Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy that commonly follows infections and, less frequently, vaccination. Although peripheral nervous system involvement may occur in systemic lupus erythematosus (SLE), GBS as the initial manifestation of SLE is uncommon, particularly in adolescents. Herein, we describe the case of a previously healthy 17-year-old Saudi female patient who presented with rapidly progressive bilateral lower-limb weakness, areflexia, bilateral foot drop, and urinary retention occurring approximately two weeks after an upper respiratory tract infection and one week after receiving an influenza vaccine. Nerve conduction studies and electromyography demonstrated a demyelinating-axonal polyneuropathy compatible with the acute motor axonal neuropathy (AMAN) variant of GBS. During hospitalization, she was also found to have inflammatory ascites, pleural effusions, Coombs-positive anemia, proteinuria, positive antinuclear antibodies, markedly elevated anti-double-stranded DNA (anti-dsDNA) antibodies, and hypocomplementemia. Renal biopsy confirmed minimal mesangial lupus nephritis (ISN/RPS Class I). Magnetic resonance imaging of the brain and entire spine was unremarkable. The patient received intravenous immunoglobulin, corticosteroids, hydroxychloroquine, and supportive treatment. Although cyclophosphamide was considered because of concerns regarding neuropsychiatric lupus, it was ultimately withheld. The patient achieved complete neurological recovery without cyclophosphamide. This case highlights the occurrence of AMAN variant GBS shortly after influenza vaccination as the initial presentation leading to the diagnosis of SLE and lupus nephritis.

Premises Identification (PID) programs in Canada assign unique identification numbers to locations where animals, such as livestock and poultry, are kept. These programs are provincial and territorial, with a purpose of supporting various animal disease outbreaks, natural disaster emergencies, and animal traceability. While most PID programs have been operating since early 2000s, there has been no study reporting on PID programs in Canada. This qualitative study explored PID programs across Canada through the perspectives of government-employed stakeholders to (1) describe PID programs in participating Canadian provinces and territories, and (2) identify the strengths and weaknesses across PID programs. Stakeholders from nine provinces and one territory (N = 22) participated in online one-on-one interviews or focus groups. Data were analyzed inductively using codebook thematic analysis. Findings suggest that PID programs must build trust with farmers through transparent communication of intended data usage, ideally through familiar social networks. Furthermore, compliance with PID appears to be stronger when there are robust cross-compliance measures in place that have proportional incentives and enforcement measures. Programs with increased capacity and resources were better equipped to maintain data quality, which was achieved by some programs by narrowing the eligibility criteria for PID around the species of interest. This study provides valuable insights for improving the effectiveness of PID programs in Canada. Future research should explore the perspectives of other stakeholders, such as farmers eligible for the program.

Dengue fever (DF) remains an emerging but underrecognized public health threat in Nigeria, often misdiagnosed as malaria or other acute febrile illnesses due to overlapping symptoms. This case series documents the first clinically and laboratory-confirmed outbreak of dengue in Edo State, Nigeria, between December 2024 and June 2025. Seven patients were diagnosed using RT-PCR atIrrua Specialist Teaching Hospital, with a mean age of 35 years (IQR: 22-45); four were females. The most common symptoms were general weakness (85.7%), headache (71.4%), and vomiting (71.4%), while fever occurred in only four cases. Geospatial mapping revealed clustering within households and local government areas, suggesting focal transmission, likely driven by urban Aedes mosquito breeding. Despite delays in hospital presentation, all patients survived without complications. Our findings present atypical dengue presentations in Nigeria, emerging local transmission, and the urgent need to strengthen surveillance, vector control, diagnostics, and public health awareness to mitigate future outbreaks.

As age increases, factors such as visual impairments, joint instability, muscle weakness, and unreliable postural reflexes contribute to reduced stability and a higher risk of fall. Weak hip abductors/adductors further increase this risk. Hip flexors and extensors, which govern sagittal-plane limb advancement and propulsion, also play a critical role in dynamic walking stability. While traditional assistive devices support mobility, exoskeleton technology may improve walking stability and reduce fall risk. This study examines the effects of five exoskeleton assistance timings and two torque magnitudes on gait stability and step characteristics. We hypothesized hip assistance would increase MoS (particularly in the ML direction) through changes in foot placement and that nonlinear COM metrics would change in a direction consistent with stability adaptations. Ten healthy young adults (four males, six females; age: 27.6 ± 5.9 years, body mass: 65.3 ± 13.1 kg, height: 1.66 ± 0.08 m) were assessed for Margin of Stability (MoS), step characteristics, and center of mass nonlinearity. Statistical analyses included linear mixed-model ANOVAs, paired t-tests, and Wilcoxon signed-rank tests. Exoskeleton assistance increased MoS in medial-lateral (ML) and anterior-posterior (AP) directions. Wider, more variable steps and increased gait irregularity suggest extensive adaptation is required. While hip exoskeletons improve walking stability, further research is needed to understand long-term adaptation and daily use. Future studies should explore larger clinical populations and the long-term implications of exoskeleton-assisted walking.

A 28-year-old male with a recent history of stroke presented with fever and generalized weakness. His previous magnetic resonance imaging (MRI) demonstrated a subacute infarct in the right MCA territory with subarachnoid haemorrhage and distal M1 segment occlusion, along with mild narrowing and beading of the right supraclinoid internal carotid artery (ICA). Blood cultures yielded Abiotrophia defectiva, a fastidious organism associated with endovascular infections. Laboratory evaluation revealed markedly elevated inflammatory biomarkers. This case underscores the importance of considering uncommon pathogens such as A. defectiva in post-stroke patients with fever and highlights the need for vigilance for possible infective endocarditis or cerebrovascular complications.