Living in Transition Societal transitions from a youth perspective in Bhutan

The purpose of this thesis was to contribute to a more holistic understanding of youth experiences under the phenomenon of societal transitions caused by processes of modernization. Bhutan has been subjected to major changes in terms of economic development, political and societal transitions. The group mostly associated with this modernization and globalization process is the youth living in the capital Thimphu. Giddens, Beck and Bauman’s theories on modernization and globalization have been employed to understand the transitions in Bhutan from an individual and structural perspective. Primary fieldwork was carried out in Thimphu from September to December 2014. Empirical data was gained through qualitative face to face in-depth interviews and observations. The findings highlight the importance of community vitality for youth experiencing societal transitions. The research suggests that modernization and globalization processes are experienced as contrasting by the youth, implying new freedoms and possibilities, and exclusions and constraints at the same time. Gross National Happiness as a development paradigm, which balances material, spiritual, cultural and emotional needs, was revealed as a bridge of traditional and modern life as well as the guide to envision a modern sense of self without losing traditional benefits

Greenspace Justice in Vienna: A Research through Design Approach

Urban greenspaces (UGS) help cities and their population cope with the consequences of climate change and have a vital positive effect on people’s health and well-being. Public greenspaces are therefore an essential component of urban infrastructure. The City of Vienna offers a high proportion of public greenspaces. However, these are not evenly distributed and not necessarily accessible or affordable for all citizens. To achieve greenspace justice, it is crucial to provide equal access and usability that meets people’s needs. The present work contributes to the debate by including issues of equity and justice in the context of public greenspaces. A Research through Design (RtD) approach is used to design and sketch out an ideal situation for the provision of public greenspace. The requisite measures are then developed to achieve these ideal conditions. In this paper, we present the first methodological steps in an unconventional approach to creating new perspectives on existing policy and planning frameworks and developing innovative strategies to improve greenspace justice in cities

A methodology to evaluate public use and the perception of riverbanks: Valdivia as a case study

The intervention of river channels and river banks as a result of urban phenomena such as urban expansion or natural disasters, has resulted in the transformation of landscapes and changes in the occupation of these areas. Today it is necessary to study these areas, providing methodologies that delve into the significant, perceptual relations of the inhabitants with the river banks and its ecosystems as well as their use. The fluvial landscapes and the use of the river channels have marked the identity of the city of Valdivia, in the Region de los Ríos, Chile. This article discusses the progress of an investigation that seeks to characterize these river bank spaces that suffered an abandonment of their social and public uses. We select two landscapes as case studies: The southern waterfront of Isla Teja, and the southern waterfront of Las Animas, in the city of Valdivia, Chile. The methodology integrates an analysis of observation, interviews, a study of pedestrian accessibility, an analysis of the elements of the landscape and an analysis of the ecological value of fluvial ecosystems. Results show the problems and potentialities associated with the habitability of the two case studies. Finally, the article conclu des with reflections about the relevance of a multidimensional approach to address restructuring the design of fluvial public spaces.La intervención de los cauces y bordes de ríos producto de fenómenos urbanos como la expansión urbana o las catástrofes naturales, han traído como consecuencia la transformación de los paisajes y cambios en la ocupación de estas áreas. Hoy se hace necesario estudiar estas áreas, aportando metodologías que consideren las relaciones significantes, perceptuales y de uso de los habitantes con el borde fluvial y con sus ecosistemas. Los paisajes fluviales y el uso de los cauces de los ríos han marcado, en este sentido, la identidad de la ciudad de Valdivia, en la Región de los Ríos, Chile. Este artículo discute los avances de una investigación que busca caracterizar espacios de borde río que sufrieron abandono de sus usos sociales y públicos. Se aborda, en concreto, la investigación de dos paisajes de Valdivia: el borde río del sector sur de la Isla Teja y el borde río del sector sur de Las Ánimas. La metodología integra un análisis de observación, de entrevistas, un estudio de accesibilidad peatonal, un análisis de los elementos del paisaje y un análisis del valor ecológico de los ecosistemas fluviales. Los resultados evidencian problemáticas y potencialidades asociadas a la habitabilidad de los dos casos citados. Finalmente, el artículo concluye con reflexiones sobre la relevancia de un enfoque multidimensional para abordar el diseño de reconversión de espacios públicos fluviales

Improving Oral Hygiene Skills by Computer-Based Training: A Randomized Controlled Comparison of the Modified Bass and the Fones Techniques

Background: Gingivitis and other plaque-associated diseases have a high prevalence in western communities even though the majority of adults report daily oral hygiene. This indicates a lack of oral hygiene skills. Currently, there is no clear evidence as to which brushing technique would bring about the best oral hygiene skills. While the modified Bass technique is often recommended by dentists and in textbooks, the Fones technique is often recommended in patient brochures. Still, standardized comparisons of the effectiveness of teaching these techniques are lacking. Methodology/Principal Findings: In a final sample of n=56 students, this multidisciplinary, randomized, examiner-blinded, controlled study compared the effects of parallel and standardized interactive computer presentations teaching either the Fones or the modified Bass technique. A control group was taught the basics of tooth brushing alone. Oral hygiene skills (remaining plaque after thorough oral hygiene) and gingivitis were assessed at baseline and 6, 12, and 28 weeks after the intervention. We found a significant group×time interaction for gingivitis (F(4/102)=3.267; p=0.016; e=0.957; ?2=0.114) and a significant main effect of group for oral hygiene skills (F(2/51)=7.088; p=0.002; ?2=0.218). Fones was superior to Bass; Bass did not differ from the control group. Group differences were most prominent after 6 and 12 weeks. Conclusions/Significance: The present trial indicates an advantage of teaching the Fones as compared to the modified Bass technique with respect to oral hygiene skills and gingivitis. Future studies are needed to analyze whether the disadvantage of teaching the Bass technique observed here is restricted to the teaching method employed. Trial Registration: German Clinical Trials Register http://www.drks.de/DRKS0000348

A time-resolved proteomic and prognostic map of COVID-19

COVID-19 is highly variable in its clinical presentation, ranging from asymptomatic infection to severe organ damage and death. We characterized the time-dependent progression of the disease in 139 COVID-19 inpatients by measuring 86 accredited diagnostic parameters, such as blood cell counts and enzyme activities, as well as untargeted plasma proteomes at 687 sampling points. We report an initial spike in a systemic inflammatory response, which is gradually alleviated and followed by a protein signature indicative of tissue repair, metabolic reconstitution, and immunomodulation. We identify prognostic marker signatures for devising risk-adapted treatment strategies and use machine learning to classify therapeutic needs. We show that the machine learning models based on the proteome are transferable to an independent cohort. Our study presents a map linking routinely used clinical diagnostic parameters to plasma proteomes and their dynamics in an infectious disease

Combined point of care nucleic acid and antibody testing for SARS-CoV-2 following emergence of D614G Spike Variant

Rapid COVID-19 diagnosis in hospital is essential, though complicated by 30-50% of nose/throat swabs being negative by SARS-CoV-2 nucleic acid amplification testing (NAAT). Furthermore, the D614G spike mutant now dominates the pandemic and it is unclear how serological tests designed to detect anti-Spike antibodies perform against this variant. We assess the diagnostic accuracy of combined rapid antibody point of care (POC) and nucleic acid assays for suspected COVID-19 disease due to either wild type or the D614G spike mutant SARS-CoV-2. The overall detection rate for COVID-19 is 79.2% (95CI 57.8-92.9%) by rapid NAAT alone. Combined point of care antibody test and rapid NAAT is not impacted by D614G and results in very high sensitivity for COVID-19 diagnosis with very high specificity

Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission

Funder: Addenbrooke's Charitable Trust, Cambridge University Hospitals; FundRef: http://dx.doi.org/10.13039/501100002927Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Over a 3 week period (April 2020), 1032 asymptomatic HCWs were screened for SARS-CoV-2 in a large UK teaching hospital. Symptomatic staff and symptomatic household contacts were additionally tested. Real-time RT-PCR was used to detect viral RNA from a throat+nose self-swab. 3% of HCWs in the asymptomatic screening group tested positive for SARS-CoV-2. 17/30 (57%) were truly asymptomatic/pauci-symptomatic. 12/30 (40%) had experienced symptoms compatible with coronavirus disease 2019 (COVID-19)>7 days prior to testing, most self-isolating, returning well. Clusters of HCW infection were discovered on two independent wards. Viral genome sequencing showed that the majority of HCWs had the dominant lineage B∙1. Our data demonstrates the utility of comprehensive screening of HCWs with minimal or no symptoms. This approach will be critical for protecting patients and hospital staff

Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2

Abstract: Although two-dose mRNA vaccination provides excellent protection against SARS-CoV-2, there is little information about vaccine efficacy against variants of concern (VOC) in individuals above eighty years of age1. Here we analysed immune responses following vaccination with the BNT162b2 mRNA vaccine2 in elderly participants and younger healthcare workers. Serum neutralization and levels of binding IgG or IgA after the first vaccine dose were lower in older individuals, with a marked drop in participants over eighty years old. Sera from participants above eighty showed lower neutralization potency against the B.1.1.7 (Alpha), B.1.351 (Beta) and P.1. (Gamma) VOC than against the wild-type virus and were more likely to lack any neutralization against VOC following the first dose. However, following the second dose, neutralization against VOC was detectable regardless of age. The frequency of SARS-CoV-2 spike-specific memory B cells was higher in elderly responders (whose serum showed neutralization activity) than in non-responders after the first dose. Elderly participants showed a clear reduction in somatic hypermutation of class-switched cells. The production of interferon-γ and interleukin-2 by SARS-CoV-2 spike-specific T cells was lower in older participants, and both cytokines were secreted primarily by CD4 T cells. We conclude that the elderly are a high-risk population and that specific measures to boost vaccine responses in this population are warranted, particularly where variants of concern are circulating

Complement lectin pathway activation is associated with COVID-19 disease severity, independent of MBL2 genotype subgroups

IntroductionWhile complement is a contributor to disease severity in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, all three complement pathways might be activated by the virus. Lectin pathway activation occurs through different pattern recognition molecules, including mannan binding lectin (MBL), a protein shown to interact with SARS-CoV-2 proteins. However, the exact role of lectin pathway activation and its key pattern recognition molecule MBL in COVID-19 is still not fully understood.MethodsWe therefore investigated activation of the lectin pathway in two independent cohorts of SARS-CoV-2 infected patients, while also analysing MBL protein levels and potential effects of the six major single nucleotide polymorphisms (SNPs) found in the MBL2 gene on COVID-19 severity and outcome.ResultsWe show that the lectin pathway is activated in acute COVID-19, indicated by the correlation between complement activation product levels of the MASP-1/C1-INH complex (p=0.0011) and C4d (p<0.0001) and COVID-19 severity. Despite this, genetic variations in MBL2 are not associated with susceptibility to SARS-CoV-2 infection or disease outcomes such as mortality and the development of Long COVID.ConclusionIn conclusion, activation of the MBL-LP only plays a minor role in COVID-19 pathogenesis, since no clinically meaningful, consistent associations with disease outcomes were noted

SARS-CoV-2 B.1.617.2 Delta variant replication and immune evasion

Abstract: The B.1.617.2 (Delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in the state of Maharashtra in late 2020 and spread throughout India, outcompeting pre-existing lineages including B.1.617.1 (Kappa) and B.1.1.7 (Alpha)1. In vitro, B.1.617.2 is sixfold less sensitive to serum neutralizing antibodies from recovered individuals, and eightfold less sensitive to vaccine-elicited antibodies, compared with wild-type Wuhan-1 bearing D614G. Serum neutralizing titres against B.1.617.2 were lower in ChAdOx1 vaccinees than in BNT162b2 vaccinees. B.1.617.2 spike pseudotyped viruses exhibited compromised sensitivity to monoclonal antibodies to the receptor-binding domain and the amino-terminal domain. B.1.617.2 demonstrated higher replication efficiency than B.1.1.7 in both airway organoid and human airway epithelial systems, associated with B.1.617.2 spike being in a predominantly cleaved state compared with B.1.1.7 spike. The B.1.617.2 spike protein was able to mediate highly efficient syncytium formation that was less sensitive to inhibition by neutralizing antibody, compared with that of wild-type spike. We also observed that B.1.617.2 had higher replication and spike-mediated entry than B.1.617.1, potentially explaining the B.1.617.2 dominance. In an analysis of more than 130 SARS-CoV-2-infected health care workers across three centres in India during a period of mixed lineage circulation, we observed reduced ChAdOx1 vaccine effectiveness against B.1.617.2 relative to non-B.1.617.2, with the caveat of possible residual confounding. Compromised vaccine efficacy against the highly fit and immune-evasive B.1.617.2 Delta variant warrants continued infection control measures in the post-vaccination era