Evidence of Similarities in Ecosystem Service Flow across the Rural-Urban Spectrum

In 2006, the world’s population passed the threshold of being equally split between rural and urban areas. Since this point, urbanisation has continued, and the majority of the global population are now urban inhabitants. With this ongoing change, it is likely that the way people receive benefits from nature (ecosystem services; ES) has also evolved. Environmental theory suggests that rural residents depend directly on their local environment (conceptualised as green-loop systems), whereas urban residents have relatively indirect relationships with distant ecosystems (conceptualised as red-loop systems). Here, we evaluate this theory using survey data from >3000 households in and around Hyderabad, India. Controlling for other confounding socioeconomic variables, we investigate how flows of 10 ES vary across rural, peri-urban and urban areas. For most of the ES we investigated, we found no statistical differences in the levels of direct or indirect use of an ecosystem, the distance to the ecosystem, nor the quantities of ES used between rural and urban residents (p > 0.05). However, our results do show that urban people themselves often travel shorter distances than rural people to access most ES, likely because improved infrastructure in urban areas allows for the transport of ES from wider ecosystems to the locality of the beneficiaries’ place of residence. Thus, while we find some evidence to support red-loop–green-loop theory, we conclude that ES flows across the rural-urban spectrum may show more similarities than might be expected. As such, the impact of future urbanisation on ES flows may be limited, because many flows in both rural and urban areas have already undergone globalisation

'Pre-endoscopy point of care test (Simtomax- IgA/IgG-Deamidated Gliadin Peptide) for coeliac disease in iron deficiency anaemia: diagnostic accuracy and a cost saving economic model'.

BACKGROUND: International guidelines recommend coeliac serology in iron deficiency anaemia, and duodenal biopsy for those tested positive to detect coeliac disease. However, pre-endoscopy serology is often unavailable, thus committing endoscopists to take routine duodenal biopsies. Some endoscopists consider duodenal biopsy mandatory in anaemia to exclude other pathologies. We hypothesise that using a point of care test at endoscopy could fill this gap, by providing rapid results to target anaemic patients who require biopsies, and save costs by biopsy avoidance. We therefore assessed three key aspects to this hypothesis: 1) the availability of pre-endoscopy serology in anaemia; 2) the sensitivities and cost effectiveness of pre-endoscopy coeliac screening with Simtomax in anaemia; 3) whether other anaemia-related pathologies could be missed by this targeted-biopsy approach. METHODS: Group 1: pre-endoscopy serology availability was retrospectively analysed in a multicentre cohort of 934 anaemic patients at 4 UK hospitals. Group 2: the sensitivities of Simtomax, endomysial and tissue-transglutaminase antibodies were compared in 133 prospectively recruited patients with iron deficiency anaemia attending for a gastroscopy. The sensitivities were measured against duodenal histology as the reference standard in all patients. The cost effectiveness of Simtomax was calculated based on the number of biopsies that could have been avoided compared to an all-biopsy approach. Group 3: the duodenal histology of 153 patients presenting to a separate iron deficiency anaemia clinic were retrospectively reviewed. RESULTS: In group 1, serology was available in 361 (33.8 %) patients. In group 2, the sensitivity and negative predictive value (NPV) were 100 % and 100 % for Simtomax, 96.2 % and 98.9 % for IgA-TTG, and 84.6 % and 96.4 % for EMA respectively. In group 3, the duodenal histology found no causes for anaemia other than coeliac disease. CONCLUSION: Simtomax had excellent diagnostic accuracy in iron deficiency anaemia and was comparable to conventional serology. Duodenal biopsy did not identify any causes other than coeliac disease for iron deficiency anaemia, suggesting that biopsy avoidance in Simtomax negative anaemic patients is unlikely to miss other anaemia-related pathologies. Due to its 100 % NPV, Simtomax could reduce unnecessary biopsies by 66 % if only those with a positive Simtomax were biopsied, potentially saving £3690/100 gastroscopies. TRIAL REGISTRATION: The group 2 study was retrospectively registered with clinicaltrials.gov. Trial registration date: 13(th) July 2016; TRIAL REGISTRATION NUMBER: NCT02834429

Nature provides valuable sanitation services

Much previous research shows that safe disposal of human waste has a positive impact on human wellbeing, while preventing the degradation of ecosystems. However, to date, the role that ecosystems themselves play in treating human waste has been largely neglected. We conceptualize the role nature plays in treating human waste—acting as a pipeline and/or treatment plant. We estimate that nature is treating ~41.7 million tons of human waste per year worldwide, a service worth at least 4.4 ± 3.0 billion USD year−1. We demonstrate the opportunities and challenges of quantifying these “sanitation ecosystem services,” using 48 cities across the globe as a worked example. In highlighting this, we are not marginalizing the vital role of engineered infrastructure, but instead are promoting better understanding of how engineered and natural infrastructure interact within a circular economy. This is a promising route for further research and may allow adaptive design and management, reducing costs, and improving effectiveness and sustainability

Structure of Dark Triad Dirty Dozen Across Eight World Regions

The Dark Triad (i.e., narcissism, psychopathy, Machiavellianism) has garnered intense attention over the past 15 years. We examined the structure of these traits’ measure—the Dark Triad Dirty Dozen (DTDD)—in a sample of 11,488 participants from three W.E.I.R.D. (i.e., North America, Oceania, Western Europe) and five non-W.E.I.R.D. (i.e., Asia, Middle East, non-Western Europe, South America, sub-Saharan Africa) world regions. The results confirmed the measurement invariance of the DTDD across participants’ sex in all world regions, with men scoring higher than women on all traits (except for psychopathy in Asia, where the difference was not significant). We found evidence for metric (and partial scalar) measurement invariance within and between W.E.I.R.D. and non-W.E.I.R.D. world regions. The results generally support the structure of the DTDD

Colorectal cancer in Mauritius: facts and figures -­‐ A ten year retrospective study

Among the various types of cancers in Mauritius, colorectal cancer has evolved as 1st in male and 3rd in female in 2008 (National Cancer Action Plan 2010 MOH & QL, Mauritius). Colorectal cancer is one of the leading causes of death worldwide. A retrospective study of 10 years (2001-­‐2010) has been carried out using the National Cancer Registry (NCR) data. In our study, age wise distribution showed that the highest incidence rate was seen in age group of 55-­‐ 74. Male to female ratio was found to be 1.2:1 (p=0.028). Topographic distribution of lesion showed that maximum cases were seen in colon. Among the registered addresses, urban had higher incidence. This study highlights that NCR should be a strong part of future planning for national cancer prevention and control programs. The need to introduce screening like FOBT (Fecal Occult Blood Test) or colonoscopy, for colorectal cancer in people more than 50 years for early diagnosis and control of the disease in Mauritius is advocated.KEY WORDS: Colorectal cancer (CRC); Facts and Figures; Mauritius; Epidemiology; Screening, National Cancer Registry (NCR

A new mechanism of action of thienopyridine antiplatelet drugs: A role for gastric nitrosthiol metabolism?

This article outlines a new hypothesis that illustrates the potential role of the stomach (and subsequent chemical reactions involving nitrite therein) in modifying thienopyridines, such as clopidogrel. Gastric modification of thienopyridines can occur before standard accepted biotransformation pathways ensue. We hypothesised that thienopyridines expose the free thiol group once acidified (by the stomach) before biotransformation into active metabolites, and in the presence of nitrite (from saliva and the stomach) to form nitrosothiol derivatives (Thienopyridine induced-SNO formation). We have performed in vitro studies with each of the thienopyridines tablets/compounds confirming direct Th-SNO formation from the parent (inactive) drug by the following mechanism. Thienopyridine-SH + H+ (Stomach) + View the MathML sourceNO2−(Salivaandstomach) ↔ Thienopyridine-SNO + H2O Thienopyridine-SNO (an S-nitrosothiol molecule) would have the potential to participate in all the reactions expected of native nitric oxide (NO) with added benefit that the NO “moiety” is protected, transportable and largely preserved from further reactive metabolism. All these biochemical steps are present in humans and could occur prior to enzymatic biotransformation