Patient symptoms and experience following COVID-19: results from a UK-wide survey

Objectives: To investigate the experience of people who continue to be unwell after acute COVID-19, often referred to as ‘long COVID’, both in terms of their symptoms and their interactions with healthcare. Design: We conducted a mixed-methods analysis of responses to a survey accessed through a UK online post-COVID support and information hub between April and December 2020 about people’s experiences after having acute COVID-19. Participants: 3290 respondents, 78% female 92.1% white ethnicity and median age range 45-54 years; 12.7% had been hospitalised. 494(16.5%) completed the survey between 4 and 8 weeks of the onset of their symptoms, 641(21.4%) between 8 and 12 weeks and 1865(62.1%) >12 weeks after. Results: The ongoing symptoms most frequently reported were; breathing problems (92.1%), fatigue (83.3%), muscle weakness or joint stiffness (50.6%), sleep disturbances (46.2%), problems with mental abilities (45.9%) changes in mood, including anxiety and depression (43.1%) and cough (42.3%). Symptoms did not appear to be related to the severity of the acute illness or to the presence of pre-existing medical conditions. Analysis of free text responses revealed three main themes (1) Experience of living with COVID-19 – physical and psychological symptoms that fluctuate unpredictably; (2) Interactions with healthcare that were unsatisfactory; (3) Implications for the future – their own condition, society and the healthcare system, and the need for research Conclusion: Consideration of patient perspective and experiences will assist in the planning of services to address problems persisting in people who remain symptomatic after the acute phase of COVID-19

Physical factors contributing to rural water supply functionality performance in Uganda

This report communicates the findings generated from one of the project surveys – deconstruction and forensic analysis of 50 individual water points in Uganda. The report presents the new data generated to Uganda’s groundwater resource potential; the nature and condition of hand-pump borehole installations; and the significance of both of these factors to service performance. Based on the evidence collected, the main physical factors affecting functionality performance within Uganda are the poor condition of handpump components, and the complex aquifer resource. The impact of these factors can be mitigated through appropriate material choice for handpump components (non GI), increased investment in borehole siting and testing, and adequate accessibility to repairs and maintenance capacity with breakdowns. These factors should not be considered to be the only driving forces of functionality outcomes in these regions of Uganda, however, and the results of this survey need to be examined alongside the wider project findings. Wider institutional arrangements, resources and dynamics, are likely to play a significant role in the implementation of appropriate borehole construction, siting and design; procurement processes; and the management capacity available for water points at national to local levels

Improvement of diaphragmatic performance through orthotopic application of decellularized extracellular matrix patch.

AbstractMuscle tissue engineering can provide support to large congenital skeletal muscle defects using scaffolds able to allow cell migration, proliferation and differentiation. Acellular extracellular matrix (ECM) scaffold can generate a positive inflammatory response through the activation of anti-inflammatory T-cell populations and M2 polarized macrophages that together lead to a local pro-regenerative environment. This immunoregulatory effect is maintained when acellular matrices are transplanted in a xenogeneic setting, but it remains unclear whether it can be therapeutic in a model of muscle diseases. We demonstrated here for the first time that orthotopic transplantation of a decellularized diaphragmatic muscle from wild animals promoted tissue functional recovery in an established atrophic mouse model. In particular, ECM supported a local immunoresponse activating a pro-regenerative environment and stimulating host muscle progenitor cell activation and migration. These results indicate that acellular scaffolds may represent a suitable regenerative medicine option for improving performance of diseased muscles

How clusters create shared value in rural areas: An examination of six case studies

The main aim of this paper is to demonstrate that clusters can support the sustainable development of rural areas through the creation of shared value. This is done via the close examination of six different cases of rural clusters in Greece, Italy, Germany, Poland, Denmark, and Sweden. Qualitative as well as quantitative data were taken from the clusters, which demonstrated that their main business approaches naturally coincided with the creation of economic, social, and environmental benefits for the local communities in which they operated. The case clusters were created in a top-down manner, aimed at boosting regional R&D activities and making the local economy more competitive and more sustainable. However, private initiative took over and al-lowed these clusters to flourish because meeting the regions’ economic, social, and environmental needs successfully coincided with the target of the clusters’ own development and profitability. The results show that clusters, with their potential for shared value creation, can constitute a powerful engine for the revitalisation and development of rural areas, addressing the significant challenges which they are currently facing

Permeability of the crystalline basement in Uganda : evidence from 665 pumping tests and implications for solar pumping

Crystalline basement rocks of Precambrian age underlie nearly three quarters of Uganda, providing groundwater supplies to meet ever increasing demand from rural areas and urban growth centres. Development of groundwater sources is commonly based on several factors including physical and socio-economic considerations that have a bearing on their functionality and long term reliability. Here we present new transmissivity data from 665 boreholes across basement aquifers in Uganda calculated from previously unanalyzed pumping test data. Other data are available to help interpret the transmissvity values, including borehole lithological logs, weathering thickness, well design and depth to groundwater. Spatial and depth comparisons are made to relate aquifer permeability to lithology and weathering, and also to relate borehole yields to well design. The data provide an improved understanding of the physical permeability of weathered crystalline basement rock aquifers across Uganda, complimenting earlier studies of vertical permeability profiles in focused areas. The analysis helps inform the physical capacity of the aquifer to supply the borehole yields to meet increasing demands, and application the potential for higher abstraction technologies, such as solar pumps

Modelling renal defects in Bardet-Biedl syndrome patients using human iPS cells

Bardet-Biedl syndrome (BBS) is a ciliopathy with pleiotropic effects on multiple tissues, including the kidney. Here we have compared renal differentiation of iPS cells from healthy and BBS donors. High content image analysis of WT1-expressing kidney progenitors showed that cell proliferation, differentiation and cell shape were similar in healthy, BBS1, BBS2, and BBS10 mutant lines. We then examined three patient lines with BBS10 mutations in a 3D kidney organoid system. The line with the most deleterious mutation, with low BBS10 expression, expressed kidney marker genes but failed to generate 3D organoids. The other two patient lines expressed near normal levels of BBS10 mRNA and generated multiple kidney lineages within organoids when examined at day 20 of organoid differentiation. However, on prolonged culture (day 27) the proximal tubule compartment degenerated. Introducing wild type BBS10 into the most severely affected patient line restored organoid formation, whereas CRISPR-mediated generation of a truncating BBS10 mutation in a healthy line resulted in failure to generate organoids. Our findings provide a basis for further mechanistic studies of the role of BBS10 in the kidney

Permeability of the weathered bedrock aquifers in Uganda: evidence from a large pumping test dataset and its implications for rural water supply

Weathered crystalline-rock aquifers underlie around 40% of sub-Saharan Africa providing water supplies for half of its rural population; they are also prevalent across the tropics. The hydrogeology of these aquifers is complex and better understanding of the controls to aquifer transmissivity, alongside accurate borehole siting and appropriate design, is pivotal to the long-term performance and sustainability of water services in many countries. This study examines a substantial new dataset (n = 655) of aquifer transmissivity values across Uganda derived from previously unanalyzed pumping-test data. These data provide important new insights: weathered crystalline-rock aquifers are distinguished by pervasively low transmissivities (median <2 m2/d) in comparison to other areas in the tropics; highest transmissivities are observed in boreholes <50 m deep, implying that drilling deeper boreholes does not typically improve supply success or sustainability in Uganda; and increased groundwater abstraction through the use of higher-yielding pump technologies will prove challenging in most areas of Uganda and limit their use for piped water supplies. This study highlights the scientific value of data held in drillers’ records, which remain unanalyzed in many countries but may provide useful insight and understanding of aquifer characteristics

Drinking water quality from rural handpump-boreholes in Africa

Groundwater provides a vital source of drinking water for rural communities in many parts of Africa, particularly in the dry season when there are few safe alternative sources. This paper summarises results from a study (n = 428) assessing dry season water quality, both microbiological and inorganic chemistry, in handpump equipped boreholes (HPBs) across the Ethiopia Highlands (n = 142), Malawi (n = 162) and Uganda (n = 124) using a stratified, randomised sampling design. This study seeks to examine general water quality by randomly sampling rural groundwater supplies across larger areas with different geology and climate. The majority, 72%, of HPBs surveyed provide good quality dry season drinking water as defined by WHO drinking water quality criteria. Within this overall picture, the most notable constraints were from thermotolerant coliforms (TTCs), which exceeded the WHO drinking water guideline of zero colony forming units (cfu/100 ml) in 21% of sites (range 0–626 cfu/100 ml). TTC contamination was found to have a significant and positive correlation with annual average rainfall (ρ = 0.2, p = 0.00003). Across all three countries, WHO health based chemical drinking water quality values were exceeded at 9% of sites and were found for manganese (4%), fluoride (2.6%) and nitrate (2.5%); arsenic concentrations were below the guideline value of 10 μg l−1 (range 400 μg l−1) found in drinking water sources in Uganda challenges the decision by WHO not to formalise a health-based guideline for Mn. While the overall level of microbiological contamination from HPBs is low, results from this study strongly suggest that at a national and regional level, microbiological contamination rather than chemical contamination will provide a greater barrier to achieving targets set for improved drinking water quality under the UN-SDG 6. Efforts should be made to ensure that boreholes are properly sited and constructed effectively to reduce pathogen contamination

The NRG1 exon 11 missense variant is not associated with autism in the Central Valley of Costa Rica

<p>Abstract</p> <p>Background</p> <p>We are conducting a genetic study of autism in the isolated population of the Central Valley of Costa Rica (CVCR). A novel Neuregulin 1 (NRG1) missense variant (exon 11 G>T) was recently associated with psychosis and schizophrenia (SCZ) in the same population isolate.</p> <p>Methods</p> <p>We genotyped the NRG1 exon 11 missense variant in 146 cases with autism, or autism spectrum disorder, with CVCR ancestry, and both parents when available (N = 267 parents) from 143 independent families. Additional microsatellites were genotyped to examine haplotypes bearing the exon 11 variant.</p> <p>Results</p> <p>The NRG1 exon 11 G>T variant was found in 4/146 cases including one de novo occurrence. The frequency of the variant in case chromosomes was 0.014 and 0.045 in the parental non-transmitted chromosomes. At least 6 haplotypes extending 0.229 Mb were associated with the T allele. Three independent individuals, with no personal or family history of psychiatric disorder, shared at least a 1 megabase haplotype 5' to the T allele.</p> <p>Conclusion</p> <p>The NRG1 exon 11 missense variant is not associated with autism in the CVCR.</p