Does Infrastructure Alleviates Poverty in Developing Countries?

Infrastructure has largely been ignored in the assessment of poverty in developing countries. This paper attempts to make some contribution in the establishing the ingredients to alleviate poverty by exploring the impact of infrastructure on the urban poor in sample of 20 developing countries, over the period 1980-2005. The results from the static fixed effect and also the dynamic GMM model both reveal that transport and communication infrastructure are indeed an efficient tool in fighting urban poverty. Panel causality analysis also validated the results. Hence the main policy concern is how to improve access of the urban poor to such an asset.Urban Poverty, Infrastructure, Developing Countries

A comparative study to determine the clinical efficacy of Ramipril versus combination of Ramipril and Telmisartan in reducing microalbuminuria associated with grade 2 hypertension

Inhibition of the renin-angiotensin system causes a reduction in urinary protein excretion. It is uncertain whether Angiotensin receptor blockers (ARBs) are equally effective antiproteinuric agents as Angiotensin converting Enzyme (ACE) inhibitors, or whether the combination of ACE inhibitors with ARBs is preferable to ACE inhibitor alone? Microalbuminuria is a prognostic marker for cardiovascular and renal risk. The objective of the study was to compare the clinical efficacy of Ramipril alone versus combination of Ramipril and Telmisartan by assessing the fall in B.P. and the improvement in the degree of microalbuminuria in stage II hypertensive patients. 60 patients of stage II hypertension without having any other cause of microalbuminuria were selected as subjects for the present study and were randomly distributed in to 2 groups- Group A included 30 patients who were given Ramipril 5 mg/ day and Group B included the same number of patients who were given a combination of Ramipril 5 mg/day and Telmisartan 40 mg/day. Baseline parameters included were measurement of Systolic, diastolic blood pressure and mean arterial pressure; microalbuminuria, blood urea, serum creatinine and serum potassium estimations. The drugs under trial were given for 20 weeks. Microalbuminuria was determined at 0 and 20 weeks. The mean percentage fall in microalbuminuria and mean arterial pressure were statistically highly significant (p<0.0001) with combination of Ramipril and Telmisartan (Group B) in comparison to Ramipril (Group A) alone. A highly significant (p‹ 0.0001) mean percentage increase in potassium level was observed in group B at the end of 20 weeks. The side effects were less observed in the combination group. Thus to conclude the combination of Ramipril and Telmisartan provides superior blood pressure (BP) lowering and target organ protection than Ramipril alone, hence the combination of Ramipril and Telmisartan is a better choice to treat and to prevent the progression of the disease.Keywords: Hypertension; Microalbuminuria; Ramipril; Telmisarta

Prostaglandin e2 receptors in abdominal aortic aneurysm and human aortic smooth muscle cells

AbstractBackgroundProstaglandin (PG) E2 (PGE2) appears to have a role in stimulating production of interleukin-6 (IL-6) and apoptosis of smooth muscle cells in diseased aortic tissue. These actions are mediated by cellular receptors for PGE2 EP receptors.ObjectiveThis study was undertaken to identify EP receptors associated with production of IL-6 by aortic explants.MethodsBiopsy specimens of abdominal aortic aneurysm were used for explant culture and preparation of messenger RNA. The presence of EP1, EP2, EP3, and EP4 receptors in tissue and cells was investigated with reverse-transcriptase polymerase chain reaction. IL-6 and cyclic adenosine monophosphate were measured with an enzyme-linked immunosorbent assay.ResultsPGE2 or 11-deoxy-PGE1 (EP 2/3/4 agonist) reversed partially the indomethacin suppression of IL-6 secretion from explant cultures, whereas butaprost (EP2 receptor agonist) and sulprostone (EP 1/3 receptor agonist) had no effect. Aortic biopsy specimens expressed EP2, EP3-III, and EP4 receptors. Aortic smooth muscle cells expressed EP2 receptor and four variants of EP3 receptor, ie, EP3-Ib, EP3-II, EP3-III, and EP3-IV, but PGE2 did not stimulate secretion of IL-6. In contrast, PGE2 or 11-deoxy-PGE1 stimulated secretion of IL-6 from aortic macrophages.ConclusionsIn aortic explants, PGE2 stimulates IL-6 secretion by activation of EP4 receptors, present in macrophages

Submarine groundwater springs are characterized by distinct fish communities

The inflow of terrestrial groundwater into the ocean is increasingly recognized as an important local source of nutrients and pollutants to coastal ecosystems. Although there is evidence of a link between fresh submarine groundwater discharge (SGD)‐derived nutrients and primary producer and primary consumer abundances, the effects of fresh SGD on the productivity of higher trophic levels such as ichthyofaunal communities remain unclear. To further investigate this relationship, we sampled three sites inside a coral reef lagoon in Mauritius: One site entailing six distinct groundwater springs, a site highly influenced by freshwater influx through the springs, and a strictly marine control site. Using remote underwater video surveys, we found that fish abundances were significantly higher at the groundwater springs than at the other two sampling sites.Principal component analyses showed that the springs and the spring‐influenced part of the lagoon were best described by elevated water nutrient loadings, whereas the control site was characterized by higher water salinity and pH. Macroalgae cover was highest at the control site and the springs. Herbivores and invertivores dominated the fish community at the springs, in contrast to generalists at the control site. At the spring‐influenced site, we mainly encountered high coral/turf algae cover and high abundances of associated fish feeding groups (territorial farmers, corallivores). Our results provide evidence of a fresh SGD‐driven relationship between altered hydrography and distinct fish communities with elevated abundances at groundwater springs in a coral reef lagoon. These findings suggest that the management and assessment of secondary consumer productivity in tropical lagoons should take into account the effects of groundwater springs

Mapping genetic vulnerabilities reveals BTK as a novel therapeutic target in oesophageal cancer

Objective Oesophageal cancer is the seventh most common cause of cancer-related death worldwide. Disease relapse is frequent and treatment options are limited. Design To identify new biomarker-defined therapeutic approaches for patients with oesophageal cancer, we integrated the genomic profiles of 17 oesophageal tumour-derived cell lines with drug sensitivity data from small molecule inhibitor profiling, identifying drug sensitivity effects associated with cancer driver gene alterations. We also interrogated recently described RNA interference screen data for these tumour cell lines to identify candidate genetic dependencies or vulnerabilities that could be exploited as therapeutic targets. Results By integrating the genomic features of oesophageal tumour cell lines with siRNA and drug screening data, we identified a series of candidate targets in oesophageal cancer, including a sensitivity to inhibition of the kinase BTK in MYC amplified oesophageal tumour cell lines. We found that this genetic dependency could be elicited with the clinical BTK/ERBB2 kinase inhibitor, ibrutinib. In both MYC and ERBB2 amplified tumour cells, ibrutinib downregulated ERK-mediated signal transduction, cMYC Ser-62 phosphorylation and levels of MYC protein, and elicited G(1) cell cycle arrest and apoptosis, suggesting that this drug could be used to treat biomarker-selected groups of patients with oesophageal cancer. Conclusions BTK represents a novel candidate therapeutic target in oesophageal cancer that can be targeted with ibrutinib. On the basis of this work, a proof-of-concept phase II clinical trial evaluating the efficacy of ibrutinib in patients with MYC and/or ERBB2 amplified advanced oesophageal cancer is currently underway (NCT02884453). Trial registration number NCT02884453; Pre-result

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

The genetics of myopia

Myopia is the most common eye condition worldwide and its prevalence is increasing. While changes in environment, such as time spent outdoors, have driven myopia rates, within populations myopia is highly heritable. Genes are estimated to explain up to 80% of the variance in refractive error. Initial attempts to identify myopia genes relied on family studies using linkage analysis or candidate gene approaches with limited progress. More genome-wide association study (GWAS) approaches have taken over, ultimately resulting in the identification of hundreds of genes for refractive error and myopia, providing new insights into its molecular machinery. These studies showed myopia is a complex trait, with many genetic variants of small effect influencing retinal signaling, eye growth and the normal process of emmetropization. The genetic architecture and its molecular mechanisms are still to be clarified and while genetic risk score prediction models are improving, this knowledge must be expanded to have impact on clinical practice

Harmful Elements in Estuarine and Coastal Systems

Estuaries and coastal zones are dynamic transitional systems which provide many economic and ecological benefits to humans, but also are an ideal habitat for other organisms as well. These areas are becoming contaminated by various anthropogenic activities due to a quick economic growth and urbanization. This chapter explores the sources, chemical speciation, sediment accumulation and removal mechanisms of the harmful elements in estuarine and coastal seawaters. It also describes the effects of toxic elements on aquatic flora and fauna. Finally, the toxic element pollution of the Venice Lagoon, a transitional water body located in the northeastern part of Italy, is discussed as a case study, by presenting the procedures adopted to measure the extent of the pollution, the impacts on organisms and the restoration activities

Impact of Basel Capital Accord on Bank Behaviour, the impact of Basel Risk based capital requirement (accord I) on Bank performance in the Context of a Small Service-Based island Economy

This paper tests the effect of the Basel Risk Based Capital Requirements (Basel Accord 1) on Mauritian banks' behaviour, using a sample of 9 commercial banks. In the absence of any simultaneity between change in capital ratio and change in credit risk following the application of 3SLS to an extension of the model proposed by Shrieves and Dahl (1992) , the study applies the Arellano-Bond GMM technique to provide unbiased and more efficient estimates by taking into account dynamic framework. The main result emanating from this research reveals that banks' response to the Basel Risk -Based Capital Accord I requirement, is weak in the Mauritian context and under the period of study

Hypomagnesemia and its Implications in Type 2 Diabetes Mellitus-A Review Article Hypomagnesemia and its Implications in Type 2 Diabetes Mellitus-A Review Article

Abstract Hypomagnesemia has been implicated in adversely affecting diabetic complications. Magnesium is a cofactor for over 300 enzymes particularly for those concerned with ATP and energy production. It is also required for normal DNA function, cell permeability regulation and neuromuscular excitability. Clinically, hypomagnesemia has been related to hypertension, atherogenic dyslipidemia, impaired clotting, increased inflammatory burden, oxidative stress, carotid wall thickness and coronary heart disease. Type 2 Diabetes Mellitus facilitates low serum magnesium levels and this in turn worsens glycemic control in diabetes, thus establishing a vicious circle that leads to a progressive impairment in metabolic control and more risk of diabetic complications. Conclusion: Hypomagnesemia is a cause or consequence of type 2 diabetes mellitus remains yet to be ascertained, but it is a cardiovascular risk factor and favors diabetic complications. Periodic determination of magnesium levels and appropriate magnesium replacement can promote a better glycemic control,a healthy life style and delay the onset of diabetes related complications