Effects of Urban Land-Use Planning on Housing Prices in Chiang Mai, Thailand

Chiang Mai is an emerging tourism-oriented city in Thailand. The booming tourism industry during the past decades has triggered significant expansion in its urban land area, resulting in a large number of newly-built residential communities appearing on unplanned land. In this study, we used multiscale geographically weighted regression (MGWR)-based hedonic price analysis to investigate 4624 housing transactions from 524 residential communities in Chiang Mai. This showed that the recent land-use planning in Chiang Mai has had unusual effects on housing prices; specifically, the effects of accessibility to hospitals, primary and secondary schools, green parks, and shopping malls could be ignored, demonstrating that local residents were well satisfied with land-use planning for high-quality medical and education sources and good living environments throughout the whole of Chiang Mai, and that no more land-use planning and investment on these facilities was needed. However, limited bus routes were only used for tourism and could not provide convenient routes for local residents, leading to their negative effects on housing prices in downtown areas, so the local government should lower the bus stop density in downtown areas and strengthen the transportation links between downtown areas and suburbs. Our study will not only support the urban land planning department of Chiang Mai to optimize residential communities and nearby facilities, but can also provide insights into housing price formation mechanisms in similar tourism-oriented cities in Thailand and beyond

PRIN Project 2010-11 “Active and recent geodynamics of Calabrian Arc and accretionary complex in the Ionian Sea”: new constraints from geological, geodetic and seismological data

This contribution illustrates the preliminary results of our Research Unit in the PRIN Project 2010-11, which focuses on active and recent geodynamics of Calabrian Arc. The integration of the new geological, geodetic and seismological data supports the inferred recent plate boundary reorganization in the central-southern Mediterranean, where the regional GNNS velocity fields point to a deceleration or cessation of Calabrian Arc migration, and to extension along the axis of the Calabrian Arc, accommodated by normal faulting (e.g. Capo Vaticano and Messina Straits (Aloisi et al., 2012; Pepe et al., 2014; Spampinato et al., 2014). The study of the lateral borders of the Arc revealed that oblique strike-slip displacement has occurred during its southeastwards migration. Active dextral transtension is occurring along the NNW-striking Aeolian-Tindari Letojanni fault system, forming the southern boundary of the Arc. It joins to the north other two boundaries characterized by different tectonic regimes, a contractional belt in the southern Tyrrhenian sea, where a tectonic inversion has occurred since the middle Pleistocene, and the extensional one in northeastern Sicily and western Calabria (Palano et al., 2012; Barreca et al., 2014a). Along the northern boundary of the Arc, the so-called Pollino line (onshore) and Sibari Line (offshore), active deformation has been documented on folds growing above blind oblique thrust ramps extending offshore, controlling the present morphobathymetric pattern (Santoro et al., 2013). Although external to the Calabrian Arc, we also devoted attention to the front of the Maghrebian thrust belt in western Sicily where we presented the first evidence of historical co-seismic deformation on a thrust array running from the Belice area to the Sicily Channel (Barreca et al., 2014b). Morphotectonic analysis and fault numeric modeling of uplifted Pleistocene marine terraces and Holocene paleo-shorelines has documented that most of the uplift along the Calabrian Arc is related to regional processes and the residual to coseismic displacement on major faults, both transpressional and transtensional, at the borders, and extensional along the chain axis

Rhizobial characterization in revegetated areas after bauxite mining.

Little is known regarding how the increased diversity of nitrogen-fixing bacteria contributesto the productivity and diversity of plants in complex communities. However, some authorshave shown that the presence of a diverse group of nodulating bacteria is required for dif-ferent plant species to coexist. A better understanding of the plant symbiotic organismdiversity role in natural ecosystems can be extremely useful to define recovery strategies ofenvironments that were degraded by human activities. This study used ARDRA, BOX-PCRfingerprinting and sequencing of the 16S rDNA gene to assess the diversity of root nodulenitrogen-fixing bacteria in former bauxite mining areas that were replanted in 1981, 1985,1993, 1998, 2004 and 2006 and in a native forest. Among the 12 isolates for which the 16SrDNA gene was partially sequenced, eight, three and one isolate(s) presented similarity withsequences of the genera Bradyrhizobium, Rhizobium and Mesorhizobium, respectively. The rich-ness, Shannon and evenness indices were the highest in the area that was replanted theearliest (1981) and the lowest in the area that was replanted most recently (2006)

Brain death in low-income countries: a report from Malawi

Most low-income nations have no practice guidelines for brain death; data describing brain death in these regions is absent. Our retrospective study describes the prevalence of brain death among patients treated in an intensive care unit (ICU) at a referral hospital in Malawi. The primary outcome was designation of brain death in the medical chart. Of 449 ICU patients included for analysis between September 2016 and May 2018, 43 (9.6%) were diagnosed with brain death during the ICU admission. The most common diagnostic reasons for admission among these patients were trauma (49%), malaria (16%) and postoperative monitoring after general abdominal surgery (19%). All patients diagnosed with brain death were declared dead in the hospital, after cardiac death. In conclusion, the incidence of brain death in a Malawi ICU is substantially higher than that seen in high-income ICU settings. Brain death is not treated as clinical death in Malawi

Arbuscular mycorrhizal fungi diversity in revegetated areas after bauxite mining.

Arbuscular mycorrhizal fungi (AMF) are obligatory biotrophs that have a symbiotic evolutionary relationship with about 80% of all terrestrial plant species. The fungus mainly supplies water and nutrients to the plant and receives photoassimilates. The AMF diversity affects both the competition among species and floristic composition of an area. Fluctuations in the population of this group of microorganisms can cause fluctuations in plant populations above ground. In this work, the AMF community profile in areas with different ages of revegetation was evaluated by morphological identification of spores and denaturing gradient gel electrophoresis (DGGE) techniques. We found 12 AMF species and dominance of the species Glomus macrocarpum determined by spore density. Since the richness level observed in each plot was low and there was predominance of one species of AMF, it can be concluded that these areas still present a high degree of disturbance. It was possible to detect complex band profiles by DGGE analyses for the two plant species studied, Visnia latifolia and Cecropia hololeuca. No relationship between AMF diversity and revegetation time was observed in these areas

Obstetric admissions and outcomes in an intensive care unit in Malawi

Background: Despite international commitment to Millennium Development Goal 5, maternal mortality remains high in low- and middle-income countries (LMICs) of sub-Saharan Africa. This is in part due to infrastructure gaps, including availability of intensive care units (ICUs). We sought to use obstetric ICU utilization as a marker of severe maternal morbidity and provide an initial characterization of its relationship with in-hospital mortality. Methods: A prospective observational cohort study of all obstetric subjects admitted to the ICU of Kamuzu Central Hospital in Malawi from September 2016 to March 2018. We reviewed charts at the time of ICU admission to assess the indication for admission, clinical characteristics and laboratory values. Subjects were followed until death or discharge. The primary outcome was in-hospital mortality. Results: One-hundred-and-five obstetric patients were admitted to the study ICU (23% of all admissions). The median age was 26 years. The majority (79%) had undergone recent surgery; 40 (52%) an abdominal postnatal or cesarean hysterectomy and 31 (40%) a cesarean delivery without hysterectomy. Ninety-five percent required mechanical ventilation and 48% required vasopressors. Overall in-hospital mortality was 49%. Conclusions: The proportion of obstetric subjects admitted to the ICU in Malawi is nearly 1 in 4, which exceeds that found in high-income countries by orders of magnitude. Intensive care unit admission was associated with high mortality in this population. Investments in improving infrastructure and care gaps may include addressing available ICU bed and blood-banking needs, and increasing the number of providers trained in managing critical illness among obstetric patients

Prevalence, Etiology, and Outcome of Sepsis among Critically Ill Patients in Malawi

There are scarce data describing the etiology and clinical sequelae of sepsis in low- and middle-income countries (LMICs). This study describes the prevalence and etiology of sepsis among critically ill patients at a referral hospital in Malawi. We conducted an observational prospective cohort study of adults admitted to the intensive care unit or high-dependency unit (HDU) from January 29, 2018 to March 15, 2018. We stratified the cohort based on the prevalence of sepsis as defined in the following three ways: quick sequential organ failure assessment (qSOFA) score ≥ 2, clinical suspicion of systemic infection, and qSOFA score ≥ 2 plus suspected systemic infection. We measured clinical characteristics and blood and urine cultures for all patients; antimicrobial sensitivities were assessed for positive cultures. During the study period, 103 patients were admitted and 76 patients were analyzed. The cohort comprised 39% male, and the median age was 30 (interquartile range: 23-40) years. Eighteen (24%), 50 (66%), and 12 patients (16%) had sepsis based on the three definitions, respectively. Four blood cultures (5%) were positive, two from patients with sepsis by all three definitions and two from patients with clinically suspected infection only. All blood bacterial isolates were multidrug resistant. Of five patients with urinary tract infection, three had sepsis secondary to multidrug-resistant bacteria. Hospital mortality for patients with sepsis based on the three definitions ranged from 42% to 75% versus 12% to 26% for non-septic patients. In summary, mortality associated with sepsis at this Malawi hospital is high. Bacteremia was infrequently detected, but isolated pathogens were multidrug resistant

ICU Risk Stratification Models Feasible for Use in Sub-Saharan Africa Show Poor Discrimination in Malawi: A Prospective Cohort Study

Background: Critical illness disproportionately affects people in low-income countries (LICs). Efforts to improve critical care in LICs must account for differences in demographics and infrastructure compared to high-income settings. Part of this effort includes the development and validation of intensive care unit (ICU) risk stratification models feasible for use in LICs. The purpose of this study was to validate and compare the performance of ICU mortality models developed for use in sub-Saharan Africa. Materials and Methods: This was a prospective, observational cohort study of ICU patients in a referral hospital in Malawi. Models were selected for comparison based on a Medline search for studies which developed ICU mortality models based on cohorts in sub-Saharan Africa. Model discrimination was evaluated using the area under the curve with 95% confidence intervals (CI). Results: During the study, 499 patients were admitted to the study ICU, and after exclusions, there were 319 patients. The cohort was 62% female, with the mean age 31 years (IQR: 23-41), and 74% had surgery preceding ICU admission. Discrimination for hospital mortality ranged from 0.54 (95% CI 0.48, 0.60) for the Universal Vital Assessment (UVA) to 0.72 (95% CI 0.66, 0.78) for the Malawi Intensive care Mortality Evaluation (MIME). After tenfold cross-validation, these results were unchanged. Conclusions: The MIME outperformed other models in this prospective study. Most ICU models developed for LICs had poor to modest discrimination for hospital mortality. Future research may contribute to a better risk stratification model for LICs by refining and enhancing the MIME

Associations of day of week and time of day of ICU admission with hospital mortality in Malawi

This prospective cohort study evaluated the associations of day and time of admission to the Intensive Care Unit (ICU) with hospital mortality at a referral hospital in Malawi, a low-income country in sub-Saharan Africa. Patients admitted to the ICU during the day (08:00–16:00) were compared to those admitted at night (16:01–07:59); patients admitted on weekdays (Monday–Friday) were compared to admissions on weekends/holidays. The primary outcome was hospital mortality. Most patients were admitted during daytime (56%) and on weekdays (72%). There was no difference in mortality between night and day admissions (58% vs. 56%, P = 0.8828; hazard ratio [HR] = 1.09, 95% confidence interval [CI = 0.82–1.44, P = 0.5614) or weekend/holiday versus weekday admissions (56% vs. 57%, P = 0.9011; HR = 0.87, 95% CI = 0.62–1.21, P = 0.4133). No interaction between time and day was found. These results may be affected by high overall hospital mortality