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Additional file 1: Supplementary methods. ADHD and Autism Phenotype Query Parameters. Supplementary Table S1. ADHD Inclusion/ Exclusion Table. Supplementary Table S2. Autism Inclusion/ Exclusion Table. Supplementary Table S3. mGluR Interacting Genes (n=273). Supplementary Table S4. CNVs in mGluR interacting gene regions significantly associated in ADHD cases vs. controls. Supplementary Table S5. CNVs in mGluR interacting gene regions significantly associated in ASD cases vs. controls. Supplementary Table S6. CNVs in mGluR interacting gene regions significantly associated in ADHD & ASD cases vs. controls. Supplementary Figure S1. DeepCNV Probability in mGluR CNVs Passing Prior Visual Inspection. Supplementary Figure S2. mGluR CNV Association Study Manhattan Plot.

Behçet’s Disease (BD) is a multisystemic inflammatory disorder that commonly presents with oral and genital ulcers and uveitis, and can involve the nervous system i.e. Neuro-Behçet’s Disease (NBD). We present the first reported case of Neuro Behçet’s Disease (NBD) in a patient of Somali origin. A 34-year-old female from Somalia who had initially presented with headaches and Generalized Tonic-Clonic Seizures (GTCS) but was lost to follow-up. She represented with additional headache, neuropathic leg pain and ulcerated leg swellings with genital itching. Physical examination revealed hyperpigmentation and erythema nodosum on the lower limbs. Laboratory investigations revealed elevated ESR, positive HLA-B51 and a positive skin pathergy test. MRI brain scan revealed non-enhancing white matter hyperintensities in the right meso-diencephalic junction classical for NBD. She was commenced on immunosuppressive therapy with good response at one month. In conclusion, NBD is rare in sub-Saharan Africa. Our case report highlights that the disease is prevalent also on the Maritime Silk Road which includes Somalia. Key words: Behçet’s disease, Neuro- Behçet’s disease, Sub-Saharan Africa, Somalia

HIV-1 transmission dynamics involving men who have sex with men (MSM) in Africa are not well understood. We investigated the rates of HIV-1 transmission between MSM across three regions in Kenya: Coast, Nairobi, and Nyanza. We analyzed 372 HIV-1 partial pol sequences sampled during 2006–2019 from MSM in Coast (N = 178, 47.9%), Nairobi (N = 137, 36.8%), and Nyanza (N = 57, 15.3%) provinces in Kenya. Maximum-likelihood (ML) phylogenetics and Bayesian inference were used to determine HIV-1 clusters, evolutionary dynamics, and virus migration rates between geographic regions. HIV-1 sub-subtype A1 (72.0%) was most common followed by subtype D (11.0%), unique recombinant forms (8.9%), subtype C (5.9%), CRF 21A2D (0.8%), subtype G (0.8%), CRF 16A2D (0.3%), and subtype B (0.3%). Forty-six clusters (size range 2–20 sequences) were found—half (50.0%) of which had evidence of extensive HIV-1 mixing among different provinces. Data revealed an exponential increase in infections among MSM during the early-to-mid 2000s and stable or decreasing transmission dynamics in recent years (2017–2019). Phylogeographic inference showed significant (Bayes factor, BF > 3) HIV-1 dissemination from Coast to Nairobi and Nyanza provinces, and from Nairobi to Nyanza province. Strengthening HIV-1 prevention programs to MSM in geographic locations with higher HIV-1 prevalence among MSM (such as Coast and Nairobi) may reduce HIV-1 incidence among MSM in Kenya.

Background: Rheumatoid arthritis (RA), one of the commonest forms of inflammatory arthritis, has significant societal impact with regards to cost, induction of disability and loss of productivity. This impact is magnified in the presence of comorbid mood disorders, as these constitute independent factors for unexplained flares and relapses.Objective: The primary purpose of our study was to determine the correlation between disease activity and depression in RA patients.Methods: Patients with RA attending rheumatology clinic at Aga Khan University Hospital, Nairobi were recruited into the study. The patients’ disease activity and functional status were assessed using the Clinical Disease Activity Index and the Stanford Health Assessment Questionnaire respectively, whereas the level of depression was evaluated using the Patient Health Questionnaire-9. Pearson’s correlation coefficient was calculated for the disease activity and functional status versus the depression scores, and relationship between the disease activity and depression scores was analyzed using Chi square tables.Results: A total of 60 patients were enrolled into the study, whose mean age was 48.8 ± 13.6 years. There were 52 females (86.7%). The mean duration of RA symptoms was 71.6 ± 86.6 months, with the mean duration of RA treatment being 43.4 ± 64.5 months. Among the study participants, 28.3% had mild depression whereas 35% had moderate/severe depression. There was a strong positive correlation between disease activity and depression (p

Objective: To evaluate the success rate of crowns and conventional fixed partial dentures provided to patients at the School of Dental Sciences, University of Nairobi.Design: Descriptive cross-sectional study.Setting: School of Dental Sciences, University of Nairobi.Subjects: 97 patients (35 male, 62 female) who had been provided with a total of 150 prostheses at the School of Dental Sciences between 2009 and 2015.Materials and Methods: An interviewer administered questionnaire was used to collect information on socio-demographic data, oral hygiene practices, pain/sensitivity associated with prosthesis, level of satisfaction with the prosthesis and frequency of dental visits. A clinical and radiographic evaluation was conducted for the crowns and fixed partial dentures.Results: The success rate for Fixed Partial Dentures (FPDs) was 75.4% (95% CI: 54.88-95.85%). A statistically significant association was demonstrated between FPD design and success (Fisher’s Exact Test = 8.194, p=0.018) and between the position of the fixed partial denture in the mouth and success (X2= 6.596, p = 0.017). The success rate of crowns was 66.7% (95% CI: 48.89-84.45%). A significant association was demonstrated between the level of training of the clinician and the success of crowns (X2 = 7.772, p= 0.009) and between length of service and the success of crowns (Fisher’s exact test = 8.846, p=0.011).Conclusion: The success rate for crowns and FPDs in our study was lower than the success rate reported in similar studies. Whereas the design and location of prosthesis in the mouth had a significant influence on the success of FPDs, the level of training of clinician and length of service had a significant influence on the success of crowns.

This paper presents an investigation into the efficacy of two data-driven modelling techniques in predicting streamflow response to local meteorological variables on a long-term basis and under limited availability of datasets. Genetic programming (GP), an evolutionary algorithm approach and differential evolution (DE)-trained artificial neural networks (ANNs) were applied for flow prediction in the upper uMkhomazi River, South Africa. Historical records of streamflow, rainfall and temperature for a 19-year period (1994-2012) were used for model design, and also in the selection of predictor variables into the input vector space of the model. In both approaches, individual monthly predictive models were developed for each month of the year using a one-year lead time. The performances of the predictive models were evaluated using three standard model evaluation criteria, namely mean absolute percentage error (MAPE), root mean-square error (RMSE) and coefficient of determination (R²). Results showed better predictive performance by the GP models (MAPE: 3.64%; RMSE: 0.52: R²: 0.99) during the validation phase when compared to the ANNs (MAPE: 93.99%; RMSE: 11.17; R²: 0.35). Generally, the GP models were found to be superior to the ANNs, as they showed better performance based on the three evaluation measures, and were found capable of giving a good representation of non-linear hydro-meteorological variations despite the use of minimal datasets.

Background: Crystal arthropathies represent a heterogeneous group of skeletal (musculo-skeletal) diseases associated with the deposition of mineralized material within joints and periarticular soft tissues. Gout is the most common and pathogenetically best understood crystal arthropathy, followed by basic calcium phosphate and calcium pyrophosphate dihydrate deposition diseases, and, in very rare cases, calcium oxalate crystal arthropathy. In Kenya there are no studies to demonstrate the prevalence of these diseases. This study endeavored to describe the different types of crystals seen in patients with synovitis in Nairobi from 1st January 2012 to 31st January 2014. Objective: To describe different types of crystals seen in patients with synovitis in Nairobi. Design: Descriptive prospective cross sectional study. Results: There were 260 samples received from patients with synovitis. Of them, 61 (23.5%) were from males while 199 (76.5%) were from females. The age range of the patients was from 14 – 110 years. The mean, median and mode were 59.6, 60 and 55 years respectively. Majority of the patients were in the 51-60 years age category. Most of the patients recruited had no crystals (n=211; 81.2%) diagnosed, with 14.2%(n=37) having uric acid crystals and 4.6 % (n=12) having CPPD crystals. For the patients who had uric acid crystals (n=37), when gender was cross tabulated against microscopy, males (n=32; 86.5%) were noted to have more uric acid crystals than females (n=5; 13.5%). Among patients diagnosed with CPPD (n=12), there were more females (n=9; 75%) patients compared to males (n=3; 25%). From the total population recruited (n=260), when age range categories were cross tabulated against microscopy, the age ranges 41-50 (n=9; 3.5%) 51-60 (n=12; 4.6%), and 61-70 (n=6; 2.3%) were noted to have more uric acid crystals than any other age category recruited. Patients in the age category 61-70 (n=6; 50 %) had more CPPD crystal detections than any other age category from the patients recruited. Conclusion: Crystal arthropathy is a major cause of synovitis in patients seen in Nairobi.

Batch adsorption of recalcitrant melanoidin using the abundantly available coal fly ash was carried out. It had low specific surface area (SBET) of 1.7287 m2/g and pore volume of 0.002245 cm3/g while qualitative evaluation of the predominant phases in it was done by XRD analysis. Colour removal efficiency was found to be dependent on various factors studied. Maximum colour removal was achieved around pH 6, whereas increasing sorbent mass from 10g/L to 200 g/L enhanced colour reduction from 25% to 86% at 298 K. Spontaneity of the process was suggested by negative Gibbs free energy while positive values for enthalpy change showed endothermic nature of the process. Non-linear optimization of error functions resulted in Freundlich and Redlich-Peterson isotherms describing sorption equilibrium data best. The coal fly ash had maximum sorption capacity of 53 mg/g and could thus be used as a low cost adsorbent in melanoidin removal.