There are numerous challenges pertaining to epilepsy care across Ontario, including Epilepsy Monitoring Unit (EMU) bed pressures, surgical access and community supports. We sampled the current clinical, community and operational state of Ontario epilepsy centres and community epilepsy agencies post COVID-19 pandemic. A 44-item survey was distributed to all 11 district and regional adult and paediatric Ontario epilepsy centres. Qualitative responses were collected from community epilepsy agencies. Results revealed ongoing gaps in epilepsy care across Ontario, with EMU bed pressures and labour shortages being limiting factors. A clinical network advising the Ontario Ministry of Health will improve access to epilepsy care.

The inoculation with Azospirillum brasilense has the potential to reduce the use of mineral fertilizers with efficient capacity to promote plant growth and yield. Most studies on the Azospirillum–plant association have been conducted on cereals and annual grasses. More studies are needed in perennial pastures, such as bermudagrass (Cynodon dactylon (L.) Pers.) that require substantial nitrogen (N) fertilization to maximize their production potential. Therefore, pastures based on Tifton 85 bermudagrass in association with annual ryegrass (Lolium multiflorum Lam.), which were inoculated with A. brasilense and fertilized with increasing amounts of N fertilizer and grazed by lactating Holstein cows were evaluated. Three grazing systems were evaluated: (i) Tifton 85, inoculated + 180 kg N/ha per year; (ii) Tifton 85 + 230 kg N/ha per year; and (iii) Tifton 85 + 280 kg N/ha per year. Forage samples were collected before and after grazing to evaluate the responses of the plants and animals. The forage yields of the systems were 21.0, 20.8 and 22.1 t DM/ha per year and the stocking rates were 3.9, 3.8 and 4.0 animal unit/ha per day, respectively. Crude protein, total digestible nutrients and neutral detergent fibre concentrations were 162, 560 and 667 g/kg, respectively. Inoculation in pastures planted with Tifton 85 bermudagrass in combination with ryegrass (plus 180 kg N/ha per year) had a positive effect, providing forage yield and nutritional value equivalent to those with fertilization with 230 kg N/ha per year.

Background: Approximately 1,000 children present with AIS annually in North America. Most suffer from long-term disability. Childhood AIS is diagnosed after a median of 23 hours post-symptom onset, limiting thrombolytic treatment options that may improve outcomes. Pediatric stroke protocols decrease time to diagnosis. AIS treatment is not uniform across Canada, nor are pediatric stroke protocols standardized. Methods: We contacted neurologists at all 16 Canadian pediatric hospitals regarding their AIS management. Results: Response rate was 100%. Seven centers have an AIS protocol and two have a protocol under development. Seven centers do not have a protocol – two redirect patients to adult neurology, and five use a case-by-case approach for management. Analysis of the seven AIS protocols reveals differences: 1) IV-tPA dosage: age-dependent 0.75-0.9 mg/kg (n=1) versus age-independent 0.9 mg/kg (n=6), with maximum doses 75 mg (n=1) or 90 mg (n=6); 2) IV-tPA lower age cut-off: 2 years (n=4) versus 3, 4 or 10 years (n=1); 3) IV-tPA exclusion criteria: PedNIHSS score <4 (n=3), <5 (n=1), or <6 (n=3); 4) Pre-treatment neuroimaging: CT (n=3) versus MRI (n=4); 5) Intra-arterial tPA use (n=3). Conclusions: The seven Canadian pediatric AIS protocols show prominent differences. We plan a teleconference discussing a Canadian pediatric AIS consensus approach.

This study aimed to (1) evaluate the effects of flint maize processing methods on the estimation of the readily soluble fraction (a), the potentially degradable fraction (b) and the rate of degradation of b (c) for dry matter (DM), organic matter (OM) and starch in the rumen; and (2) verify whether two different applications of in situ technique can be used to estimate in vivo DM, OM and starch digestibilities. Five ruminally cannulated Nellore bulls (265 ± 18.2 kg; 8 ± 1.0 mo) were distributed in a 5 × 5 Latin square. Three experimental diets were composed of 0.30 whole-plant maize silage, 0.10 supplement and 0.60 of one of the following processing methods: dry ground maize grain (DMG); high-moisture maize (HMM); reconstituted maize grain silage (RMG). Two additional diets were composed of 0.10 supplement, 0.80 snaplage and 0.10 stalklage (SNAP-80); or 0.10 supplement and 0.90 snaplage (SNAP-90). Digestibilities were estimated using in vivo procedure or predicted from in situ technique using a single 24 h incubation point or an equation proposed in previous literature. Diets based on ensiled grains presented greater (P < 0.05) fraction a and c and lower (P < 0.05) fraction b of DM, OM and starch compared to DMG. Both alternative use of in situ technique accurately estimated (P > 0.05) in vivo DM, OM and starch digestibilities. The results suggest that ensilage process may increase the availability of nutrients. The two different applications of in situ technique showed precision and accuracy to estimate in vivo digestibility.

This study aimed to analyse the spatial–temporal distribution of COVID-19 mortality in Sergipe, Northeast, Brazil. It was an ecological study utilising spatiotemporal analysis techniques that included all deaths confirmed by COVID-19 in Sergipe, from 2 April to 14 June 2020. Mortality rates were calculated per 100 000 inhabitants and the temporal trends were analysed using a segmented log-linear model. For spatial analysis, the Kernel estimator was used and the crude mortality rates were smoothed by the empirical Bayesian method. The space–time prospective scan statistics applied the Poisson's probability distribution model. There were 391 COVID-19 registered deaths, with the majority among ⩾60 years old (62%) and males (53%). The most prevalent comorbidities were hypertension (40%), diabetes (31%) and cardiovascular disease (15%). An increasing mortality trend across the state was observed, with a higher increase in the countryside. An active spatiotemporal cluster of mortality comprising the metropolitan area and neighbouring cities was identified. The trend of COVID-19 mortality in Sergipe was increasing and the spatial distribution of deaths was heterogeneous with progression towards the countryside. Therefore, the use of spatial analysis techniques may contribute to surveillance and control of COVID-19 pandemic.

This study aimed to analyse the trend and spatial–temporal clusters of risk of transmission of COVID-19 in northeastern Brazil. We conducted an ecological study using spatial and temporal trend analysis. All confirmed cases of COVID-19 in the Northeast region of Brazil were included, from 7 March to 22 May 2020. We used the segmented log-linear regression model to assess time trends, and the local empirical Bayesian estimator, the global and local Moran indexes for spatial analysis. The prospective space–time scan statistic was performed using the Poisson probability distribution model. There were 113 951 confirmed cases of COVID-19. The average incidence rate was 199.73 cases/100 000 inhabitants. We observed an increasing trend in the incidence rate in all states. Spatial autocorrelation was reported in metropolitan areas, and 178 municipalities were considered a priority, especially in the states of Ceará and Maranhão. We identified 11 spatiotemporal clusters of COVID-19 cases; the primary cluster included 70 municipalities from Ceará state. COVID-19 epidemic is increasing rapidly throughout the Northeast region of Brazil, with dispersion towards countryside. It was identified high risk clusters for COVID-19, especially in the coastal side.

This study presents two years of characterization of a warm temperate rhodolith bed in order to analyse how certain environmental changes influence the community ecology. The biomass of rhodoliths and associated species were analysed during this period and in situ experiments were conducted to evaluate the primary production, calcification and respiration of the dominant species of rhodoliths and epiphytes. The highest total biomass of rhodoliths occurred during austral winter. Lithothamnion crispatum was the most abundant rhodolith species in austral summer. Epiphytic macroalgae occurred only in January 2015, with Padina gymnospora being the most abundant. Considering associated fauna, the biomass of Mollusca increased from February 2015 to February 2016. Population densities of key reef fish species inside and around the rhodolith beds showed significant variations in time. The densities of grouper (carnivores/piscivores) increased in time, especially from 2015 to 2016. On the other hand, grunts (macroinvertebrate feeders) had a modest decrease over time (from 2014 to 2016). Other parameters such as primary production and calcification of L. crispatum were higher under enhanced irradiance, yet decreased in the presence of P. gymnospora. Community structure and physiological responses can be explained by the interaction of abiotic and biotic factors, which are driven by environmental changes over time. Biomass changes can indicate that herbivores play a role in limiting the growth of epiphytes, and this is beneficial to the rhodoliths because it decreases competition for environmental resources with fleshy algae.

In an empirical study on the classification of the psychoses, 302 patients were rated using the Longitudinal Psychopathology Schedule. The data were condensed by factor analysis, which yielded 10 factors - mania and schizomania, depression and suicidal activity, and 6 factors concerned with psychotic symptoms (verbal hallucinosis/passivity, delusion formation, defect symptoms, social decline, cycloid symptomatology and a factor loading depressive auditory hallucinations and visual hallucinations). Provisional diagnostic groups were obtained using DSM III. Discriminant function analyses showed that the only clearly distinct diagnostic group was bipolar disorder, and this was true for various definitions. Canonical variate analyses were performed using 3- and 4-criterion groups. These showed that a group corresponding approximately to cycloid psychosis also met criteria for being a distinct group. The most detailed examination pf the data, using 4-criterion groups and serial reclassification, suggested that the psychoses might fall into 5 groups - bipolar disorder, cycloid psychosis, depression, defect states and schizoaffective depression.

One third of all patients that comitted suicide attended Mental Health Services in the year that preceded their suicide (1/5 in the previous month) and 50-70% of all specialists and 40-50% of Psychiatry residents experience at least one case during their clinical practice. In fact, 97% of all therapists assume a patient's suicide as their strongest fear. All available studies describe a patient's suicide as an emotional, often traumatic, experience for the therapist. Our study aimed to assess and describe the impact of a patient suicide in their therapist in a sample of portuguese psychiatrists, both specialists and residents, focusing in their emotional responses. An annonimous questionnaire was emailed to all psychiatrist working in the Centre of Portugal (area of Coimbra). Included questions regarding socio-demographic information of the therapist, years of practice, sociodemographic data regarding the patient and context of suicidal behaviour, and ten different emotional responses assessing both its intensity and duration. Deadline for accepting replies is 30th November 2013. We hope to finish analysing all data by the end of January 2013 and be ready to present by February 2013.

Nonsuicidal self-injury (NSSI) is defined as intentionally causing bodily harm to oneself without the intent to kill oneself. NSSI can be associated with a number of psychiatric disorders, including mental retardation, schizophrenia, borderline personality disorder, pervasive developmental disorders, stereotypic movement disorder, and Tourette's Disorder. In this paper we present the case of a 23-year old patient with Gilles de la Tourette's syndrome that exhibited severe compulsive self-mutilation and hostility leading to eye surgery following traumatic eye injury, as well as, familiar distress and social malfunctioning.

A review of the recent literature on NSSI different contexts and presentations, as well as, a case report, is presented. Our objective is to draw attention to less debated conditions related to NSSI, with particular focus on Tourette's syndrome and its potentially self-harming symptoms.

Visceral organs play an important role in animals' energy requirements, so their growth must be well understood. The objective of the current study was to fit and compare growth curves that best describe body and visceral organ growth over time in Saanen goats of different sexes. Data were synthesized from seven studies in which curves were fitted to visceral organ growth over time for female, intact male and castrated male Saanen goats from 5 to 45 kg body weight. The liver, pancreas, spleen, rumen–reticulum, omasum, abomasum, small intestine, large intestine and mesenteric adipose tissue (MAT) data were fitted to eight models: simple linear regression, quadratic, monomolecular, Brody, Von Bertalanffy, logistic, Gompertz and Richards. The best-fit model was chosen based on the corrected Akaike information criterion and the concordance correlation coefficient. Model parameters for each sex were compared. Overall, the model that best described visceral organ growth was the logistic model. Sex did not influence the parameters that predicted organ growth (g), except for MAT, where females presented a lower tissue deposition rate and greater inflection point than males. Irrespective of sex, at the beginning of the growth curve, the liver accounted for 28 ± 1.1 g/kg of empty body weight, and the inflection point occurred at 1.7 months. The rumen–reticulum and large intestine presented higher growth rates in the first 2 months of life. Knowledge of the visceral organ growth curve is useful in improving the understanding of the effect of nutritional requirements for goats and must be used to optimize the nutritional plans.

There is a long history of exploitation of the South American river turtle Podocnemis expansa. Conservation efforts for this species started in the 1960s but best practices were not established, and population trends and the number of nesting females protected remained unknown. In 2014 we formed a working group to discuss conservation strategies and to compile population data across the species’ range. We analysed the spatial pattern of its abundance in relation to human and natural factors using multiple regression analyses. We found that > 85 conservation programmes are protecting 147,000 nesting females, primarily in Brazil. The top six sites harbour > 100,000 females and should be prioritized for conservation action. Abundance declines with latitude and we found no evidence of human pressure on current turtle abundance patterns. It is presently not possible to estimate the global population trend because the species is not monitored continuously across the Amazon basin. The number of females is increasing at some localities and decreasing at others. However, the current size of the protected population is well below the historical population size estimated from past levels of human consumption, which demonstrates the need for concerted global conservation action. The data and management recommendations compiled here provide the basis for a regional monitoring programme among South American countries.

The aim of this study was to evaluate transcriptome changes in the muscle tissue of Bos taurus indicus cull cows subjected to recovery weight gain under grazing conditions. In all, 38 Nellore cull cows were divided randomly into two different management groups: (1) Maintenance (MA) and (2) Recovery gain (RG) from weight loss by moderate growth under high forage availability. After slaughter, RNA analysis was performed on the Longissimus thoracis muscle. Semaphorin 4A, solute carrier family 11 member 1, and Ficolin-2 were expressed in the RG, which may indicate an inflammatory response during tissue regrowth. Signaling factors, such as Myostatin, related to fibroblast activation, negative control of satellite cell proliferation in adults and muscle protein synthesis were less abundant in the RG group. The only gene related to anabolic processes that were more abundant in the MA group was related to fat deposition. The genes that were differentially expressed in the experiment showed muscle repair-related changes during RG based on the greater expression of genes involved in inflammatory responses and the lower expression of negative regulators of muscle cell proliferation and hypertrophy.