Impact of COVID-19 on poverty and living standards in Ghana: A micro-perspective

The novel Coronavirus disease 2019 (COVID-19), which has become a global epidemic, hit Ghana on 12 March 2020 and, in less than a week, increased by over 300% with two deaths. As of 11 August 2020, Ghana had recorded over 41,000 cases with over 215 deaths. This study seeks to provide a micro-level evidence on how COVID-19 is posing a threat to some of the Sustainable Development Goals, particularly poverty in Ghana. Specifically, the study examined the effect of COVID-19 on poverty and living standards of Ghanaian households. The study further analysed which class of persons within the income distributions has been mostly hit by the pandemic. Data on 3,905 households were obtained via concurrent online survey and telephone interviews. Multiple analytical approaches were employed―Ordinary least squares, probit model and simultaneous quantile regressions. Results showed that COVID-19 had significantly increased the poverty levels of households while deteriorating living standards. The study also discovered that gender and locational heterogeneities exist regarding the impact of COVID-19 with females and rural dwellers mostly disadvantaged. However, simultaneous quantile regression result shows that in terms of overall household consumption, those in the middle and upper classes are profoundly affected compared to those in the lowest class. A key policy implication from this study is that Ghana needs to broaden its social protection programmes to assist both the new poor and existing poor

Concomitant CIS on TURBT does not impact oncological outcomes in patients treated with neoadjuvant or induction chemotherapy followed by radical cystectomy

© Springer-Verlag GmbH Germany, part of Springer Nature 2018Background: Cisplatin-based neoadjuvant chemotherapy (NAC) for muscle invasive bladder cancer improves all-cause and cancer specific survival. We aimed to evaluate whether the detection of carcinoma in situ (CIS) at the time of initial transurethral resection of bladder tumor (TURBT) has an oncological impact on the response to NAC prior to radical cystectomy. Patients and methods: Patients were identified retrospectively from 19 centers who received at least three cycles of NAC or induction chemotherapy for cT2-T4aN0-3M0 urothelial carcinoma of the bladder followed by radical cystectomy between 2000 and 2013. The primary and secondary outcomes were pathological response and overall survival, respectively. Multivariable analysis was performed to determine the independent predictive value of CIS on these outcomes. Results: Of 1213 patients included in the analysis, 21.8% had concomitant CIS. Baseline clinical and pathologic characteristics of the ‘CIS’ versus ‘no-CIS’ groups were similar. The pathological response did not differ between the two arms when response was defined as pT0N0 (17.9% with CIS vs 21.9% without CIS; p = 0.16) which may indicate that patients with CIS may be less sensitive to NAC or ≤ pT1N0 (42.8% with CIS vs 37.8% without CIS; p = 0.15). On Cox regression model for overall survival for the cN0 cohort, the presence of CIS was not associated with survival (HR 0.86 (95% CI 0.63–1.18; p = 0.35). The presence of LVI (HR 1.41, 95% CI 1.01–1.96; p = 0.04), hydronephrosis (HR 1.63, 95% CI 1.23–2.16; p = 0.001) and use of chemotherapy other than ddMVAC (HR 0.57, 95% CI 0.34–0.94; p = 0.03) were associated with shorter overall survival. For the whole cohort, the presence of CIS was also not associated with survival (HR 1.05 (95% CI 0.82–1.35; p = 0.70). Conclusion: In this multicenter, real-world cohort, CIS status at TURBT did not affect pathologic response to neoadjuvant or induction chemotherapy. This study is limited by its retrospective nature as well as variability in chemotherapy regimens and surveillance regimens.Peer reviewedFinal Accepted Versio

Expanded huntingtin CAG repeats disrupt the balance between neural progenitor expansion and differentiation in human cerebral organoids

Huntington disease (HD) manifests in both adult and juvenile forms. Mutant HTT gene carriers are thought to undergo normal brain development followed by a degenerative phase, resulting in progressive clinical manifestations. However, recent studies in children and prodromal individuals at risk for HD have raised the possibility of abnormal neurodevelopment. Although key findings in rodent models support this notion, direct evidence in the context of human physiology remains lacking. Using a panel of isogenic HD human embryonic pluripotent stem cells and cerebral organoids, we investigated the impact of mutant HTT on early neurodevelopment. We find that ventricular zone-like neuroepithelial progenitor layer expansion is blunted in an HTT CAG repeat length-dependent manner due to premature neurogenesis in HD cerebral organoids, driven by cell intrinsic processes. Transcriptional profiling and imaging analysis revealed impaired cell cycle regulatory processes, increased G1 length, and increased asymmetric division of apical progenitors, collectively contributing to premature neuronal differentiation. We demonstrate increased activity of the ATM-p53 pathway, an up-stream regulator of cell cycle processes, and show that treatment with ATM antagonists partially rescues the blunted neuroepithelial progenitor expansion in HD organoids. Our findings suggest that CAG repeat length regulates the balance between neural progenitor expansion and differentiation during early neurodevelopment. Our results further support the view that HD, at least in its early-onset forms, may not be a purely neurodegenerative disorder, and that abnormal neurodevelopment may be a component of HD pathophysiology

The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer

Activité et performance des hôpitaux municipaux en Chine rurale. Une analyse sur données d'enquêtes dans la province de Shandong

La décentralisation en Chine a placé les hôpitaux municipaux (HM) au cœur du système sanitaire en zone rurale. Nous avons collecté des informations dans un échantillon de 21 HM de la province de Shandong et dans les administrations concernées pour analyser par des méthodes quantitatives les déterminants de leur activité, mesurer leur efficience et en rechercher les facteurs explicatifs pour la période 1986-2000. Nos résultats suggèrent entre autres que le revenu per capita de la zone de desserte des HM et leur attractivité perçue ont un effet positif sur leur activité, que les tarifs pratiqués en sont un frein et que les dispositifs de couverture maladie n'ont pas d'impact significatif sur leur fréquentation. L'intégration verticale partielle des HM avec les centres de santé villageois a relativement freiné l'activité de ces hôpitaux. Leur efficience s'est globalement améliorée, selon une dynamique relativement hétérogène, durant la période étudiée, mais on observe une certaine convergence des performances. Cette évolution s'est faite en partie sous l'influence de facteurs institutionnels qui tiennent à des modalités de régulation sectorielle et à des questions de gouvernance liées aux relations entre les HM et la tutelle

Phase Manipulation Based Polarization Profile Realization and Hybrid Holograms Using Geometric Metasurfaces

The outstanding ability of optical metasurfaces to tailor light's amplitude, phase, and polarization with a subwavelength resolution has attracted big interest. A multifunctional metasurface device is reported and experimentally demonstrated that integrates an arbitrary polarization profile for image concealment and a computer‐generated hybrid hologram. Herein, a high‐resolution image is hidden in the polarization profile of the light beam, while the holographic images are encoded in its phase profile for the reconstruction of two different types of holographic images. The designed polarization profile is realized based on the superposition of two different phase profiles for circular polarization states with opposite handedness. This method can further extend the design degree of freedom in optical metasurfaces, which may open an alternative avenue for anticounterfeiting, optical image encoding, and optical information security

Roles of Arbuscular mycorrhizal Fungi as a Biocontrol Agent in the Control of Plant Diseases

Arbuscularmycorrhizal fungi (AMF) are a class of beneficial microorganisms that are widely distributed in soil ecosystems and can form symbionts with 80% of terrestrial higher plants, and improve the nutritional status of plants. The use of AMF as a biocontrol method to antagonize soil-borne pathogens has received increasing interest from phytopathologists and ecologists. In this paper, the mechanisms of resistance to diseases induced by AMF and the application of AMF to plant fungal, bacterial, and nematode diseases have been summarized. This study aimed to enhance the potential use of AMF as a biological control method to prevent plant diseases in the future. Root morphological alteration characteristics were explained, including the influence of AMF on root structure, function, and the regulation of AMF via secondary metabolites. AMF can improve the rhizosphere environment by influencing the physical and chemical proprieties of soil, enhancing the growth of other beneficial microorganisms, and by competing with pathogenic microorganisms. Two microorganism types may compete for the same invasive sites in root systems and regulate nutrition distribution. AMF can induce the host plant to form defense systems, including improving phytohormone concentrations, inducing signal substrate production, gene expression regulation, and enhancing protein production