Global Health Commodities Supply Chain in the Era of COVID-19 Pandemic: Challenges, Impacts, and Prospects: A Systematic Review

Background: The COVID-19 pandemic led to the most substantial health crisis in the 21st Century. This pandemic interrupted the supply of essential commodities for human beings. Among the essential commodities for human survival, disruption of the supply of essential health commodities has become a global concern. Objective: The study aimed to systematically analyze published articles on the challenges, impacts, and prospects of the global health commodities’ supply chain in the era of the COVID-19 pandemic. Methods: A standard searching strategy was conducted in seven research databases to retrieve pertinent articles. Finally, 459 articles were retrieved for further screening, and only 13 articles were selected for final synthesis. Results: Almost 38.5% of the studies targeted the supply chain of health commodities used to treat HIV, TB, and malaria. Lockdown policies, travel restrictions, lack of transportation, low manufacturing capacity, and rising costs were the significant challenges indicated for the supply interruption of essential health commodities and COVID-19 vaccines. Findings indicated that the supply interruption of essential health commodities leads to a devastating impact on global health. Conclusion: Global medicine shortages due to the pandemic crisis can have a devastatingly harmful impact on patient outcomes and might result in a devastatingly long-lasting effect on the health of the world community. Supply-related challenges of the COVID-19 vaccine affect countries’ ambitions for achieving herd immunity quickly. Monitoring the pandemic’s effect on the health commodities’ supply system and designing a short-term and long-ter

Rare Manifestation of a Rare Disease, Acute Liver Failure in Adult Onset Still’s Disease: Dramatic Response to Methylprednisolone Pulse Therapy—A Case Report and Review

Adult onset Still’s disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. It is characterized by daily fevers, arthralgias or arthritis, typical skin rash, and leukocytosis. Hepatic involvement is frequently observed in the course of AOSD with mildly elevated transaminases and/or hepatomegaly. Fulminant hepatic failure, occasionally requiring urgent liver transplantation, is a rare manifestation of AOSD. Here, we present a case of 22-year-old woman with no significant medical history who initially came with fever, arthralgias, myalgias, generalized weakness, and sore throat. Laboratory data showed mildly elevated transaminases and markedly elevated ferritin levels. She was diagnosed with AOSD based on Yamaguchi diagnostic criteria and was started on prednisone. Three months later, while she was on tapering dose of steroid, she presented with fever, abdominal pain, jaundice, and markedly elevated transaminases. Extensive workup excluded all potential causes of liver failure. She was diagnosed with AOSD associated acute liver failure (ALF). Intravenous (IV) methylprednisolone pulse therapy was started, with dramatic improvement in liver function. Our case demonstrated that ALF can present as a complication of AOSD and IV mega dose pulse methylprednisolone therapy can be employed as a first-line treatment in AOSD associated ALF with favorable outcome

Landscape positions dictating crop fertilizer responses in wheat-based farming systems of East African Highlands

Improving fertilizer use efficiency has remained a challenge, particularly for small-scale farming in undulating ‘abnormal’ landscapes of East Africa. Milne's 1930s concept on ‘Catena’ was considered as a breakthrough in understanding soil variability and its implication on productivity in East African highlands. However, there is limited information on how the ‘Catena’ features could be used for fine tuning fertilizer recommendations. We initiated multiple on-farm replicated experiments in three wheat-growing districts (Endamohoni, Lemo and Worreilu) in the Ethiopian highlands in 2014, 2015 and 2016 to assess landscape positions affecting crop-nutrient responses, identify yield limiting nutrients across the ‘Catena’ (N, P, K, S and Zn) and quantify effects of landscape positions on resources use efficiency. We clustered farmlands across the ‘Catena’ (Hillslopes, Midslopes and Footslopes) based on land scape positions in the respective locations. Wheat yield was more strongly and significantly affected by landscape positions (P N92 P46) while differences between landscape positions diminish at lower rates. Yield benefits due to application of K was significant only in the dry years (P < 0.05), while there was hardly any yield benefit from the application of zinc and sulfur. The crop nitrogen recovery fraction and crop water productivity decreased with an increasing slope regardless of nutrient combinations. The results indicated that the landscape position could be considered as a proxy indicator for targeted fertilizer application, particularly in farms with undulating topographic features. Hillslopes are better served by the application of organic fertilizers along with conservation measures as applying higher rates of mineral fertilizer in hillslopes would rather increase the risk of downstream nutrient movement

The growth pattern of the human intestine and its mesentery

Supplemental Figures. 3D PDF CS14, CS16, CS20, CS23, and 9.0 and 9.5 WKS. Interactive 3D PDFs are provided for CS14, CS16, CS20, CS23, and 9.0 and 9.5 WKS. See the supplement “3D PDF operation manual” for instructions how to use the interactive PDF tools. The color codes correspond to those used in the Figures (Legend Table). (PDF 394 kb

Habitat characteristics or protected area size: What is more important for the composition and diversity of mammals in nonprotected areas?

The margins of protected areas are usually considered to have greater forest degradation, and given that most mammals live outside protected areas, researchers and conservation practitioners are increasingly recognizing that nonprotected areas must be incorporated into conservation strategy. However, the strategy used to manage these areas still involves increasing the size of protected areas, while not considering the habitat characteristics and requirements of the species. In this study, during a 3-year period, camera trap and habitat characteristic surveys were used to estimate composition, diversity, and habitat characteristics of mammals to determine habitat characteristics or increase the size of protected areas what should be considered first for mammals’ conservation in a nonprotected area near the Huangshan Mountains in Anhui Province, China. From June 2017 to October 2019, 18 species of mammals were recorded, more than in any other protected area nearby. The linear model analysis results showed that habitat characteristics of mammals were different and showed a significant correlation with their relative abundance. Most species were related to vegetation characteristics, except primates (Macaca thibetana), and rodents (Leopoldamys edwardsi). Therefore, to establish conservation policies for nonprotected areas, habitat characteristics should be of prime concern, followed by increasing the size of protected areas to provide effective refuge areas for species conservation

Bargaining Power of Developing Countries in Trade Negotiations

The bargaining power of a country plays an influential and impactful role in trade negotiation. The final trade agreement is the result of the background negotiation among the contracting countries in a bilateral, regional or a multilateral arrangement. This paper has attempted to explore main strategies often exercised by the countries in trade negotiation and identifying factors that, in one way or the other, determine the bargaining power, particularly, of the developing countries. The data gathered from secondary sources are qualitatively analyzed. As strategies, the principle of reciprocity (negotiation based on a ‘give and a take’ policy) and prior preparation (conducting the negotiation process with full prior information, research finding and analysis), have been identified. Furthermore, the basic factors for building or relinquishing bargaining power particularly from the developing country’s perspective have been discerned as market, commercial intelligence, capacity to control others and resource. As trade cooperation is becoming an unavoidable and inescapable phenomenon in the entire world, developing countries are advised to make themselves ready to play well the trade negotiation game by improving their bargaining power and by exploiting maximum possible out of that. There is no trade deal that is wholesale good or bad; it rather depends on how the country negotiates

Reduced tillage, but not organic matter input, increased nematode diversity and food web stability in European long‐term field experiments

Soil nematode communities and food web indices can inform about the complexity, nutrient flows and decomposition pathways of soil food webs, reflecting soil quality. Relative abundance of nematode feeding and life‐history groups are used for calculating food web indices, i.e., maturity index (MI), enrichment index (EI), structure index (SI) and channel index (CI). Molecular methods to study nematode communities potentially offer advantages compared to traditional methods in terms of resolution, throughput, cost and time. In spite of such advantages, molecular data have not often been adopted so far to assess the effects of soil management on nematode communities and to calculate these food web indices. Here, we used high‐throughput amplicon sequencing to investigate the effects of tillage (conventional vs. reduced) and organic matter addition (low vs. high) on nematode communities and food web indices in 10 European long‐term field experiments and we assessed the relationship between nematode communities and soil parameters. We found that nematode communities were more strongly affected by tillage than by organic matter addition. Compared to conventional tillage, reduced tillage increased nematode diversity (23% higher Shannon diversity index), nematode community stability (12% higher MI), structure (24% higher SI), and the fungal decomposition channel (59% higher CI), and also the number of herbivorous nematodes (70% higher). Total and labile organic carbon, available K and microbial parameters explained nematode community structure. Our findings show that nematode communities are sensitive indicators of soil quality and that molecular profiling of nematode communities has the potential to reveal the effects of soil management on soil quality

The application of predictive modelling for determining bio-environmental factors affecting the distribution of blackflies (Diptera: Simuliidae) in the Gilgel Gibe watershed in Southwest Ethiopia

Blackflies are important macroinvertebrate groups from a public health as well as ecological point of view. Determining the biological and environmental factors favouring or inhibiting the existence of blackflies could facilitate biomonitoring of rivers as well as control of disease vectors. The combined use of different predictive modelling techniques is known to improve identification of presence/absence and abundance of taxa in a given habitat. This approach enables better identification of the suitable habitat conditions or environmental constraints of a given taxon. Simuliidae larvae are important biological indicators as they are abundant in tropical aquatic ecosystems. Some of the blackfly groups are also important disease vectors in poor tropical countries. Our investigations aim to establish a combination of models able to identify the environmental factors and macroinvertebrate organisms that are favourable or inhibiting blackfly larvae existence in aquatic ecosystems. The models developed using macroinvertebrate predictors showed better performance than those based on environmental predictors. The identified environmental and macroinvertebrate parameters can be used to determine the distribution of blackflies, which in turn can help control river blindness in endemic tropical places. Through a combination of modelling techniques, a reliable method has been developed that explains environmental and biological relationships with the target organism, and, thus, can serve as a decision support tool for ecological management strategies

Novel <i>IRF6 </i>mutations in families with Van Der Woude syndrome and popliteal pterygium syndrome from sub-Saharan Africa

Orofacial clefts (OFC) are complex genetic traits that are often classified as syndromic or nonsyndromic clefts. Currently, there are over 500 types of syndromic clefts in the Online Mendelian Inheritance in Man (OMIM) database, of which Van der Woude syndrome (VWS) is one of the most common (accounting for 2% of all OFC). Popliteal pterygium syndrome (PPS) is considered to be a more severe form of VWS. Mutations in the IRF6 gene have been reported worldwide to cause VWS and PPS. Here, we report studies of families with VWS and PPS in sub-Saharan Africa. We screened the DNA of eight families with VWS and one family with PPS from Nigeria and Ethiopia by Sanger sequencing of the most commonly affected exons in IRF6 (exons 3, 4, 7, and 9). For the VWS families, we found a novel nonsense variant in exon 4 (p.Lys66X), a novel splice-site variant in exon 4 (p.Pro126Pro), a novel missense variant in exon 4 (p.Phe230Leu), a previously reported splice-site variant in exon 7 that changes the acceptor splice site, and a known missense variant in exon 7 (p.Leu251Pro). A previously known missense variant was found in exon 4 (p.Arg84His) in the PPS family. All the mutations segregate in the families. Our data confirm the presence of IRF6-related VWS and PPS in sub-Saharan Africa and highlights the importance of screening for novel mutations in known genes when studying diverse global populations. This is important for counseling and prenatal diagnosis for high-risk families