Search

Background Mobile stroke units have been shown to deliver faster patient care and improve clinical outcomes. However, costs associated with staffing limit their use to densely populated cities. Using the Melbourne mobile stroke unit, we aim to evaluate the safety, timeliness, and resource efficiency of a telemedicine model, where the neurologist assesses a patient remotely, via telemedicine, compared with an onboard neurologist model. We hypothesize that, without compromising patient safety, the telemedicine model will provide timely care and superior resource efficiency. Methods Using a prospective, randomized, blinded end‐point controlled design, 270 participants consecutively assessed on the Melbourne mobile stroke unit over ≈12 months will be assigned into 2 arms: (1) telemedicine neurologist assessment (intervention) versus (2) onboard assessment (comparator). Enrollment is based on prospectively designated randomized days of neurologist review onboard versus telemedicine. The primary outcome will be the odds that a randomly selected participant in the telemedicine arm will have a better outcome than a randomly selected participant in the onboard arm, measured using a desirability‐of‐outcome ranking, an outcome measure that includes, in order of importance: (1) safety, (2) scene‐to‐treatment‐decision time metrics, and (3) resource usage. All participants within each arm will be compared with those in the other, resulting in a “win/tie/loss” distribution for telemedicine compared with the onboard model. Conclusions The study will establish whether use of a telemedicine neurologist delivers superior resource efficiency without compromising patient care. This would enable the broader use of mobile stroke units, particularly relevant to regions with limited access to neurologists, thus improving equity in access to time‐critical, lifesaving stroke care. Registration URL: clinicaltrials.gov; Unique Identifier: NCT05991310.

More than two thousand years ago the first hydrostatic balance with a rudimentary structure was invented by the Greek sage “Archimedes.” Iranian scholars would later develop balances that were used not only for weighing but also for determining the density and titration of alloys.To appraise the path of evolution of these balances as well as their potentials, an experimental research program was undertaken by the Iranian Research Organisation for Science and Technology (IROST). Therefore, five different balances were selected, ranging from the oldest known in the history of science, the Archimedes balance, to the most sophisticated one, the balance of wisdom by Al-Khazini, which are separated by a lapse of time of about fourteen hundred years. Balances designed by Abu Rayhan Al-Biruni, Zakariya Al-Razi, and Omar Khayyam were the other three. In the course of the research, replicas of the selected balances were designed and fabricated according to the remaining design details in the related literature. The article covers the detailed design of each balance, their construction and functional test details as well as a comparison of their functions and their precision in densitometry and titration.

This study is directed to explore the teachers’ and students’ thoughts on instructional components involved in CBI tasks for productive skills learning in Indonesian secondary school context. There are ten teachers with more than five years of experience teaching English and eighty-six students taken as respondents. The findings reported the teacher voices focus on appropriate instructional components to support design of task-based learning through CBI approach, namely learning objective, learning material, learning activity, class organization, delivery mode, skill focus, use of media, learning resource, students’ worksheet and evaluation. In designing CBI tasks, learning objectives firstly formulated based on basic competence, the selection of learning material theme is surrounding-based materials and cultural-based materials, learning activities are organized in pairs and group in order to active interaction process in a learning atmosphere. They recommended to utilize web-based materials as learning resources and arrange students’ worksheet to empower the autonomous practical activity. Additionally, the students’ voices on contents of productive skills tasks clarified the tasks cover vocabulary, specific information, caption of picture, reading text, short dialogue and short paragraph as well as including the integration of language sub skills and skills. It is supportive contents for English learning tasks based on CBI approach.

En Côte d'Ivoire, malgré toutes les actions de lutte, le paludisme demeure un véritable problème de santé publique. À Bouaflé, cette pathologie devenue endémique, sévit différemment dans sa transmission d’un quartier à l’autre, voire d’un ménage à l’autre. Cette contribution a pour objet de déterminer la relation entre la transmission du paludisme et le niveau de vie des ménages. À partir des sources secondaires et des enquêtes sur le terrain, effectuées auprès d’un échantillon de 417 chefs de ménage répartis dans les quartiers retenus, l’analyse des données révèle que la prévalence du paludisme est plus prégnante dans les quartiers huppés tels que Millionnaire, Lopouafla résidentiel et Vahou situés à la périphérie par rapport aux quartiers populaires tels que Dioulabougou, Gropeni et Commerce du centre-ville. Les quartiers huppés situés à la périphérie de ville, encore faiblement urbanisés, présentent plus de biotopes d’anophèles que les quartiers centraux, plus urbanisés. Mots-clés : Bouaflé, distribution spatiale, paludisme, niveau de vie

Abstract Unique patterns of inheritance and selection on Y chromosomes have led to the evolution of specialized gene functions. We report CRISPR mutants in Drosophila of the Y-linked gene, WDY, which is required for male fertility. We demonstrate that the sperm tails of WDY mutants beat approximately half as fast as those of wild-type and that mutant sperm do not propel themselves within the male ejaculatory duct or female reproductive tract. Therefore, although mature sperm are produced by WDY mutant males, and are transferred to females, those sperm fail to enter the female sperm storage organs. We report genotype-dependent and regional differences in sperm motility that appear to break the correlation between sperm tail beating and propulsion. Furthermore, we identify a significant change in hydrophobicity at a residue at a putative calcium-binding site in WDY orthologs at the split between the melanogaster and obscura species groups, when WDY first became Y-linked. This suggests that a major functional change in WDY coincided with its appearance on the Y chromosome. Finally, we show that mutants for another Y-linked gene, PRY, also show a sperm storage defect that may explain their subfertility. Overall, we provide direct evidence for the long-held presumption that protein-coding genes on the Drosophila Y regulate sperm motility.

Background: Recognizing that access to safe and healthy working conditions is a human right, the World Health Organization (WHO) calls for specific occupational safety and health (OSH) programs for health workers (HWs). The WHO health systems’ building blocks, and the International Labour Organization (ILO), highlight the importance of information as part of effective systems. This study examined how OSH stakeholders access, use, and value an occupational health information system (OHIS). Methods: A cross-sectional survey of OSH stakeholders was conducted as part of a larger quasi experimental study in four teaching hospitals. The study hospitals and participants were purposefully selected and data collected using a modified questionnaire with both closed and open-ended questions. Quantitative analysis was conducted and themes identified for qualitative analysis. Ethics approval was provided by the University of Pretoria and University of British Columbia. Results: There were 71 participants comprised of hospital managers, health and safety representatives, trade unions representatives and OSH professionals. At least 42% reported poor accessibility and poor timeliness of OHIS for decision-making. Only 50% had access to computers and 27% reported poor computer skills. When existing, OHIS was poorly organized and needed upgrades, with 85% reporting the need for significant reforms. Only 45% reported use of OHIS for decision-making in their OSH role. Conclusion: Given the gap in access and utilization of information needed to protect worker’s rights to a safe and healthy workplace, more attention is warranted to OHIS development and use as well as education and training in South Africa and beyond.

Capparis sepiaria (Capparaceae) is a plant used in African traditional medicine to treat psychiatic disorders. The aim of this study was to assess the anti-amnesic effect of aqueous lyophilisate of the root bark of Capparis sepiaria (C. sepiaria) on scopolamine-induced animal model of memory impairment using Swiss albino adult mice of both sexes. Memory integrity was assessed by Morris water Maze test, Novel Object Recognition (NOR) and Object-location memory (OLT) tasks were used to assess behavioural components of memory processes and learning. Malondialdehyde (MDA), reduced glutathione (GSH), NO levels and catalase were used to assess oxidative stress while acethylcholinesterase activity was used to evaluate acetylcholine activity in the hippocampus tissues. The quantitative phytochemistry and acute toxicity of the roots of C. sepiaria were also evaluated. The aqueous lyophilisate of C. sepiaria at doses of 10 mg/kg and 40 mg/kg significantly increased the discrimination index in the Morris Water Maze and the objet location tasks. The aqueous lyophilisate of C. sepiaria significantly increased hippocampal GSH and catalase levels and decreased hippocampal MDA, NO levels and achetylcholinesterase (AChE) activities. The aqueous lyophilisate of C. sepiaria showed no acute toxicity with a LD50 > 5000 mg/kg, and revealed a content of flavonoids, tannins and phenols. These results suggest that C. sepiaria improve memory impairment induced by scopolamine and therefore possess antiamnesic properties. These properties would result from a modulation of cholinergic neurotransmission as well as an antioxidant activity of the plant.

Dementia disproportionately affects individuals from disadvantaged backgrounds, including those living in areas of lower neighborhood-level socioeconomic status. It is important to understand whether there are specific neighborhood characteristics associated with dementia risk factors and cognition which may inform dementia risk reduction interventions. We sought to examine whether greenspace, walkability, and crime associated with the cumulative burden of modifiable dementia risk factors and cognition. This was a cross-sectional analysis of 2016–2020 data from the Healthy Brain Project, a population-based cohort of community-dwelling individuals across Australia. Participants were aged 40–70 and free of dementia. Measures included greenspace (greenspace % in the local area, and distance to greenspace, n = 2,181); and intersection density (n = 1,159), and crime (rate of recorded offences; n = 1,159). Outcomes included a modified Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score to index the burden of modifiable vascular dementia risk factors; and composite scores of both memory and attention, derived from the Cogstate Brief Battery. Linear regressions adjusted for age, sex, education, and personal socio-economic status, demonstrated distance to greenspace (b ± SE per 2-fold increase = 0.09 ± 0.03, p =.005) and crime rate (b ± SE per 2-fold increase = 0.07 ± 0.03, p =.018) were associated with higher modified CAIDE. Higher crime was associated with lower memory performance (b ± SE = -0.03 ± 0.01, p =.018). The association between distance to greenspace and modified CAIDE was only present in low-moderate socioeconomic status neighborhoods (p interaction = 0.004). Dementia prevention programs that address modifiable risk factors in midlife should consider the possible role of neighborhood characteristics.

Implementing a cropping intensity program with rice cultivation four times a year (CI 400) can be achieved using early maturing varieties of rice. However, this development needs to pay attention to the adaptability of the varieties planted to ensure successful implementation. The adaptability approach is a combination of assessing stability and productivity potential. This concept has been developed and applied in several studies, including research on rice. However, this approach is considered less comprehensive because it is non-parametric and only focuses on one stability analysis. Therefore, a systematic integration of various stability analyses, including index methods, is needed to comprehensively assess adaptability, particularly for early-maturing rice in South Sulawesi. This region is characterized by a dynamic climate zone and is one of the top four highest rice producers in Indonesia. Meanwhile, this study aims to develop a comprehensive adaptability index and select the best early-maturing rice varieties, especially in South Sulawesi. The investigation was conducted in Bone, Soppeng, and Gowa over two seasons using a nested randomized complete block design, with organized replications in each environment (location-season). Additionally, there was a significant focus on the application of five early-maturing and two check rice varieties, with each factor repeated three times at each location, totaling 126 experimental units. The results showed that the adaptability index, by combining stability rank accumulation with yield min max standardization, was effective at assessing the yield potential and stability of early-maturing rice varieties in supporting CI 400. Inpari 13 had the best index value at 0.55, followed by Cakrabuana at 0.31; hence both were recommended as adaptive early-maturing rice varieties, especially in South Sulawesi.

BackgroundThere is little information regarding the safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke and COVID-19.MethodsThis multicenter study included consecutive stroke patients with and without COVID-19 treated with IV-tPA between February 18, 2019, to December 31, 2020, at 9 centers participating in the CASCADE initiative. Clinical outcomes included modified Rankin Scale (mRS) at hospital discharge, in-hospital mortality, the rate of hemorrhagic transformation. Using Bayesian multiple regression and after adjusting for variables with significant value in univariable analysis, we reported the posterior adjusted odds ratio (OR, with 95% Credible Intervals [CrI]) of the main outcomes.ResultsA total of 545 stroke patients, including 101 patients with COVID-19 were evaluated. Patients with COVID-19 had a more severe stroke at admission. In the study cohort, 85 (15.9%) patients had a hemorrhagic transformation, and 72 (13.1%) died in the hospital. After adjustment for confounding variables, discharge mRS score ≥2 (OR: 0.73, 95% CrI: 0.16, 3.05), in-hospital mortality (OR: 2.06, 95% CrI: 0.76, 5.53), and hemorrhagic transformation (OR: 1.514, 95% CrI: 0.66, 3.31) were similar in COVID-19 and non COVID-19 patients. High-sensitivity C reactive protein level was a predictor of hemorrhagic transformation in all cases (OR:1.01, 95%CI: 1.0026, 1.018), including those with COVID-19 (OR:1.024, 95%CI:1.002, 1.054).ConclusionIV-tPA treatment in patients with acute ischemic stroke and COVID-19 was not associated with an increased risk of disability, mortality, and hemorrhagic transformation compared to those without COVID-19. IV-tPA should continue to be considered as the standard of care in patients with hyper acute stroke and COVID-19.

Background and purposeWhether reperfusion into infarcted tissue exacerbates cerebral edema has treatment implications in patients presenting with extensive irreversible injury. We investigated the effects of endovascular thrombectomy and reperfusion on cerebral edema in patients presenting with radiological evidence of large hemispheric infarction at baseline.MethodsIn a systematic review and individual patient-level meta-analysis of 7 randomized controlled trials comparing thrombectomy versus medical therapy in anterior circulation ischemic stroke published between January 1, 2010, and May 31, 2017 (Highly Effective Reperfusion Using Multiple Endovascular Devices collaboration), we analyzed the association between thrombectomy and reperfusion with maximal midline shift (MLS) on follow-up imaging as a measure of the space-occupying effect of cerebral edema in patients with large hemispheric infarction on pretreatment imaging, defined as diffusion-magnetic resonance imaging or computed tomography (CT)-perfusion ischemic core 80 to 300 mL or noncontrast CT-Alberta Stroke Program Early CT Score ≤5. Risk of bias was assessed using the Cochrane tool.ResultsAmong 1764 patients, 177 presented with large hemispheric infarction. Thrombectomy and reperfusion were associated with functional improvement (thrombectomy common odds ratio =2.30 [95% CI, 1.32–4.00]; reperfusion common odds ratio =4.73 [95% CI, 1.66–13.52]) but not MLS (thrombectomy β=−0.27 [95% CI, −1.52 to 0.98]; reperfusion β=−0.78 [95% CI, −3.07 to 1.50]) when adjusting for age, National Institutes of Health Stroke Score, glucose, and time-to-follow-up imaging. In an exploratory analysis of patients presenting with core volume >130 mL or CT-Alberta Stroke Program Early CT Score ≤3 (n=76), thrombectomy was associated with greater MLS after adjusting for age and National Institutes of Health Stroke Score (β=2.76 [95% CI, 0.33–5.20]) but not functional improvement (odds ratio, 1.71 [95% CI, 0.24–12.08]).ConclusionsIn patients presenting with large hemispheric infarction, thrombectomy and reperfusion were not associated with MLS, except in the subgroup with very large core volume (>130 mL) in whom thrombectomy was associated with increased MLS due to space-occupying ischemic edema. Mitigating cerebral edema-mediated secondary injury in patients with very large infarcts may further improve outcomes after reperfusion therapies.

Preventive zinc supplementation provided as a stand-alone dispersible tablet, or via home fortification as multiple micronutrient powders (MNPs), has been considered a potential strategy to prevent zinc deficiency and improve health (including immune) outcomes among children in low- and middle-income countries. However, the impact of zinc supplementation on immune profiles has not been well characterized. We sought to define the effect of zinc supplementation on peripheral blood gene expression and cytokine levels among young children in Dhaka, Bangladesh. In a sub-study of a large randomized, controlled, community-based efficacy trial where children 9-11 months of age received one of the following interventions on a daily basis for 24 weeks: (1) MNPs containing 10 mg of zinc; (2) dispersible tablet containing 10 mg zinc; or (3) placebo powder, we used RNA sequencing to profile the peripheral blood gene expression, as well as highly sensitive multiplex assays to detect cytokine profiles. We profiled samples from 100 children enrolled in the parent trial (zinc MNPs 28, zinc tablets 39, placebo 33). We did not detect an effect from either zinc intervention on differential peripheral blood gene expression at the end of the intervention, or an effect from the intervention on changes in gene expression from baseline. We also did not detect an effect from either intervention on cytokine concentrations. Exploratory analysis did not identify an association between undernutrition (defined as stunting, underweight or wasting) and peripheral blood gene expression. Zinc interventions in children did not produce a gene expression or cytokine signature in the peripheral blood. However, this study demonstrates a proof of principle that sensitive multi-omic techniques can be applied to samples collected in field studies.

To increase the resilience of farmers' livelihood systems, detailed knowledge of adaptation strategies for dealing with the impacts of climate change is required. Knowledge co-production approach is an adaptation strategy that is considered appropriate in the context of the increasing frequency of disasters caused by climate change. Previous research of knowledge co-production on climate change adaptation in Indonesia is insufficient, particularly at local level, so we examined the flow of climate change adaptation knowledge in the knowledge co-production process through climate field school (CFS) activities in this study. We interviewed 120 people living in Bulukumba Regency, South Sulawesi Province, Indonesia, involving 12 crowds including male and female farmers participated in CFS and not participated in CFS, local government officials, agriculture extension workers, agricultural traders, farmers' family members and neighbors, etc. In brief, the 12 groups of people mainly include two categories of people, i.e., people involved in CFS activities and outside CFS. We applied descriptive method and Social Network Analysis (SNA) to determine how knowledge flow in the community network and which groups of actors are important for knowledge flow. The findings of this study reveal that participants in CFS activities convey the knowledge they acquired formally (i.e., from TV, radio, government, etc.) and informally (i.e., from market, friends, relatives, etc.) to other actors, especially to their families and neighbors. The results also show that the acquisition and sharing of knowledge facilitate the flow of climate change adaptation knowledge based on knowledge co-operation. In addition, the findings highlight the key role of actors in the knowledge transfer process, and key actors involved in disseminating information about climate change adaptation. To be specific, among all the actors, family member and neighbor of CFS actor are the most common actors in disseminating climate knowledge information and closest to other actors in the network; agricultural trader and family member of CFS actor collaborate most with other actors in the community network; and farmers participated in CFS, including those heads of farmer groups, agricultural extension workers, and local government officials are more willing to contact with other actors in the network. To facilitate the flow of knowledge on climate change adaptation, CFS activities should be conducted regularly and CFS models that fit the situation of farmers’ vulnerability to climate change should be developed.

Objectives. To ascertain whether and how working as a partnership of two World Health Organization collaborating centres (WHOCCs), based respectively in the Global North and Global South, can add insights on “what works to protect healthcare workers (HCWs) during a pandemic, in what contexts, using what mechanism, to achieve what outcome”. Methods. A realist synthesis of seven projects in this research program was carried out to characterize context (C) (including researcher positionality), mechanism (M) (including service relationships) and outcome (O) in each project. An assessment was then conducted of the role of the WHOCC partnership in each study and overall. Results. The research found that lower-resourced countries with higher economic disparity, including South Africa, incurred greater occupational health risk and had less acceptable measures to protect HCWs at the onset of the COVID-19 pandemic than higher-income more-equal counterpart countries. It showed that rigorously adopting occupational health measures can indeed protect the healthcare workforce; training and preventive initiatives can reduce workplace stress; information systems are valued; and HCWs most at-risk (including care aides in the Canadian setting) can be readily identified to trigger adoption of protective actions. The C-M-O analysis showed that various ways of working through a WHOCC partnership not only enabled knowledge sharing, but allowed for triangulating results and, ultimately, initiatives for worker protection. Conclusions. The value of an international partnership on a North-South axis especially lies in providing contextualized global evidence regarding protecting HCWs as a pandemic emerges, particularly with bi-directional cross-jurisdiction participation by researchers working with practitioners.

BackgroundThe emergence of the COVID-19 pandemic has significantly impacted global healthcare systems and this may affect stroke care and outcomes. This study examines the changes in stroke epidemiology and care during the COVID-19 pandemic in Zanjan Province, Iran.MethodsThis study is part of the CASCADE international initiative. From February 18, 2019, to July 18, 2020, we followed ischemic and hemorrhagic stroke hospitalization rates and outcomes in Valiasr Hospital, Zanjan, Iran. We used a Bayesian hierarchical model and an interrupted time series analysis (ITS) to identify changes in stroke hospitalization rate, baseline stroke severity [measured by the National Institutes of Health Stroke Scale (NIHSS)], disability [measured by the modified Rankin Scale (mRS)], presentation time (last seen normal to hospital presentation), thrombolytic therapy rate, median door-to-needle time, length of hospital stay, and in-hospital mortality. We compared in-hospital mortality between study periods using Cox-regression model.ResultsDuring the study period, 1,026 stroke patients were hospitalized. Stroke hospitalization rates per 100,000 population decreased from 68.09 before the pandemic to 44.50 during the pandemic, with a significant decline in both Bayesian [Beta: -1.034; Standard Error (SE): 0.22, 95% CrI: -1.48, -0.59] and ITS analysis (estimate: -1.03, SE = 0.24, p

Many low- and middle-income countries (LMICs) grapple with shortages of health workers, a crucial component of robust health systems. The COVID-19 pandemic underscored the imperative for appropriate staffing of health systems and the occupational health (OH) threats to health workers. Issues related to accessibility, coverage, and utilization of OH services in public sector health facilities within LMICs were particularly accentuated during the pandemic. This paper draws on the observations and experiences of researchers engaged in an international collaboration to consider how the South African concept of Ubuntu provides a promising way to understand and address the challenges encountered in establishing and sustaining OH services in public sector health facilities. Throughout the COVID-19 pandemic, the collaborators actively participated in implementing and studying OH and infection prevention and control measures for health workers in South Africa and internationally as part of the World Health Organizations’ Collaborating Centres for Occupational Health. The study identified obstacles in establishing, providing, maintaining and sustaining such measures during the pandemic. These challenges were attributed to lack of leadership/stewardship, inadequate use of intelligence systems for decision-making, ineffective health and safety committees, inactive trade unions, and the strain on occupational health professionals who were incapacitated and overworked. These shortcomings are, in part, linked to the absence of the Ubuntu philosophy in implementation and sustenance of OH services in LMICs.

Introduction The benefit of additional reperfusion attempts in patients with partial angiographic reperfusion (TICI2b) is unknown. The PROCEED model predicts subsequent favorable occurrence of complete reperfusion (i.e. delayed reperfusion [DR]) at 24 hours after initial incomplete angiographic reperfusion at the conclusion of thrombectomy. This study aims to externally validate the PROCEED model using pooled data from multiple international trials that systematically performed follow‐up perfusion imaging. Methods Individual patient data for external validation were obtained from the EXTEND‐IA, EXTEND‐IA TNK part 1 and 2 trials (clinicaltrials.gov, unique‐identifier: NCT01492725, NCT02388061 and NCT03340493). The model’s primary outcome of interest was the occurrence of DR, defined as the absence of any focal perfusion deficit on follow‐up CT or MRI perfusion imaging maps, despite initial incomplete angiographic reperfusion on the final thrombectomy angiography series. The updated model’s performance was evaluated with discrimination, calibration and clinical decision curves. Results We analyzed 267 patients for the external validation, with median age of 74 (IQR 64 – 80), 44.2% were female and 62% had DR. The externally validated model had good discrimination (C‐statistic 0.81, 95% CI 0.72 – 0.86) and was well calibrated (intercept 0.22, 95% CI 0.18‐0.33 and slope 0.96, 95% CI 0.81‐1.23). With threshold probability of R=12% (i.e. 88% chance of having DR), pursuing additional reperfusion attempts to pursue complete angiographic reperfusion in a patient with high‐likelihood of DR were seven times worse (Cost:Benefit Ratio 1:7, Figure 1) than no further endovascular maneuver. In terms of standardized net reduction, the PROCEED model could reduce one in five unnecessary interventions without missing an intervention for any patient who would eventually have DR. Across a wide range of threshold probabilities, the model outperformed the scenario of the typical decision‐making process in the angiography suite, based on the current treatment guidelines. Conclusion The externally validated model had good predictive accuracy and discrimination. Depending on the acceptable risk threshold, the model may compliment clinical judgment of the treating physicians and inform on natural progression of untreated incomplete reperfusion.

Background and purposeThe novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic.MethodsThis is an international, multicenter, hospital-based study on stroke incidence and outcomes during the COVID-19 pandemic. We will describe patterns in stroke management, stroke hospitalization rate, and stroke severity, subtype (ischemic/hemorrhagic), and outcomes (including in-hospital mortality) in 2020 during COVID-19 pandemic, comparing them with the corresponding data from 2018 and 2019, and subsequently 2021. We will also use an interrupted time series (ITS) analysis to assess the change in stroke hospitalization rates before, during, and after COVID-19, in each participating center.ConclusionThe proposed study will potentially enable us to better understand the changes in stroke care protocols, differential hospitalization rate, and severity of stroke, as it pertains to the COVID-19 pandemic. Ultimately, this will help guide clinical-based policies surrounding COVID-19 and other similar global pandemics to ensure that management of cerebrovascular comorbidity is appropriately prioritized during the global crisis. It will also guide public health guidelines for at-risk populations to reduce risks of complications from such comorbidities.

The phenomenon of poor English language proficiency among Indonesian students suggests revisiting the instructional methods that have long been commonly used in English as a foreign language (EFL) classrooms. This long-lasting problem makes it essential for English practitioners to seek alternative approaches paving the ground for the EFL learners to reach more promising achievements. One of the approaches that may fill in this lacuna is Pair-Interaction Model (PIM). Therefore, the present study was an attempt to disclose the effects of PIM on fostering Indonesian EFL learners’ proficiency compared to the Grammar-Translation Method (GTM). For this purpose, a total of 90 first-year English students from three renowned universities in South Sulawesi, i.e. Hasanuddin University, Indonesian Moslem University situated in Makassar, and the Muhammadiyah University of Pare-Pare, were selected using a purposive sampling technique. The participants went through a pre-test, an intervention, and a post-test procedures. Findings revealed that the English proficiency of the participants who received instructions based on the principles and procedures of PIM significantly improved at the end of the interventions. This improvement was particularly seen in the participants’ grammar knowledge and speaking skills. The findings offered strong evidence that PIM can be implemented in the Indonesian classes to foster EFL learners’ proficiency. The study concludes by offering some implications for relevant stakeholders and opening up some avenues for further research.

This study aimed to carry out a comparative study of the main models of chronic epilepsy induced by pentylenetetrazole (PTZ)-kindling method and to assess the efficacy of sodium valproate, one of the main antiepileptics, on the best epilepsy-inducing kindling model. Two sets of 24 animals were divided into 4 groups of 6 animals and treated as follow: Set 1 included: group 1, control; group 2, the classic kindling PTZ group (UKEOD); group 3, PTZ kindling every other day group with challenge (CKEOD); group 4, PTZ kindling every day group, with challenge (CKED); Set 2 included: group 1, control; group 2, CKEOD group; group 3 and 4, receiving either valproate 200 mg/kg or valproate 300 mg/kg + CKEOD procedure. Results show that CKEOD group significantly reduced the number of injections necessary to reach the fully-kindled state, increased the severity of seizures and improved the stability of seizures. In addition, the CKEOD group significantly increased the level of malondialdehyde and GABA transaminase, reduced the level of reduced glutathione, catalase and GABA. Furthermore, it had no impact on plasma levels of alanine aminotransferase (ALAT) and aspartate aminotransferase (ASAT). Valproate 300 mg/kg significantly protected animals against kindling induced by CKEOD. The kindling model with a challenge dose administered on day 1 (CKEOD) thus allows to induce more severe, more stable chronic epilepsy and in a shorter period of time, and could thus contribute to a better understanding of epilepsy, as well as its uses in drug discovery.

This study aimed to determine the effect of each component of cultivation technology application on the production of rice (Oryza Sativa L.) in South Sulawesi. This research was carried out in three rain-type sectors within South Sulawesi Province, namely Maros for the West Sector, Bone for the East Sector, and North Luwu for the Transitional sector. A study was conducted from December 2019 to January 2020 in the form of a survey (study literature, observation, and interviews), with the selection of samples carried out purposively to 90 respondents. Data analysis employed multiple linear regression with SPSS software. The results showed that the average rice production in Maros, Bone and North Luwu regencies, South Sulawesi, was still relatively low, Maros Regency was 7,032 kg per ha, Bone was 5,020 kg per ha and North Luwu was 6,497 kg per ha. The multiple regression equation for rice production in Maros, Bone and North Luwu Regencies, South Sulawesi is Y = 3354,185 -17,751X1 – 4,044X2 +36,839X3 . Factors from the aspect of cultivation technology application can increase rice production. Variables of cropping system, irrigation system, and fertilizer dose had a significant effect on rice production, while the variables of varieties and harvest time did not have a significant effect on rice production.

Bulukumba Regency is one of the major rice-producing areas in South Sulawesi, Indonesia and has experienced frequent climate disasters over the past decade. Several downstream villages within the Bettu River irrigation area have been affected by the drought, culminating in reduced lowland rice production and increasing the vulnerability of farmers’ livelihoods. This study aims to evaluate the vulnerability of the livelihood system among rice farmers in the Bettu River irrigation area by classifying the area into two zones based on the distance from the main irrigation canal, namely the upstream area and downstream area. The livelihood vulnerability index (LVI) framework and livelihood vulnerability index-Intergovernmental Panel on Climate Change (LVI-IPCC) approach were applied by selecting geographic and socio-demographic indicators that affected the farmer households, including 8 major components and 26 sup-components. The data for LVI-IPCC estimation were collected by randomly selecting 132 households from villages in the two areas. The empirical results showed that farmers in the downstream area were more vulnerable to climate change than farmers in the upstream area. The major components causing the livelihood vulnerability of the downstream farmers were livelihood strategy, food, water, land, health, as well as natural disasters and climate variability. In particular, the sub-components of agricultural livelihood diversification, consistent water supply for farming, and drought events were important in the downstream area. Farmers in the upstream area were vulnerable to socio-demographic profile and social network components. The LVI-IPCC findings suggested that the government should prioritize farmers in the downstream area to develop resilience strategies, particularly by increasing irrigation infrastructure and the number of reservoirs and drilling holes. Furthermore, to increase their adaptive capacity in terms of diversification of agricultural livelihood systems, the government and donor agencies need to provide trainings on the development of home food industries for poor farmers and vulnerable households that were affected by disasters.

The COVID-19 pandemic highlighted hurdles for healthcare delivery and personnel globally. Vaccination has been an important tool for preventing severe illness and death in healthcare workers (HCWs) as well as the public at large. However, vaccination has resulted in some HCWs requiring time off work post-vaccination to recover from adverse events. We aimed to understand which HCWs needed to take time off work post-vaccination, for which vaccine types and sequence, and how post-vaccination absence impacted uptake of booster doses in a cohort of 26,267 Canadian HCWs. By March 31, 2022, more than 98% had received at least two doses of the approved COVID-19 vaccines, following a two-dose mandate. We found that recent vaccination and longer intervals between doses were associated with significantly higher odds of time-loss, whereas being a medical resident and receiving the BNT162b2 vaccine were associated with lower odds. A history of lab-confirmed SARS-CoV-2 infection was associated with lower odds of receiving a booster dose compared with no documented infection, aOR 0.61 (95% CI: 0.55, 0.68). Similarly, taking sick time following the first or second dose was associated with lower odds of receiving a booster dose, aOR 0.83 (95% CI: 0.75, 0.90). As SARS-CoV-2 becomes endemic, the number and timing of additional doses for HCWs requires consideration of prevention of illness as well as service disruption from post-vaccination time-loss. Care should be taken to ensure adequate staffing if many HCWs are being vaccinated, especially for coverage for those who are more likely to need time off to recover.

Recently, Social Sustainability has gained significant value as it was considered by the late studies as a principal dimension along with the environmental and economic sustainability. And because of, on the other hand, the significant social role of the school for forming the student’s personality, this research is an appeal for rehabilitating and promoting Iraqi Schools according the issue of social sustainability.As there is no evaluation for the Iraqi Schools, the research is dedicated to this problem, aiming to carry out the stated evaluation and define the design treatments needed for the rehabilitation process. To achieve this goal, a theoretical background for the concept of social sustainability, its criteria, the school and its social functions was introduced. From reviewing previous architectural practices and theoretical studies, different design treatments were extracted and structured within the level of the building itself and the outside landscape. The design treatments were, then, applied to rehabilitate a selected standard school model used by the Directorate of Education in Nineveh Governorate. Evaluating the proposed model, the conclusions demonstrated the possibility of rehabilitating the existing Iraqi Schools to hold most indicators of social sustainability