An integrated cell atlas of the lung in health and disease

Single-cell technologies have transformed our understanding of human tissues. Yet, studies typically capture only a limited number of donors and disagree on cell type definitions. Integrating many single-cell datasets can address these limitations of individual studies and capture the variability present in the population. Here we present the integrated Human Lung Cell Atlas (HLCA), combining 49 datasets of the human respiratory system into a single atlas spanning over 2.4 million cells from 486 individuals. The HLCA presents a consensus cell type re-annotation with matching marker genes, including annotations of rare and previously undescribed cell types. Leveraging the number and diversity of individuals in the HLCA, we identify gene modules that are associated with demographic covariates such as age, sex and body mass index, as well as gene modules changing expression along the proximal-to-distal axis of the bronchial tree. Mapping new data to the HLCA enables rapid data annotation and interpretation. Using the HLCA as a reference for the study of disease, we identify shared cell states across multiple lung diseases, including SPP1+ profibrotic monocyte-derived macrophages in COVID-19, pulmonary fibrosis and lung carcinoma. Overall, the HLCA serves as an example for the development and use of large-scale, cross-dataset organ atlases within the Human Cell Atlas

In Enemy Land The Jews of Kielce and the Region, 1939-1946

This book offers a study of the Jewish community in Kielce and its environs during World War II and the Holocaust:.This book offers a study of the Jewish community in Kielce and its environs during World War II and the Holocaust:.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries

Medical Engineering Education based on the Spiral Approach

The goal of Medical Engineering (ME) education is to qualify students to become engineers who can provide technological solutions to problems encountered in medical environments. The undergraduate program of ME has been emerging as a distinct discipline at academic institutions. Students in this program undergo extensive training in both medicine and engineering sciences. This manuscript presents the curriculum of the ME bachelor's degree program at Afeka College of Engineering, which is designed according to the spiral approach. This approach is based on iterative revisiting of topics, such that with each encounter, levels of difficulty and sophistication are increased, new learning is related to previous learning, and students' competency is enhanced. A survey of students and graduates indicates that the approach greatly contributes to an integrative understanding of the studied material. Our experience of using this approach suggests that it fosters a holistic perspective and that it provides graduates with skills for dealing with industrial and academy challenges. This manuscript could contribute for anyone who develops or improves curriculum, particularly in a multidisciplinary program

Seasonal dynamics impact habitat preferences and protected area use of the critically endangered Kordofan giraffe (Giraffa camelopardalis antiquorum)

Understanding animals' habitat selection and movement behaviours relative to human activities is important for evaluating resource requirements and ensuring effective conservation management. The world's largest remaining population of Kordofan giraffe (Giraffa camelopardalis antiquorum) reside in Zakouma National Park, Chad. However, it is unclear whether the park boundaries sufficiently encompass the full range of this population's preferred habitats. We used GPS telemetry data from 17 female giraffe over multiple years to better understand landscape and seasonal factors that influence their home range patterns and habitat preferences at multiple spatial scales. Kordofan giraffe seasonal ranges and core seasonal ranges were larger during the wet season and core utilization distributions had greater overlap with the national park in the dry season. The importance of shifts in seasonal habitat use, attributed to the flooding and drying that occurs within the park, necessitates Kordofan giraffe to move beyond the park's boundaries. Kordofan giraffe selected for open grasslands (mean coefficient = 0.48, 95% CI [0.22,0.74]), and increased their tortuosity of movement in these areas (mean coefficient = –0.18, 95% CI [–0.23,–0.14]). Conversely, with Vachellia savannas as the reference level for land-cover variables, the giraffe avoided anthropogenic areas, barren lands, Combretaceae savannas and forests. We advise increased community-based co-learning projects and awareness of giraffe outside the park. In addition, by identifying key habitat types that giraffe selected, we advise enhanced monitoring in preferred giraffe habitats during the wet season to protect these areas from being encroached by human settlement or agricultural expansion, with the support of the legal framework of the Bahr Salamat Wildlife Reserve and other agreements that protect wet season wildlife corridors

Randomized controlled trial to evaluate locally sourced two-component compression bandages for HIV-associated Kaposi sarcoma leg lymphedema in western Kenya: The Kenyan Improvised Compression for Kaposi Sarcoma (KICKS) study protocol.

BackgroundHIV-associated Kaposi sarcoma (KS), among the most frequent cancers seen in sub-Saharan Africa, is associated with a high prevalence of lymphedema. Lymphedema causes progressive functional impairment marked by swelling, physical discomfort, disfiguring changes, skin hardening from fibrosis, poor wound healing, and recurrent skin infection. While compression therapy is considered a major component of lymphedema management, this intervention has never been evaluated in HIV-associated KS lymphedema.Methods/designThe Kenyan Improvised Compression for Kaposi Sarcoma (KICKS) study is a randomized, controlled trial. Due to variable lymphedema stage, we will use block randomization with a 1:1 allocation to assign participants to one of two groups: "Immediate compression" or "Delayed compression." Those randomized to "Immediate compression" intervention arm will receive weekly two-component compression bandages while receiving chemotherapy, whereas those in the "Delayed compression" control arm will be followed during chemotherapy and then receive compression after chemotherapy is completed. The primary outcome is change in Lower Extremity Lymphedema Index from enrollment at Week 0 to blinded outcome assessment at Week 14 between intervention and control arms. Secondary outcomes are change in leg lymphedema-specific quality of life (LYMQOL) and change in overall health quality of life in cancer (EORTC QLQ C30).DiscussionThis represents the first study in sub-Saharan Africa to assess a lymphedema-directed intervention for KS, and the intervention-locally sourced two-component compression bandages-is affordable and available. Thus, the KICKS study is an important step towards developing an evidence-based path for regionally relevant management of HIV-associated KS lymphedema.Trial registrationThis trial was registered at ClinicalTrials.gov on January 19, 2018: identifier NCT03404297

Compression Therapy for HIV-Associated Kaposi Sarcoma Leg Lymphedema: Results of the Kenyan Improvised Compression for Kaposi Sarcoma Randomized Controlled Trial

Evaluate the effectiveness of compression while receiving chemotherapy compared with chemotherapy alone in the treatment of HIV-associated Kaposi sarcoma (KS) lymphedema. METHODS: A randomized controlled trial was conducted in a single oncology clinic in western Kenya (NCT03404297). A computer-generated randomization schedule was used to allocate treatment arms. Randomized block design was used for stratification by lymphedema stage. Participants were HIV positive adults age ≥ 18 years on antiretroviral therapy with biopsy-proven KS associated with leg lymphedema and being initiated on chemotherapy. The intervention was 10 weeks of weekly clinic-based application of two-component paste compression bandages. The primary outcome was change in the Lower Extremity Lymphedema Index (LELI) score from week 0 to week 14. The secondary outcomes were change in the Lymphedema Quality of Life measure (LYMQOL) and change in the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 score from week 0 to week 14. Blinded outcome assessments were conducted. RESULTS: Of 30 participants randomly assigned, 25 eligible patients (chemotherapy [control], n = 13; compression plus chemotherapy [intervention], n = 12) returned at week 14. Change in LELI, LYMQOL, and EORTC QLQ-C30 scores between week 14 and week 0 did not significantly differ by arm. The mean (standard deviation) change in LELI score was –25.9 (34.6) for the control arm compared with –13.3 (29.5) for the intervention arm, P = .340. The difference (95% CI) in the change in LELI score was –12.6 (–39.3 to 14.1). CONCLUSION: Future studies evaluating a 14-week change in LELI for KS lymphedema should assume a standard deviation of approximately 30. Lessons learned from this pilot trial should inform the development of a larger, multicenter trial to evaluate the effectiveness of compression for KS lymphedema