Assessment of the domestic energy use impacts of unplanned refugee settlements on the forest ecology of Cox’s Bazar, Bangladesh

This study monitors the forest ecology in Himchari National Park, Teknaf Wildlife Sanctuary, and between the areas in Cox's Bazar district, Bangladesh. The area has a rich biodiversity, including globally endangered species such as Asian Elephants (Elephas maximus) and Boilam Trees (Anisoptera scaphula), which are threatened by anthropogenic development, newly refugees’ unplanned settlements and their use of domestic energy. Geographic Information System (GIS) and Landsat satellite images are used to monitor forest coverage for 1995–2018. The Normalized Difference Vegetation Index (NDVI) is applied to quantify forest area. Focus group discussions and questionnaire surveys were conducted to reveal stakeholder perceptions about their dependency on forest resources as ecosystem services. Close to the refugee camp areas, the forest coverage changes to grassland due to the unsustainable forest resource extraction. Despite the free of charge supply of Liquefied Petroleum Gas, the refugees burn 2,380 metric tons of firewood every month to satisfy energy for cooking. Besides, 200,000 households frequently use bamboo, small trees, and shrubs to maintain their dwellings' structure. Thus, deforestation caused by immigration between 2017–2018 is similar to that caused by the effect of climate change, including severe tropical cyclones in 1994–1995. This research identifies domestic energy supply deficiency and impacts, and the need for comparatively durable housing materials to reduce stress on forest resources and health hazards

Assessment of the domestic energy use impacts of unplanned refugee settlements on the forest ecology of Cox's Bazar, Bangladesh

This study monitors the forest ecology in Himchari National Park, Teknaf Wildlife Sanctuary, and between the areas in Cox's Bazar district, Bangladesh. The area has a rich biodiversity, including globally endangered species such as Asian Elephants (Elephas maximus) and Boilam Trees (Anisoptera scaphula), which are threatened by anthropogenic development, newly refugees' unplanned settlements and their use of domestic energy. Geographic Information System (GIS) and Landsat satellite images are used to monitor forest coverage for 1995-2018. The Normalized Difference Vegetation Index (NDVI) is applied to quantify forest area. Focus group discussions and questionnaire surveys were conducted to reveal stakeholder perceptions about their dependency on forest resources as ecosystem services. Close to the refugee camp areas, the forest coverage changes to grassland due to the unsustainable forest resource extraction. Despite the free of charge supply of Liquefied Petroleum Gas, the refugees burn 2,380 metric tons of firewood every month to satisfy energy for cooking. Besides, 200,000 households frequently use bamboo, small trees, and shrubs to maintain their dwellings' structure. Thus, deforestation caused by immigration between 2017-2018 is similar to that caused by the effect of climate change, including severe tropical cyclones in 1994-1995. This research identifies domestic energy supply deficiency and impacts, and the need for comparatively durable housing materials to reduce stress on forest resources and health hazards

Stakeholder preferences for attributes of digital health technologies to consider in health service funding

Objectives: Health service providers are currently making decisions on the public funding of digital health technologies (DHTs) for managing chronic diseases with limited understanding of stakeholder preferences for DHT attributes. This study aims to understand the community, patient/carer, and health professionals' preferences to help inform a prioritized list of evaluation criteria. Methods: An online best-worst scaling survey was conducted in Australia, New Zealand, Canada, and the United Kingdom to ascertain the relative importance of twenty-four DHT attributes among stakeholder groups using an efficient incomplete block design. The attributes were identified from a systematic review of DHT evaluation frameworks for consideration in a health technology assessment. Results were analyzed with multinomial models by stakeholder group and latent class. Results: A total of 1,251 participants completed the survey (576 general community members, 543 patients/carers, and 132 health professionals). Twelve attributes achieved a preference score above 50 percent in the stakeholder group model, predominantly related to safety but also covering technical features, effectiveness, ethics, and economics. Results from the latent class model supported this prioritization. Overall, connectedness with the patient's healthcare team seemed the most important; with Helps health professionals respond quickly when changes in patient care are needed as the most highly prioritized of all attributes. Conclusions: It is proposed that these prioritized twelve attributes be considered in all evaluations of DHTs that manage chronic disease, supplemented with a limited number of attributes that reflect the specific perspective of funders, such as equity of access, cost, and system-level implementation considerations

The SmithVent Experience and a Framework for Collaborative Distributed Design and Fabrication

This paper addresses the collaborative journey of the SmithVent team, a 30-person distributed group of volunteers, who designed, fabricated, and tested a simplified and cost-efficient ventilator over a three-month period, and won the CoVent19 Challenge in July 2020. The paper first presents the SmithVent experience through a co-constructed narrative that describes the team’s approaches to collaborative distributed design and fabrication. The paper next reviews frameworks from five theoretical lenses and then details the process of extracting, synthesizing, and organizing relevant factors to create a new and emergent framework reflective of the SmithVent experience. Lastly, the paper discusses educational implications of the SmithVent experience and proposed framework, emphasizing that the team’s strategies provide a model for educational and industry settings for future collaborative and distributed design and fabrication

Estudio para identificar y analizar experiencias nacionales relacionadas con el fortalecimiento de la educación alimentaria y nutricional en el marco de Programas de Nutrición y Alimentación Escolar. Documento técnico

La educación alimentaria y nutricional (EAN) es un concepto amplio, el cual ha sido abordado desde diferentes políticas de seguridad alimentaria y nutricional (SAN) en los últimos años. Se considera que los programas de alimentación escolar (PAE) deben incluir dentro de sus intervenciones la EAN para crear impacto a largo plazo y no solo brindar asistencia alimentaria (FAO, 2017). En apoyo a la implementación del Plan de Seguridad Alimentaria, Nutrición y Erradicación del Hambre de la CELAC 2025 (Plan SAN CELAC 2025), particularmente el Pilar #3 sobre Bienestar Nutricional, la FAO ha realizado un estudio que busca identificar y analizar experiencias nacionales existentes relacionadas con el fortalecimiento de la EAN en el marco de programas de Nutrición y Alimentación Escolar. El objetivo del estudio es identificar y analizar el abordaje de buenas prácticas y programas de éxito de EAN en el marco de los PAE que puedan ser ampliados/ replicados en otros países de América Latina y el Caribe (ALC). Los objetivos específicos son: a) Identificar los principales retos y desafíos existentes en los componentes de EAN en el marco de los PAE; b) Identificar oportunidades que permitan que los gobiernos fortalezcan los componentes de EAN en el marco de los PAE; y c) Desarrollar recomendaciones a fin de contar con PAE sostenibles e integrados, que incluyan dentro de sus actividades buenas prácticas de EAN dentro del currículo escolar, con adecuados marcos legales que favorezcan la correcta incorporación de los contenidos de alimentación, nutrición y estilo de vida saludable impartidos en las escuelas. Durante la primera fase de este estudio se realizó la revisión bibliográfica de las experiencias por país en ALC al nivel de Programas de Alimentación Escolar y la EAN, posterior a lo cual se seleccionaron países que cuentan con experiencias que pueden servir como ejemplo para otros países. Estos países fueron México, República Dominicana, El Salvador, Costa Rica, Brasil, Perú, Trinidad y Tobago. La segunda fase comprende la realización de entrevistas a profundidad, utilizando una guía de discusión, sobre EAN en los países seleccionados para conocer la situación en cada contexto. Se realizaron 31 entrevistas en tres niveles: Gobierno, a representantes del nivel central del PAE en el Ministerio de Educación; Departamento/Estado, a representantes PAE a nivel del estado/departamento; y Comunidad/Escuela, a representantes PAE a nivel escolar/comunitario. La tercera fase del tudio, cuyo objetivo fue la construcción de recomendaciones para una política pública para la incorporación de la EAN como parte fundamental de los PAE en América Latina y el Caribe, incluyó la realización de talleres en modalidad virtual con representantes de FAO en los países a fin de que brindaran recomendaciones para la elaboración de una política pública sobre EAN

Mucosal-associated invariant T (MAIT) cells are activated in the gastrointestinal tissue of patients with combination ipilimumab and nivolumab therapy-related colitis in a pathology distinct from ulcerative colitis

The aim of this study was to investigate the pathogenesis of combination ipilimumab and nivolumab-associated colitis (IN-COL) by measuring gut-derived and peripheral blood mononuclear cell (GMNC; PBMC) profiles. We studied GMNC and PBMC from patients with IN-COL, IN-treated with no adverse-events (IN-NAE), ulcerative colitis (UC) and healthy volunteers using flow cytometry. In the gastrointestinal-derived cells we found high levels of activated CD8+ T cells and mucosal-associated invariant T (MAIT) cells in IN-COL, changes that were not evident in IN-NAE or UC. UC, but not IN-C, was associated with a high proportion of regulatory T cells (Treg). We sought to determine if local tissue responses could be measured in peripheral blood. Peripherally, checkpoint inhibition instigated a rise in activated memory CD4+ and CD8+ T cells, regardless of colitis. Low circulating MAIT cells at baseline was associated with IN-COL patients compared with IN-NAE in one of two cohorts. UC, but not INCOL, was associated with high levels of circulating plasmablasts. In summary, the alterations in T cell subsets measured in IN-COL-affected tissue, characterized by high levels of activated CD8+ T cells and MAIT cells and a low proportion of Treg, reflected a pathology distinct from UC. These tissue changes differed from the periphery, where T cell activation was a widespread on-treatment effect, and circulating MAIT cell count was low but not reliably predictive of colitis

Polymer hydrogel-based microneedles for metformin release

Drug delivery devices ensure the effective delivery of a broad range of therapeutics to millions of patients worldwide on a daily basis.1 Microneedles are a class of drug delivery device that provide pain free transdermal delivery with improved patient compliance.2-4 The release of metformin, a drug used in the treatment of cancer and diabetes, from polymer hydrogel-based microneedle patches was demonstrated in vitro. Tuning the composition of the polymer hydrogels enabled preparation of robust microneedle patches with mechanical properties such that they would penetrate skin (insertion force of a single microneedle to be ca. 40 N). Swelling experiments conducted at 20°C, 35°C and 60°C show temperature dependent degrees of swelling and kinetics (Fickian diffusion). Drug release from the hydrogel-based microneedles was fitted to various models (e.g., zero order, first order, second order, Korsmeyer-Peppas, Peppas-Sahlins), observing the best fit for the zero-order model. Such microneedles have potential application for transdermal delivery of metformin for the treatment of cancer and diabetes

Poly(2-Hydroxyethyl Methacrylate) Hydrogel-Based Microneedles for Metformin Release

The release of metformin, a drug used in the treatment of cancer and diabetes, from poly(2-hydroxyethyl methacrylate), pHEMA, hydrogel-based microneedle patches is demonstrated in vitro. Tuning the composition of the pHEMA hydrogels enables preparation of robust microneedle patches with mechanical properties such that they would penetrate skin (insertion force of a single microneedle to be ≈40 N). Swelling experiments conducted at 20, 35, and 60 °C show temperature-dependent degrees of swelling and diffusion kinetics. Drug release from the pHEMA hydrogel-based microneedles is fitted to various models (e.g., zero order, first order, second order). Such pHEMA microneedles have potential application for transdermal delivery of metformin for the treatment of aging, cancer, diabetes, etc

A new integrated assessment framework for climate-smart nutrition security in sub-Saharan Africa : the integrated Future Estimator for Emissions and Diets (iFEED)

Funding statement This work was supported by the Biotechnology and Biological Sciences Research Council through UK Research and Innovation as part of the Global Challenges Research Fund, AFRICAP programme, grant number BB/P027784/1.Peer reviewedPublisher PD

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance