Search

Bioblitzes are a tool for the rapid appraisal of biodiversity and are particularly useful in remote and understudied regions and for understudied taxa. Lichens are an example of an often overlooked group, despite being widespread in virtually all terrestrial ecosystems and having many important ecological functions.We report the lichens and allied fungi collected during the 2018 terrestrial bioblitz conducted on Calvert Island on the Central Coast of British Columbia, Canada. We identified 449 specimens belonging to 189 species in 85 genera, increasing the total number of species known from Calvert Island to 194, and generated Internal Transcribed Spacer (ITS) sequences for 215 specimens from 121 species. Bryoria furcellata, Chaenothecopsis lecanactidis and C. nigripunctata were collected for the first time in British Columbia. We also found Pseudocyphellaria rainierensis, which is listed as Special Concern on the federal Species at Risk Act, and other rarely reported species in British Columbia including Opegrapha sphaerophoricola, Protomicarea limosa, Raesaenenia huuskonenii and Sarea difformis. We demonstrate that DNA barcoding improves the scope and accuracy of expert-led bioblitzes by facilitating the detection of cryptic species and allowing for consistent identification of chemically and morphologically overlapping taxa. Despite the spatial and temporal limitations of our study, the results highlight the value of intact forest ecosystems on the Central Coast of British Columbia for lichen biodiversity, education and conservation.

Background and Aims: It has been recently proposed to change the nomenclature of “chronic radiation proctitis” (CRP) to “radiation-associated vascular ectasia” on the basis that signs of inflammation are rarely observed. We herein present data supporting the idea that inflammation is a critical step that initiates the process that culminates in the characteristic changes of CRP. Methods: In support of inflammation in the pathogenesis of CRP, we review the pertinent literature and publish our new results, including the role of amifostine treatment and proinflammatory factors (p38 MAP kinase, VEGF, and CEACAM1). Results: Immunohistochemistry from anterior rectal wall biopsies obtained in a prospective pilot study demonstrates that expression of VEGF and the downstream vascular effector CEACAM1 were elevated before radiotherapy and declined with time. We also show that MAP Kinase p38 expression usually precede the radiation. Fibrosis scores increase from baseline at 9 and 18 months, while vascular scores decrease at 18 months. Conclusion: The proposed new nomenclature should be held in obeyance until more supportive data are presented. Possibly, the best way to view CRP is as a continuum that may take one of three forms, inflammation-predominant, vasculopathy-predominant, or mixed.

No abstract available.

Aims: To assess whether meeting both fasting plasma glucose (FPG) and HbA1c criteria for prediabetes in people at high risk indicates with near certainty the presence of dysglycemia on repeat testing. Methods: Observational study using data from Vitamin D and Type 2 Diabetes (D2d) study. HbA1c, FPG were measured at screening visit 1; FPG, HbA1c and 2 h plasma glucose (2hPG) measured at screening visit 2 (a median of 21 days later); participants classified as having normal glucose regulation (all 3 tests in normal range), prediabetes or diabetes (at least 1 of 3 tests in diabetes range). A predictive model was developed to estimate the probability of confirming dysglycemia and for detecting diabetes at screening visit 2 based on values of FPG and HbA1c at screening visit 1. Results: Of 1271 participants who met both FPG and HbA1c criteria for prediabetes at screening visit 1, 98.6% exhibited dysglycemia (defined as prediabetes or diabetes) on repeat testing (84.5% were classified as having prediabetes, 14.1% were reclassified as having diabetes). Of those with diabetes, 62.6% were identified by 2hPG alone. Conclusions: Combined measurement of FPG and HbA1c is a reliable and reproducible measure to identify presence of dysglycemia among people at high risk. A prediction model is provided to help clinicians decide whether an oral glucose tolerance test will provide value in detecting diabetes based on the 2hPG criterion.

Background: Big data analytics (BDA) offers a frontier of opportunities across all industries enabling improvements in marketing, customer service and product development. The adoption process for BDA is often challenging for organisations, given the complexities associated with it. Objective: The objective of this study was hence to understand factors that influence the BDA adoption process in organisations. The technology–organisation–environment framework was combined with factors from a Big Data Adoption model and used as a foundation for the study. Method: A case study research strategy was performed on a large telecommunication organisation. Themes were identified which provided rich explanations into the factors influencing the BDA adoption process in organisations. Results: Five technological factors were confirmed to influence the BDA adoption process. These were: (1) relative advantage, (2) complexity, (3) compatibility, (4) trialability and (5) data quality. Four organisational factors were confirmed to influence the BDA adoption process. These were: (1) top management support, (2) human resource expertise, (3) business and information technology (IT) alignment and (4) organisation size. Five environmental factors were confirmed to influence the BDA adoption process. These were: (1) competitive pressure, (2) data privacy, (3) vendor support, (4) IT fashion and (5) regulatory requirements. Two factors were confirmed as influencing an organisations’ ability to move from intention to adopt BDA to actual deployment. These were: (1) complexity tolerance and (2) paradigm shifts. Conclusion: This study provided evidence that organisations that have a high tolerance for complexity are more likely to move rapidly from intention to adopt BDA to actual deployment and effectively reduce the deployment gap.

The virus, which causes orf and induces acute pustular skin lesions in sheep and goats, is transmissible to humans yet is rarely observed in North America. We present a case of a 65-year-old female farmer from Connecticut who contracted orf from her sheep. The clinical and histopathologic features, important to arrive at the correct diagnosis of this uncommon yet important infection, are described. We also discuss the benign nature of this condition and emphasize that treatment is not required.

Background: Lack of alignment or harmony between information technology (IT) and business imperatives continues to plague organisations despite decades of research. Strategic information systems planning (SISP) is the process of coordinating the relationship between IT and the business in order to steer alignment. Shared domain knowledge (SDK) is a factor that is posited as important for improving both SISP and alignment, which is theorised to be the main outcome of SISP. Objectives: The aim of this article is to examine the impact of SDK on SISP and alignment. Method: Data were gathered from management consultants in a large, global IT organisation, through the use of a structured questionnaire, and analysed. Results: It was shown that SDK positively influences SISP characteristics and the alignment outcome. Specifically, it was found that high levels of rationality in SISP positively influenced the intellectual dimension of alignment, whilst IT manager participation in business planning influenced the social dimension of alignment. SDK was found to have a bearing on all of the SISP characteristics measured (i.e. rationality, adaptation, business planning-SISP integration and IT manager participation in business planning). SDK was also found to positively impact both the intellectual and social dimensions of alignment. Conclusion: The implications of the findings are that fostering a knowledge sharing environment in organisations will help improve alignment, as well as the formal processes designed to steer alignment such as SISP.

In Internet banking and Internet-related transactions, security and privacy are of great concern. To alleviate these concerns, the South African government has promulgated the Electronic Communications and Transactions (ECT) Act No. 25 of 2002. The Act regulates all electronic communication transactions in South Africa. Business organisations implement the Act by, for example, posting a privacy policy statement on their websites, which, in accordance with the requirements of the ECT Act, states how the organisation will use any personal identifiable information provided by the client. This study investigates whether South African banks that subscribe to the ECT Act comply with the principles relating to the protection of a consumer’s personal information. The study employed the research methods of content analysis and interviews. The findings indicate that some banks only complied with a few of the ECT Act principles, which, according to the interview respondents, undermines the levels of trust which are in play between their banks and themselves. The respondents themselves were not fully aware of all the ECT Act requirements. This lack of awareness results in consumers failing to assess the comprehensiveness of their bank’s policy statements and to what extent such banks comply with the ECT Act.

In the past decade, the use of the World Wide Web (WWW) as a tool for job-seeking and recruitment has increased globally, changing the dynamics for job-seekers and recruitment organisations. The purpose of this study was to gain greater insight into the factors that influence the adoption of the Internet (WWW) for job-seeking within a South African context. The impact of the Internet (WWW) and newspaper-reading habits on the adoption process was of specific interest. Data was gathered by survey through telephonic interviews with 228 job seekers applying for information technology (IT) work in Cape Town, South Africa. The findings show that the income of a job-seeker influences the favourability of internet facilitating conditions they encounter. Facilitating conditions in turn influence Internet (WWW) usage habits. Such habits influence performance expectancy, effort expectancy and intentions to use the Internet (WWW) for job-seeking. The actual extent of Internet (WWW) usage for job-seeking is positively influenced by these usage intentions and negatively influenced by newspaper-reading habits. These and other findings are discussed and implications drawn.

Context. Leiomyosarcomas are rare malignant smooth muscle tumors that may arise in any organ or tissue that contains smooth muscle, commonly within the gastrointestinal tract. They are most often found in the stomach, large and small intestines, and retroperitoneum. Primary pancreatic leiomyosarcoma is extremely rare, and to the best of our knowledge only 30 cases have been reported in the world literature since 1951. Our case represents the first to have a clear origin from the main pancreatic duct. Case Report. This case was diagnosed in a large, tertiary care center in Tampa, Florida. Pertinent information was obtained from chart review and interdepartmental collaboration. A mass in the tail of the pancreas was identified with large pleomorphic and spindle-shaped cells. Immunohistochemistry for vimentin, smooth muscle actin, and desmin was positive. All remaining immunohistochemical markers performed were negative. The tumor clearly originated from the pancreatic duct wall, filled and expanded the duct lumen, and was covered with a layer of benign biliary epithelium. Conclusion. Leiomyosarcoma of the pancreas is an extremely rare malignancy with few reported cases in the literature. The prognosis is poor, and treatment consists of alleviating symptoms and pain management. To our knowledge, this represents the first reported case demonstrating clear origin of a leiomyosarcoma from the pancreatic duct.

Background: Routine health information systems (RHISs) are crucial to informing decision-making at all levels of the health system. However, the use of RHIS data in low- and middle-income countries (LMICs) is limited due to concerns regarding quality, accuracy, timeliness, completeness and representativeness., Objective: This study systematically reviewed technical, behavioural and organisational/environmental challenges that hinder the use of RHIS data in LMICs and strategies implemented to overcome these challenges., Method: Four electronic databases were searched for studies describing challenges associated with the use of RHIS data and/or strategies implemented to circumvent these challenges in LMICs. Identified articles were screened against inclusion and exclusion criteria by two independent reviewers., Results: Sixty studies met the inclusion criteria and were included in this review, 55 of which described challenges in using RHIS data and 20 of which focused on strategies to address these challenges. Identified challenges and strategies were organised by their technical, behavioural and organisational/environmental determinants and by the core steps of the data process. Organisational/environmental challenges were the most commonly reported barriers to data use, while technical challenges were the most commonly addressed with strategies., Conclusion: Despite the known benefits of RHIS data for health system strengthening, numerous challenges continue to impede their use in practice., Implications: Additional research is needed to identify effective strategies for addressing the determinants of RHIS use, particularly given the disconnect identified between the type of challenge most commonly described in the literature and the type of challenge most commonly targeted for interventions.

Objectives: The purposes of this study were to determine why chronic obstructive pulmonary disease (COPD) is associated with heart failure (HF). Specific objectives included whether COPD is associated with myocardial fibrosis, whether myocardial fibrosis is associated with hospitalization for HF and death in COPD, and whether COPD and smoking are associated with myocardial inflammation., Background: COPD is associated with HF independent of shared risk factors. The underlying pathophysiological mechanism is unknown., Methods: A prospective, multicenter, longitudinal cohort study of 572 patients undergoing cardiac magnetic resonance (CMR), including 450 patients with COPD and 122 age- and sex-matched patients with a median: 726 days (interquartile range: 492 to 1,160 days) follow-up. Multivariate analysis was used to examine the relationship between COPD and myocardial fibrosis, measured using cardiac magnetic resonance (CMR). Cox regression analysis was used to examine the relationship between myocardial fibrosis and outcomes; the primary endpoint was composite of hospitalizations for HF or all-cause mortality; secondary endpoints included hospitalizations for HF and all-cause mortality. Fifteen patients with COPD, 15 current smokers, and 15 healthy volunteers underwent evaluation for myocardial inflammation, including ultrasmall superparamagnetic particles of iron oxide CMR., Results: COPD was independently associated with myocardial fibrosis (p < 0.001). Myocardial fibrosis was independently associated with the primary outcome (hazard ratio [HR]: 1.14; 95% confidence interval [CI]: 1.08 to 1.20; p < 0.001), hospitalization for HF (HR: 1.25 [95% CI: 1.14 to 1.36]); p < 0.001), and all-cause mortality. Myocardial fibrosis was associated with outcome measurements more strongly than any other variable. Acute and stable COPD were associated with myocardial inflammation., Conclusions: The associations between COPD, myocardial inflammation and myocardial fibrosis, and the independent prognostic value of myocardial fibrosis elucidate a potential pathophysiological link between COPD and HF., Competing Interests: Funding Support and Author Disclosures The study was supported by a research grant from Guerbet. Guerbet had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation or approval of the manuscript; and the decision to submit the manuscript for publication. Dr. Lagan was funded by a Clinical Research Training Fellowship from the British Heart Foundation (FS/17/47/32805). Dr. Miller is funded by a Clinician Scientist Award (CS-2015-15-003) from the National Institute for Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. Dr. Vestbo is supported by the National Institute for Health Research Manchester Biomedical Research Centre. The work was also supported in part by a British Heart Foundation Accelerator award to The University of Manchester (AA/18/4/34221). The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Ensuring financial protection (FP) against health expenditures is a key component of Sustainable Development Goal (SDG) 3.8, which aims to achieve Universal Health Coverage (UHC). While the proportion of households with catastrophic health expenditures exceeding a proportion of their total income or consumption has been adopted as the official SDG indicator, other approaches exist and it is unclear how useful the official indicator is in tracking progress toward the FP sub-target across countries and across time. This paper evaluates the usefulness of the official SDG indicator to measure FP using the RACER framework and discusses how alternative indicators may improve upon the limitations of the official SDG indicator for global monitoring purposes. We find that while all FP indicators have some disadvantages, the official SDG indicator has some properties that severely limit its usefulness for global monitoring purposes. We recommend more research to understand how alternative indicators may enhance global monitoring, as well as improvements to the quality and quantity of underlying data to construct FP indicators in order to improve efforts to monitor progress toward UHC.

Background: Routine health information systems (RHISs) support resource allocation and management decisions at all levels of the health system, as well as strategy development and policy-making in many low- and middle-income countries (LMICs). Although RHIS data represent a rich source of information, such data are currently underused for research purposes, largely due to concerns over data quality. Given that substantial investments have been made in strengthening RHISs in LMICs in recent years, and that there is a growing demand for more real-time data from researchers, this systematic review builds upon the existing literature to summarize the extent to which RHIS data have been used in peer-reviewed research publications., Methods: Using terms 'routine health information system', 'health information system', or 'health management information system' and a list of LMICs, four electronic peer-review literature databases were searched from inception to February 202,019: PubMed, Scopus, EMBASE, and EconLit. Articles were assessed for inclusion based on pre-determined eligibility criteria and study characteristics were extracted from included articles using a piloted data extraction form., Results: We identified 132 studies that met our inclusion criteria, originating in 37 different countries. Overall, the majority of the studies identified were from Sub-Saharan Africa and were published within the last 5 years. Malaria and maternal health were the most commonly studied health conditions, although a number of other health conditions and health services were also explored., Conclusions: Our study identified an increasing use of RHIS data for research purposes, with many studies applying rigorous study designs and analytic methods to advance program evaluation, monitoring and assessing services, and epidemiological studies in LMICs. RHIS data represent an underused source of data and should be made more available and further embraced by the research community in LMIC health systems.

Intervention: This study examines the impact of London's Healthy Kids Community Challenge (HKCC) 'Water Does Wonders' interventions, which combined water infrastructure and education programs., Research Question: How effective were the HKCC interventions at increasing water and decreasing sugar-sweetened beverage (SSB) consumption among grade 4-8 children in London, Ontario?, Methods: Non-randomized controlled trial. Children's knowledge and beverage intake were measured before and after the interventions were implemented during the 2016-2017 school year. Children at intervention schools (n = 521) received education programs (Growing Chefs or UTRCA [Upper Thames River Conservation Authority]) and water bottle filling stations. Children at control schools (n = 410) received filling stations only. Multivariable linear mixed-model ANCOVAs were used to compare water and SSB consumption and knowledge across intervention groups, accounting for school-level clustering., Results: Children who received an education intervention and filling station compared with only a filling station consumed more water (β = 2.18 (95% CI - 1.87, 6.22) for Growing Chefs and β = 2.90 (95% CI - 0.23, 6.03) for UTRCA) and fewer SSBs (β = - 1.17 (95% CI - 3.83, 1.49) for Growing Chefs and β = - 2.56 (95% CI - 5.12, 0.001) for UTRCA) post-intervention, and had higher nutrition knowledge (β = 1.57 (95% CI - 1.68, 4.83) for Growing Chefs and β = 2.02 (95% CI - 0.35, 4.39) for UTRCA). These findings were not statistically significant., Conclusions: An intervention intended to promote healthy beverage consumption yielded effects in the expected direction; however, they were small and not statistically significant. This is likely because the educational interventions were not fully aligned with the goals of the 'Water Does Wonders' program, preventing them from evoking meaningful changes in dietary behaviours.

Access to electricity is an important issue in low- and middle-income countries (LMICs) however its health implications are poorly understood. This paper systematically reviews the health effects of access to electricity and develops a conceptual model to summarise the pathways through which these effects may occur. The databases CINAHL, Embase, and MEDLINE were searched for studies examining the effects of access to electricity on health in LMICs. Thirty-three studies met the inclusion criteria: 23 focusing on electrification and 10 focusing on electricity reliability. Using a modified socio-ecological model, 4 main levels of influence were identified: (1) individual, (2) household, (3) community, and (4) institutional. Electrification was generally associated with positive health outcomes, such as reduced mortality, lower rates of disease, and improved quality of and access to care, while poor electricity reliability was associated with negative health outcomes, including increased morbidity and mortality, lower quality of care, and reduced utilisation of health services. Although the overall quality of the evidence was weak, given the many potential pathways through which electricity may affect health, efforts should be made not only to increase the number of connected households globally, but to improve the reliability of the electricity supply as well.

Achieving Universal Health Coverage (UHC) has been recognized as one of the Sustainable Development Goals (SDGs) and includes both ensuring access to health services and providing financial protection (FP) against using these services. Currently, progress towards achieving the FP component of UHC is assessed using the catastrophic health expenditure budget share indicator, which estimates the proportion of the population with health expenditures exceeding 10% of total income or consumption. Other indicators exist, however, and are widely used in the literature, yet few studies have compared the usefulness of these indicators for UHC monitoring. Using panel data from Burkina Faso, this paper seeks to evaluate the performance of common FP indicators based on three properties: (1) their ability to identify those most at risk of financial hardship (i.e. the poor), (2) their ability to detect households with health shocks, and (3) their sensitivity to seasonal variation. Our results indicate that, while some indicators perform better in certain conditions than others, none are without limitation. Indeed, despite being the best able to differentiate households who have experienced a health shock, the official SDG indicator performs the worst at identifying the poorest group of the population and is the most sensitive to seasonal variation. As such, more research is needed in order to improve the measurement of FP such that progress towards achieving UHC can be accurately monitored., (© 2020 The Authors.)

Objective: To examine the relationship between knowledge and beverage consumption habits among children., Design: Cross-sectional analysis. Linear regression was used to identify sociodemographic, dietary and behavioural determinants of beverage consumption and knowledge, and to describe the relationships between children's knowledge and water and sugar-sweetened beverage (SSB) consumption., Settings: Seventeen elementary schools in London, Ontario, Canada., Participants: A total of 1049 children aged 8-14 years., Results: Knowledge scores were low overall. Children with higher knowledge scores consumed significantly fewer SSB (β = -0·33; 95 % CI -0·49, -0·18; P < 0·0001) and significantly more water (β = 0·34; 95 % CI 0·16, 0·52; P = 0·0002). More frequent refillable water bottle use, lower junk food consumption, lower fruit and vegetable consumption, female sex, higher parental education, two-parent households and not participating in a milk programme were associated with a higher water consumption. Male sex, higher junk food consumption, single-parent households, lower parental education, participating in a milk programme, less frequent refillable water bottle use and permission to leave school grounds at lunchtime were associated with a higher SSB consumption. Water was the most frequently consumed beverage; however, 79 % of respondents reported consuming an SSB at least once daily and 50 % reported consuming an SSB three or more times daily., Conclusions: Elementary-school children have relatively low nutrition and water knowledge and consume high proportions of SSB. Higher knowledge is associated with increased water consumption and reduced SSB consumption. Interventions to increase knowledge may be effective at improving children's beverage consumption habits.

Introduction: Electricity outages are common in low/middle-income countries and have been shown to adversely affect the operation of health facilities; however, little is known about the effect of outages on the utilisation of health services., Methods: Using data from the 2015-2016 India Demographic Health Survey, combined with information on electricity outages as reported by the state electricity provider, we explore the associations between outage duration and frequency and delivery in an institution, skilled birth attendance, and caesarean section delivery in Maharashtra State, India. We employ multivariable logistic regression, adjusting for individual and household-level covariates as well as month and district-level fixed effects., Results: Power outage frequency was associated with a significantly lower odds of delivering in an institution (OR 0.98; 95% CI 0.96 to 0.99), and the average number of 8.5 electricity interruptions per month was found to yield a 2.08% lower likelihood of delivering in a facility, which translates to an almost 18% increase in home births. Both power outage frequency and duration were associated with a significantly lower odds of skilled birth attendance (OR 0.97; 95% CI 0.95 to 0.99, and OR 0.99; 95% CI 0.992 to 0.999, respectively), while neither power outage frequency nor duration was a significant predictor of caesarean section delivery., Conclusion: Power outage frequency and duration are important determinants of maternal health service usage in Maharashtra State, India. Improving electricity services may lead to improved maternal and newborn health outcomes., Competing Interests: Competing interests: None declared.

Accidental hypothermia due to environmental exposure is a common condition encountered in the wilderness setting. I report a case of hypothermia that occurred in New Hampshire to a 42-year-old, poorly prepared mountaineer. He presented with ataxia, impaired judgment, oliguria, and slight confusion, suggestive of mild to moderate hypothermia. He was treated in the field using passive and active external rewarming methods and 1 active internal method. The signs, symptoms, and progression of hypothermia are reviewed, and treatment options are discussed, with an emphasis on management of hypothermia in the wilderness setting. Additionally, more complicated treatment modalities are canvassed, as these are of use to rescue teams and expeditions. Current controversies regarding the treatment of hypothermia, resuscitation efforts, and potential complications are also mentioned.