Ongoing exposure to peritoneal dialysis fluid alters resident peritoneal macrophage phenotype and activation propensity

Peritoneal dialysis (PD) is a more continuous alternative to haemodialysis, for patients with chronic kidney disease, with considerable initial benefits for survival, patient independence and healthcare costs. However, long-term PD is associated with significant pathology, negating the positive effects over haemodialysis. Importantly, peritonitis and activation of macrophages is closely associated with disease progression and treatment failure. However, recent advances in macrophage biology suggest opposite functions for macrophages of different cellular origins. While monocyte-derived macrophages promote disease progression in some models of fibrosis, tissue resident macrophages have rather been associated with protective roles. Thus, we aimed to identify the relative contribution of tissue resident macrophages to PD induced inflammation in mice. Unexpectedly, we found an incremental loss of homeostatic characteristics, anti-inflammatory and efferocytic functionality in peritoneal resident macrophages, accompanied by enhanced inflammatory responses to external stimuli. Moreover, presence of glucose degradation products within the dialysis fluid led to markedly enhanced inflammation and almost complete disappearance of tissue resident cells. Thus, alterations in tissue resident macrophages may render long-term PD patients sensitive to developing peritonitis and consequently fibrosis/sclerosis

Prioritizing investments in innovations to protect women from the leading causes of maternal death

PATH, an international nonprofit organization, assessed nearly 40 technologies for their potential to reduce maternal mortality from postpartum hemorrhage and preeclampsia and eclampsia in low-resource settings. The evaluation used a new Excel-based prioritization tool covering 22 criteria developed by PATH, the Maternal and Neonatal Directed Assessment of Technology (MANDATE) model, and consultations with experts. It identified five innovations with especially high potential: technologies to improve use of oxytocin, a uterine balloon tamponade, simplified dosing of magnesium sulfate, an improved proteinuria test, and better blood pressure measurement devices. Investments are needed to realize the potential of these technologies to reduce mortality

A Comparison of Approaches to Regional Land-Use Capability Analysis for Agricultural Land-Planning

Smallholder agriculture is a major source of income and food for developing nations. With more frequent drought and increasing scarcity of arable land, more accurate land-use planning tools are needed to allocate land resources to support regional agricultural activity. To address this need, we created Land Capability Classification (LCC) system maps using data from two digital soil maps, which were compared with measurements from 1305 field sites in the Dosso region of Niger. Based on these, we developed 250 m gridded maps of LCC values across the region. Across the region, land is severely limited for agricultural use because of low available water-holding capacity (AWC) that limits dry season agricultural potential, especially without irrigation, and requires more frequent irrigation where supplemental water is available. If the AWC limitation is removed in the LCC algorithm (i.e., simulating the use of sufficient irrigation or a much higher and more evenly distributed rainfall), the dominant limitations become less severe and more spatially varied. Finally, we used additional soil fertility data from the field samples to illustrate the value of collecting contemporary data for dynamic soil properties that are critical for crop production, including soil organic carbon, phosphorus and nitrogen. View Full-Text</div

Ecological effects of nitrogen and sulfur air pollution in the US: what do we know?

Four decades after the passage of the US Clean Air Act, air-quality standards are set to protect ecosystems from damage caused by gas-phase nitrogen (N) and sulfur (S) compounds, but not from the deposition of these air pollutants to land and water. Here, we synthesize recent scientific literature on the ecological effects of N and S air pollution in the US. Deposition of N and S is the main driver of ecosystem acidification and contributes to nutrient enrichment in many natural systems. Although surface-water acidification has decreased in the US since 1990, it remains a problem in many regions. Perturbations to ecosystems caused by the nutrient effects of N deposition continue to emerge, although gas-phase concentrations are generally not high enough to cause phytotoxicity. In all, there is overwhelming evidence of a broad range of damaging effects to ecosystems in the US under current air-quality conditions

Adaptive fishing pole design

The objective of this project was to develop an adaptable fishing device for a client at the Massachusetts Hospital School which would allow the user to cast, reel, and set the hook easily and comfortabily from his wheelchair. The casting mechanism involves a motor that rotates the rod backward while extending a spring. The spring then snaps the rod forward. Using another motor and a conventional reel, the reeling function is performed. Setting the hook can be achieved manually or by using the casting motor. The device is supported by a platform, which is placed to the side of the wheechair and can be adjusted for different heights. The adaptive fishing pole device casts a 5/8-oz weight an average of 25 ft and reels at a rate between 0.62 ft/sec and 1.46 ft/sec

Syringes must be prioritized globally to ensure equitable access to COVID-19 and other essential vaccines and to sustain safe injection practices

Supply of autodisable (AD) syringes has been a key component of global COVID-19 vaccination campaigns, and it is critical to maintaining safe injection practices for routine immunization as well as pandemic response. AD syringe production increased significantly in response to demand, but distribution challenges have included the need to coordinate syringes to meet the specific delivery requirements of various COVID-19 vaccines, shipping bottlenecks, and syringe export restrictions. Stockpiling syringes, ensuring standardization of future vaccine dose volumes, and geographical diversification of syringe production would improve syringe logistics in the future. Balancing syringe supply and demand and stabilizing the market over the long term is essential to ensure that the world is prepared for possible new variants of COVID-19 or a new global outbreak. This will require concerted action on the part of public, nonprofit, and private partners

A low-cost uterine balloon tamponade for management of postpartum hemorrhage: modeling the potential impact on maternal mortality and morbidity in sub-Saharan Africa

Background: Postpartum hemorrhage (PPH) is the leading cause of maternal deaths worldwide. This study sought to quantify the potential health impact (morbidity and mortality reductions) that a low-cost uterine balloon tamponade (UBT) could have on women suffering from uncontrolled PPH due to uterine atony in sub-Saharan Africa. Methods: The Maternal and Neonatal Directed Assessment of Technology (MANDATE) model was used to estimate maternal deaths, surgeries averted, and cases of severe anemia prevented through UBT use among women with PPH who receive a uterotonic drug but fail this therapy in a health facility. Estimates were generated for the year 2018. The main outcome measures were lives saved, surgeries averted, and severe anemia prevented. Results: The base case model estimated that widespread use of a low-cost UBT in clinics and hospitals could save 6547 lives (an 11% reduction in maternal deaths), avert 10,823 surgeries, and prevent 634 severe anemia cases in sub-Saharan Africa annually. Conclusions: A low-cost UBT has a strong potential to save lives and reduce morbidity. It can also potentially reduce costly downstream interventions for women who give birth in a health care facility. This technology may be especially useful for meeting global targets for reducing maternal mortality as identified in Sustainable Development Goal 3

Market analysis for cultured proteins in low- and lower-middle income countries

The global burden of malnutrition is unacceptably high. Animal-source foods are important components of diverse diets and provide high-quality proteins and other essential nutrients that promote optimal growth and development. The global demand for animal-source foods is projected to increase substantially, particularly in many low- and lower-middle income countries (LMICs). However, cost is a significant barrier to access, and meeting this growing demand through livestock production will be highly resource intensive. As such, sustainable, high-quality alternatives to protein from livestock have the potential for significant transformative impact for both people and the planet. This analysis focuses on fermentation-derived cultured proteins as a specific alternative to animal-source proteins, given their near-term time to market, product qualities, and potential to be used in LMIC settings. Most cultured protein manufacturers are currently focused on creating milk (casein and whey) and egg white cultured protein products. Using a process known as fermentation-based cellular agriculture, animal proteins found in milk and eggs can be produced without animals. Through this method, a gene encoded with an animal protein is introduced into a starter culture of microflora (e.g., fungi or yeast). This culture is grown in controlled fermentation tanks, where it expresses the desired protein. Finally, the protein is separated from the microflora, generally producing a purified protein powder. These resulting “cultured” proteins are designed to be identical to the corresponding animal-source proteins produced through traditional livestock farming and can be used as ingredients in existing or new food products. Although there are many potential sustainability and nutrition-related benefits of these innovations, they also face several challenges to commercialization and market uptake.Non-PRIFPRI5; 1 Fostering Climate-Resilient and Sustainable Food Supply; CRP5; Alternate ProteinsEPTDCGIAR Research Program on Water, Land and Ecosystems (WLE