainable and are designed to meet community needs

Severe dengue epidemics in Sri Lanka, 2003-2006

Recent emergence of dengue hemorrhagic fever in the Indian subcontinent has been well documented in Sri Lanka. We compare recent (2003-2006) and past (1980-1997) dengue surveillance data for Sri Lanka. The 4 dengue virus (DENV) serotypes have been cocirculating in Sri Lanka for >30 years. Over this period, a new genotype of DENV-1 has replaced an old genotype. Moreover, new clades of DENV-3 genotype III viruses have replaced older clades. Emergence of new clades of DENV-3 in 1989 and 2000 coincided with abrupt increases in the number of reported dengue cases, implicating this serotype in severe epidemics. In 1980-1997, most reported dengue cases were in children. Recent epidemics have been characterized by many cases in children and adults. Changes in local transmission dynamics and genetic changes in DENV-3 are likely increasing emergence of severe dengue epidemics in Sri Lanka

Using rapid damage observations for Bayesian updating of hurricane vulnerability functions: A case study of Hurricane Dorian using social media

Rapid impact assessments immediately after disasters are crucial to enable rapid and effective mobilization of resources for response and recovery efforts. These assessments are often performed by analysing the three components of risk: hazard, exposure and vulnerability. Vulnerability curves are often constructed using historic insurance data or expert judgments, reducing their applicability for the characteristics of the specific hazard and building stock. Therefore, this paper outlines an approach to the creation of event-specific vulnerability curves, using Bayesian statistics (i.e., the zero-one inflated beta distribution) to update a pre-existing vulnerability curve (i.e., the prior) with observed impact data derived from social media. The approach is applied in a case study of Hurricane Dorian, which hit the Bahamas in September 2019. We analysed footage shot predominantly from unmanned aerial vehicles (UAVs) and other airborne vehicles posted on YouTube in the first 10 days after the disaster. Due to its Bayesian nature, the approach can be used regardless of the amount of data available as it balances the contribution of the prior and the observations

Influence of culture medium on in-vitro biofilm formation by Candida species

Objectives: Objective of this study was to establish an in vitro biofilm on the 96 well plates and to determine the efficacy of three different culture media on biofilm formation of Candida albicans and C. tropicalis Methods: A 96 well sterile, polystyrene plate was inoculated using 10^6 cell/ml of C. albicans and C. tropicalis suspensions and the growth rate of planktonic cells was determined by measuring the absorbance (OD492) at 2 hour intervals. Adhesion of Candidial cells to initiate the biofilm formation in the presence of three culture media (Yeast Nitrogen Base (YNB) supplemented with 100 mM glucose, Sabouraud Dextrose Broth (SDB) and RPMI1640) was quantified using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and Crystal Violet (CV) assay after 90 minutes. Biofilms of C. albicans, C. tropicalis and 1:1 co-biofilms were developed and the growth rates were quantified at 24 hours’ time intervals. Scanning electron microscope (SEM) was performed to assess the architecture. Results: Planktonic cells of both C. albicans and C. tropicalis showed maximum growth with SDB. C. albicans and co-biofilm adhesion were significantly facilitated with RPMI1640 and the best medium for C. tropicalis adhesion was YNB. Biofilms showed the maximum growth rate in RPMI 1640. C. tropicalis exhibited the minimum growth with all three culture media.Conclusions: The maximum growth rate for planktonic C. albicans and C. tropicalis was achieved with SDB. However RPMI 1640 was the best medium for growth of biofilms