Effect of circulating ceramides on adiposity and insulin resistance in patients with type 2 diabetes: An observational cross-sectional study.

INTRODUCTION: Insulin resistance (IR) is one of the common chronic metabolic disorders in Africa and elsewhere. Accumulation of lipids in the body may be due to an imbalance in the metabolism of lipids, glucose and proteins. Ceramides are a sphingolipid class of lipids that are biologically active and vital in the production of more complex lipids. Circulating ceramides are thought to have a role in the development of obesity-related IR, although the precise involvement remains unclear. AIM: To investigate the impact of circulating ceramide on IR and body adiposity in people with and without type 2 diabetes mellitus (T2DM). METHODOLOGY: The study was observational and cross-sectional. There were a total of 84 volunteers with T2DM and 75 nondiabetics (control). The participants' ages, body mass indexes (BMI), waist circumferences, and blood pressure (BP) were among the clinical parameters assessed. Ceramide levels, fasting plasma glucose (FPG), lipids, basal insulin levels and glycated haemoglobin (HbA1c) were also measured. Additionally, the homeostatic model assessment for IR (HOMA-IR) and beta cell function (HOMA-ß) were computed. RESULTS: T2DM and control participants had different mean values for anthropometric parameters, BP, FPG, HbA1c, lipids, insulin, HOMA-IR, HOMA-ß and ceramide levels (p < .05 for all). HOMA-IR, HOMA-ß and cardiovascular risk were significant correlates with ceramide levels in the T2DM group (r = 0.24; -0.34; 0.24, p < .05, respectively). Further, FPG (OR = 1.83, p = .01) and ceramide (OR = 1.05, p = .01) levels were significant predictors of IR in the case group. CONCLUSION: Patients with T2DM exhibited high ceramide concentrations, which, when combined with high FPG, were associated with IR. The consequences of circulating ceramides in health and disease; however, merit further research.

District-level analysis of socio-demographic factors and COVID-19 infections in Greater Accra and Ashanti regions, Ghana

Since December 2019 when COVID-19 was detected, it took the world by surprise in terms of spread and morbidity/mortality. The high rate of spread and casualties recorded from COVID-19 called for research in all directions to find ways to contain and reverse the incidences. It is against this background that this paper sought to measure the association of the socio-demographic factors in the hard-hit districts in Greater Accra and Ashanti to analyze its relationship with the novel COVID-19 virus. Data on COVID-19 cases from 35 Districts in both Greater Accra and Ashanti Regions were collected from the Ghana Health Service and population data from Ghana Statistical Service. Descriptive statistics and regression analysis were generated using R. We found that some socio-demographic variables have an association with COVID-19 infections. For example, age and religion especially Christianity and Islam pose risk to COVID-19. The population aged 15–64 was particularly at high risk of infections due to the high level of movement of this age group. We, therefore, recommend that places of congregation such as Churches and Mosques be targeted for vigorous sensitization on COVID-19 protocols and prevention. Also, districts with a high population between the ages of 15–64 should step sensitization efforts to educate their inhabitants on the need to reduce travel and related activities to curb the spread of the virus.

Characterization of COVID-19 Pre-Surgical Screening Amongst Ophthalmic Patients

Purpose : During the COVID-19 pandemic, ophthalmologists were presented with the challenge of providing safe care to patients while limiting the spread of COVID-19. As a result, many institutions implemented universal pre-surgical COVID-19 screening prior to surgery for all patients. The goals of this study are to characterize the rate of COVID-19 positivity during pre-surgical screening at our institution, the surgical outcomes experienced in COVID-19 positive ophthalmic patients, and to report overall cost of universal pre-surgical screening. Methods : This retrospective study included patients ≥ 18 years who underwent ophthalmic surgical procedures at a tertiary institution between May 11, 2020 and December 31, 2020. Patients without a valid pre-surgical COVID-19 test within the three days prior to their scheduled procedure, incomplete or mislabeled visits, and incomplete or missing data in their file were excluded. COVID-19 screening was completed by the Thermo Fisher TaqPath Polymerase Chain Reaction (PCR) kit. Results : Of the 3,585 patients who met inclusion criteria, 2,044 patients (57.02%) were female, and the average age was 68.2 ± 12.8 years (mean ± standard deviation). 13 asymptomatic patients (0.36%) tested positive for COVID-19 via PCR screening. Three patients had known positive COVID-19 infection within the 90 days prior to surgery, thus 10 patients (0.28%) were found to have asymptomatic naïve COVID-19 infection via PCR. Testing was associated with a total charge of $788,700. Five of the 13 COVID-19 positive patients (38.46%) experienced a delay in their surgery. The average surgical delay was 17.23 ± 22.97 days (mean ± standard deviation). Conclusions : Asymptomatic ophthalmic surgical patients experienced a low positivity rate with a limited impact on surgery scheduling at a significant cost. Further studies would be valuable in evaluating a targeted pre-surgical screening population as opposed to universal testing.

Integration of multiple geospatial applications and intelligence for responding to COVID-19 in Ghana.

OBJECTIVE: We describe the use of integrated geospatial applications for the provision of access to timely and accurate data on samples, visualisation of Spatio-temporal patterns of cases and effective communication between field sample collectors, testing laboratories, Regional Health directors and Government Decision Makers. DESIGN: This study describes how an integrated geospatial platform based on case location and intelligence was developed and used for effective COVID-19 response during the initial stages of COVID-19 in Ghana. DATA SOURCE: Collector for ArcGIS, ArcGIS Survey123. MAIN OUTCOME MEASURE: successful development and deployment of integrated geospatial applications and analytics. RESULTS: The Collector for ArcGIS app was customised to collect COVID-19 positive cases location information. Survey 123 was introduced as a COVID-19 contact tracing application to digitise the case-based forms and provide real-time results from the laboratories to GHS and other stakeholders. The laboratory backend allowed the testing laboratories access to specific information about each patient (sample) collected by the fieldworkers. The regional supervisors' backend web application provided accessing test results for confidentiality and timely communication of results. CONCLUSION: Geospatial platforms were successfully established in Ghana to provide timely results to Regional Health Directors and Government decision-makers. This helped to improve the timeliness of response and contact tracing at the district level. FUNDING: The development and deployment of the application, COVID-19 pandemic response and writing workshop by the Ghana Field Epidemiology and Laboratory Training Programme (GFELTP) was supported with funding from President Malaria Initiative - CDC, and Korea International Cooperation Agency (on CDC CoAg 6NU2GGH001876) through AFENET and the United States Agency for International Development (USAID) through Results for Development (R4D).

Preliminary findings from stimulated spontaneous reporting of adverse drug reactions during COVID-19 pandemic: an experience from Ghana.

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is limited information on the safety of drugs used for the treatment of COVID-19. OBJECTIVE: Objective of this study is to describe the pattern of stimulated spontaneous adverse drug reaction (ADR) reports received from healthcare professionals for SARS-CoV-2 positive patients in Ghana and lessons learnt particularly for low- and middle-income countries. METHODS: This is a study of individual case safety reports (ICSRs) received from healthcare professionals between 1st April 2020 to 31st July 2020 in SARS-CoV-2 positive patients in Ghana. The ICSRs were retrieved from the SafetyWatch System and descriptive statistics used to describe the ADRs by System Organ Classification and Preferred Term. RESULTS: Information was received from 40 COVID-19 Treatment Centres across the country with 9 centres submitting a total of 53 ICSRs containing 101 ADRs; approximately two ADRs per ICSR. Females accounted for 29(54.7%) of the ICSRs and males 24(45.3%). Newly reported ADRs of interest were one report each of tremor for doxycycline; scrotal pain, dyspnoea, gait disturbances and dysgeusia for chloroquine; and dry throat, hyperhidrosis, restlessness and micturition frequency increased for hydroxychloroquine. A strong spontaneous system with the availability of focal persons at the Treatment Centres played a key role in reporting ADRs during the pandemic. CONCLUSION: This is the first experience with spontaneous reporting during COVID-19 pandemic in Ghana. The profile of most of the ADRs reported appears consistent with what is expected from the summary of product characteristics. A study with a larger sample size with well-defined denominator in future studies is paramount in determining the relative risk of these medications in SARS-CoV-2 positive patients. FUNDING: None declared.

A Multicenter Evaluation of the Feasibility, Patient/Provider Satisfaction, and Value of Virtual Spine Consultation During the COVID-19 Pandemic.

OBJECTIVE: To assess the feasibility, patient/provider satisfaction, and perceived value of telehealth spine consultation after rapid conversion from traditional in-office visits during the COVID-19 pandemic. METHODS: Data were obtained for patients undergoing telehealth visits with spine surgeons in the first 3 weeks after government restriction of elective surgical care at 4 sites (March 23, 2020, to April 17, 2020). Demographic factors, technique-specific elements of the telehealth experience, provider confidence in diagnostic and therapeutic assessment, patient/surgeon satisfaction, and perceived value were collected. RESULTS: A total of 128 unique visits were analyzed. New (74 [58%]), preoperative (26 [20%]), and postoperative (28 [22%]) patients were assessed. A total of 116 (91%) visits had successful connection on the first attempt. Surgeons felt very confident 101 times (79%) when assessing diagnosis and 107 times (84%) when assessing treatment plan. The mean and median patient satisfaction was 89% and 94%, respectively. Patient satisfaction was significantly higher for video over audio-only visits (P < 0.05). Patient satisfaction was not significantly different with patient age, location of chief complaint (cervical or thoracolumbar), or visit type (new, preoperative, or postoperative). Providers reported that 76% of the time they would choose to perform the visit again in telehealth format. Sixty percent of patients valued the visit cost as the same or slightly less than an in-office consultation. CONCLUSIONS: This is the first study to demonstrate the feasibility and high patient/provider satisfaction of virtual spine surgical consultation, and appropriate reimbursement and balanced regulation for spine telehealth care is essential to continue this existing work.

Leveraging public data to offer online inquiry opportunities.

Inquiry activities have become increasingly common in Ecology and Evolution courses, but the rapid shift to remote instruction for many faculty members in response to the COVID-19 pandemic has created new challenges for maintaining these student-centered activities in a distance learning format. Moving forward, many instructors will be asked to create flexible course structures that allow for a mix of different teaching modalities and will be looking for resources to support student inquiry in both online and in-person settings. Here, we propose the use of data-driven inquiry activities as a flexible option for offering students experiences to build career-relevant skills and learn fundamental ecological concepts. We share lessons learned from our experiences teaching a two-semester course-based research experience in global change ecology that leverages publicly available datasets to engage students in broadly relevant scientific inquiry.