Search

Chlorophyll-a (Chl-a) and Total Suspended Matter (TSM) are key health indicators of the coastal ocean and seas. The former is linked to primary productivity, while the latter is associated with water quality; both are influenced by change in climate. Recent studies have highlighted a declining trend in Chl-a levels along the Mediterranean coastal region. River discharge plays an important role in regulating the coastal Chl-a concentration levels. The present research primarily focuses on understanding the significance of Tiber River −driven spatial dynamics of Chl-a and TSM along the central Tyrrhenian Sea coasts. The research also focuses on evaluating the applicability of Sentinel-2 and identifying a suitable method for estimating Chl-a and TSM from Sentinel-2. Neural networks and dark spectrum fitting techniques were applied using multiple algorithms to estimate the dynamic distribution of Chl-a and TSM driven by the Tiber River in the study area. Multiple statistical analyses were performed, and statistically significant relationships were observed. The Case-2 Regional Coast Colour Neural Network (C2RCC-Net) outperformed all other algorithms, with an R2 value of 0.903 for Chl-a and an R2 value of 0.966 for TSM. Furthermore, the present research also identified a positive pixel to pixel spatial correlation between Chl-a and TSM in all four seasons, highlighting the positive impact of Tiber River on maintaining Chl-a levels along the coasts of Tyrrhenian Sea. This stands in contrast with the negative trend seen in the Mediterranean scale.

Abstract Plasma RNAemia, delayed antibody responses and inflammation predict COVID-19 outcomes, but the mechanisms underlying these immunovirological patterns are poorly understood. We profile 782 longitudinal plasma samples from 318 hospitalized patients with COVID-19. Integrated analysis using k-means reveals four patient clusters in a discovery cohort: mechanically ventilated critically-ill cases are subdivided into good prognosis and high-fatality clusters (reproduced in a validation cohort), while non-critical survivors segregate into high and low early antibody responders. Only the high-fatality cluster is enriched for transcriptomic signatures associated with COVID-19 severity, and each cluster has distinct RBD-specific antibody elicitation kinetics. Both critical and non-critical clusters with delayed antibody responses exhibit sustained IFN signatures, which negatively correlate with contemporaneous RBD-specific IgG levels and absolute SARS-CoV-2-specific B and CD4+ T cell frequencies. These data suggest that the “Interferon paradox” previously described in murine LCMV models is operative in COVID-19, with excessive IFN signaling delaying development of adaptive virus-specific immunity.

Objectives The Self-Management Analysis in Chronic Conditions (SMACC) checklist was developed as a guidance tool to support the development, comparison and evaluation of self-management support programmes for persons with a chronic condition. The checklist was based on a previously performed concept analysis of self-management. The aim of this study was to validate its content using an international Delphi study and to deliver a final version.Design A two-round Delphi study was conducted between October 2022 and January 2023. Using the researchers’ networks, professionals with research or clinical expertise in self-management support and chronic conditions were recruited via online purposive snowball sampling. Participants were asked to score each item of the checklist (16 items total) on 3 content validity indicators: (1) clarity and comprehensibility, (2) relevance and importance and (3) degree of alignment with the overall goal of the checklist to promote adequate and comprehensive self-management support programmes. A consensus threshold of 75% agreement was used. The participants were also asked general questions about the checklist as a whole and were asked to provide feedback considering its refinement.Results Fifty-four professionals with an average 14.5 years of experience participated in round 1, 48 with an average 12.5 years of experience participated in round 2. The majority of professionals were from Western Europe. For the majority of items consensus was reached after round 1. In round 2, 3 of the 4 remaining items reached consensus, 1 last item was retained based on highly recurring feedback.Conclusions The SMACC checklist was considered a valid and comprehensive tool to aid the development, evaluation and comparison of self-management support programmes. It was acknowledged as a useful instrument to supplement existing frameworks and was seen as feasible to implement in both research and clinical settings. Further validation in the field, with input from patients and peer experts, will be valuable.

Resilience to adverse events is increasingly recognized as important for human health. Socio-economic status (SES) is also frequently identified as a predictor of resilience. However, it is not well-understood how people define resilience in their everyday lives, and whether individuals have different experiences of resilience based on their SES. This study sought to fill these gaps, in the context of the COVID-19 pandemic and pandemic mitigation policies in the Netherlands.We interviewed high (n = 38) and low (n = 37) SES participants about their understanding and experiences of resilience during this period. Participants took part in individual interviews and focus groups in September 2021. Transcripts were analyzed thematically.A key theme was coping with adversity, in line with commonly-used definitions of resilience. However, we found that resilience was often defined more broadly. Resilience also encompassed aspects of self-reflection and improvement, and faith in oneself, the community and the nation. There were also key differences by SES background: elaborate and optimistic definitions and experiences of resilience were more often described by high SES individuals. For instance, high SES participants more frequently defined resilience as growing and improving. In contrast, low SES participants more commonly experienced resilience as enduring until better times arrived.Having a higher SES seemed to support resilience during the COVID-19 pandemic. This indicates that adverse events may exacerbate pre-existing financial and material difficulties among low SES individuals. This finding underscores the importance of addressing financial precarity prior to adverse events.

Background Evidence about the impact of the COVID-19 pandemic on existing health inequalities is emerging. This study explored dif-ferences in mental health, sense of coherence (SOC), sense of community coherence (SOCC), sense of national coherence (SONC), and social support between low and high socioeconomic (SES) groups, and the predictive value of these predictors for mental health. Material and methods A cross-sectional study was conducted using an online survey in the Netherlands in October 2021, comprising a total of 91 respondents (n = 41, low SES; n = 50, high SES). Results There were no differences in mental health, SOC, SOCC, SONC, and social support between the groups. SOC was a predictor for mental health in both groups and SOCC for the low SES group. Conclusions We found that both SOC and SOCC predict mental health during the pandemic. In the article we reflect on possible path-ways for strengthening these resources for mental health.

Summary: Neutralizing antibodies (NAbs) hold great promise for clinical interventions against SARS-CoV-2 variants of concern (VOCs). Understanding NAb epitope-dependent antiviral mechanisms is crucial for developing vaccines and therapeutics against VOCs. Here we characterized two potent NAbs, EH3 and EH8, isolated from an unvaccinated pediatric patient with exceptional plasma neutralization activity. EH3 and EH8 cross-neutralize the early VOCs and mediate strong Fc-dependent effector activity in vitro. Structural analyses of EH3 and EH8 in complex with the receptor-binding domain (RBD) revealed the molecular determinants of the epitope-driven protection and VOC evasion. While EH3 represents the prevalent IGHV3-53 NAb whose epitope substantially overlaps with the ACE2 binding site, EH8 recognizes a narrow epitope exposed in both RBD-up and RBD-down conformations. When tested in vivo, a single-dose prophylactic administration of EH3 fully protected stringent K18-hACE2 mice from lethal challenge with Delta VOC. Our study demonstrates that protective NAbs responses converge in pediatric and adult SARS-CoV-2 patients.

ABSTRACT The heavily glycosylated HIV-1 envelope glycoprotein (Env) is the sole viral antigen present at the surface of virions and infected cells, representing the main target for antibody responses. The FDA-approved small molecule temsavir acts as an HIV-1 attachment inhibitor by preventing Env-CD4 interaction. This molecule also stabilizes Env in a prefusion “closed” conformation that is preferentially targeted by several broadly neutralizing antibodies (bNAbs). A recent study showed that an analog of temsavir (BMS-377806) affects the cleavage and addition of complex glycans on Env. In this study, we investigated the impact of temsavir on the overall glycosylation, proteolytic cleavage, cell surface expression, and antigenicity of Env. We found that temsavir impacts Env glycosylation and processing at physiological concentrations. This significantly alters the capacity of several bNAbs to recognize Env present on virions and HIV-1-infected cells. Temsavir treatment also reduces the capacity of bNAbs to eliminate HIV-1-infected cells by antibody-dependent cellular cytotoxicity (ADCC). Consequently, the impact of temsavir on Env glycosylation and antigenicity should be considered for the development of new antibody-based approaches in temsavir-treated individuals. IMPORTANCE FDA-approved fostemsavir, the prodrug for the active moiety small molecule temsavir (GSK 2616713 [formally BMS-626529]), acts as an attachment inhibitor by targeting the HIV-1 envelope (Env) and preventing CD4 interaction. Temsavir also stabilizes Env in its “closed,” functional state 1 conformation, which represents an ideal target for broadly neutralizing antibodies (bNAbs). Since these antibodies recognize conformation-dependent epitopes composed of or adjacent to glycans, we evaluated the impact of temsavir treatment on overall Env glycosylation and its influence on bNAb recognition. Our results showed an alteration of Env glycosylation and cleavage by temsavir at physiological concentrations. This significantly modifies the overall antigenicity of Env and therefore reduces the capacity of bNAbs to recognize and eliminate HIV-1-infected cells by ADCC. These findings provide important information for the design of immunotherapies aimed at targeting the viral reservoir in temsavir-treated individuals.

Individuals with Netherton syndrome (NTS) have increased serine protease activity, which strongly impacts the barrier function of the skin epidermis and leads to skin inflammation. Here, we investigated how serine protease activity in NTS correlates with changes in the stratum corneum (SC) ceramides, which are crucial components of the skin barrier. We examined two key enzymes involved in epidermal ceramide biosynthesis, β-glucocerebrosidase (GBA) and acid-sphingomyelinase (ASM). We compared in situ expression levels and activities of GBA and ASM between NTS patients and controls and correlated the expression and activities with i) SC ceramide profiles, ii) in situ serine protease activity, and iii) clinical presentation of patients. Using activity-based probe labeling, we visualized and localized active epidermal GBA, and a newly developed in situ zymography method enabled us to visualize and localize active ASM. Reduction in active GBA in NTS patients coincided with increased ASM activity, particularly in areas with increased serine protease activity. NTS patients with scaly erythroderma exhibited more pronounced anomalies in GBA and ASM activities than patients with ichthyosis linearis circumflexa. They also displayed a stronger increase in SC ceramides processed via ASM. We conclude that changes in the localization of active GBA and ASM correlate with i) altered SC ceramide composition in NTS patients, ii) local serine protease activity, and iii) the clinical manifestation of NTS.

Highly conserved epitopes within the coreceptor binding site (CoRBS) and constant region 1 and 2 (C1-C2 or cluster A) are only available for antibody recognition after the HIV-1 Env trimer binds host cell CD4; therefore, they are not accessible on virions and infected cells, where the expression of CD4 is downregulated. Here, we have developed new antibody fusion molecules in which domains 1 and 2 of soluble human CD4 are linked with monoclonal antibodies of either the CoRBS or cluster A specificity.

Discoglossus pictus is a North African amphibian that was introduced in southern France early the 20th century and has spread south and north along the Mediterranean coastal plains up to 170 km. In order to disentangle the conservation implications of the spread of D. pictus for sensitive native species, we examined the impact of long-term climate warming on the basis of niche overlap analysis, taking into account abiotic factors. The study area covered the distribution ranges of all genus Discoglossus species in northwestern Africa (659,784 km2), Sicily (27,711 km2), the Iberian Peninsula, and southern France (699,546 km2). Niche overlap was measured from species environmental spaces extracted via PCA, including climate and relief environmental variables. Current and future climatic suitability for each species was assessed in an ensemble-forecasting framework of species distribution models, built using contemporary species data and climate predictors and projected to 2070′s climatic conditions. Our results show a strong climatic niche overlap between D. pictus and native and endemic species in the Iberian Peninsula. In this context, all species will experience an increase in climatic suitability over the next decades, with the only exception being Pelodytes punctatus, which could be negatively affected by synergies between global warming and cohabitation with D. pictus.

SARS-CoV-2 continues to infect millions of people worldwide. The subvariants arising from the variant-of-concern (VOC) Omicron include BA.1, BA.1.1, BA.2, BA.2.12.1, BA.4, and BA.5. All possess multiple mutations in their Spike glycoprotein, notably in its immunogenic receptor-binding domain (RBD), and present enhanced viral transmission. The highly mutated Spike glycoproteins from these subvariants present different degrees of resistance to recognition and cross-neutralisation by plasma from previously infected and/or vaccinated individuals. We have recently shown that the temperature affects the interaction between the Spike and its receptor, the angiotensin converting enzyme 2 (ACE2). The affinity of RBD for ACE2 is significantly increased at lower temperatures. However, whether this is also observed with the Spike of Omicron and sub-lineages is not known. Here we show that, similar to other variants, Spikes from Omicron sub-lineages bind better the ACE2 receptor at lower temperatures. Whether this translates into enhanced transmission during the fall and winter seasons remains to be determined.

Background: The rainfall regime and its distribution define the productivity and quality of the pastures for use as forage. Objective: Evaluate changes in the chemical-mineral composition and nutritional value of Cenchrus purpureus sprouts in the rainy season. Methodology: A study was developed in a completely randomized design in factorial arrangement, with varieties of C. purpureus (CT-601; 603 and 115 as control) at different regrowth ages (60, 80, 100 and 120 days) and their interaction 4 x 3, for a total of twelve treatments with four repetitions. Results: The second degree interaction affected the structural composition of the cell wall in leaves, increasing (P≤0.001) the fiber concentration in acid detergent (FAD) as the age of the plant advanced, while lignin (LAD), cellulose (Cel) and hemicellulose (Hcel) showed erratic behaviors at different ages in the three varieties (P≤0.001). In the whole plant (WP), the FAD and FND decreased (P≤0.001) as a function of the increase in age, LAD, Cel and Hcel showed the same pattern as in leaves, differing (P≤0.001) between varieties with respect to the control in the different ages. The highest in vitro degradability’s of dry matter (IDDM) and organic (IDOM) in leaves were centered at the age of 60 days in the varieties CT-603 and 115, respectively, in WP at 100 days in CT-601 and 603 (P≤0.001) compared to CT-115. Implications: The varieties CT-601 and CT-603 do not show affectations in the structure of the cell wall that affect the nutritional value with respect to the control treatment (variety CT-115). Conclusions: Varieties, depending on DR, modify the structure of the cell wall, without affecting their nutritional value.

Participation in muscle strengthening activities is a less examined component of public health physical activity guidelines for children and youth compared to participation in physical activity. In part, the lack of focus on strength is associated with the difficultly of measuring strength activities during participation. The aim of this pilot study was to develop and provide evidence of the concurrent and predictive validity of the Strength Observation during Vaulting (SOV) tool. Six female youth (4 with a disability and 2 without a disability) ranging in age from 11 - 22 years (Mage = 14.2 y, SD = 4.0) participating in a 5-day inclusive equestrian vaulting camp were recruited. Participants completed three measures of strength, and video of vaulters engaging in camp activities was coded using the System for Observing Fitness Instruction Time (SOFIT) and SOV tools. From a linear regression model (significant p = .020), the three measures of strength accounted for 98.7% of the shared variance with time spent in SOV levels 4 and 5. Bivariate correlation coefficients comparing SOV levels 4 and 5 and moderate-vigorous physical activity (MVPA) from SOFIT were r = .73 for all contexts, r = .89 for floor-work, r = .64 for barrel vaulting, r = .76 for horse vaulting, and r = .81 for stable chores. The predictive and concurrent validity of the SOV tool was more than adequate. Based on these results, the systematic observation is a feasible approach to assess engagement in strength activities during vaulting.

Previously, a skin barrier repair model was developed to examine the effect of formulations on the lipid properties of compromised skin. In this model, the lipid organization mimics that of several skin diseases with impaired skin barrier and less dense lateral lipid organization. In addition, parakeratosis was occasionally observed. The present study investigated whether the extent of initial barrier disruption affects lipid organization and parakeratosis in regenerated stratum corneum. After barrier disruption and stratum corneum regeneration the fraction of lipids adopting a less dense lateral organization gradually increased with increasing degree of barrier disruption. Only when 75% of the stratum corneum was removed, were parakeratosis and a change in lamellar organization observed. This demonstrates the possibility of using the skin barrier repair model to study the effects of formulations on compromised skin in which the presence of parakeratosis and lipid organization can be modified by the extent of barrier disruption.

The HIV-1 envelope glycoprotein (Env) is synthesized in the endoplasmic reticulum as a trimeric gp160 precursor, which requires proteolytic cleavage by a cellular furin protease to mediate virus-cell fusion. Env is conformationally flexible but controls its transition from the unbound “closed” conformation (State 1) to downstream CD4-bound conformations (States 2/3), which are required for fusion. In particular, HIV-1 has evolved several mechanisms that reduce the premature “opening” of Env which exposes highly conserved epitopes recognized by non-neutralizing antibodies (nnAbs) capable of mediating antibody-dependent cellular cytotoxicity (ADCC). Env cleavage decreases its conformational transitions favoring the adoption of the “closed” conformation. Here we altered the gp160 furin cleavage site to impair Env cleavage and to examine its impact on ADCC responses mediated by plasma from HIV-1-infected individuals. We found that infected primary CD4+ T cells expressing uncleaved, but not wildtype, Env are efficiently recognized by nnAbs and become highly susceptible to ADCC responses mediated by plasma from HIV-1-infected individuals. Thus, HIV-1 limits the exposure of uncleaved Env at the surface of HIV-1-infected cells at least in part to escape ADCC responses.

This paper systematically reviews the potential of the Sentinel-2 (A and B) in assessing drought. Research findings, including the IPCC reports, highlighted the increasing trend in drought over the decades and the need for a better understanding and assessment of this phenomenon. Continuous monitoring of the Earth’s surface is an efficient method for predicting and identifying the early warnings of drought, which enables us to prepare and plan the mitigation procedures. Considering the spatial, temporal, and spectral characteristics, the freely available Sentinel-2 data products are a promising option in this area of research, compared to Landsat and MODIS. This paper evaluates the recent developments in this field induced by the launch of Sentinel-2, as well as the comparison with other existing data products. The objective of this paper is to evaluate the potential of Sentinel-2 in assessing drought through vegetation characteristics, soil moisture, evapotranspiration, surface water including wetland, and land use and land cover analysis. Furthermore, this review also addresses and compares various data fusion methods and downscaling methods applied to Sentinel-2 for retrieving the major bio-geophysical variables used in the analysis of drought. Additionally, the limitations of Sentinel-2 in its direct applicability to drought studies are also evaluated.

Antibodies that mediate killing of HIV-infected cells through antibody-dependent cellular cytotoxicity (ADCC) have been implicated in protection from HIV infection and disease progression. Despite these observations, these types of HIV antibodies are understudied compared to neutralizing antibodies. Here we describe four monoclonal antibodies (mAbs) obtained from one individual that target the HIV transmembrane protein, gp41, and mediate ADCC activity. These four mAbs arose from independent B cell lineages suggesting that in this individual, multiple B cell responses were induced by the gp41 antigen. Competition and phage peptide display mapping experiments suggested that two of the mAbs target epitopes in the cysteine loop that are highly conserved and a common target of HIV gp41-specific antibodies. The amino acid sequences that bind these mAbs are overlapping but distinct. The two other mAbs were competed by mAbs that target the C-terminal heptad repeat (CHR) and the fusion peptide proximal region (FPPR) and appear to both target a similar unique conformational epitope. These gp41-specific mAbs mediated killing of infected cells that express high levels of Env due to either pre-treatment with interferon or deletion of vpu to increase levels of BST-2/Tetherin. They also mediate killing of target cells coated with various forms of the gp41 protein, including full-length gp41, gp41 ectodomain or a mimetic of the gp41 stump. Unlike many ADCC mAbs that target HIV gp120, these gp41-mAbs are not dependent on Env structural changes associated with membrane-bound CD4 interaction. Overall, the characterization of these four new mAbs that target gp41 and mediate ADCC provides evidence for diverse gp41 B cell lineages with overlapping but distinct epitopes within an individual. Such antibodies that can target various forms of envelope protein could represent a common response to a relatively conserved HIV epitope for a vaccine.

El cambio climático ha modificado el comportamiento de las variables del clima, por esta razón, los pastos manifiestan un comportamiento productivo estacional, donde se modifica la deposición de carbohidratos estructurales, y en algunos casos la absorción de minerales. El objetivo de esta investigación fue caracterizar, en variedades de Cenchrus purpureus tolerantes a la sequía, la composición química de hojas y tallos a diferentes edades de rebrote en condiciones de sequía estacional. El periodo experimental abarcó del año 2013 al 2015, en la Estación Experimental de Pastos y Forrajes del Instituto de Investigaciones Agropecuarias “Jorge Dimitrov”. Se empleó un diseño completamente aleatorizado con arreglo factorial, y se caracterizó la dinámica de la composición química de hojas y tallos de nuevas variedades de C. purpureus, en diferentes edades de rebrote y diferentes períodos climáticos (lluvioso y poco lluvioso) y su combinación (4 x 3 x 2). La interacción edad de rebrote con estación climática afectó la composición química de las hojas (p≤0,001), alteró el contenido de celulosa (Cel), hemicelulosa (Hcel), fibra en detergente neutro (FDN), fibra en detergente ácido (FDA), contenido celular (CC), calcio (Ca) y sílice (Si), mientras que, en los tallos esta interacción solo afectó la concentración de FDA. El efecto aislado de la estación climática modificó en hojas (p≤0,01) el contenido de fósforo (P) y lignina (Lig), en tallos el contenido de P (p≤0,001). Cuando varió la edad de rebrote, hubo una modificación de la composición química de las hojas (proteína bruta y Lig) y de los tallos (proteína bruta). Las nuevas variedades de C. purpureus, bajo condiciones de degradación y sequía estacional, mostraron un patrón de comportamiento químico semejante al de las gramíneas tropicales, pero con bajos contenidos de proteína y fósforo.

Water and energy are recognized as the most influential climatic vegetation growth-limiting factors. These factors are usually measured from ground meteorological stations. However, since both vary in space, time, and scale, they can be assessed by satellite-derived biophysical indicators. Energy, represented by land surface temperature (LST), is assumed to resemble air temperature; and water availability, related to precipitation, is represented by the normalized difference vegetation index (NDVI). It is hypothesized that positive correlations between LST and NDVI indicate energy-limited conditions, while negative correlations indicate water-limited conditions. The current project aimed to quantify the spatial and seasonal (spring and summer) distributions of LST−NDVI relations over Europe, using long-term (2000−2017) MODIS images. Overlaying the LST−NDVI relations on the European biome map revealed that relations between LST and NDVI were highly diverse among the various biomes and throughout the entire study period (March−August). During the spring season (March−May), 80% of the European domain, across all biomes, showed the dominance of significant positive relations. However, during the summer season (June−August), most of the biomes—except the northern ones—turned to negative correlation. This study demonstrates that the drought/vegetation/stress spectral indices, based on the prevalent hypothesis of an inverse LST−NDVI correlation, are spatially and temporally dependent. These negative correlations are not valid in regions where energy is the limiting factor (e.g., in the drier regions in the southern and eastern extents of the domain) or during specific periods of the year (e.g., the spring season). Consequently, it is essential to re-examine this assumption and restrict applications of such an approach only to areas and periods in which negative correlations are observed. Predicted climate change will lead to an increase in temperature in the coming decades (i.e., increased LST), as well as a complex pattern of precipitation changes (i.e., changes of NDVI). Thus shifts in plant species locations are expected to cause a redistribution of biomes.

Although the breeding ecology of Audouin's gull has been widely studied, its spatial distribution patterns have received little attention. We assessed the foraging movements of 36 GPS-tracked adult Audouin's gulls breeding at the Ebro Delta (NW Mediterranean), coinciding with the incubation period (May 2011). This also coincided with a trawling moratorium northwards from the colony. We modelled the distribution of the gulls by combining these tracking data with environmental variables (including fishing activities from Vessel Monitoring System, VMS), using Maxent. The modelling range included both marine and terrestrial areas. Models were produced separately for every 2h time interval across the day, and for 2 fishing activity scenarios (workdays vs. weekends), allowing to assess the spatio-temporal distribution patterns of the gulls and the degree of association with fisheries. During workdays, gull distribution at sea fully matched with fishing activities, both trawling (daylight) and purse-seining (nightime). Gulls tended to avoid the area under trawling moratorium, confirming the high influence of fisheries on the distribution patterns of this species. On weekends, gulls made lesser use of the sea and tended to increase the use of rice fields. Overall, Audouin's gull activity was more intense during dailight hours, although birds also showed nocturnal activity, on both workdays and weekends. Nocturnal patterns at sea were more disperse during the latter, probably because these gulls are able to capture small pelagic fish at night in natural conditions, but tend to congregate around purse-seiners (which would enhance their foraging efficiency) in workdays. These results provide important insight for the management of this species. This is of particular relevance under the current scenario of European fisheries policies, since new regulations are aimed at eliminating discards, and this would likely influence Audouin's gull populations.

Objectives: Respiratory syncytial virus (RSV) is undoubtedly the single most important cause of severe lower respiratory tract infection (LRTI) globally. While new prevention measures in young infants have become available, their use in developing countries is likely many years away. While risk factors for severe or very severe RSV LRTI in impoverished rural areas likely differ to urban areas, there are very few studies, especially those conducted in India, the major country contributing to the global burden of disease., Methods: Active surveillance for acute LRTI in enrolled infants and children <2 years of age, was conducted through weekly home visits in 93 villages of Melghat, India, from August 2016 to December 2020. Local hospitals and primary health centres were surveyed for admissions of enrolled subjects. Nasopharyngeal swabs were collected from children with severe, or very severe LRTIs and all who died, with RSV testing using nucleic acid tests at ICMR, National Institute of Virology Pune. Risk factors for both RSV associated and non-RSV associated, severe and very severe LRTI were identified through univariate and multivariate logistic regression., Results: There were 483 severe or very severe RSV LRTI cases and 2807 non-RSV severe or very severe LRTI infections in a cohort of 13,318 children. Weight for age z-score ≤-2, the use of kerosene or wood for cooking, obtaining drinking water from a public tap and low gestational age significantly increased the risk of RSV LRTI. A higher wealth score index and water purification were protective. Comparison with non-RSV LRTI showed male sex as an additional risk factor. The analysis highlighted the risk of kerosene use [OR = 17.8 (3.0-104.4) (p ≤ 0.001)] and [OR = 3.4 (0.8-14.4) (p ≤ 0.05)] for RSV and non-RSV LRTIs, respectively., Conclusions: Nutritional status and environmental air quality are predisposing factors for developing an RSV LRI in young children, factors which are amenable to environmental and behavioural interventions., (© 2024 John Wiley & Sons Ltd.)

Screening for visual acuity loss (VAL) is not applied systematically because of uncertain recommendations based on observations from affordable countries. Our study aimed to evaluate the effectiveness of primary health care-based screening. A cross-sectional investigation was carried out among adults who did not wear glasses and did not visit an ophthalmologist in a year (N = 2070). The risk factor role of sociodemographic factors and the cardiometabolic status for hidden VAL was determined by multivariable linear regression models. The prevalence of unknown VAL of at least 0.5 was 3.7% and 9.1% in adults and in the above-65 population. Female sex (b = 1.27, 95% CI: 0.35; 2.18), age (b = 0.15, 0.12; 0.19), and Roma ethnicity (b = 2.60, 95% CI: 1.22; 3.97) were significant risk factors. Higher than primary school (b secondaryschoolwithoutgraduation = -2.06, 95% CI: -3.64; -0.47; and b secondaryschoolwithgraduation = -2.08, 95% CI: -3.65; -0.51), employment (b = -1.33, 95% CI: -2.25; 0.40), and properly treated diabetes mellitus (b = -2.84, 95% CI: -5.08; -0.60) were protective factors. Above 65 years, female sex (b = 3.85, 95% CI: 0.50; 7.20), age (b = 0.39, 95% CI: 0.10; 0.67), Roma ethnicity (b = 24.79, 95% CI: 13.83; 35.76), and untreated diabetes (b = 7.30, 95% CI: 1.29; 13.31) were associated with VAL. Considering the huge differences between the health care and the population's social status of the recommendation-establishing countries and Hungary which represent non-high-income countries, the uncertain recommendation of VAL screening should not discourage general practitioners from organizing population-based screening for VAL in non-affordable populations.

Background: Melghat in India is a hilly, forested, difficult to access, impoverished rural area in northeast part of Maharashtra (Central India) with difficult healthcare access. Melghat has very high Mortality rates, because of grossly inadequate medical facilities. (1) Home deaths contribute to 67% of deaths,(2) which are difficult to track and where cause of death is mostly unknown., Methods: A feasibility study was carried out in 93 rural villages and 5 hospitals to assess feasibility of tracking real-time community mortality and to ascertain cause of death in 0-60 months and 16-60 years age group using Minimal Invasive Tissue Sampling (MITS) in purpose-modified ambulance. We used the network of village health workers (VHW)s, to establish real-time community mortality tracking. Upon receipt of reports of home death, we performed MITS within 4 h of death in the vicinity of the village., Results: We conducted 16 MITS. Nine, in MITS ambulance in community and seven at MAHAN hospital. The acceptance rate of MITS was 59.26%. Standard operating procedure (SOP) of conducting community MITS in an ambulance, is established. Major challenges were, Covid19 lockdown, reluctance of tribal parents for consent for MITS due to illiteracy, superstitions and fear of organ removal. Ambulance was an easy to reach transport means in remote area, provided a well-designed and discrete facility to perform MITS in community, winning the confidence of bereaved family. This has reduced time interval between time of death and performing MITS., Conclusions: MITS in purpose-modified Ambulance can be used worldwide for community MITS especially in areas which are remote and lack healthcare access. This solution needs to be assessed in different cultural settings to document culture specific issues., (© 2023. The Author(s).)

The expansion of adipose progenitor cells (APCs) plays an important role in the regeneration of the adipose tissue in physiological and pathological situations. The major role of CD26-expressing APCs in the generation of adipocytes has recently been highlighted, revealing that the CD26 APC subtype displays features of multipotent stem cells, giving rise to CD54- and CD142-expressing preadipocytes. However, a relevant human in vitro model to explore the regulation of the APC subpopulation expansion in lean and obese adipose tissue microenvironments is still lacking. In this work, we describe a novel adipose tissue model, named ExAdEx, that can be obtained from cosmetic surgery wastes. ExAdEx products are adipose tissue units maintaining the characteristics and organization of adipose tissue as it presents in vivo. The model was viable and metabolically active for up to two months and could adopt a pathological-like phenotype. The results revealed that inflammatory and fibrotic microenvironments differentially regulated the expansion of the CD26 APC subpopulation and its CD54 and CD142 APC progenies. The approach used significantly improves the method of generating adipose tissue models, and ExAdEx constitutes a relevant model that could be used to identify pathways promoting the expansion of APCs in physiological and pathological microenvironments.

Background: Melghat, an impoverished rural area in Maharashtra state, India; has scarce hospital services and low health-seeking behaviour. At baseline (2004) the under-five mortality rate (U5MR) (number of deaths in children aged 0-5 years/1000 live births) was 147.21 and infant mortality rate (IMR) (number of deaths of infants aged under 1 year/1000 live births) was 106.6 per 1000 live births. We aimed at reducing mortality rates through home-based child care (HBCC) using village health workers (VHWs)., Methods: A cluster-randomised control trial was conducted in 34 randomly assigned clusters/villages of Melghat, Maharashtra state, between 2004 and 2009. Participants included all under-five children and their parents. Interventions delivered through VHWs were patient-public involvement, newborn care, disease management and behaviour change communications. Primary outcome indicators were U5MR and IMR. Secondary outcome indicators were neonatal mortality rate (NMR) (number of neonatal deaths aged 0-28 days/1000 live births) and perinatal mortality rate (PMR) (number of stillbirths and early neonatal deaths/1000 total births). Analysis was by intention-to-treat at the individual level. This trial was extended to a service phase (2010-2015) in both arms and a government replication phase (2016-2019) only for the intervention clusters/areas (IA)., Findings: There were 18 control areas/clusters (CA) allocated and analysed with 4426 individuals, and 16 of 18 allocated IA, analysed with 3230 individuals. The IMR and U5MR in IA were reduced from 106.60 and 147.21 to 32.75 and 50.38 (reduction by 69.28% and 65.78%, respectively) compared with increases in CA from 67.67 and 105.3 to 86.83 and 122.8, respectively, from baseline to end of intervention. NMR and PMR in IA showed reductions from 50.76 to 22.67 (by 55.34%) and from 75.06 to 24.94 (by 66.77%) respectively. These gains extended to villages in the service and replication phases., Interpretation: This socio-culturally contextualised model for HBCC through VHWs backed up with institutional support is effective for significant reduction of U5MR, IMR and NMR in impoverished rural areas. This reduction was maintained in the study area during the service phase, indicating feasibility of implementation in large-scale public health programmes. Replicability of the model was demonstrated by a linear decline in all the mortality rates in 20 new villages during the government phase., Trial Registration Number: NCT02473796., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Several therapeutic options have been developed to address the obesity epidemic and treat associated metabolic diseases. Despite the beneficial effects of surgery and drugs, effective therapeutic solutions have been held back by the poor long-term efficiency and detrimental side effects. The development of alternative approaches is thus urgently required. Fat transplantation is common practice in many surgical procedures, including aesthetic and reconstructive surgery, and is a budding future direction for treating obesity-related metabolic defects. This review focuses on adipose tissue transplantation and the recent development of cell-based therapies to boost the mass of energy-expenditure cells. Brown adipocyte transplantation is a promising novel therapy to manage obesity and associated metabolic disorders, but the need to have an abundant and relevant source of brown fat tissue or brown adipocytes for transplantation is a major hurdle to overcome. Current studies have focused on the rodent model to obtain a proof of concept of a tissue-transplantation strategy able to achieve effective long-term effects to reverse metabolic defects in obese patients. Future perspectives and opportunities to develop innovative human fat tissue models and 3D engineered hiPSC-adipocytes are discussed., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Although respiratory syncytial virus (RSV) is the most important viral cause of lower respiratory tract infection deaths in infants, there are few data on infant community deaths caused by RSV., Methods: This was an active surveillance of children younger than 2 years of age in 93 villages, 5 primary health centers, and 3 hospitals serving these villages. Village health workers and counselors at the health facilities monitored all lower respiratory tract infections (LRTIs) in consented subjects. Children with severe, or very severe LRTIs and all who died, had nasopharyngeal swabs collected for detection of RSV by molecular methods., Results: In the 12 134 subjects, there were 2064 episodes of severe LRTIs and 1732 of very severe LRTIs, of which 271 and 195, respectively, had RSV. Fifteen of 16 (94%) children with RSV died of LRTIs, 14 in the community and 1 in the hospital. The case fatality ratios for severe RSV LRTIs in the first 6 months of life were 3/52 (7.1%) and 1/36 (2.8%) in the community and hospital, respectively. Of those with very severe LRTIs in the community, 17.6% died. There were no very severe RSV LRTI hospital deaths. The adjusted RSV LRTI mortality rates ranged from 1.0 to 3.0/1000 child-years (CY) overall, and 2.0 to 6.1/1000 CY, accounting for 20% of the LRTI deaths and 10% of the postneonatal infant mortality., Conclusions: Community deaths from RSV account for the majority of RSV LRTI deaths, and efforts at prevention should be preferentially directed at populations where access to care is limited., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)

Background: Globally, respiratory syncytial virus (RSV) is a common cause of acute lower tract infection (LRTI) in children younger than 2 years of age, but there are scant population-based studies on the burden of RSV illness in rural communities and no community studies in preterm infants., Methods: Active surveillance of LRTI was performed in the community and hospital setting for the population of 93 tribal villages in Melghat, Central India, over 4 respiratory seasons. A nasopharyngeal swab was obtained from cases presenting as a severe LRTI for molecular analysis of respiratory pathogens including RSVA and B., Results: High rates of RSV-associated LRTI were found in preterm and term infants beyond 6 months of age, extending into the second year of life. Community severe RSV LRTI rates for 0-11 months of age was 22.4 (18.6-27.0)/1000 child-years (CY) and the hospital-associated rate was 14.1 (11.1-17.8)/1000 CY. For preterm infants, these rates were 26.2 (17.8-38.5)/1000 CY and 12.6 (7.2-22.0)/1000 CY. Comparable rates in the first 6 months were 15.9 (11.8-21.4)/1000 CY and 12.9 (9.3-18.0)/1000 CY in term infants and 26.3 (15.4-45.0)/1000 CY and 10.1 (4.2-24.2)/1000 CY for preterms. The single RSV B season had higher incidences of RSV LRTI in every age group than the 2 RSV A seasons in both preterm and term infants. There were 11 deaths, all term infants., Conclusions: Studies restricted to the healthcare settings significantly underestimate the burden of RSV LRTI and preterm and term infants have comparable burdens of disease in this rural community., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)

Background and Objective: Osteoarthritis (OA) is a chronic degenerative disorder which primarily affects the articular cartilage of synovial joints followed by bony remodeling and overgrowth at the margins of these joints. The consequences of OA are pain, joint stiffness, decreased muscle performance, and decreased aerobic capacity, which eventually affect the quality of life (QOL) and increased risk for disability. The objective of the present study was to investigate the effectiveness of two nonpharmacological treatment regimens, that is, yoga and conventional physiotherapy, on QOL in patients suffering from OA of knee joint., Materials and Methods: A total of 83 patients with bilateral OA of knee joint, between the age group of 40 and 80 years, both males and females, were assigned into two groups using computer-generated scheme: 43 in the experimental group (yoga with conventional physiotherapy program) and 40 in control group (conventional physiotherapy program). Western Ontario and McMaster Universities OA index (WOMAC) and Short-Form 36 (SF-36) health survey were measured before, after 15 days, and after 30 days of treatment sessions, and the data were analyzed using paired and unpaired t -test., Results: The results of the study show significant improvement in both groups with regard to WOMAC and SF-36 at the end of 15 and 30 days of treatment regimen; however, when compared to the control group, experimental group had more significant improvement ( P < 0.05) in WOMAC and SF-36 at the end of 15 and 30 days of treatment., Conclusion: Yoga is more beneficial when added to conventional physiotherapy treatment regimen in promoting health and improving QOL in patients with OA of knee joint., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

Brown and brown-like adipocytes (BAs) are promising cell targets to counteract obesity thanks to their potential to drain and oxidize circulating glucose and triglycerides. However, the scarcity of BAs in human adults is a major limitation for energy expenditure based therapies. Enhanced characterization of BA progenitor cells (BAPs) and identification of critical pathways regulating their generation and differentiation into mature BAs would be an effective way to increase the BA mass. The identification of molecular mechanisms involved in the generation of thermogenic adipocytes is progressing substantially in mice. Much less is known in humans, thus highlighting the need for an in vitro model of human adipocyte development. Pluripotent stem cells (PSCs), i.e., embryonic stem cells and induced pluripotent stem cells, help gain insight into the different phases in the development of multiple cell types. We will discuss the capacity of human PSCs to differentiate into BAs in this review. Several groups, including ours, have reported low spontaneous adipocyte generation from PSCs. However, factors governing the differentiation of induced pluripotent stem cell-derived BA progenitors cells were recently identified, and the TGFβ signaling pathway has a pivotal role. The development of new relevant methods, such as the differentiation of hPSC-BAPs into 3D adipospheres to better mimick the lobular structure of human adipose tissue, will also be discussed. Differentiation of human PSCs into thermogenic adipocytes at high frequency provides an opportunity to characterize new targets for anti-obesity therapy., (Copyright © 2020 Yao, Dani and Dani.)

Background: Chronic obstructive pulmonary disease (COPD) is a group of progressive lung diseases; the most common are emphysema and chronic bronchitis. It is considered to be the major cause of morbidity and mortality worldwide and is considered to be one of the leading causes of deaths in India, the main reason being misconception/misinterpretation of the disease and unawareness about the risk factors which hinder early diagnosis and its treatment effectively. Therefore, the present study aimed to assess the knowledge, attitude and behavior about the disease process and physiotherapy management in patients diagnosed with COPD., Materials and Methods: Ethical clearance was obtained before initiating the study. It was a cross-sectional, qualitative study. In total, 14 patients of COPD were recruited for the study by convenience sampling. The total study duration was 6 months. Two focused groups ( n = 14) were conducted with seven COPD patients (diagnosed by chest physician on the basis of pulmonary function testing) in each after obtaining the written informed consent. Focus group contents were video graphed after obtaining the consent and a focus group discussion (FGD) guide comprising of 15 questions was used for the study. Transcripts were prepared from the audio/video recordings and were analyzed qualitatively by narrative analysis., Results: The narration transcripted during both the sessions of FGD showed significant negligence about the disease process, its precipitating factors, preventive measures, and physiotherapy management among the patients suffering from COPD in the community. None of the patients were aware even about the term "chronic obstructive pulmonary disease" and only 35.71% of patients were aware of physiotherapy management as a mean of treatment for COPD., Conclusions: The present study concludes that there is a lack of knowledge, incorrect attitudes, and flawed behavioral changes which needs to be corrected among the patients with COPD. These patients require correct, detailed, and broad-based information about their condition and availability of treatment options., Competing Interests: There are no conflicts of interest.

Objectives: In France, one pregnancy out of three is unplanned. Half of those pregnancies lead to abortion. However, the use of emergency contraception is far from systematic. It is therefore relevant to question the reasons and factors linked to the low rate of use of emergency contraception., Methods: A retrospective observational study was conducted in the orthogenic service of the University hospital Center of Nice, over a six weeks period. Patients were consulting in the context of voluntary termination of pregnancy and were subjected to a questionnaire during a semi-structured interview. The collected data were: age, degree of education, profession, size of their home town municipality, legal status, obstetrical history, contraception used at the time of unplanned pregnancy, emergency contraception background and justification for not using an emergency contraception., Results: A total of one hundred and five questionnaires were studied. The absence of emergency contraception was due to an underestimation of the risk of pregnancy in 81% of cases. Among characteristic variables of the studied population, none was related to the non-use of emergency contraception., Conclusions: Independently of the patient profile, underestimation of the risk of pregnancy is the main cause of non-use of emergency contraception. It seems crucial to inform women with childbearing age and their families about their fertility and the basic mechanisms of fertility in order to reduce the number of unplanned pregnancies in France., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

The symbiotic interaction between cnidarians (e.g., corals and sea anemones) and photosynthetic dinoflagellates of the genus Symbiodinium is triggered by both host-symbiont recognition processes and metabolic exchange between the 2 partners. The molecular communication is crucial for homeostatic regulation of the symbiosis, both under normal conditions and during stresses that further lead to symbiosis collapse. It is therefore important to identify and fully characterise the key players of this intimate interaction at the symbiotic interface. In this study, we determined the cellular and subcellular localization and expression of the sterol-trafficking Niemann-Pick type C proteins (NPC1 and NPC2) in the symbiotic sea anemones Anemonia viridis and Aiptasia sp. We first established that NPC1 is localised within vesicles in host tissues and to the symbiosome membranes in several anthozoan species. We demonstrated that the canonical NPC2-a protein is mainly expressed in the epidermis, whereas the NPC2-d protein is closely associated with symbiosome membranes. Furthermore, we showed that the expression of the NPC2-d protein is correlated with symbiont presence in healthy symbiotic specimens. As npc2-d is a cnidarian-specific duplicated gene, we hypothesised that it probably arose from a subfunctionalisation process that might result in a gain of function and symbiosis adaptation in anthozoans. Niemann-Pick type C proteins may be key players in a functional symbiosis and be useful tools to study host-symbiont interactions in the anthozoan-dinoflagellate association., (© 2017 John Wiley & Sons Ltd.)