Organic Amendments for Mitigation of Salinity Stress in Plants: A Review.

Natural and/or human-caused salinization of soils has become a growing problem in the world, and salinization endangers agro-ecosystems by causing salt stress in most cultivated plants, which has a direct effect on food quality and quantity. Several techniques, as well as numerous strategies, have been developed in recent years to help plants cope with the negative consequences of salt stress and mitigate the impacts of salt stress on agricultural plants. Some of them are not environmentally friendly. In this regard, it is crucial to develop long-term solutions that boost saline soil productivity while also protecting the ecosystem. Organic amendments, such as vermicompost (VC), vermiwash (VW), biochar (BC), bio-fertilizer (BF), and plant growth promoting rhizobacteria (PGPR) are gaining attention in research. The organic amendment reduces salt stress and improves crops growth, development and yield. The literature shows that organic amendment enhances salinity tolerance and improves the growth and yield of plants by modifying ionic homeostasis, photosynthetic apparatus, antioxidant machineries, and reducing oxidative damages. However, the positive regulatory role of organic amendments in plants and their stress mitigation mechanisms is not reviewed adequately. Therefore, the present review discusses the recent reports of organic amendments in plants under salt stress and how stress is mitigated by organic amendments. The current assessment also analyzes the limitations of applying organic amendments and their future potential.

COVID-19 vaccine incentive scheduling using an optimally controlled reinforcement learning model

We model Covid-19 vaccine uptake as a reinforcement learning dynamic between two populations: the vaccine adopters, and the vaccine hesitant. Using data available from the Center for Disease Control (CDC), we calculate a payoff matrix governing the dynamic interaction between these two groups and show they are playing a Hawk-Dove evolutionary game with an internal evolutionarily stable Nash equilibrium (the asymptotic percentage of vaccinated in the population). We then ask whether vaccine adoption can be improved by implementing dynamic incentive schedules that reward/punish the vaccine hesitant, and if so, what schedules are optimal and how effective are they likely to be? When is the optimal time to start an incentive program, and how large should the incentives be? By using a tailored replicator dynamic reinforcement learning model together with optimal control theory, we show that well designed and timed incentive programs can improve vaccine uptake by shifting the Nash equilibrium upward in large populations, but only so much, and incentive sizes above a certain threshold show diminishing returns.

Implementation of novel and conventional outbreak control measures in managing a COVID-19 outbreak in a large UK prison

BackgroundSARS-CoV-2 can spread rapidly within correctional facilities. On, following identification of a confirmed COVID-19 case in a prisoner in Prison A (UK), an Outbreak Control Team was convened consisting of prison staff and public health experts from Public Health England and the UK National Health Service. MethodsAt the start of the outbreak, four prisoners and 40 staff were isolating with COVID-19 symptoms. An outbreak was declared and full prison lockdown implemented. Prompt implementation of novel outbreak control measures prevented an explosive prison outbreak, specifically establishment of dedicated isolation and cohorting units, including (i) Reverse Cohorting Units (RCUs) for accommodating new detainees; (ii) Protective Isolation Units (PIUs) for isolating symptomatic prisoners (new detainees and existing residents), and (iii) Shielding Units (SUs) to protect medically vulnerable prisoners. FindingsIn total, 120 probable and 25 confirmed cases among prisoners and staff were recorded between. Among prisoners, there were six possible, 79 probable, and three confirmed cases. Among staff, there were 83 possible, 79 probable, and 22 confirmed cases. Testing of symptomatic prisoners was limited for most of the outbreak, with only 33% of probable cases tested. This explains the low number of confirmed cases (three) among prisoners despite the large number of probable cases (n=81; 92%). Over 50% of the initial cases among prisoners were on the two wings associated with the index case. InterpretationRapid transmission of SARS-COV-2 was prevented through proactive steps in identifying and isolating infected prisoners (and staff), cohorting new admissions and shielding vulnerable individuals. These novel and cost-effective approaches can be implemented in a wide range of correctional facilities globally and proved effective even in the absence of mass testing. Funding Sourcenone Research in contextO_ST_ABSEvidence before this studyC_ST_ABSA systematic literature search on Pubmed from database inception to October 2020 was conducted. The broad terms included were "COVID-19" OR "SARS-COV-2" OR "coronavirus" AND "prison" OR "correctional facility" OR "place of detention" OR "penitentiary" OR "detention centre". There were no language restrictions. We reviewed reference lists and forward citations of all articles pertinent to the study objectives. We identified 122 results. Only two prison outbreak reports were identified, both focusing on prisons in the USA. Outbreak guidance identified during the literature review was typically adapted from other institutional settings such as care homes and hospital, with a focus on self-isolation, social distancing, reduced admissions and rapid testing. Many of these features form the basis of CDC, WHO and ECDC prison outbreak guidance. However, these measures have not proven effective in many countries, resulting in major and sustained COVID-19 outbreaks in regions such as the USA and South America. Therefore, alternative and cost-effective approaches need to be considered to reduce the transmission of SARS-COV-2. Added value of this studyThis study outlines novel outbreak control measures (not reported elsewhere in the literature), that were clearly efficacious in preventing the rapid transmission of SARS-COV-2 in a large UK prison. These include: (1) the timely establishment of "Reverse Cohorting Units" to accommodate new prison admissions, allowing emergent infectious cases to be detected before entering the general population; (2) "Protective Isolation Units" for accommodating confirmed / suspected cases and (3) "Shielding Units" to protect prisoners most at risk from COVID-19. Implications of all the available evidenceThe innovative and cost-effective interventions presented here proved effective in controlling the spread of SARS-COV-2, even in the absence of mass testing. The best defence against incursions of future infection into global prisons is implementation of strict outbreak control measures, specifically the screening and quarantining of new prison admissions.

Poor-quality medicines: a global threat to health / Lao Medical Journal

@#Poor quality medicines have been described as a global pandemic that threatens the lives of millions of people. The problem is much more severe in poor-resource countries where pharmaceutical legislation and regulation are limited. Poor quality medicines are divided into three categories: substandard, degraded and falsified and the countermeasures vary according to each category. The use of poor quality medicine leads from minimal to severe complications (including death) for the individuals but also harms the community. Furthermore, they lead to a loss of confidence of the patients in essential medicines, in manufacturers and in health system and they increase the work burden for health workers, customs and police. To detect them, different techniques have been developed, each with advantages and limits. This article describes these aspects of poor quality medicines and also presents the factors that contribute to the existence and spread of poor quality medicines. A section of the article is devoted to the issue of poor quality medicine in Laos.

Uncommon Presentation of Infective Endocarditis / Lao Medical Journal

@#Diagnosis of infective endocarditis is challenging as the clinical diversity of the disease sometimes misleads clinicians in the recognition, correct diagnosis and rapid treatment, which are important to reduce the morbidity and mortality associated with this disease. We report the case of a 14-year-old girl who presented with left axillary pain and fever. She was eventually diagnosed with infective endocarditis caused by Abiotropia defectiva, complicated by a large saccular aneurysm of the left axillary artery.@*@#

Serological Diagnosis for Infectious Diseases: Not As Easy as It Appears ! / Lao Medical Journal

Serological diagnoses for infectious diseases such as those based on disease¬specific IgM antibody detection often confuse clinicians and therefore make treatment decisions difficult. This is due to the relatively long persistence of IgM in the blood circulation following exposure to the organism or nonspecific polyclonal activation of memory cells. We report a Lao patient diagnosed as having scrub typhus on admission based on detection of IgM to Orientia tsutsugamushi and initially treated with Doxycycline. The patient became afebrile but had severe pulmonary involvement. The blood culture was subsequently positive for Leptospira spp. which is the cause of leptospirosis. The admission blood sample of the patient was negative for Orientia tsutsugamushi, Rickettsia typhi, and Rickettsia spp. DNA targets, by PCR, suggesting that the patient did not have scrub typhus, murine typhus or Spotted Fever. After one week of IV ceftriaxone treatment, the patient improved and was discharged well. The positive IgM to scrub typhus detected on admission was probably due to previous exposure to O. tsutusgamushi, and scrub typhus was not the cause of her presenting illness. Fortunately, Doxycycline, given to the patient for scrub typhus treatment, is also effective for leptospirosis preventing death. However, the patient required intravenous ceftriaxone (which would not have been effective for scrub typhus) when she developed severe disease. This patient’s illness is a reminder that clinicians should be cautious about serological diagnosis. At present, laboratory diagnosis of leptospirosis remains a big challenge for the clinicians because the existing gold standard test such as Microscopic Agglutination Test (MAT) and culture are labour intensive, expensive and seldom available. Until the development of the simple, rapid, and more reliable tests, the empirical treatment of patients with suspected leptospirosis with doxycycline, penicillins or ceftriaxone are strategies to reduce severe complications and death although it should be born in mind that penicillins and ceftriaxone will not be effective against rickettsial organisms.

TB Meningitis (TBM): An Important Problem Which Should Not be Neglected in Laos! / Lao Medical Journal

Tuberculosis (TB) is an infectious disease commonly found in both developing and developed countries. Tuberculosis meningitis (TBM) is a serious central nervous system infection with a high mortality rate despite anti-TB drug treatment and is associated with HIV/AIDS. The diagnosis of TBM is difficult since the clinical aspects of the disease are similar to other central nervous system infections, examination for AFB in cerebrospinal fluid (CSF) stained with Ziehl-Neelsen is not sensitive and culture of Mycobacterium tuberculosis from CSF takes too long to influence initial therapy. Delayed diagnosis and treatment of TBM results in high mortality and disability. We report a Lao patient who had pulmonary TB in combination with TBM (confirmed by positive AFB in a sputum examination and a positive culture of Mycobacterium tuberculosis in the CSF) whose diagnosis and treatment were delayed resulting in serious nervous system sequelae and disability which may not be easily reversible. We discuss TBM diagnosis and use of simple clinical and laboratory features and suggest a low threshold for empirical treatment with anti-TB drug in case of suspected TBM.