125 research outputs found
Supporting private entrepreneurs to deliver public goods: engaging sanitation entrepreneurs
Despite the inclusion of sanitation in 2002 as part of the MDGs, the global backlog still grows. Current
investment is heavily biased in favour of sewerage over nonnetwork
forms of sanitation, yet the vast
majority of urban dwellers in developing countries actually live with what is (often euphemistically)
known as âonsite
sanitationâ. Onsite
sanitation is typically seen as a household responsibilityÍŸ if people
want a toilet built or emptied, it is for them to find someone to do itÍŸ public agencies working on onsite
sanitation are often few and far between. Smallscale
providers and sanitation entrepreneurs typically fill
this service gap and are very prevalent across the globe. This article reviews how the 'onsite
sanitation
market' functions and discusses existing roles of sanitation entrepreneurs. It identifies four areas that
need exploring in order for the sanitation aspects of the MDGs to become relevant to the urban poor
Tissue Expression and Actin Binding of a Novel N-Terminal Utrophin Isoform
Utrophin and dystrophin present two large proteins that link the intracellular actin cytoskeleton to the extracellular matrix via the C-terminal-associated protein complex. Here we describe a novel short N-terminal isoform of utrophin and its protein product in various rat tissues (N-utro, 62âkDa, amino acids 1â539, comprising the actin-binding domain plus the first two spectrin repeats). Using different N-terminal recombinant utrophin fragments, we show that actin binding exhibits pronounced negative cooperativity (affinity constants K1 = âŒ5 Ă 106
and K2 = âŒ1 Ă 105âMâ1) and is Ca2+-insensitive. Expression of the different fragments in COS7 cells and in myotubes indicates that the actin-binding domain alone binds exlusively to actin filaments. The recombinant N-utro analogue binds in vitro to actin and in the cells associates to the membranes. The results indicate that N-utro may be responsible for the anchoring of the cortical actin cytoskeleton to the membranes in muscle and other tissues
Antiferromagnetic interlayer exchange coupling across an amorphous metallic spacer layer
By means of magneto-optical Kerr effect we observe for the first time
antiferromagnetic coupling between ferromagnetic layers across an amorphous
metallic spacer layer. Biquadratic coupling occurs at the transition from a
ferromagnetically to an antiferromagnetically coupled region. Scanning
tunneling microscopy images of all involved layers are used to extract
thickness fluctuations and to verify the amorphous state of the spacer. The
observed antiferromagnetic coupling behavior is explained by RKKY interaction
taking into account the amorphous structure of the spacer material.Comment: Typset using RevTex, 4 pages with 4 figures (.eps
E-Glider: Active Electrostatic Flight for Airless Body Exploration
The environment near the surface of asteroids, comets, and the Moon is electrically charged due to the Sun's photoelectric bombardment and lofting dust, which follows the Sun illumination as the body spins. Chargeddust is ever present, in the form of dusty plasma, even at high altitudes, following the solar illumination. If abody with high surface resistivity is exposed to the solar wind and solar radiation, sun-exposed areas andshadowed areas become differentially charged. The E-Glider (Electrostatic Glider) is an enabling capability foroperation at airless bodies, a solution applicable to many types of in-situ mission concepts, which leverages thenatural environment. With the E-Glider, we transform a problem (spacecraft charging) into an enablingtechnology, i.e. a new form of mobility in microgravity environments using new mechanisms and maneuveringbased on the interaction of the vehicle with the environment. Consequently, the vision of the E-Glider is toenable global scale airless body exploration with a vehicle that uses, instead of avoids, the local electricallycharged environment. This platform directly addresses the "All Access Mobility" Challenge, one of the NASA'sSpace Technology Grand Challenges. Exploration of comets, asteroids, moons and planetary bodies is limitedby mobility on those bodies. The lack of an atmosphere, the low gravity levels, and the unknown surface soilproperties pose a very difficult challenge for all forms of know locomotion at airless bodies. This E-Gliderlevitates by extending thin, charged, appendages, which are also articulated to direct the levitation force in themost convenient direction for propulsion and maneuvering. The charging is maintained through continuouscharge emission. It lands, wherever it is most convenient, by retracting the appendages or by firing a cold-gasthruster, or by deploying an anchor. The wings could be made of very thin Au-coated Mylar film, which areelectrostatically inflated, and would provide the lift due to electrostatic repulsion with the naturally chargedasteroid surface. Since the E-glider would follow the Sun's illumination, the solar panels on the vehicle wouldconstantly charge a battery. Further articulation at the root of the lateral strands or inflated membrane wings,would generate a component of lift depending on the articulation angle, hence a selective maneuveringcapability which, to all effects, would lead to electrostatic (rather than aerodynamic) flight. Preliminarycalculations indicate that a 1 kg mass can be electrostatically levitated in a microgravity field with a 2 mdiameter electrostatically inflated ribbon structure at 19kV, hence the need for a "balloon-like" system. Due tothe high density and the photo-electron sheath and associate small Debye length, significant power is requiredto levitate even a few kilograms. The power required is in the kilo-Watt range to maintain a constant chargelevel
Clinical prediction model for prognosis in kidney transplant recipients (KIDMO): study protocol
Background: Many potential prognostic factors for predicting kidney transplantation outcomes have been identified. However, in Switzerland, no widely accepted prognostic model or risk score for transplantation outcomes is being routinely used in clinical practice yet. We aim to develop three prediction models for the prognosis of graft survival, quality of life, and graft function following transplantation in Switzerland.
Methods: The clinical kidney prediction models (KIDMO) are developed with data from a national multi-center cohort study (Swiss Transplant Cohort Study; STCS) and the Swiss Organ Allocation System (SOAS). The primary outcome is the kidney graft survival (with death of recipient as competing risk); the secondary outcomes are the quality of life (patient-reported health status) at 12 months and estimated glomerular filtration rate (eGFR) slope. Organ donor, transplantation, and recipient-related clinical information will be used as predictors at the time of organ allocation. We will use a Fine & Gray subdistribution model and linear mixed-effects models for the primary and the two secondary outcomes, respectively. Model optimism, calibration, discrimination, and heterogeneity between transplant centres will be assessed using bootstrapping, internal-external cross-validation, and methods from meta-analysis.
Discussion: Thorough evaluation of the existing risk scores for the kidney graft survival or patient-reported outcomes has been lacking in the Swiss transplant setting. In order to be useful in clinical practice, a prognostic score needs to be valid, reliable, clinically relevant, and preferably integrated into the decision-making process to improve long-term patient outcomes and support informed decisions for clinicians and their patients. The state-of-the-art methodology by taking into account competing risks and variable selection using expert knowledge is applied to data from a nationwide prospective multi-center cohort study. Ideally, healthcare providers together with patients can predetermine the risk they are willing to accept from a deceased-donor kidney, with graft survival, quality of life, and graft function estimates available for their consideration
Familial deletion 18p syndrome: case report
BACKGROUND: Deletion 18p is a frequent deletion syndrome characterized by dysmorphic features, growth deficiencies, and mental retardation with a poorer verbal performance. Until now, five families have been described with limited clinical description. We report transmission of deletion 18p from a mother to her two daughters and review the previous cases. CASE PRESENTATION: The proband is 12 years old and has short stature, dysmorphic features and moderate mental retardation. Her sister is 9 years old and also has short stature and similar dysmorphic features. Her cognitive performance is within the borderline to mild mental retardation range. The mother also presents short stature. Psychological evaluation showed moderate mental retardation. Chromosome analysis from the sisters and their mother revealed the same chromosomal deletion: 46, XX, del(18)(p11.2). Previous familial cases were consistent regarding the transmission of mental retardation. Our family differs in this regard with variable cognitive impairment and does not display poorer verbal than non-verbal abilities. An exclusive maternal transmission is observed throughout those families. Women with del(18p) are fertile and seem to have a normal miscarriage rate. CONCLUSION: Genetic counseling for these patients should take into account a greater range of cognitive outcome than previously reported
Prevalence of congenital heart defects in Europe, 2008-2015: A registryâbased study
Background: The total prevalence of congenital heart defects (CHDs) varies by populations and over time. Studies that examine trends in the prevalence of CHD in different regions may shed light on our understanding of the occurrence of CHD and the impact of different risk factors.
Objectives: To examine trends in total and live birth prevalence of nonsyndromic CHD in Europe between the years 2008 and 2015 and to investigate if the decreasing trend reported by previous studies is continuing.
Methods: Cases of CHD delivered between January 1, 2008 and December 31, 2015 notified to 25 population-based EUROCAT (European Surveillance of Congenital Anomalies) registries in 14 countries, formed the population-based case-series. Prevalence (total/live) rates and 95% confidence intervals were calculated as the number of cases per 10,000 births (live and stillbirths). Time trends in prevalence of all nonsyndromic CHDs and for three CHD severity groups (very severe, severe, and less severe) were plotted using a Poisson
regression multilevel approach.
Results: The total prevalence of nonsyndromic CHD was 57.1 per 10,000 births (live births and stillbirths) for the 8-year period and remained stable across the three CHD severity groups while the live birth prevalence was 60.2 per 10,000 births. There was considerable variation in the reported total CHD prevalence and the direction of trends by registry. A decreasing prevalence ofCHD was observed for the Norway and England/Wales registries, whereas the CHD prevalence increased for registries in Italy and Croatia.
Conclusions: The total prevalence of CHD in Europe between the years 2008 and 2015 remained stable for all CHD and across the three CHD severity groups. The decreasing trend reported by previous studies has not continued. However, we found significant differences in the total and live birth prevalence
by registry.info:eu-repo/semantics/publishedVersio
Maternal age and the prevalence of congenital heart defects in Europe, 1995â2015: A registerâbased study
Background: Evidence on the direction and strength of association between maternal age and the prevalence of congenital heart defects (CHD) in different age group categories is conflicting. Some studies have illustrated different trends with an increase in prevalence in younger and older age groups while other studies have reported a linear relationship. Given the increase in maternal age over recent years, it is important to study the CHD prevalence by maternal age.
Objectives: To examine the association between maternal age and the prevalence of CHD in Europe between 1995 and 2015 using population-based data from 24 registries belonging to the European Surveillance of Congenital Anomalies (EUROCAT) network.
Methods: Associations over time of all nonsyndromic CHD according to maternal age category and for three CHD severity groupings (severity group I: very severe; severity group II: severe; severity group III: less severe) were examined using Bayesian multilevel Poisson regression modeling. Further subgroup
analyses were undertaken within four maternal age-bands: â€24, 25â29, 30â34 and 35â44 years. Descriptive summaries are also presented.
Results: There were 51,608 nonsyndromic CHD cases in Europe over the 20-year study period. Total prevalence for all CHD combined was increased for younger mothers (â€24 years) and for mothers 35â44 years of age when compared with mothers aged 25â29 years (reference group) (IRR: 1.05, 95% CI: 1.02, 1.07). The total prevalence was increased for severity group I (very severe) only for younger mothers compared to those aged 25â29 years (IRR: 1.14, 95% CI: 1.04, 1.23). We found an increased prevalence of the following CHD subtypes: double outlet right ventricle (IRR:1.33, 95% CI: 1.09, 1.60), hypoplastic
left heart syndrome (IRR: 1.18, 95% CI: 1.05, 1.32), hypoplastic right heart syndrome (IRR: 1.41, 95% CI: 1.05, 1.84), atrioventricular septal defect (IRR: 1.15, 95% CI: 1.01, 1.32), coarctation of aorta (IRR: 1.15, 95% CI: 1.03, 1.28) and atrial septal defect (IRR: 1.08, 95% CI: 1.02, 1.13). For older mothers (35â44 years) compared to the reference category, we observed an increased risk in the prevalence for severity group II (IRR: 1.09, 95% CI: 1.03, 1.14), severity group III (IRR: 1.05, 95% CI: 1.01, 1.08) and an increased prevalence of the CHD subtypes: Pulmonary valve stenosis (IRR: 1.22, 95% CI: 1.09, 1.34), ASD
(IRR: 1.07, 95% CI: 1.02, 1.13), CoA (IRR: 1.18, 95% CI: 1.06, 1.32) and Tetralogy of Fallot (IRR: 1.14, 95% CI: 1.01, 1.28). Finally, for all age categories compared to the reference category, different associations of ASD and an increased prevalence of CoA was also observed.
Conclusions: Based on data for cases of CHD from 24 European populationbased registries, evidence of a positive association between maternal age and the total prevalence of CHD for younger (â€24 years old) and older (35â44 years old) mothers was observed. The results suggest that young maternal age (â€24 years old) is a factor associated with severe CHD phenotypes while a positive association between advanced maternal age (35â44 years old) and mild CHD phenotypes was observed.info:eu-repo/semantics/publishedVersio
Maternal age and the prevalence of congenital heart defects in Europe, 1995-2015:A register-based study
BACKGROUND: Evidence on the direction and strength of association between maternal age and the prevalence of congenital heart defects (CHD) in different age group categories is conflicting. Some studies have illustrated different trends with an increase in prevalence in younger and older age groups while other studies have reported a linear relationship. Given the increase in maternal age over recent years, it is important to study the CHD prevalence by maternal age.OBJECTIVES: To examine the association between maternal age and the prevalence of CHD in Europe between 1995 and 2015 using population-based data from 24 registries belonging to the European Surveillance of Congenital Anomalies (EUROCAT) network.METHODS: Associations over time of all nonsyndromic CHD according to maternal age category and for three CHD severity groupings (severity group I: very severe; severity group II: severe; severity group III: less severe) were examined using Bayesian multilevel Poisson regression modeling. Further subgroup analyses were undertaken within four maternal age-bands: â€24, 25-29, 30-34 and 35-44âyears. Descriptive summaries are also presented.RESULTS: There were 51,608 nonsyndromic CHD cases in Europe over the 20-year study period. Total prevalence for all CHD combined was increased for younger mothers (â€24âyears) and for mothers 35-44âyears of age when compared with mothers aged 25-29âyears (reference group) (IRR: 1.05, 95% CI: 1.02, 1.07). The total prevalence was increased for severity group I (very severe) only for younger mothers compared to those aged 25-29âyears (IRR: 1.14, 95% CI: 1.04, 1.23). We found an increased prevalence of the following CHD subtypes: double outlet right ventricle (IRR:1.33, 95% CI: 1.09, 1.60), hypoplastic left heart syndrome (IRR: 1.18, 95% CI: 1.05, 1.32), hypoplastic right heart syndrome (IRR: 1.41, 95% CI: 1.05, 1.84), atrioventricular septal defect (IRR: 1.15, 95% CI: 1.01, 1.32), coarctation of aorta (IRR: 1.15, 95% CI: 1.03, 1.28) and atrial septal defect (IRR: 1.08, 95% CI: 1.02, 1.13). For older mothers (35-44âyears) compared to the reference category, we observed an increased risk in the prevalence for severity group II (IRR: 1.09, 95% CI: 1.03, 1.14), severity group III (IRR: 1.05, 95% CI: 1.01, 1.08) and an increased prevalence of the CHD subtypes: Pulmonary valve stenosis (IRR: 1.22, 95% CI: 1.09, 1.34), ASD (IRR: 1.07, 95% CI: 1.02, 1.13), CoA (IRR: 1.18, 95% CI: 1.06, 1.32) and Tetralogy of Fallot (IRR: 1.14, 95% CI: 1.01, 1.28). Finally, for all age categories compared to the reference category, different associations of ASD and an increased prevalence of CoA was also observed.CONCLUSIONS: Based on data for cases of CHD from 24 European population-based registries, evidence of a positive association between maternal age and the total prevalence of CHD for younger (â€24âyears old) and older (35-44âyears old) mothers was observed. The results suggest that young maternal age (â€24âyears old) is a factor associated with severe CHD phenotypes while a positive association between advanced maternal age (35-44âyears old) and mild CHD phenotypes was observed.</p
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