Neuromuscular disease: 2021 update.

This review highlights ten important advances in the neuromuscular disease field that were first reported in 2020. The overarching topics include (i) advances in understanding of fundamental neuromuscular biology; (ii) new / emerging diseases; (iii) advances in understanding of disease etiology and pathogenesis; (iv) diagnostic advances; and (v) therapeutic advances. Within this broad framework, the individual disease entities that are discussed in more detail include neuromuscular complications of COVID-19, supervillin-deficient myopathy, 19p13.3-linked distal myopathy, vasculitic neuropathy due to eosinophilic granulomatosis with polyangiitis, spinal muscular atrophy, idiopathic inflammatory myopathies, and transthyretin neuropathy/myopathy. In addition, the review highlights several other advances (such as the revised view of the myofibrillar architecture, new insights into molecular and cellular mechanisms of muscle regeneration, and development of new electron microscopy tools) that will likely have a significant impact on the overall neuromuscular disease field going forward.

Superior Mesenteric Artery Thrombosis and Intestinal Ischemia as a Consequence of COVID-19 Infection.

COVID-19-associated arterial and venous thrombotic events are multifactorial in origin, resulting in significant morbidity and mortality. Intestinal ischemia due to thrombus is a rare manifestation of COVID infection. Here, we report the case of a patient who presented with fever, malaise, and diarrhea, and was found to be COVID-19 positive; his clinical course was further complicated by devastating thrombosis of the superior mesentery artery (SMA) associated with COVID-19 infection.

optimizing Security based on Face Recognition in Small Spaces

In the current pandemic, which started on last 2020, there are many limitations we should do for reducing the spread of the virus named covid19. Keeping the distance from others is the way to prevent infected covid19. Contactless technology should be developed further, for example, in this paper. Access Control System by Face recognition and Biometrics is one reason to be developed. OpenCV is a tool that will use to build face recognition. This system is only intended for small office areas or smart homes. Currently, only five registered users. The data registration process is carried out outside the system or only loads an algorithm model. This system will also provide information on social media, Whatsapp, if a known person enters the room or an unknown person. © 2022 IEEE.

Covid-19 Lockdown Measures and Presumptive Taxation in Zimbabwe

This desktop study evaluated the effects of lockdown measures on Zimbabwe's presumed taxation. As a result of the COVID-19-induced health-care crisis, the Zimbabwean government, like many countries around the world, imposed a lockdown. This has diverse effects on various tax systems. This article examined the literature regarding the effects of lockdown measures on Zimbabwe's presumptive taxation. The study's methodology differed from the traditional approach to research as it focused more on literature review and the findings, conclusions and recommendations were based on the reviewed literature. The results showed that COVID-19-induced lockdown restrictions affected ZIMRA's presumptive tax collection and the livelihood of informal merchants. One of the factors that aggravated the harm was the short notice in declaring lockdown enforcement. According to the findings, it will take some time for presumptive tax collections to recover. To hasten this process, the Zimbabwean government must provide aid to small business owners to enable them resume operations. In addition, there is an urgent need to educate informal merchants about health risks such as COVID-19, and support from the formal sector and international donors should ensure that informal traders such as vegetable vendors, cobblers, and transport operators have protective equipment as recommended by medical experts so that they can continue to conduct business safely and pay their presumptive taxes in time.

The Possible Role of Allicin in Ameliorating Azithromycin Induced Cardiotoxicity in Adult Male Albino Rat: A Histological and Immunohistochemical Study

Introduction: Azithromycin (AZ) is a broad-spectrum macrolide that is incorporated in the treatment of various infectious diseases, and recently enlisted in the protocol of Covid-19 management. Allicin is a classical garlic extraction with cardioprotective, antioxidant, anti-inflammatory, and anti-apoptotic properties. Aim of the Work: To evaluate the cardiotoxic effect of AZ and evaluate the possible protective effect of Allicin against AZ cardiotoxicity using various histological and immunohistochemical techniques. Materials and Methods: Forty adult male albino rats were randomly divided into four main groups: group-I acted as a control group, group-II was given Allicin (20 mg/kg/day) orally for consecutive 14 days, group-III was given AZ (30 mg/kg/ day) orally for consecutive 14 days and group-IV was given both AZ and Allicin in the same doses for consecutive 14 days. The cardiac specimens were processed for different histological and immunohistochemical techniques. Morphometrical and statistical studies were also done. Results: Azithromycin induced several myocardial changes in the form of focal areas of destruction of cardiac muscle fibers, darkly stained pyknotic nuclei and cytoplasmic vacuoles. Wavy muscle fibers, widening of the intercellular spaces, mononuclear cellular infiltration, fatty infiltration and hemorrhage were obvious. Dilated and congested blood vessels were also noticed. A significant increase in the mean area percentage of both Masson and α-SMA immunoreactivity was detected while a significant decrease in the mean area percentage of Bcl-2 was demonstrated. In contrast, most of the histological changes disappeared by Allicin co-treatment except in few localized areas. Conclusion: Azithromycin induced several destructive changes in cardiac muscle fibers. Allicin had a potent ameliorative role in prevention of cardiotoxicity induced by AZ. © 2022. All rights served.

Smart lab medicine in the digital era

The world of Biomedical innovation is complex and diverse, full of promising technologies that will improve care, the patient-physician relationship and take laboratory medicine and healthcare to the next level. The COVID-19 pandemic has significantly favored digital transitions and emerging technologies to deal with emergency health situations, the shift towards remote working and mobility restrictions. The use of cutting-edge technologies, including artificial intelligence (AI), big data, telemedicine, blockchain, 5G technology, smart applications, Internet of Medical Things (IoMT), robotics, geospatial technology, and drones are substantially important for COVID-19 detecting, monitoring, diagnosing, screening, surveillance, mapping, tracking, and creating awareness. Smart technologies are transforming healthcare and smartphone applications that connect large populations can be configured to tackle emergency situations. Patients have moved dramatically toward online channels. Technology and social media companies are already on their own mission to achieve global spread, reaching a point where everyone on this planet who wants one can have a digital and online presence. Smart healthcare not only means adopting new products and technologies for diagnosis and treatment, but it includes a greater exchange of information among the parties. With smart medical devices paving the way for physicians and specialists of lab medicine to monitor patients outside of the hospital and sensor and imaging technology evolving at a rapid rate, the amount of valuable patient data the healthcare world collects will continue to increase. The crisis has demonstrated that it is impossible to ignore technological advancements and the digital opportunities that can support the long-term sustainable development of each country. Digital transformation is changing the face of healthcare;however, to effectively use these technologies, we first need to fully understand the challenges that the healthcare sector experiences from multiple perspectives, including patients, healthcare professionals, management and public health.

Avoidant restrictive food intake disorder emerging during COVID-19 pandemic resulting in superior mesenteric artery syndrome.

The COVID-19 pandemic has significantly increased the prevalence of psychiatric disorders within pediatric populations. However, only a limited number of studies have sought to understand the correlation between the pandemic and increased incidence of eating disorders. This case study highlights the hospital course of an 18-year-old female who presented with restrictive eating patterns and intensive exercise regimen, self-attributed to the COVID-19 pandemic, leading to superior mesenteric artery syndrome. In understanding the patient's avoidant restrictive food intake disorder (ARFID), this case study seeks to inform readers of this newer DSM-V diagnosis with the intent of educating pediatric providers of the severity and long-term impact of this disease. Moreover, the case study highlights the importance of gaining a more holistic view of psychiatric disorders emerging as a result of the COVID-19 pandemic.

Research on the mechanism of berberine in the treatment of COVID-19 pneumonia pulmonary fibrosis using network pharmacology and molecular docking.

Purpose Pulmonary fibrosis caused by COVID-19 pneumonia is a serious complication of COVID-19 infection, there is a lack of effective treatment methods clinically. This article explored the mechanism of action of berberine in the treatment of COVID-19 (Corona Virus Disease 2019, COVID-19) pneumonia pulmonary fibrosis with the help of the network pharmacology and molecular docking. Methods We predicted the role of berberine protein targets with the Pharmmapper database and the 3D structure of berberine in the Pubchem database. And GeneCards database was used in order to search disease target genes and screen common target genes. Then we used STRING web to construct PPI interaction network of common target protein. The common target genes were analyzed by GO and KEGG by DAVID database. The disease-core target gene-drug network was established and molecular docking was used for prediction. We also analyzed the binding free energy and simulates molecular dynamics of complexes. Results Berberine had 250 gene targets, COVID-19 pneumonia pulmonary fibrosis had 191 gene targets, the intersection of which was 23 in common gene targets. Molecular docking showed that berberine was associated with CCl2, IL-6, STAT3 and TNF-α. GO and KEGG analysis reveals that berberine mainly plays a vital role by the signaling pathways of influenza, inflammation and immune response. Conclusion Berberine acts on TNF-α, STAT3, IL-6, CCL2 and other targets to inhibit inflammation and the activation of fibrocytes to achieve the purpose of treating COVID-19 pneumonia pulmonary fibrosis.

When Two Is Better Than One: A Pilot Study on Transcranial Magnetic Stimulation Plus Muscle Vibration in Treating Chronic Pelvic Pain in Women.

Chronic pelvic pain syndrome (CPPS) affects about 4-16% of adult women, and about one-third of them require medical assistance due to severe symptoms. Repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area (SMA) has been shown to manage pain in refractory CPPS. Focal muscle vibration (FMV) has also been reported to relieve pelvic pain. The objective of this study was to assess the feasibility and effect of rTMS coupled with FMV to reduce pain in seven adult women with refractory CPPS. This pilot, open-labeled, prospective trial examined treatment by 5 Hz rTMS over SMA and 150 Hz FMV over the perineum, suprapubic, and sacrococcygeal areas, with one daily session for five consecutive days for three weeks. We assessed tolerance and subjective pain changes (as per visual analog scale, VAS) until one month post-treatment, with a primary endpoint at day 7. No patients experienced serious adverse effects or a significant increase in pain. Six out of seven patients experienced a VAS improvement of at least 10% at T7; three of these individuals experienced a VAS improvement of more than 30%. Overall, we found a significant VAS reduction of 15 points (95% CI 8.4-21.6) at T7 (t = 6.3, p = 0.001; ES = 2.3 (1.1-3.9)). Three of the women who demonstrated a significant VAS reduction at T7 retained such VAS improvement at T30. VAS decreased by six points (95% CI 1.3-10.7) at T30 (t = 3.1, p = 0.02; ES = 1.5 (0.2-2.6)). This coupled approach seems promising for pain management in adult women with refractory CPPS and paves the way for future randomized controlled trials.

A novel improved SMA with quasi reflection operator: Performance analysis, application to the image segmentation problem of Covid-19 chest X-ray images

Slime mould algorithm (SMA) is a meta-heuristic optimization technique based on nature’s slime module oscillation modes. Like other meta-heuristic algorithms, SMA is prone to poor diversity, local optima, and imbalanced exploitation abilities. A new, quasi-reflected slime mould (QRSMA) method, which combines the SMA algorithm with a quasi-reflection-based learning mechanism (QRBL), is presented to increase SMA’s performance. The enhancement contains two parts: firstly, the QRBL mechanism was established to boost population variety early. Then, quasi-reflection-based jumping (QRBJ) was added to enhance convergence and avoid local optimum in each population update and to maintain the balance between exploitation and exploration. On the CEC20 benchmark functions of various kinds and dimensions, the performance of QRSMA was evaluated and checked that the proposed QRSMA’s more robust search capabilities compared to the classic SMA and different search methodologies in terms of statistical, convergence, and diversity measurement. The findings reveal that QRSMA can significantly increase the convergence speed and solution precision of the basic SMA and others by comparing it with basic SMA and other algorithms. Two further tests have also been conducted to assess QRSMA performance. The first is the division of 10 natural gray pictures. Next, the QRSMA was evaluated for a real-world application, such as COVID-19 X-ray images. The region of interest inside the picture containing the characteristics of COVID-19 must be extracted to increase the precision of the classification. Four X-ray images have thus been utilized to assess QRSMA’s performance. To evaluate the quality and performance of the QRSMA, comprehensive comparisons have also been carried out using different approaches. Overall test findings show that the QRSMA is an effective Multi-Level Thresholding (MLT) strategy superior to other current methods.

Effect of the COVID-19 Pandemic on Children With SMA Receiving Nusinersen: What Is Missed and What Is Gained?

Nusinersen is the first oligonucleotide-based drug that is approved for the treatment of spinal muscular atrophy. In January 2020, the WHO declared COVID-19 a pandemic and nusinersen-provider centers had to postpone planned infusions for some children along with other related interventions. Considering the important contribution that the intrathecal infusions and other support activities could have on the quality of life of spinal muscular atrophy patients and their families, this emergency could have a relevant impact on the course of the pathology. The present work aims to assess the clinical and social issues that arise for spinal muscular atrophy children in care at the referral pediatric palliative care Centre of Padua (Veneto) from a delay in nusinersen infusions, resulting from the contingent COVID-19 restrictions. This evaluation has been carried out in both the short and long term after the first lockdown period and can be considered as a "proxy" of a situation of a possible delay in administration or management of infusions, due to other different causes.

Combination therapy with onasemnogene and risdiplam in spinal muscular atrophy type 1.

INTRODUCTION/AIMS: There are currently three medications approved for spinal muscular atrophy (SMA), but the use of these medications in combination has not been well described. METHODS: This is a retrospective report of four cases of SMA treated with dual onasemnogene and risdiplam therapy at our institution. RESULTS: Following onasemnogene therapy, all four patients experienced a perceived plateau of therapeutic benefit, at which time daily risdiplam was started. Transient fatigue and weakness was seen in two patients following risdiplam initiation, but this resolved within 1 mo. One patient was hospitalized with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and post-viral pneumonia, weeks following risdiplam initiation. No other adverse effects related to onasemnogene and risdiplam combination therapy were identified and all patients experienced objective and subjective improvement. DISCUSSION: Combination therapy with onasemnogene and risdiplam in patients with SMA appears to be well-tolerated. Further large prospective trials are needed to determine whether dual therapy is more efficacious than monotherapy, and to identify rare adverse events that may occur with the use of combination therapy.

Early Detection and Successful Management of Acute Mesenteric Ischaemia in Symptomatic COVID-19 Patient.

Acute mesenteric ischaemia is a life-threatening vascular emergency that requires early diagnosis and intervention to adequately restore mesenteric blood flow and to prevent bowel necrosis and patient death. Its overall mortality is 60-80% and the reported incidence is increasing. This case report emphasises that a patient with early detection and radiological management of acute mesenteric ischaemia being symptomatic for COVID-19 can avoid major bowel surgery and negate any morbidity or mortality associated with the same.

Improved ANFIS model for forecasting Wuhan City Air Quality and analysis COVID-19 lockdown impacts on air quality.

In this study, we propose an improved version of the adaptive neuro-fuzzy inference system (ANFIS) for forecasting the air quality index in Wuhan City, China. We propose a hybrid optimization method to improve ANFIS performance, called PSOSMA, using a new modified meta-heuristics (MH) algorithm, Slime mould algorithm (SMA), which is improved by using the particle swarm optimizer (PSO). The proposed PSOSMA-ANFIS has been trained with air quality index time series data of three years and has been applied to forecast the fine particulate matter (PM2.5), sulfur dioxide (SO2), carbon dioxide (CO2), and nitrogen dioxide (NO2) for one year. We also compared the proposed PSOSMA to other MH algorithms used to train ANFIS. We found that the modified ANFIS using PSOSMA achieved better performance than compared algorithms. Moreover, we analyzed the impacts of the lockdown of Wuhan City on the concentrations of PM2.5, NO2, CO2, and SO2. We compared the correspondence period with previous years, and we concluded that there are significant decreases in the concentrations of PM2.5, CO2, SO2, and NO2.

Superior Mesenteric Artery Thrombosis in COVID-19 Pneumonia: an Underestimated Diagnosis-First Case Report in Asia.

The COVID-19 disease caused by novel coronavirus was first reported in Wuhan, China, in December 2019 with 5% patients having severe lung injury. Though this disease primarily presents as a lower respiratory tract infection, multiple digestive manifestations have been reported which are often overlooked. The present case report describes the unusual progression of COVID-19 disease from pneumonia to a procoagulant state leading to superior mesenteric artery thrombosis and subsequent gut ischemia necessitating emergency laparotomy. Coagulopathy in COVID-19 is due to an imbalance in the coagulation homeostasis with increase in prothrombin time, fibrinogen, and D-dimers. Early recognition of abdominal symptoms, diagnosis of pathology, and timely surgical intervention may definitely improve outcome. In the management of any patient with COVID-19 disease, we advocate a comprehensive integrated approach with early recognition of digestive symptoms and their timely intervention which should run parallel to the respiratory management.

HSMA_WOA: A hybrid novel Slime mould algorithm with whale optimization algorithm for tackling the image segmentation problem of chest X-ray images.

Recently, a novel virus called COVID-19 has pervasive worldwide, starting from China and moving to all the world to eliminate a lot of persons. Many attempts have been experimented to identify the infection with COVID-19. The X-ray images were one of the attempts to detect the influence of COVID-19 on the infected persons from involving those experiments. According to the X-ray analysis, bilateral pulmonary parenchymal ground-glass and consolidative pulmonary opacities can be caused by COVID-19 - sometimes with a rounded morphology and a peripheral lung distribution. But unfortunately, the specification or if the person infected with COVID-19 or not is so hard under the X-ray images. X-ray images could be classified using the machine learning techniques to specify if the person infected severely, mild, or not infected. To improve the classification accuracy of the machine learning, the region of interest within the image that contains the features of COVID-19 must be extracted. This problem is called the image segmentation problem (ISP). Many techniques have been proposed to overcome ISP. The most commonly used technique due to its simplicity, speed, and accuracy are threshold-based segmentation. This paper proposes a new hybrid approach based on the thresholding technique to overcome ISP for COVID-19 chest X-ray images by integrating a novel meta-heuristic algorithm known as a slime mold algorithm (SMA) with the whale optimization algorithm to maximize the Kapur's entropy. The performance of integrated SMA has been evaluated on 12 chest X-ray images with threshold levels up to 30 and compared with five algorithms: Lshade algorithm, whale optimization algorithm (WOA), FireFly algorithm (FFA), Harris-hawks algorithm (HHA), salp swarm algorithms (SSA), and the standard SMA. The experimental results demonstrate that the proposed algorithm outperforms SMA under Kapur's entropy for all the metrics used and the standard SMA could perform better than the other algorithms in the comparison under all the metrics.

Spinal muscular atrophy care in the COVID-19 pandemic era.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in reorganization of healthcare settings affecting the delivery of clinical care to patients with spinal muscular atrophy (SMA). There is a concern that patients with SMA may be at increased risk of manifesting severe symptoms of COVID-19. Currently approved therapies for SMA improve survival and motor function; however, their delivery requires an increased exposure to the health system and a dedicated healthcare team. In this study, we discuss consensus recommendations pertaining to care of SMA patients during the pandemic. We highlight that SMA treatments should not be perceived as elective. Decisions regarding the delay of treatments should be made with consideration of the potential risks of COVID-19 exposure and the risk of that delay. We emphasize the importance of collaborative treatment decisions between the patient, family, and healthcare provider, considering any geographic- or institution-specific policies and precautions for COVID-19.