The Cost of Flexible Bronchoscopes:A Systematic Review and Meta-analysis

BACKGROUND AND OBJECTIVE: Until 2009, only reusable bronchoscopes were marketed, but the introduction and widespread adoption of single-use flexible bronchoscopes (SFBs) as an emerging technology has since accelerated. Several studies have described the costs of reusable flexible bronchoscopes (RFBs) and SFBs. This meta-analysis aimed to compile the current published evidence to analyse the cost of different scenarios using RFBs and SFBs. METHODS: All published literature describing the cost of RFBs or SFBs was identified by searching PubMed, Embase and Google Scholar, limited to those between 1 January, 2009 and 6 November, 2020. Included studies should report the total cost of RFBs. Continuous data were extracted for relevant outcomes and analysed using RStudio(®) 4.0.3 as the standardised mean difference and standard error of the mean in a mixed-effects model. Risk of bias was assessed based on the reporting quality. RESULTS: In the systematic literature review, 342 studies were initially identified, and 11 were included in the final analysis. The mean RFB procedure cost was $266 (standard error of the mean: 34), including capital investments, repairs and reprocessing costs of$91, $92 and$83, respectively. The mean SFB procedure cost was $289 (standard error of the mean: 10). The incremental cost was$23 (standard error of the mean: 33) and was not significant (p = 0.46). Because of the economy of scale, RFB is more likely to be cost minimising compared with SFB when performing 306 or 39 procedures per site or RFB, respectively. CONCLUSIONS: In this study, we found no significant difference in the cost of use between RFBs and SFBs and a high risk of bias. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41669-022-00356-0

Ecological engineering projects increased vegetation cover, production, and biomass in semiarid and subhumid Northern China

Multiple ecological engineering projects have been implemented in semiarid and subhumid Northern China since 1978 with the purpose to combat desertification, control dust storms, and improve vegetation cover. Although a plethora of local studies exist, the effectiveness of these projects has not been studied in a systematic and comprehensive way. Here, we used multiple satellite-based time-series data as well as breakpoint analysis to assess shifts in leaf area index (a proxy for green vegetation cover), gross primary production, and aboveground biomass in Northern China. We documented increased vegetation growth in northwest and southeastern parts of the region, despite drought anomalies as documented by the standardized precipitation-evapotranspiration index during 1982–2016. Significant breakpoints in leaf area index were observed for over 72.5% of the southeastern and northwestern regions, and 70.6% of these breakpoints were detected after 1999, which correspond well to the areas with the highest ecological engineering efforts. Areas with negative trends were mainly located in the Inner Mongolian Plateau, Hulun Biur, Horqin Sand Land, and urban areas. The Loess Plateau had the largest increase in vegetation growth, followed by the north parts of Northern China where biomass increased more in the provinces of Shanxi, Liaoning, Shannxi, Hebei, and Beijing than Xinjiang, Inner Mongolia, Tianjin, and Qinghai. Our results show that multiple ecological engineering projects in the region have increased vegetation cover, production, and aboveground biomass that have led to improved environmental conditions in the study area

Heme catabolism by heme oxygenase-1 confers host resistance to Mycobacterium infection

Heme oxygenases (HO) catalyze the rate-limiting step of heme degradation. The cytoprotective action of the inducible HO-1 isoform, encoded by the Hmox1 gene, is required for host protection against systemic infections. Here we report that upregulation of HO-1 expression in macrophages (M) is strictly required for protection against mycobacterial infection in mice. HO-1-deficient (Hmox1(-/-)) mice are more susceptible to intravenous Mycobacterium avium infection, failing to mount a protective granulomatous response and developing higher pathogen loads, than infected wild-type (Hmox1(+/+)) controls. Furthermore, Hmox1(-/-) mice also develop higher pathogen loads and ultimately succumb when challenged with a low-dose aerosol infection with Mycobacterium tuberculosis. The protective effect of HO-1 acts independently of adaptive immunity, as revealed in M. avium-infected Hmox1(-/-) versus Hmox1(+/+) SCID mice lacking mature B and T cells. In the absence of HO-1, heme accumulation acts as a cytotoxic pro-oxidant in infected M, an effect mimicked by exogenous heme administration to M. avium-infected wild-type M in vitro or to mice in vivo. In conclusion, HO-1 prevents the cytotoxic effect of heme in M, contributing critically to host resistance to Mycobacterium infection.European Community 6th Framework grant: (LSH-2005-1.2.5-1), FCT fellowships: (SFRH/BD/29257/2006, SFRH/BPD/25436/2005), Instituto Gulbenkian de Ciência, Universidade do Minho, ICBAS

Fluorescent Discrimination between Traces of Chemical Warfare Agents and Their Mimics

An array of fluorogenic probes is able to discriminate between nerve agents, sarin, soman, tabun, VX and their mimics, in water or organic solvent, by qualitative fluorescence patterns and quantitative multivariate analysis, thus making the system suitable for the inthe- field detection of traces of chemical warfare agents as well as to differentiate between the real nerve agents and other related compounds.Ministerio de Economía y Competitividad, Spain (Project CTQ2012- 31611), Junta de Castilla y León, Consejería de Educación y Cultura y Fondo Social Europeo (Project BU246A12-1), the European Commission, Seventh Framework Programme (Project SNIFFER FP7-SEC-2012-312411) and the Swedish Ministry of Defence (no. A403913

The FLUXNET2015 dataset and the ONEFlux processing pipeline for eddy covariance data

The FLUXNET2015 dataset provides ecosystem-scale data on CO2, water, and energy exchange between the biosphere and the atmosphere, and other meteorological and biological measurements, from 212 sites around the globe (over 1500 site-years, up to and including year 2014). These sites, independently managed and operated, voluntarily contributed their data to create global datasets. Data were quality controlled and processed using uniform methods, to improve consistency and intercomparability across sites. The dataset is already being used in a number of applications, including ecophysiology studies, remote sensing studies, and development of ecosystem and Earth system models. FLUXNET2015 includes derived-data products, such as gap-filled time series, ecosystem respiration and photosynthetic uptake estimates, estimation of uncertainties, and metadata about the measurements, presented for the first time in this paper. In addition, 206 of these sites are for the first time distributed under a Creative Commons (CC-BY 4.0) license. This paper details this enhanced dataset and the processing methods, now made available as open-source codes, making the dataset more accessible, transparent, and reproducible.Peer reviewe

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three genomic nomenclature systems to all sequence data from the World Health Organization European Region available until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation, compare the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2