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The objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40 926 persons (67% of total 60 839) had complete records of RT-PCR test across 35 states and the Federal Capital Territory, 12 289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100 000 population and 2.8%, respectively. The highest proportion of COVID-19 cases and deaths were recorded in persons aged 31–40 years (25.5%) and 61–70 years (26.6%), respectively; and males accounted for a higher proportion of confirmed cases (65.8%) and deaths (79.0%). Sixty-six per cent of confirmed COVID-19 cases were asymptomatic at diagnosis. In conclusion, this paper has provided an insight into the early epidemiology of COVID-19 in Nigeria, which could be useful for contextualising public health planning.
To induce diet-induced obesity (DIO) in rodents, diets high in saturated fat and/or carbohydrates are commonly used. In the laboratory, standardised diets evolved over time without paying particular attention to the effect of fat composition on metabolic alterations. In the present study, customised high-fat diets (HFD) enriched with a combination of lard and different concentrations of New Zealand green-lipped mussel (Perna canaliculus) oil or MSC Hoki (Macruronus novaezelandiae, blue grenadier) liver oil, important sources of n-3 PUFA, in comparison with a solely lard-based diet, were fed to lean and DIO male C57BL/6 mice and their effects on metabolic parameters were monitored. Intriguingly, an isoenergetic HFD containing 63 % of total fat in the form of mussel oil and only 28 % in the form of lard attenuated HFD-induced body weight gain after 1 and 4 weeks, respectively. Consistently, changing a lard-enriched HFD to the mussel oil diet reduced body weight markedly even after mice had been exposed to the former diet for 10 months. The weight-reducing effect of the diet was not caused by altered energy intake or expenditure, but was associated with reduced visceral fat mass. Collectively, these data suggest a novel weight-reducing potential of green-lipped mussel oil.
Avian malaria is a mosquito-borne disease caused by Plasmodium spp. protozoa. Although these parasites have been extensively studied in North America and Eurasia, knowledge on the diversity of Plasmodium, its vectors and avian hosts in Africa is scarce. In this study, we report on natural malarial infections in free-ranging sparrows (Passer domesticus) sampled at Giza Governorate, Egypt. Parasites were morphologically characterized as Plasmodium cathemerium based on the examination of thin blood smears from the avian host. Sequencing a fragment of the mitochondrial cytochrome b gene showed that the parasite corresponded to lineage PADOM02. Phylogenetic analysis showed that this parasite is closely related to the lineages SERAU01 and PADOM09, both of which are attributed to P. cathemerium. Experimental infection of Culex pipiens complex was successful, with ookinetes first detected at 1-day post infection (dpi), oocysts at 4 dpi and sporozoites at 6 dpi. The massive infection of the salivary glands by sporozoites corroborates that Cx. pipiens complex is a competent vector of PADOM02. Our findings confirm that Plasmodium lineage PADOM02 infects sparrows in urban areas along the Nile River, Egypt, and corroborate that Cx. pipiens complex is a highly competent vector for these parasites. Furthermore, our results demonstrate that this lineage corresponds to the morphospecies P. cathemerium and not P. relictum as previously believed.
Alcohol dependency can cause serious complications if not managed appropriately.
To evaluate if the local guidelines (based on NICE) for the management of acute withdrawal are followed at the Bede Unit/South Tyneside. These advises a three day course of intramuscular Pabrinex and seven days reducing regime of benzodiazepine (commonly Chlordiazepoxide) with additional PRN (as required) benzodiazepine.
The project's main objective is to identify how the guidelines can be delivered more effectively.
Retrospective data collection from all kardex for all patients (21 identified) who received a reducing regime of benzodiazepines between Oct/11 & Jan/12, for alcohol withdrawal symptoms, examining if they were prescribed bezodiazepines regularly, ‘as required’ or both to treat withdrawal symptoms. Vitamin supplementation as part of their management of alcohol withdrawal was also reviewed.
All patients were prescribed chlordiazepoxide. Seventeen of these were prescribed both regular and PRN chlordiazepoxide, while one received regular only and three patients received PRN only. Period of treatment ranged from 2-11. Five received the recommended seven days reducing regimen.
Only one patient was managed in accordance with local guidelines (three days of intramuscular Pabrinex/seven days reducing chlordiazepoxide/PRN benzodiazepine)
There was inconsistency in the use of PRN benzodiazepine.
There might be doubts about patients’ knowledge regarding as required medication, and on how withdrawal symptoms are monitored.
The reducing regime of benzodiazepines is limited to the format of the kardex, which made it difficult to identify drug errors or omissions and hence increased the margin for medication errors.
Frequent attenders to the Accident & Emergency (A&E) can cause a huge burden on the services.
To screen this group of patients for any previous existing psychiatric background as well as to identify patients with Medically Unexplained Physical Symptoms (MUPS) in order to sign post them to the appropriate services and to create a joint management plan with the A&E department.
Not different from the objectives.
The list top 52 frequent attenders to two busy A&E departments in the North East of England for the period between Jan-Jun 2012, was obtained. Their records been verified on PARIS (the local Psychiatric Services Electronic Notes System) looking for at least one previous encounter with the services, if the patient was open to mental health and if the patient was care coordinated during that period. Diagnosis, history of substance misuse and significant alerts as well as housing were recorded. For the MUPS main reason for presentation was recorded. Joint care plan with A&E was also verified.
This group generated 851 attendance to A&E during this period. Mean attendance 16 (12-41). Nearly 80% of the sample had at least one encounter with the psychiatric services. 40% were actively open to the services. 18 patients were care cordinated. 30% had significant alert to harm others. 9 patients in total were classified as homeless.
Significant number of regular patients at the A&E department have psychiatric background. There was limitation in identifying MUPS due to anomalies in coding.
According to WHO, suicide is a major public health problem and the most affected age group by suicide in Tunisia is that of over 70 years.
To study the perception of the Tunisian elderly of suicide.
A cross-sectional study was conducted during a 3-month period from October to December 2015. Fifty persons aged at least 65 years participated to the study. We used an anonymous questionnaire with a specific scale: “Attitudes Towards Suicide Questionnaire” (ATTS).
The mean age of our patients was 67.5 years. Sex ratio was 1.27. Most of the participants were married (82%), unemployed (63.2%), with a secondary or high educational level (62%), and low income (73.5%). All participants were believers. As for religious practice, 74.5% of the recruited elderly made the fast and 73.5% were prayers. Among women, 70.8% wore the veil. Concerning the perception of suicide, it was on the dimension of “permissiveness” (M = 1.88) that our participants agreed less. Those who made prayers had lower scores of “permissiveness” (P = 0.032). Women who wore the veil had higher scores on the field of “incomprehensibility” than the unveiled ones (P = 0.047). Furthermore, 68% of our participants believed that suicide is stigmatizing.
It might be time to try to lift the taboo and stigma through information and sensitizing campaigns on suicide. In this direction, studies of perception help to identify, somehow, “automatic thoughts” regarding representations of suicide and to try to develop an “alternative thinking” in the general population.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The current development of new technologies dedicated to healthcare, such as smartphones, provides an interesting opportunity to improve both assessment and follow-up of different illnesses, particularly mental diseases.
To investigate, the contributions and risks of smartphone use among mental health patients.
We conducted a literature research of PubMed and Sciencedirect using the key words “smartphone”; “bipolar disorder”; “schizophrenia”; “anxiety disorders”; “addiction”; “dementia”.
Literature data provide several examples of the use of the smartphone's features for patient monitoring. One such example involved patients with Alzheimer disease. An attempt to deal with the risk of wandering was proposed with the use of the Android app iWander, which works by using the smartphone's GPS to track the patient at all times. As for bipolar disorder, several applications have been proposed both for diagnostic ic instruments…) and interventional purposes (applications that offer subjects psycho-education in the form of emotional self-awareness…). Several other applications can be used in the management of schizophrenia, social anxiety disorder and addictions. Along with its obvious benefits, however, the smartphone use has a dark side. Problematic smartphone use is one form of behavioral addiction recently identified. In addition, the access to Internet through the smartphone opens the door to Internet addiction and its sub-types (cybersexual addiction, cyber-relationship addiction…).
The use of smartphone for medical purposes must be cautious among mental health patients, because of a field of vulnerability that promotes the appearance of other mental diseases, especially addictions, which may darken their prognosis.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We agree with Lake and colleagues on their list of “key ingredients” for building human-like intelligence, including the idea that model-based reasoning is essential. However, we favor an approach that centers on one additional ingredient: autonomy. In particular, we aim toward agents that can both build and exploit their own internal models, with minimal human hand engineering. We believe an approach centered on autonomous learning has the greatest chance of success as we scale toward real-world complexity, tackling domains for which ready-made formal models are not available. Here, we survey several important examples of the progress that has been made toward building autonomous agents with human-like abilities, and highlight some outstanding challenges.
In order to test a preliminary orbit determination method, we fit an orbit of the geostationary satellite TELECOM-2D, as if we did not know any a priori information on its trajectory. The method is based on a genetic algorithm coupled to an analytical propagator of the trajectory, that is used over a couple of days, and that uses a whole set of altazimutal data that are acquired by the tracking network made up of the two TAROT telescopes. The adjusted orbit is then compared to a numerical reference. The method is described, and the results are analyzed, as a step towards an operational method of preliminary orbit determination for uncatalogued objects.
We review clinical, neuroimaging, and genetic information on six individuals with isolated sulfite oxidase deficiency (ISOD).
All patients were examined, and clinical records, biochemistry, neuroimaging, and sulfite oxidase gene (SUOX) sequencing were reviewed.
Data was available on six individuals from four nuclear families affected by ISOD. Each individual began to seize within the first week of life. neurologic development was arrested at brainstem reflexes, and severe microcephaly developed rapidly. neuroimaging within days of birth revealed hypoplasia of the cerebellum and corpus callosum and damage to the supratentorial brain looking like severe hypoxic-ischemic injury that evolved into cystic hemispheric white matter changes. Affected individuals all had elevated urinary S-sulfocysteine and normal urinary xanthine and hypoxanthine levels diagnostic of ISOD. Genetic studies confirmed SUOX mutations in four patients.
ISOD impairs systemic sulfite metabolism, and yet this genetic disease affects only the brain with damage that is commonly confused with the clinical and radiologic features of severe hypoxic-ischemic encephalopathy.
This contribution presents a novel simulation for a fixed-wing aircraft powered by gas turbine engines and advanced propellers (turboprops). The work is part of a large framework for the simulation of aircraft flight through a multi-disciplinary approach. Novel numerical methods are presented for flight mechanics, turboprop engine simulation (in direct and inverse mode), and propeller dynamics. We present in detail the integration of the propeller with the airframe, aircraft and tonal noise model. At the basic level, we address a shortfall in multi-disciplinary integration in turboprop-powered aircraft, including economical operations and environmental emissions (exhausts and noise). The models introduced are based on first principles, supplied with semi-empirical correlations, if required. Validation strategies are presented for component-level analysis and system integration. Results are presented for aerodynamics, specific air range, optimal cruise conditions, payload-range performance, and propeller noise. Selected results are shown for the ATR 72-500, powered by PW127M turboprop engines and F568-1 propellers.
Increasing prevalence of inflammatory bowel disease may be due to imbalance in the intake of n-6 and n-3 PUFA in the diet. This study investigates the impact of varying ratios of dietary linoleic acid (LA, 18 : 2n-6) to α-linolenic acid (ALA, 18 : 3n-3) on the inflammatory response in dextran sulphate sodium (DSS)-induced colitis. Weanling male Sprague–Dawley rats were divided into five groups: a non-colitic group with a LA:ALA ratio of 215 (CON-215), and colitic groups with LA:ALA ratios of 215 (DSS-215), 50 (DSS-50), 10 (DSS-10) and 2 (DSS-2). Blends of groundnut, palmolein and linseed oils were used to provide varying LA:ALA ratios. All the rats were fed the respective experimental isoenergetic diets containing 10 % fat for 90 d and DSS was administered during the last 11 d. Colonic inflammation was evaluated by clinical, biochemical and histological parameters. The results showed attenuation of colitis in the DSS-2 group as evidenced by significant reductions in disease activity index, mucosal myeloperoxidase activity (P < 0·05), alkaline phosphatase activity (P < 0·01) and increase in colon length (P < 0·01) compared to the groups fed with higher ratios (DSS-215). This was accompanied by significant reductions in mucosal proinflammatory cytokines TNF-α (P < 0·01) and IL-1β (P < 0·01) and improvement in the histological score. Further, ALA supplementation increased long-chain (LC) n-3 PUFA and decreased LC n-6 PUFA in colon structural lipids. These data suggest that substitution of one-third of LA with ALA (LA:ALA ratio 2) mitigates experimental colitis by down-regulating proinflammatory mediators.
Background: We performed a genome-wide scan in a homogeneous Arab population to identify genomic regions linked to blood pressure (BP) and its intermediate phenotypes during mental and physical stress tests. Methods: The Oman Family Study subjects (N = 1277) were recruited from five extended families of ~10 generations. Hemodynamic phenotypes were computed from beat-to-beat BP, electrocardiography and impedance cardiography. Multi-point linkage was performed for resting, mental (word conflict test, WCT) and cold pressor (CPT) stress and their reactivity scores (s), using variance components decomposition-based methods implemented in SOLAR. Results: Genome-wide scans for BP phenotypes identified quantitative trait loci (QTLs) with significant evidence of linkage on chromosomes 1 and 12 for WCT-linked cardiac output (LOD = 3.1) and systolic BP (LOD = 3.5). Evidence for suggestive linkage for WCT was found on chromosomes 3, 17 and 1 for heart rate (LOD = 2.3), DBP (LOD = 2.4) and left ventricular ejection time (LVET), respectively. For △WCT, suggestive QTLs were detected for CO on chr11 (LOD = 2.5), LVET on chr3 (LOD = 2.0) and EDI on chr9 (LOD = 2.1). For CPT, suggestive QTLs for HR and LVET shared the same region on chr22 (LOD 2.3 and 2.8, respectively) and on chr9 (LOD = 2.3) for SBP, chr7 (LOD = 2.4) for SV and chr19 (LOD = 2.6) for CO. For △CPT, CO and TPR top signals were detected on chr15 and 10 (LOD; 2.40, 2.08) respectively. Conclusion: Mental stress revealed the largest number of significant and suggestive loci for normal BP reported to date. The study of BP and its intermediate phenotypes under mental and physical stress may help reveal the genes involved in the pathogenesis of essential hypertension.
This paper presents the preparation of multi-walled carbone nanotubes (CNTs) and CdS nanoparticles based hybrid materials. We aim at comparing two kinds of CNTs’ functionalization by thiol groups in order to demonstrate that the surface chemistry done on the CNTs can direct the morphology of the nanohybrids. Indeed, strong oxidation of CNTs leads to shorter nanotubes opened at their ends, allowing the grafting of mercaptotriethoxysilane whereas the generation of diazonium salts in presence of pristine nanotubes should lead to the functionalization of the whole lateral surface of the nanotubes. CdS nanoparticles can then be anchored to thiol groups, leading to interesting hybrid precursors for photovoltaic applications.
Based on an analysis of original social network data collected from 407 households in an urban community in Northern Nigeria, this article evaluates whether patronage relationships between households have consequences for children's educational attainment. A “social resources” perspective suggests that patronage ties may serve as a form of social capital that activates upward social mobility for entire families, thereby yielding more than simple transitory returns on social connections. An alternative “social constraints” perspective suggests that patronage ties may have no effects (or negative effects) on the schooling of clients' children, since patron-clientage reflects prevailing social inequalities and exists for reasons other than the promotion of dynastic mobility among clients and their families. In the case study reported in this article, the latter pattern holds, and the results are interpreted with reference to the historical record, which shows that a latent function of patron-clientage is the preservation of intergenerational status immobility.