Implementation of a drive-through testing clinic in Qatar for residents having recently returned from a country with a Covid-19 travel warning

© 2020 Alinier, Morris, Abu, Shaikh, Owen, licensee HBKU Press. This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.INTRODUCTION: The spread of the SARS-CoV-2 virus has caused chaos around the world. At the onset of the virus' detection in the State of Qatar, a free-testing system was rapidly established to invite individuals who had recently returned from countries with a COVID-19 disease travel warning to avoid putting other people at risk. The testing site needed to be accessible to individuals without requiring them to enter the hospital and congregate in a waiting area. The aim of this article is to share our experience with the early implementation of a drive-through testing clinic using the invited person's vehicle as an isolation compartment during screening to minimize person-to-person contamination. METHODS: A Hamad Medical Corporation site was selected to stage a drive-through testing facility to avoid congestion and offer space to facilitate the process. A process was rapidly agreed upon, and staff received the required training regarding infection control measures and documentation. At the testing site, individuals were subjected to the following steps: registration and history taking, temperature measurement, swabbing, and receipt of a sick leave certificate and a flyer about self-quarantine. RESULTS: Over the first six days of implementation, the relevant authorities determined that 687 individuals had to be contacted, 103 attended their testing appointment in that period, and an additional 327 people (close relations of the individuals contacted or individuals contacted but without a health card) also subjected themselves to the testing process, which took a median time of 11 minutes 39 seconds. No individual exhibited symptoms that warranted immediate isolation while they were at the drive-through testing clinic. However, four individuals were diagnosed with COVID-19 following laboratory analysis of the swab taken and followed up. The median time between swab collection and laboratory testing was 13 hours 41 minutes 59 seconds. CONCLUSIONS: Collaboration among various key health, governmental, and travel industry partners was essential to the successful and rapid implementation of a COVID-19 drive-through testing clinic in the early days of the pandemic in Qatar. The general public reacted well to this process. Communication, coordination, and planning were identified as critical factors at every step of the process. It started from the initial call to the travelers who had recently returned from a country with a newly instituted travel warning and concluded by them leaving with their sick leave certificate and an information flyer with reminders about preventative infection control measures and encouraging them to self-quarantine after having been swabbed.Peer reviewe

The health profile of people living with Parkinson\u27s Disease managed in a comprehensive care setting

Background: Globally there are few reports of the impairments, disabilities and medications used in people living with idiopathic Parkinson’s disease. Caregiver characteristics and caregiver burden have seldom been reported. We examined the health status in a large cohort of people living with Parkinson’s disease and their caregivers managed in a comprehensive health care setting. Methods/Design: A prospective, cross sectional analysis of impairments, disabilities and Parkinson’s disease medication use was conducted in a sample of 100 people with Parkinson’s disease rated I-IV on the modified Hoehn & Yahr scale. Participants were recruited from the Victorian Comprehensive Parkinson Program in Melbourne, Australia. Their caregivers were invited to provide their views on the burden of care, services provided and support received. Results: The severity of impairments and disabilities was strongly associated with disease duration (mean of 5.5 years). Those with long standing disease or more severe disease also used more Parkinson’s disease medications and participated in fewer social roles than people who were newly diagnosed or mildly affected. The severity of impairments was strongly correlated with limitations in performing activities of daily living. Limitations in performing daily activities were also found to be a significant contributing factor for health-related quality of life (PDQ-39 SI β=0.55, p=0.000; EQ-5D SI β=0.43, p=0.001). People with Parkinson’s disease lived at home with relatives. The average caregiver was a spouse or child providing approximately 3.5 hours of care per day, with the capacity to provide 9.4 hours per day and had provided care for four years. Additional support was high (63%) for 2.5 hours per day. Conclusion: The comprehensive care setting of this cohort describes a relatively benign condition despite a wide range of disease duration and severity. This report provides a baseline with which to compare other delivery models

Physiological, Biochemical, and Transcriptional Responses to Single and Combined Abiotic Stress in Stress-Tolerant and Stress-Sensitive Potato Genotypes

Potato production is often constrained by abiotic stresses such as drought and high temperatures which are often present in combination. In the present work, we aimed to identify key mechanisms and processes underlying single and combined abiotic stress tolerance by comparative analysis of tolerant and susceptible cultivars. Physiological data indicated that the cultivars Desiree and Unica were stress tolerant while Agria and Russett Burbank were stress susceptible. Abiotic stress caused a greater reduction of photosynthetic carbon assimilation in the susceptible cultivars which was associated with a lower leaf transpiration rate. Oxidative stress, as estimated by the accumulation of malondialdehyde was not induced by stress treatments in any of the genotypes with the exception of drought stress in Russett Burbank. Stress treatment resulted in increases in ascorbate peroxidase activity in all cultivars except Agria which increased catalase activity in response to stress. Transcript profiling highlighted a decrease in the abundance of transcripts encoding proteins associated with PSII light harvesting complex in stress tolerant cultivars. Furthermore, stress tolerant cultivars accumulated fewer transcripts encoding a type-1 metacaspase implicated in programmed cell death. Stress tolerant cultivars exhibited stronger expression of genes associated with plant growth and development, hormone metabolism and primary and secondary metabolism than stress susceptible cultivars. Metabolite profiling revealed accumulation of proline in all genotypes following drought stress that was partially suppressed in combined heat and drought. On the contrary, the sugar alcohols inositol and mannitol were strongly accumulated under heat and combined heat and drought stress while galactinol was most strongly accumulated under drought. Combined heat and drought also resulted in the accumulation of Valine, isoleucine, and lysine in all genotypes. These data indicate that single and multiple abiotic stress tolerance in potato is associated with a maintenance of CO2 assimilation and protection of PSII by a reduction of light harvesting capacity. The data further suggests that stress tolerant cultivars suppress cell death and maintain growth and development via fine tuning of hormone signaling, and primary and secondary metabolism. This study highlights potential targets for the development of stress tolerant potato cultivars

Birth weight associations with DNA methylation differences in an adult population

The Developmental Origins of Health and Disease (DOHaD) theory predicts that prenatal and early life events shape adult health outcomes. Birth weight is a useful indicator of the foetal experience and has been associated with multiple adult health outcomes. DNA methylation (DNAm) is one plausible mechanism behind the relationship of birth weight to adult health. Through data linkage between Generation Scotland and historic Scottish birth cohorts, and birth records held through the NHS Information and Statistics Division, a sample of 1,757 individuals with available birth weight and DNAm data was derived. Epigenome-wide association studies (EWAS) were performed in two independently generated DNAm subgroups (n(Set1) = 1,395, n(Set2) = 362), relating adult DNAm from whole blood to birth weight. Meta-analysis yielded one genome-wide significant CpG site (p = 5.97x10(−9)), cg00966482. There was minimal evidence for attenuation of the effect sizes for the lead loci upon adjustment for numerous potential confounder variables (body mass index, educational attainment, and socioeconomic status). Associations between birth weight and epigenetic measures of biological age were also assessed. Associations between lower birth weight and higher Grim Age acceleration (p((FDR)) = 3.6x10(−3)) and shorter DNAm-derived telomere length (p((FDR)) = 1.7x10(−3)) are described, although results for three other epigenetic clocks were null. Our results provide support for an association between birth weight and DNAm both locally at one CpG site, and globally via biological ageing estimates

Quantifying the profile and progression of impairments, activity, participation, and quality of life in people with Parkinson disease : protocol for a prospective cohort study

Background Despite the finding that Parkinson disease (PD) occurs in more than one in every 1000 people older than 60 years, there have been few attempts to quantify how deficits in impairments, activity, participation, and quality of life progress in this debilitating condition. It is unclear which tools are most appropriate for measuring change over time in PD. Methods and design This protocol describes a prospective analysis of changes in impairments, activity, participation, and quality of life over a 12 month period together with an economic analysis of costs associated with PD. One-hundred participants will be included, provided they have idiopathic PD rated I-IV on the modified Hoehn & Yahr (1967) scale and fulfil the inclusion criteria. The study aims to determine which clinical and economic measures best quantify the natural history and progression of PD in a sample of people receiving services from the Victorian Comprehensive Parkinson\u27s Program, Australia. When the data become available, the results will be expressed as baseline scores and changes over 3 months and 12 months for impairment, activity, participation, and quality of life together with a cost analysis. Discussion This study has the potential to identify baseline characteristics of PD for different Hoehn & Yahr stages, to determine the influence of disease duration on performance, and to calculate the costs associated with idiopathic PD. Valid clinical and economic measures for quantifying the natural history and progression of PD will also be identified

Characterisation of an inflammation-related epigenetic score and its association with cognitive ability

BACKGROUND: Chronic systemic inflammation has been associated with incident dementia, but its association with age-related cognitive decline is less clear. The acute responses of many inflammatory biomarkers mean they may provide an unreliable picture of the chronicity of inflammation. Recently, a large-scale epigenome-wide association study identified DNA methylation correlates of C-reactive protein (CRP)-a widely used acute-phase inflammatory biomarker. DNA methylation is thought to be relatively stable in the short term, marking it as a potentially useful signature of exposure. METHODS: We utilise a DNA methylation-based score for CRP and investigate its trajectories with age, and associations with cognitive ability in comparison with serum CRP and a genetic CRP score in a longitudinal study of older adults (n = 889) and a large, cross-sectional cohort (n = 7028). RESULTS: We identified no homogeneous trajectories of serum CRP with age across the cohorts, whereas the epigenetic CRP score was consistently found to increase with age (standardised β = 0.07 and 0.01) and to do so more rapidly in males compared to females. Additionally, the epigenetic CRP score had higher test-retest reliability compared to serum CRP, indicating its enhanced temporal stability. Higher serum CRP was not found to be associated with poorer cognitive ability (standardised β = - 0.08 and - 0.05); however, a consistent negative association was identified between cognitive ability and the epigenetic CRP score in both cohorts (standardised β = - 0.15 and - 0.08). CONCLUSIONS: An epigenetic proxy of CRP may provide a more reliable signature of chronic inflammation, allowing for more accurate stratification of individuals, and thus clearer inference of associations with incident health outcomes

Omega-3 Fatty Acids Reduce Adipose Tissue Macrophages in Human Subjects with Insulin Resistance

Fish oils (FOs) have anti-inflammatory effects and lower serum triglycerides. This study examined adipose and muscle inflammatory markers after treatment of humans with FOs and measured the effects of ω-3 fatty acids on adipocytes and macrophages in vitro. Insulin-resistant, nondiabetic subjects were treated with Omega-3-Acid Ethyl Esters (4 g/day) or placebo for 12 weeks. Plasma macrophage chemoattractant protein 1 (MCP-1) levels were reduced by FO, but the levels of other cytokines were unchanged. The adipose (but not muscle) of FO-treated subjects demonstrated a decrease in macrophages, a decrease in MCP-1, and an increase in capillaries, and subjects with the most macrophages demonstrated the greatest response to treatment. Adipose and muscle ω-3 fatty acid content increased after treatment; however, there was no change in insulin sensitivity or adiponectin. In vitro, M1-polarized macrophages expressed high levels of MCP-1. The addition of ω-3 fatty acids reduced MCP-1 expression with no effect on TNF-α. In addition, ω-3 fatty acids suppressed the upregulation of adipocyte MCP-1 that occurred when adipocytes were cocultured with macrophages. Thus, FO reduced adipose macrophages, increased capillaries, and reduced MCP-1 expression in insulin-resistant humans and in macrophages and adipocytes in vitro; however, there was no measureable effect on insulin sensitivity. Diabetes 62:1709–1717, 201

Episodic mass loss in binary evolution to the Wolf-Rayet phase: Keck and HST proper motions of RY Scuti's nebula

Binary mass transfer via Roche-lobe overflow (RLOF) is a key channel for producing stripped-envelope Wolf-Rayet (WR) stars and may be critical to account for SN Ib/c progenitors. RY Scuti is an extremely rare example of a massive binary star caught in this brief but important phase. Its toroidal nebula indicates equatorial mass loss during RLOF, while the mass-gaining star is apparently embedded in an opaque accretion disk. RY Scuti's toroidal nebula has two components: an inner ionised double-ring system, and an outer dust torus that is twice the size of the ionised rings. We present two epochs of Lband Keck NGS-AO images of the dust torus, plus three epochs of HST images of the ionised gas rings. Proper motions show that the inner ionised rings and the outer dust torus came from two separate ejection events roughly 130 and 250 yr ago. This suggests that RLOF in massive contact binaries can be accompanied by eruptive and episodic burst of mass loss, reminiscent of LBVs. We speculate that the repeating outbursts may arise in the mass gainer from instabilities associated with a high accretion rate. If discrete mass-loss episodes in other RLOF binaries are accompanied by luminous outbursts, they might contribute to the population of extragalactic optical transients. When RLOF ends for RY Scuti, the overluminous mass gainer, currently surrounded by an accretion disk, will probably become a B[e] supergiant and may outshine the hotter mass-donor star that should die as a Type Ib/c supernova.Comment: 15 pages, 7 figures, submitted to MNRA