Extraskeletal Effects of Vitamin D: Potential Impact on WV Disease Morbidity and Mortality

Vitamin D is an essential nutrient and a secosteroid hormone that regulates many physiologic processes beyond calcium and bone homeostasis. These extraskeletal effects are impacted by the circulating levels of the storage form of vitamin D, 25-hydroxyvitamin D3. Levels of vitamin D can be detected after completing a simple 25(OH)D blood test. Vitamin D deficiency (\u3c 30 ng/mL) is associated with a higher risk of many chronic diseases including, but not limited to, fourteen types of cancers, type 1 and 2 diabetes mellitus, obesity, cardiovascular disease, hypertension, stroke, and asthma. This article explores the association between vitamin D deficiency and the burden of chronic diseases in West Virginia

International Profiles of Health Care Systems, 2015

This publication presents overviews of the health care systems of Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views

Autoimmunity and Novel Therapies in Immune-Mediated Thrombocytopenia

Immune-mediated thrombocytopenic purpura (ITP) is recognized as a cell-specific autoimmune disorder, yet, multifactorial in origin. The development of thrombocytopenia is well proven to be mediated by both humoral (anti-platelet antibodies) and cellular (T-cell) mediated mechanisms. In some cases other autoantibodies are also induced, eg, antinuclear antibody (ANA), anti-dsDNA, and anti-cardiolipin, in addition to anti-platelet antibodies. The persistance of these autoantibodies during the course of ITP could herald future development of another autoimmune disease, eg, systemic lupus erythematosus (SLE) or anti-phospholipid syndrome (APS). Due to the better understanding of the pathophysiology of ITP, new novel therapies were introduced aiming to achieve long-lasting remissions. In this review we will focus on the autoimmune nature of the disease and on some of the mechanisms of action of these new therapies

Ichthyosis in Sjögren–Larsson syndrome reflects defective barrier function due to abnormal lamellar body structure and secretion

Sjögren–Larsson syndrome is a genetic disease characterized by ichthyosis, mental retardation, spasticity and mutations in the ALDH3A2 gene coding for fatty aldehyde dehydrogenase, an enzyme necessary for oxidation of fatty aldehydes and fatty alcohols. We investigated the cutaneous abnormalities in 9 patients with Sjögren–Larsson syndrome to better understand how the enzymatic deficiency results in epidermal dysfunction. Histochemical staining for aldehyde oxidizing activity was profoundly reduced in the epidermis. Colloidal lanthanum perfusion studies showed abnormal movement of tracer into the extracellular spaces of the stratum corneum consistent with a leaky water barrier. The barrier defect could be attributed to the presence of abnormal lamellar bodies, many with disrupted limiting membranes or lacking lamellar contents. Entombed lamellar bodies were present in the cytoplasm of corneocytes suggesting blockade of lamellar body secretion. At the stratum granulosum–stratum corneum interface, non-lamellar material displaced or replaced secreted lamellar membranes, and in the stratum corneum, the number of lamellar bilayers declined and lamellar membrane organization was disrupted by foci of lamellar/non-lamellar phase separation. These studies demonstrate the presence of a permeability barrier abnormality in Sjögren–Larsson syndrome, which localizes to the stratum corneum interstices and can be attributed to abnormalities in lamellar body formation and secretion

Vitamin D Deficiency: At Risk Patient Populations and Potential Drug Interactions

Vitamin D is known to play an essential role in calcium homeostasis; however, excessive amounts can have harmful effects. Calcium and vitamin D levels are known to be influenced by drug interactions and pathology ranging from of cancer to cardiovascular disease. Vitamin D supplementation has become widespread, and it is important for clinicians to understand the way that certain conditions and medications interact with vitamin D and calcium homeostasis. The purpose of this review is to outline the benefits and adverse effects of vitamin D and how its levels are affected by certain pathologic and pharmacologic interactions

Gaze Behaviour on Interacted Objects during Hand Interaction in Virtual Reality for Eye Tracking Calibration

In this paper, we investigate the probability and timing of attaining gaze fixations on interacted objects during hand interaction in virtual reality, with the main purpose for implicit and continuous eye tracking re-calibration. We conducted an evaluation with 15 participants in which their gaze was recorded while interacting with virtual objects. The data was analysed to find factors influencing the probability of fixations at different phases of interaction for different object types. The results indicate that 1) interacting with stationary objects may be favourable in attaining fixations to moving objects, 2) prolonged and precision-demanding interactions positively influences the probability to attain fixations, 3) performing multiple interactions simultaneously can negatively impact the probability of fixations, and 4) feedback can initiate and end fixations on objects

"Domains of deprivation framework" for mapping slums, informal settlements, and other deprived areas in LMICs to improve urban planning and policy : a scoping review

The majority of urban inhabitants in low- and middle-income country (LMIC) cities live in deprived urban areas. However, statistics and data (e.g., local monitoring of Sustainable Development Goals - SDGs) are hindered by the unavailability of spatial data at metropolitan, city and sub-city scales. Deprivation is a complex and multidimensional concept, which has been captured in existing literature with a strong focus on household-level deprivation while giving limited attention to area-level deprivation. Within this scoping review, we build on existing literature on household- as well as area-level deprivation frameworks to arrive at a combined understanding of how urban deprivation is defined with a focus on LMIC cities. The scoping review was enriched with local stakeholder workshops in LMIC cities to arrive at our framework of Domains of Deprivations, splitting deprivation into three different scales and nine domains. (1) Socio-Economic Status and (2) Housing Domains (Household scale); (3) Social Hazards & Assets, (4) Physical Hazards & Assets, (5) Unplanned Urbanization and (6) Contamination (Within Area scale); and (7) Infrastructure, (8) Facilities & Services and (9) city Governance (Area Connect scale). The Domains of Deprivation framework provides a clear guidance for collecting data on various aspects of deprivation, while providing the flexibility to decide at city level which indicators are most relevant to explain individual domains. The framework provides a conceptual and operational base for the Integrated Deprived Area Mapping System (IDEAMAPS) Project for the creation of a data ecosystem, which facilitates the production of routine, accurate maps of deprived “slum” areas at scale across cities in LMICs. The Domains of Deprivation Framework is designed to support diverse health, poverty, and development initiatives globally to characterize and address deprivation in LMIC cities

“Domains of deprivation framework” for mapping slums, informal settlements, and other deprived areas in LMICs to improve urban planning and policy : a scoping review

The majority of urban inhabitants in low- and middle-income country (LMIC) cities live in deprived urban areas. However, policy efforts and the monitoring of global goals and agendas such as the United Nation's Sustainable Development Goals (SDGs) and UN-Habitat New Urban Agenda are hindered by the unavailability of statistical and spatial data at metropolitan, city and sub-city scales. Deprivation is a complex and multidimensional concept, and presently, there is a strong focus within the existing literature on household-level (including individual) deprivation and less on area-level deprivation and this is problematic because deprivation at the area and household-level are known to interrelate and result in multiple challenges for individuals and communities. Within this scoping review, we build on existing literature that focuses on household- or area-level deprivation to arrive at a combined understanding of how urban deprivation is defined in relation to LMIC cities. The scoping review of existing literature was used in conjunction with local stakeholder workshops to produce a framework titled “Domains of Deprivation Framework”. The Domains of Deprivation Framework conceptualizes urban deprivation at three different scales, including at the household scale, within the area scale and at the area connect scale. It includes nine domains, (1) Socio-Economic Status and (2) Housing Domains (Household scale); (3) Social Hazards & Assets, (4) Physical Hazards & Assets, (5) Unplanned Urbanization and (6) Contamination (Within Area scale); and (7) Infrastructure, (8) Facilities & Services and (9) City Governance (Area Connect scale). The Domains of Deprivation Framework is designed to support diverse urban, health, poverty, and development initiatives globally to characterize and address deprivation in LMIC cities from a holistic perspective, combining traditional data sources (e.g., surveys or census data) with new data sources (e.g., Earth Observation data)

Systematic conservation planning for Antarctic research stations

The small ice-free areas of Antarctica are essential locations for both biodiversity and scientific research but are subject to considerable and expanding human impacts, resulting primarily from station-based research and support activities, and local tourism. Awareness by operators of the need to conserve natural values in and around station and visitor site footprints exists, but the cumulative nature of impacts often results in reactive rather than proactive management. With human activity spread across many isolated pockets of ice-free ground, the pathway to the greatest reduction of human impacts within this natural reserve is through better management of these areas, which are impacted the most. Using a case study of Australia's Casey Station, we found significant natural values persist within the immediate proximity (<10 m) of long-term station infrastructure, but encroachment by physical disturbance results in ongoing pressures. Active planning to better conserve such values would provide a direct opportunity to enhance protection of Antarctica's environment. Here we introduce an approach to systematic conservation planning, tailored to Antarctic research stations, to help managers improve the conservation of values surrounding their activity locations. Use of this approach provides a potential mechanism to balance the need for scientific access to the continent with international obligations to protect its environment. It may also facilitate the development of subordinate conservation tools, including management plans and natural capital accounting. By proactively minimising and containing their station footprints, national programs can also independently demonstrate their commitment to protecting Antarctica's environment