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Coronavirus disease 2019, is now a global pandemic that has spread rapidly causing many deaths. Most countries have opted for compulsory confinement which had repercussions on mental health and well-being.
The purpose of this study is to assess mental health consequences during the confinement period.
This is a cross-sectional descriptive study of 360 Tunisians in April and May 2020. We used an anonymous E-questionnaire that included a socio-demographic fact sheet, The HAD questionnaire, and a Q-EDD questionnaire to explore eating disorders.
The subjects of our sample were mostly males with a mean age of 31. The body mass index was 25.5 (range 16.10 -46.24), 15% suffered from obesity. Half of the subjects were single and 6.7% spent the confinement time alone. 11.1% were smokers while 4.4% were alcohol users. The HAD-A and the HAD-D scores had an average of 9.1 and 8.48 respectively.A pathological threshold of anxiety and depression was found in 20% and 30% of the sample respectively.15% had an eating disorder: 76% had binge eating, 20% had bulimia and 17% had anorexia. In our study, we found an association between eating disorder and obesity, single marital status (p=0.007), living alone (p=0.001), history of depression (p=0.046), anxiety (p=0.049) and depression (p=0.038).
Reduced social interactions, decreased physical activity and increased stress are potentially harmful causes for our brain. Confining the population for several weeks has a negative impact on our physical and mental health. A crisis unit has been formed in Tunisia to help subjects overcome these psychological difficulties.
Autoimmune diseases play a critical role in the progression of infertility in both sexes and their severity has been reported to increase with age. However, few reports have discussed their effect on the morphological features of the testis. Therefore, we compared the morphological alterations in the testes of autoimmune model mice (MRL/MpJ-Faslpr) and the control strain (MRL/MpJ) with those of their background strain (C57BL/6N) at 3 and 6 months. Furthermore, we analyzed the changes in spermatocytes, Sertoli cells, immune cells, and Zonula occludens-1 junctional protein by immunohistochemical staining. The MRL/MpJ-Faslpr mice showed a significant increase in the serum Anti-double stranded DNA antibody level, relative spleen weight, and seminiferous luminal area when compared with other studied two strains. In contrast, a significant decrease in the relative testis weight, and numbers of both Sertoli, meiotic spermatocyte was observed in MRL/MpJ-Faslpr and MRL/MpJ mice compared with C57BL/6N mice especially at 6 months. Similarly, Zonula occludens-1 junctional protein positive cells showed a significant decrease in the same strains at 6 months. However, no immune cell infiltration could be observed among the studied three strains. Our findings suggest that the increase in autoimmune severity especially with age could lead to infertility through loss of spermatogenic and Sertoli cells, rather than the disturbance of the blood–testis barrier.
Coronavirus disease 2019 (COVID-19) is responsible for significant lung disease in adults. Despite mild manifestations in most children, multisystem inflammatory syndrome (MIS-C) associated with COVID-19 is well described in older children with cardiac manifestations. However, MIS-C-related cardiac manifestations are not as well described in younger children.
The study is a retrospective analysis of MIS-C patients under the age of 5 years admitted between May and November 2020 to a single centre. Included cases fulfilled the case definition of MIS-C according to Royal College of Pediatrics and Child Health criteria with laboratory, electrocardiogram, or echocardiographic evidence of cardiac disease. Collected data included patients’ demographics, laboratory results, echocardiographic findings, management, and outcomes.
Out of 16 MIS-C cases under 5 years of age, 10 (62.5%) had cardiac manifestations with a median age of 12 months, 9 (90%) were previously healthy. Cardiac manifestations included coronary arterial aneurysms or ectasia in five (50%) cases, two (20%) with isolated myopericarditis, coronary ectasia with myocarditis in two (20%), and supraventricular tachycardia in one (10%). Intravenous immunoglobulins were given in all cases with coronary involvement or myocarditis. The median duration of hospitalisation was 7 (6–14) days; two (20%) cases with cardiac disease were mechanically ventilated and mortality in MIS-C cases below 5 years was 12.5%. Normalisation of systolic function occurred in half of the affected cases within 1 week and reached 100% by 30 days of follow-up.
MIS-C associated with SARS-CoV-2 has a high possibility of serious associated cardiac manifestations in children under the age of 5 years with mortality and/or long-term morbidities such as coronary aneurysms even in previously healthy children.
Welding is a complex manufacturing process. Its quality depends on the welder skills, especially in welding complex paths. For consistency in modern industries, the arm robot is used to accomplish this task. However, its programming and reprogramming are time consuming and costly and need an expert programmer. These limit the use of robots in medium and small industries. This paper introduces a new supervised learning technique for programming a 4-degree of freedom (DOF) welding arm robot with an automatic feeding electrode. This technique is based on grasping the welding path control points and motion behavior of an expert welder. This is achieved by letting the welder move the robot end effector, which represents the welding torch, through the welding path. At the path control points, the position and speed are recorded using a vision system. Later, these data are retrieved by the robot to replicate the welding path. Several 2D paths are tested to assess the proposed approach accuracy and programming time and easiness in comparison with the common one. The results prove that the proposed approach includes fewer steps and consumes less programming time. Moreover, programming can be accomplished by the welder and no need for an expert programmer. These enhancements will improve the share of robots in welding and similar industries.
Irritability is a transdiagnostic feature of diverse forms of psychopathology and a rapidly growing literature implicates the construct in child maladaptation. However, most irritability measures currently used are drawn from parent-report questionnaires not designed to measure irritability per se; furthermore, parent report methods have several important limitations. We therefore examined the utility of observational ratings of children's irritability in predicting later psychopathology symptoms. Four-hundred and nine 3-year-old children (208 girls) completed observational tasks tapping temperamental emotionality and parents completed questionnaires assessing child irritability and anger. Parent-reported child psychopathology symptoms were assessed concurrently to the irritability assessment and when children were 5 and 8 years old. Children's irritability observed during tasks that did not typically elicit anger predicted their later depressive and hyperactivity symptoms, above and beyond parent-reported irritability and context-appropriate observed anger. Our findings support the use of observational indices of irritability and have implications for the development of observational paradigms designed to assess this construct in childhood.
Family medicine practitioners (FMP) take care of a varied range of patients with undifferentiated conditions over a lifetime. Although it was incepted in Saudi Arabia in 1980, limited data exists on FMP. This paper explores what family physicians deem relevant.
A cross-sectional survey was conducted among FMP in Saudi Arabia in 2018–2019 who responded to an online questionnaire that listed 20 activities usually done by FMP asking them to rate their meaningfulness on a 5-point Likert Scale, and select the top 3 they would like to spend the most and the least time on. Chi-square statistics were used to compare preference for time spent on these six activities by participant characteristics
Of the 415 survey participants, the majority were male (246) and had a Bachelor’s degree (176). The management of risk conditions, follow-up of chronic illnesses and running preventive health clinics were listed as most meaningful. The majority wished to spend more time on managing health risks, handling daily common complaints and follow-up of chronic illnesses and less time on terminal care activities (46.8%), emergency care (32.3%) and addiction medicine (23.4%). Bachelor’s degree holders wished to spend more time on emergency care compared to Diploma, Board-certified and Fellowship holders (63%, 21%, 10% and 5%, respectively; P = 0.01).
The activities preferred by FMP align with prevailing disease epidemiology. Variations in preferences of ‘managing emergencies’ reflect the varied format of training. Training of FMP should be standardized and further studies investigate reasons for specific preferences.
Substrate-integrated waveguide (SIW) technology has recently drawn attention to its benefits in the microwave field, such as integration in planar microwave circuits, low manufacturing cost, and high-quality factor compared to other technologies. In this paper, a broadband and high gain SIW cavity-backed L-shaped slot antenna structure has been designed and made for X-band applications. Three pairs of L-shaped half-wave resonators are placed on the lower wall of the cavity (backed-slots) to further expand bandwidth and improve gain. The final antenna designed operates on a band ranging from 9.4 to 10.5 GHz with a bandwidth of 11%. Moreover, the gain reaches a value of 9.5 dBi. The final antenna is realized on a Rogers RT/Duroid 5870 substrate. The gain, the reflection coefficient, and the radiation patterns are measured and compared to the EM simulation results and a very good agreement is obtained. The proposed cavity-backed L-shaped slot antenna gives a good compromise between a high gain and a large bandwidth.
Primary care is geared to manage patients with mild to moderate presentations of common mental disorders and to refer patients with more severe mental disorders to specialist mental health services. With growing demand for specialty care, the quality of the referral is increasingly important to ensure efficient patient flow across the primary/secondary care interface and appropriate use of secondary services. We report on an initiative in a Qatari mental health clinic to improve the quality of referrals from primary care to specialist mental health services through an educational intervention for family physicians. We highlight the problem, the intervention and the outcome of our initiative, which was the first of its kind in the region. The number of inappropriate referrals fell by 93%, and the number of referrals with inadequate clinical information declined from 15 (January 2019) to 1 (September 2019). Feedback was very positive; respondents reported feeling supported, with better understanding of care pathways, the scope of primary care and mental health services.
Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children.
This cRCT randomized 32 women's groups – 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted.
In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges.
This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content.
An understanding of the current state of mental health services in the United Arab Emirates (UAE) from a clinical perspective is an important step in advising government and stakeholders on addressing the mental health needs of the fast-growing population. We conducted a retrospective study of data on all patients admitted to a regional psychiatric in-patient unit between June 2012 and May 2015. More Emiratis (UAE nationals) were admitted compared with expatriates. Emiratis were diagnosed more frequently with substance use disorders and expatriates with stress-related conditions. Psychotic and bipolar disorders were the most common causes for admission and had the longest in-patient stays; advancing age was associated with longer duration of in-patient stay.
Uterine fibroids (UFs), also known as leiomyomas or myomas, are the most common benign gynaecologic neoplasm in premenopausal women worldwide and estimated to occur in 7–8 women out of 10 during their lifetime . The aetiology behind UFs is thought to involve genetic, biologic, and environmental factors . Growth factors have been implicated in certain molecular processes involved in the pathogenesis of UFs which includes inflammation, cell proliferation, fibrosis, and angiogenesis . Numerous studies and clinical observations have shown that growth of UFs is dependent on ovarian steroid hormones. Accordingly, there have been no documented cases of UFs prior to menarche, while its prevalence increases with age and peaks during the fifth decade of life . Consequently, the risk tends to decline after menopause, especially in women over the age of 70 years . About 20% of UF patients present with heavy or abnormal bleeding and pelvic pressure; additionally, UFs can cause infertility or loss of pregnancy .
Uterine fibroids (UFs) are the most common non-malignant neoplasms affecting women of reproductive age. Some estimates suspect nearly 70–80% of all women will develop at least one fibroid during their lifetime . Women suffering from UFs can present with heavy or prolonged vaginal bleeding, pain or pressure in pelvic region, dysmenorrhoea, dyspareunia, bladder problems, constipation, subfertility, and even loss of pregnancy . Many women with fibroids experience heavy menstrual bleeding (HMB), thereby making them more prone to developing iron deficiency anaemia . Many women suffering from severe symptomatic fibroids choose to have a hysterectomy, making it the second most commonly performed procedure in the United States . Unfortunately the risks involved with surgery, in conjunction with the possibility of eradicating any hope of future pregnancies, make it a less favourable option for women. Thus understanding the pathogenesis behind fibroid formation is paramount for the development of novel therapeutic strategies.
Coronavirus disease 2019 (COVID-19) has rapidly spread globally, forcing countries to apply lockdowns and strict social distancing measures. The aim of this study was to assess eating habits and lifestyle behaviours among residents of the Middle East and North Africa (MENA) region during the lockdown. A cross-sectional study among adult residents of the MENA region was conducted using an online questionnaire designed on Google Forms during April 2020. A total of 2970 participants from eighteen countries participated in the present study. During the pandemic, over 30 % reported weight gain, 6·2 % consumed five or more meals per d compared with 2·2 % before the pandemic (P < 0·001) and 48·8 % did not consume fruits on a daily basis. Moreover, 39·1 % did not engage in physical activity, and over 35 % spent more than 5 h/d on screens. A significant association between the frequency of training during the pandemic and the reported change in weight was found (P < 0·001). A significantly higher percentage of participants reported physical and emotional exhaustion, irritability and tension either all the time or a large part of the time during the pandemic (P < 0·001). Although a high percentage of participants reported sleeping more hours per night during the pandemic, 63 % had sleep disturbances. The study highlights that the lockdown due to the COVID-19 pandemic caused a variety of lifestyle changes, physical inactivity and psychological problems among adults in the MENA region.
With rapid growth and development in recent decades, the State of Qatar has been redefining strategies and policies towards building a world-class healthcare system. Mental health has emerged as a priority area for development. As a result, mental health services in the region are being redefined and expanded, and this was realised with the launching of the ambitious National Mental Health Strategy in 2013. Traditionally, mental healthcare in Qatar had been considered to be the remit of psychiatrists within secondary care. The new strategy supported the transition towards community-based care. It outlined a plan to design and build a comprehensive and integrated mental health system, offering treatment in a range of settings. In this article, we provide an overview of the advent of primary care mental health services in Qatar. We discuss the historical aspects of psychiatric care and development of primary care mental health services in Qatar.
Dromedary camels remain the currently identified reservoir for the Middle East respiratory syndrome coronavirus (MERS-CoV). The virus is released in the secretions of the infected camels, especially the nasal tract. The virus shedding curve through the nasal secretions was studied. Although human transmission of the virus through the respiratory tract of close contact people with dromedary reported previously, the exact mechanism of transmission is still largely unknown. The main goal of this study was to check the possibility of MERS-CoV shedding in the exhaled air of the infected camels. To achieve this goal, we conducted a follow-up study in one of the dromedary camel herds, December 2018–April 2019. We tested nasal swabs, breath samples from animals within this herd by the real-time PCR. Our results showed that some of the tested nasal swabs and breath were positive from 24 March 2019 until 7 April 2019. The phylogenetic analysis of the obtained S and N gene sequences revealed the detected viruses are clustering together with some human and camel samples from the eastern region, especially from Al-Hufuf city, as well as some samples from Qatar and Jordon. These results are clearly showing the possibility of shedding of the virus in the breath of the infected camels. This could explain, at least in part, the mechanism of transmission of MERS-CoV from animals to humans. This study is confirming the shedding of MERS-CoV in the exhaled air of the infected camels. Further studies are needed for a better understanding of the MERS-CoV.
Finasteride is commonly used in the management of alopecia and nodular prostatic hyperplasia. It was reported to have a harmful effect on spermatogenesis with subsequent infertility. Thus, this research was to determine the ameliorative effect of resveratrol against testicular damage caused by finasteride. Forty adult male rats were randomly divided into four main groups: group I acted as the control, group II was administrated resveratrol 20 mg/kg/day, group III was administrated finasteride 5 mg/kg/day, and group IV was administrated finasteride and resveratrol as in the previous groups. Finasteride induced a significant decrement in the testosterone and dihydrotestosterone levels. The level of malondialdehyde significantly increased, while the levels of glutathione peroxidase, superoxide dismutase, and catalase significantly decreased in the finasteride-administrated rats. Variable histopathological alterations in the testes were revealed in the form of irregular seminiferous tubules. Some seminiferous tubules appeared with degenerated germinal epithelium. Others showed detachment of their germinal epithelium. Congested blood vessels and homogeneous acidophilic substance in-between tubules were also detected. A significant decrement in PCNA positive cells and a significant increment in Bax expression were demonstrated. Ultrastructural examination showed Sertoli cells with rarefied cytoplasm. Vacuolated cytoplasm, shrunken nuclei, and dilated perinuclear spaces were also revealed in the spermatogonia, primary spermatocytes, and early spermatids. On the contrary, few changes were noticed in rats received resveratrol concomitant with finasteride. This study indicated that resveratrol exerted a potent ameliorative effect against testicular injury caused by finasteride.
The design and experimental works of an autonomous robotic platform for road marks painting are presented in this paper as the first autonomous system of its kind. The whole system involves two main sub-systems, namely: an autonomous mobile robot navigation system which is used for recognizing the roads and estimating the position of road marks, and automatic road marks painting system that is attached to the mobile robot platform to control the spray of the paint on the road’s surface. The experimental results show the capability of the proposed system to perform the task of autonomous road marks painting with accuracy of ±10 cm.
Suspecting a genetic etiology for movement disorders of childhood often requires a high index of suspicion due to the heterogenous phenotypic expression, variable penetrance, and the influence of epigenetic modifiers that are largely unknown.
To report the utilization of diagnostic intracytoplasmic sperm injection (D-ICSI), an ICSI cycle performed in the natural cycle, to obtain information about embryo development potential after sperm injection into zona pellucida (ZP)-free oocytes.
Materials and Methods:
We report the case of a couple with primary unexplained infertility with a history of previous failed, in vitro fertilization intracytoplasmic sperm injection (IVF-ICSI) cycles characterized by the presence of ZP-free oocytes. Whole exome sequencing (WES) was carried out to analyse the possible genetic basis of oocyte abnormality.
Diagnostic ICSI provided information about the embryo development potential from ZP-free oocytes and allowed better planning of the subsequent ICSI cycle. WES revealed that the absence of ZP was likely to be due to a new (ZP1) mutation. The subsequent ICSI cycle resulted in the delivery of a healthy baby.
To the best of our knowledge, our report is the first to describe the use of D-ICSI to determine the feasibility of embryo development and implantation in a patient with ZP1 mutation, resulting in the subsequent delivery of a healthy baby. We used ‘diagnostic’ ICSI in the normal menstrual cycle to explore the feasibility of embryo development after sperm injection into ZP-free oocytes. Our results may expand the spectrum of diagnostic procedures associated with unexplained infertility.