Governance in socioeconomic pathways and its role for future adaptive capacity

Governance is one of the critical components for sustainability, but quantification within scenarios and projections of future socioeconomic development has been lacking. This analysis of various pathways looks at how best to overcome 'weak' governance and strengthen adaptive capacity. Weak governance is one of the key obstacles for sustainable development. Undoubtedly, improvement of governance comes with a broad range of co-benefits, including countries' abilities to respond to pressing global challenges such as climate change. However, beyond the qualitative acknowledgement of its importance, quantifications of future pathways of governance are still lacking. This study provides projections of future governance in line with the Shared Socioeconomic Pathways. We find that under a 'rocky road' scenario, 30% of the global population would still live in countries characterized by weak governance in 2050, while under a 'green road' scenario, weak governance would be almost entirely overcome over the same time frame. On the basis of pathways for governance, we estimate the adaptive capacity of countries to climate change. Limits to adaptive capacity exist even under optimistic pathways beyond mid-century. Our findings underscore the importance of accounting for governance in assessments of climate change impacts

Automatic Detection of Optic Disc Based on PCA and Mathematical Morphology

The algorithm proposed in this paper allows to automatically segment the optic disc from a fundus image. The goal is to facilitate the early detection of certain pathologies and to fully automate the process so as to avoid specialist intervention. The method proposed for the extraction of the optic disc contour is mainly based on mathematical morphology along with principal component analysis (PCA). It makes use of different operations such as generalized distance function (GDF), a variant of the watershed transformation, the stochastic watershed, and geodesic transformations. The input of the segmentation method is obtained through PCA. The purpose of using PCA is to achieve the grey-scale image that better represents the original RGB image. The implemented algorithm has been validated on five public databases obtaining promising results. The average values obtained (a Jaccard s and Dice s coefficients of 0.8200 and 0.8932, respectively, an accuracy of 0.9947, and a true positive and false positive fractions of 0.9275 and 0.0036) demonstrate that this method is a robust tool for the automatic segmentation of the optic disc. Moreover, it is fairly reliable since it works properly on databases with a large degree of variability and improves the results of other state-of-the-art methods.This work was supported in part by the project IMIDTA/2010/47 and in part by projects Consolider-C (SEJ2006-14301/PSIC), "CIBER of Physiopathology of Obesity and Nutrition, an initiative of ISCIII" and Excellence Research Program PROMETEO (Generalitat Valenciana. Conselleria de Educacion, 2008-157).Morales Martínez, S.; Naranjo Ornedo, V.; Angulo Lopez, J.; Alcañiz Raya, ML. (2013). Automatic Detection of Optic Disc Based on PCA and Mathematical Morphology. IEEE Transactions on Medical Imaging. 32(4):786-796. https://doi.org/10.1109/TMI.2013.2238244S78679632

Characterization and catalytic performances of biochars synthesized from a hyperaccumulator plant: Alyssum murale

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Understanding the impact of hamstring injuries on match performance in Spanish professional soccer players: two full seasons follow-up

This study aimed to analyze the changes in match physical demands in professional soccer players after sustaining a hamstring injury, which was categorized based on injury severity. Seventy-two hamstring injuries involving sixty-four professional soccer players from the Spanish LaLiga™ were considered for this study. All injuries were classified according to their severity as moderate (resulting in eight to 28 missed days) and major (resulting in more than 28 missed days). Mediacoach video-tracking system collected time and external load variables and subsequently compared them between the pre-injury and return-to-play periods. The analyzed variables included distance covered at different velocities (i.e., total distance, at 18-21 km.h−1, at 21-24 km.h−1, and at more than 24 km.h-1), the number of sprints, accelerations, decelerations, and high metabolic load distance (HMLD). The results showed that players with both moderate and major injuries played fewer minutes after injury (p<.001 to p<.05) and experienced a decrease in maximum speed (p<.01 to p<.05), covering less total distance (p<.05) and exhibiting a decrease (p<.05) in average speed (only observed in players with major injuries). Additionally, moderately injured players experienced a reduction in the number of maximum accelerations (p<.05) and decelerations (p<.05), high metabolic load distance/min (p<.05), and average accelerations (p<.05). Furthermore, a significant reduction in the magnitude of maximum decelerations was observed in players with major injuries (p<.05). These findings highlight the importance of implementing strategies that enable the attainment of initial levels of high-intensity actions and maximum speed in reconditioning programs following hamstring injuries

Comparative study of human embryonic stem cells (hESC) and human induced pluripotent stem cells (hiPSC) as a treatment for retinal dystrophies

Retinal dystrophies (RD) are major causes of familial blindness and are characterized by progressive dysfunction of photoreceptor and/or retinal pigment epithelium (RPE) cells. In this study, we aimed to evaluate and compare the therapeutic effects of two pluripotent stem cell (PSC)-based therapies. We differentiated RPE from human embryonic stem cells (hESCs) or human-induced pluripotent stem cells (hiPSCs) and transplanted them into the subretinal space of the Royal College of Surgeons (RCS) rat. Once differentiated, cells from either source of PSC resembled mature RPE in their morphology and gene expression profile. Following transplantation, both hESC- and hiPSC-derived cells maintained the expression of specific RPE markers, lost their proliferative capacity, established tight junctions, and were able to perform phagocytosis of photoreceptor outer segments. Remarkably, grafted areas showed increased numbers of photoreceptor nuclei and outer segment disk membranes. Regardless of the cell source, human transplants protected retina from cell apoptosis, glial stress and accumulation of autofluorescence, and responded better to light stimuli. Altogether, our results show that hESC- and hiPSC-derived cells survived, migrated, integrated, and functioned as RPE in the RCS rat retina, providing preclinical evidence that either PSC source could be of potential benefit for treating RD

Urolitiasis

The objective is the realization of a review article about renal lithiasis, based on recent bibliographies to guide the population which is the correct and most recent approach and treatment of it. In order to carry out the research, a systematic review of scientific articles has been carried out, consulting different databases with date restrictions from 2018 onwards, in the Spanish and English languages. After the disease, understanding pathophysiological issues, as well as its natural course. In terms of prevention and public health, proper diagnosis and treatment is important according to the characteristics and location of the stone.El objetivo&nbsp;es la realización de un artículo de revisión acerca de la litiasis renal, basándonos en bibliografías recientes para orientar a la población cuál es el correcto y más reciente abordaje y tratamiento del mismo. Para poder llevar a cabo la investigación, se ha realizado una revisión sistemática de artículos científicos consultando diferentes bases de datos con restricción de fecha del 2018 en adelante, en los idiomas español e inglés. Tras entender la enfermedad en temas fisiopatológicos, así como su curso natural, en tema de prevención y salud pública es importante el diagnóstico y tratamiento adecuado de acuerdo a las características y ubicación del lit

Climate, conflict and forced migration

Despite the lack of robust empirical evidence, a growing number of media reports attempt to link climate change to the ongoing violent conflicts in Syria and other parts of the world, as well as to the migration crisis in Europe. Exploiting bilateral data on asylum seeking applications for 157 countries over the period 2006–2015, we assess the determinants of refugee flows using a gravity model which accounts for endogenous selection in order to examine the causal link between climate, conflict and forced migration. Our results indicate that climatic conditions, by affecting drought severity and the likelihood of armed conflict, played a significant role as an explanatory factor for asylum seeking in the period 2011–2015. The effect of climate on conflict occurrence is particularly relevant for countries in Western Asia in the period 2010–2012 during when many countries were undergoing political transformation. This finding suggests that the impact of climate on conflict and asylum seeking flows is limited to specific time period and contexts

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p&lt;0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (&lt;1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (&lt;1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt