Spatial Inequality in Times of Urban Transition: Complex Land Markets in Uganda and Somaliland: Overarching Synthesis Report

This report synthesises the analysis of research on “Spatial Inequalities in Times of Urban Transitions” that was executed from December 2017 to September 2019 in 4 cities in Uganda and Somaliland. Based on a systemic view of land markets and integrated with a political settlement analysis it is meant to help in understanding and eventually overcoming constraints to the ways that land markets can contribute to spatial justice. The report draws on an understanding of political settlements as a way of understanding how varieties of clientelism through informal interfaces manifest themselves in cities and how the materialities and resources of cities shape and afford possibilities for clientelism (Goodfellow, 2017)

Spatial Inequality in Times of Urban Transition: Complex Land Markets in Uganda and Somaliland: Public Facing Report

This report synthesizes the main issues, findings and recommendations from the analysis of our research on Spatial Inequalities of Urban Transitions, executed between Dec. 2017 and Sept. 2019. Based on a systemic view of land markets and integrated with a political settlement analysis, this report helps in understanding and eventually overcoming constraints to the ways that land markets can contribute to spatial justice. The report can identify some of the ways in which land markets relate to spatial justice. The aim of the report is to suggest forms of support to assist policy development and policy interventions that can enable East African cities to offer greater opportunities to poor and marginalised urban groups. It presents findings on overarching issues in each city from all the research components and associated policy recommendations

Outcome predictors for maternal red blood cell alloimmunisation with anti-K and anti-D managed with intrauterine blood transfusion

Red blood cell (RBC) alloimmunisation with anti-D and anti-K comprise the majority of cases of fetal haemolytic disease requiring intrauterine red cell transfusion (IUT). Few studies have investigated which haematological parameters can predict adverse fetal or neonatal outcomes. The aim of the present study was to identify predictors of adverse outcome, including preterm birth, intrauterine fetal demise (IUFD), neonatal death (NND) and/or neonatal transfusion. We reviewed the records of all pregnancies alloimmunised with anti-K and anti-D, requiring IUT over 27 years at a quaternary fetal centre. We reviewed data for 128 pregnancies in 116 women undergoing 425 IUTs. The median gestational age (GA) at first IUT was significantly earlier for anti-K than for anti-D (24·3 vs. 28·7 weeks, P = 0·004). Women with anti-K required more IUTs than women with anti-D (3·84 vs. 3·12 mean IUTs, P = 0·036) and the fetal haemoglobin (Hb) at first IUT was significantly lower (51.0 vs. 70.5 g/l, P = 0·001). The mean estimated daily decrease in Hb did not differ between the two groups. A greater number of IUTs and a slower daily decrease in Hb (g/l/day) between first and second IUTs were predictive of a longer period in utero. Earlier GA at first IUT and a shorter interval from the first IUT until delivery predicted IUFD/NND. Earlier GA and lower Hb at first IUT significantly predicted need for phototherapy and/or blood product use in the neonate. In the anti-K group, a greater number of IUTs was required in women with a higher titre. Furthermore, the higher the titre, the earlier the GA at which an IUT was required in both groups. The rate of fall in fetal Hb between IUTs decreased, as the number of transfusions increased. Our present study identified pregnancies at considerable risk of an unfavourable outcome with anti-D and anti-K RBC alloimmunisation. Identifying such patients can guide pregnancy management, facilitates patient counselling, and can optimise resource use. Prospective studies can also incorporate these characteristics, in addition to laboratory markers, to further identify and improve the outcomes of these pregnancies

Visuele beperkingen bij ouderen in Nederland – risicogroepen en mogelijkheden tot interventie

Doel Het in kaart brengen van het aantal ouderen met een visuele beperking in Nederland, nu en in de toekomst. Mogelijkheden tot interventie worden aangegeven. Methode en materiaal De schattingen zijn gebaseerd op een recent onderzoek in opdracht van Stichting InZicht, ZonMw, waarin literatuur gegevens over prevalentie van blindheid en slechtziendheid en de oorzaken daarvan uit bevolkingsonderzoeken in Nederland, West Europa, de Verenigde Staten en Australië zijn gerelateerd aan de laatste demografische gegevens voor Nederland. Resultaten Van de 16,4 miljoen Nederlanders in 2008 zijn er 2,4 miljoen (14,7%) 65 jaar of ouder. Van deze laatste groep wonen 155.000 mensen in een verpleeg of verzorgingshuis, de rest woont zelfstandig. In 2008 zijn naar schatting 77.000 Nederlanders blind en 234.000 slechtziend. Van hen is 79% 65 jaar of ouder. Van de ouderen in instellingen is 20% blind (32.000) en 22% slechtziend (34.000). Bij 62% van hen is de visuele beperking te behandelen of was te voorkomen geweest (‘vermijdbaar’). Van de zelfstandig wonende ouderen is 1,2% blind (27.000) en 6,8% slechtziend (154.000). Bij 57% van hen is de aandoening vermijdbaar. Conclusie In 2008 hebben 247.000 ouderen een visuele beperking die bij 143.000 (58%) van hen te behandelen is of te voorkomen was geweest. Screening en behandeling van ouderen in instellingen lijkt aangewezen, evenals voorlichting aan en gerichte screening van zelfstandig wonende ouderen

A 'civilized' drink and a 'civilizing' industry: wine growing and cultural imagining in colonial New South Wales

My starting point for this thesis was the absence of a foundation history of Australian wine growing conducted by an historian rather than researchers in other disciplines or the media. I have used existing work on wine history in New South Wales from 1788 to 1901 alongside a significant body of new research to create an historical argument suitable for incorporation into more broadly-themed narratives of Australian history and to inform studies of wine growing in other academic fields. My main argument is that although wine growing proved of little economic value in colonial primary production compared with nation-building commodities - such as pastoralism, wheat growing and gold - advocates of the cultivation of wine grapes believed wine growing embodied beneficial, even transformative, cultural value so they persisted in attempting to create a ‘civilizing’ industry producing a ‘civilized’ drink despite lacklustre consumption of their product and very modest profits. Several times, from 1788 to 1901, these advocates spoke out or wrote about wine and wine growing as capable of creating order in a wild or ‘savage’ landscape and within a settler society shaped culturally by shifting adaptations to both imported and ‘native’ influences in agriculture as well as alcohol production, consumption and distribution. While the methodological framework employed here falls mainly within cultural and economic history, sociological theories have contributed to findings on causation. The result is a comprehensive narrative of colonial wine growing in New South Wales enriched by links to key developments in Australian colonial history and with reference to wine growing in other British colonies or former territories

Glutamine synthetase activity fuels nucleotide biosynthesis and supports growth of glutamine-restriced glioblastoma

L-Glutamine (Gln) functions physiologically to balance the carbon and nitrogen requirements of tissues. It has been proposed that in cancer cells undergoing aerobic glycolysis, accelerated anabolism is sustained by Gln-derived carbons, which replenish the tricarboxylic acid (TCA) cycle (anaplerosis). However, it is shown here that in glioblastoma (GBM) cells, almost half of the Gln-derived glutamate (Glu) is secreted and does not enter the TCA cycle, and that inhibiting glutaminolysis does not affect cell proliferation. Moreover, Gln-starved cells are not rescued by TCA cycle replenishment. Instead, the conversion of Glu to Gln by glutamine synthetase (GS; cataplerosis) confers Gln prototrophy, and fuels de novo purine biosynthesis. In both orthotopic GBM models and in patients, (13)C-glucose tracing showed that GS produces Gln from TCA-cycle-derived carbons. Finally, the Gln required for the growth of GBM tumours is contributed only marginally by the circulation, and is mainly either autonomously synthesized by GS-positive glioma cells, or supplied by astrocytes

A pivotal role for starch in the reconfiguration of 14C-partitioning and allocation in Arabidopsis thaliana under short-term abiotic stress.

Plant carbon status is optimized for normal growth but is affected by abiotic stress. Here, we used 14C-labeling to provide the first holistic picture of carbon use changes during short-term osmotic, salinity, and cold stress in Arabidopsis thaliana. This could inform on the early mechanisms plants use to survive adverse environment, which is important for efficient agricultural production. We found that carbon allocation from source to sinks, and partitioning into major metabolite pools in the source leaf, sink leaves and roots showed both conserved and divergent responses to the stresses examined. Carbohydrates changed under all abiotic stresses applied; plants re-partitioned 14C to maintain sugar levels under stress, primarily by reducing 14C into the storage compounds in the source leaf, and decreasing 14C into the pools used for growth processes in the roots. Salinity and cold increased 14C-flux into protein, but as the stress progressed, protein degradation increased to produce amino acids, presumably for osmoprotection. Our work also emphasized that stress regulated the carbon channeled into starch, and its metabolic turnover. These stress-induced changes in starch metabolism and sugar export in the source were partly accompanied by transcriptional alteration in the T6P/SnRK1 regulatory pathway that are normally activated by carbon starvation

Wartenberg’s migrant sensory neuritis: a prospective follow-up study

Migrant sensory neuropathy (Wartenberg’s migrant sensory neuritis) is characterized by sudden numbness in the distribution of one or multiple cutaneous nerves. To study disease course and outcome, we prospectively followed 12 patients who presented to our tertiary referral neuromuscular outpatient clinic between January 2003 and January 2004. Medical history, neurological, laboratory and electrophysiological examinations were obtained from all patients. All patients were reviewed a second time in 2007, and five had a follow-up electrophysiological examination. At the first visit, 50% described an episode of stretching preceding the sensory complaints. All but three described pain in the affected area before or concomitant with sensory loss. At clinical examination a median of six skin areas were affected, and in 75% this could be confirmed by nerve conduction studies in at least one nerve. Forty-two percent had involvement of the trigeminal nerve. After a mean disease duration of 7.5 years, three patients reported a complete disappearance of sensory complaints and five that the pain had disappeared, but numbness remained. Three patients still had both painful and numb sensory deficits. One patient developed a distal symmetric sensory polyneuropathy. In conclusion, Wartenberg’s sensory neuritis is a distinct, exclusively sensory, neuropathy, marked by pain preceding numbness in affected nerves. An episode of stretching preceding pain is not necessary for the diagnosis. Wartenberg’s sensory neuritis often retains its spotty, exclusively sensory characteristics after long term follow-up

The evaluation of an online nurse-assisted eye-screening tool in older adults receiving home healthcare

PURPOSE: To investigate the agreement between an online nurse-assisted eye-screening tool and reference tests in older adults receiving home healthcare and to collect user experiences. METHODS: Older adults (65+) receiving home healthcare were included. Home healthcare nurses assisted in administering the eye-screening tool at participants' homes. Approximately 2 weeks later, a researcher administered reference tests at participants' homes. Experiences from participants and home healthcare nurses were collected. Agreement in outcomes (distance and near visual acuity, with the latter being measured using two different optotypes, and macular problems) between the eye-screening tool and reference clinical testing was compared. A difference of less than ±0.15 logMAR was considered acceptable. RESULTS: A total of 40 participants were included. Here, we describe the results for the right eye; results for the left eye were similar. The mean difference between the eye-screening tool and reference tests for distance visual acuity was 0.02 logMAR. The mean difference between the eye-screening tool and reference tests using two different optotypes for near visual acuity was 0.06 and 0.03 logMAR, respectively. The majority of the individual data points were within the ±0.15 logMAR threshold (75%, 51% and 58%, respectively). The agreement between tests for macular problems was 75%. Participants and home healthcare nurses were generally satisfied with the eye-screening tool, although remarks for further improvements were made. CONCLUSIONS: The eye-screening tool is promising for nurse-assisted eye screening in older adults receiving home healthcare, with the mostly satisfactory agreement. After implementing the eye-screening tool in practice, cost-effectiveness needs to be investigated

Dichloroacetate reverses the hypoxic adaptation to bevacizumab and enhances its antitumor effects in mouse xenografts.

Inhibition of vascular endothelial growth factor increases response rates to chemotherapy and progression-free survival in glioblastoma. However, resistance invariably occurs, prompting the urgent need for identification of synergizing agents. One possible strategy is to understand tumor adaptation to microenvironmental changes induced by antiangiogenic drugs and test agents that exploit this process. We used an in vivo glioblastoma-derived xenograft model of tumor escape in presence of continuous treatment with bevacizumab. U87-MG or U118-MG cells were subcutaneously implanted into either BALB/c SCID or athymic nude mice. Bevacizumab was given by intraperitoneal injection every 3 days (2.5 mg/kg/dose) and/or dichloroacetate (DCA) was administered by oral gavage twice daily (50 mg/kg/dose) when tumor volumes reached 0.3 cm(3) and continued until tumors reached approximately 1.5-2.0 cm(3). Microarray analysis of resistant U87 tumors revealed coordinated changes at the level of metabolic genes, in particular, a widening gap between glycolysis and mitochondrial respiration. There was a highly significant difference between U87-MG-implanted athymic nude mice 1 week after drug treatment. By 2 weeks of treatment, bevacizumab and DCA together dramatically blocked tumor growth compared to either drug alone. Similar results were seen in athymic nude mice implanted with U118-MG cells. We demonstrate for the first time that reversal of the bevacizumab-induced shift in metabolism using DCA is detrimental to neoplastic growth in vivo. As DCA is viewed as a promising agent targeting tumor metabolism, our data establish the timely proof of concept that combining it with antiangiogenic therapy represents a potent antineoplastic strategy