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UAV-based remote sensing of chlorophyll-a concentrations in inland water bodies: a systematic review
Get PDFMonitoring chlorophyll-a content is crucial for irrigation water quality, as excessive levels can harm water bodies and reduce their volumetric capacity due to algal growth. While satellite data enhances monitoring, its coarse resolution limits application in small water bodies. Unmanned Aerial Vehicles (UAVs) offer high-resolution, near-real-time data, bridging this gap. This review explores global progress, gaps, and recommendations on UAV-based chlorophyll-a monitoring in small inland water bodies, focusing on sensor characteristics, platforms, validation data and retrieval algorithms, using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach. Multispectral sensors onboard DJI UAVs are the most widely used and, machine learning methods like random forest dominate chlorophyll-a inversion models. However, gaps remain in Africa due to high UAV costs, limited expertise and stringent regulations. Additionally, a universal chlorophyll-a retrieval method is also lacking. This review serves as a reference for future studies, highlighting UAVs' potential in water quality monitoring
Vitamin D supplementation to prevent acute respiratory infections: systematic review and meta-analysis of stratified aggregate data.
Get PDFBACKGROUND: A 2021 meta-analysis of 37 randomised controlled trials (RCTs) of vitamin D supplementation for prevention of acute respiratory infections (ARIs) revealed a statistically significant protective effect of the intervention (odds ratio [OR] 0·92 [95% CI 0·86 to 0·99]). Since then, six eligible RCTs have been completed, including one large trial (n=15 804). We aimed to re-examine the link between vitamin D supplementation and prevention of ARIs. METHODS: Updated systematic review and meta-analysis of data from RCTs of vitamin D for ARI prevention using a random effects model. Subgroup analyses were done to determine whether effects of vitamin D on risk of ARI varied according to baseline 25-hydroxyvitamin D (25[OH]D) concentration, dosing regimen, or age. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and the ClinicalTrials.gov between May 1, 2020 (end-date of search of our previous meta-analysis) and April 30, 2024. No language restrictions were imposed. Double-blind RCTs supplementing vitamin D for any duration, with placebo or lower-dose vitamin D control, were eligible if approved by a Research Ethics Committee and if ARI incidence was collected prospectively and pre-specified as an efficacy outcome. Aggregate data, stratified by baseline 25(OH)D concentration and age, were obtained from study authors. The study was registered with PROSPERO (no. CRD42024527191). FINDINGS: We identified six new RCTs (19 337 participants). Data were obtained for 16 085 (83·2%) participants in three new RCTs and combined with data from 48 488 participants in 43 RCTs identified in our previous meta-analysis. For the primary comparison of any vitamin D versus placebo, the intervention did not statistically significantly affect overall ARI risk (OR 0·94 [95% CI 0·88-1·00], p=0·057; 40 studies; 61 589 participants; I2=26·4%). Pre-specified subgroup analysis did not reveal evidence of effect modification by age, baseline vitamin D status, dosing frequency, or dose size. Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (OR 0·96 [95% CI 0·90-1·04]; 38 studies; I2=0·0%). A funnel plot showed left-sided asymmetry (p=0·0020, Egger's test). INTERPRETATION: This updated meta-analysis yielded a similar point estimate for the overall effect of vitamin D supplementation on ARI risk to that obtained previously, but the 95% CI for this effect estimate now includes 1·00, indicating no statistically significant protection. FUNDING: None
Autologous Human Dendritic Cells from XDR-TB Patients Polarize a Th1 Response Which Is Bactericidal to Mycobacterium tuberculosis.
Get PDFExtensively drug-resistant tuberculosis (XDR-TB) is a public health concern as drug resistance is outpacing the drug development pipeline. Alternative immunotherapeutic approaches are needed. Peripheral blood mononuclear cells (PBMCs) were isolated from pre-XDR/XDR-TB (n = 25) patients and LTBI (n = 18) participants. Thereafter, monocytic-derived dendritic cells (mo-DCs) were co-cultured with M. tb antigens, with/without a maturation cocktail (interferon-γ, interferon-α, CD40L, IL-1β, and TLR3 and TLR7/8 agonists). Two peptide pools were evaluated: (i) an ECAT peptide pool (ESAT6, CFP10, Ag85B, and TB10.4 peptides) and (ii) a PE/PPE peptide pool. Sonicated lysate of the M. tb HN878 strain served as a control. Mo-DCs were assessed for DC maturation markers, Th1 cytokines, and the ability of the DC-primed PBMCs to restrict the growth of M. tb-infected monocyte-derived macrophages. In pre-XDR/XDR-TB, mo-DCs matured with M. tb antigens (ECAT or PE/PPE peptide pool, or HN878 lysate) + cocktail, compared to mo-DCs matured with M. tb antigens only, showed higher upregulation of co-stimulatory molecules and IL-12p70 (p < 0.001 for both comparisons). The matured mo-DCs had enhanced antigen-specific CD8+ T-cell responses to ESAT-6 (p = 0.05) and Ag85B (p = 0.03). Containment was higher with mo-DCs matured with the PE/PPE peptide pool cocktail versus mo-DCs matured with the PE/PPE peptide pool (p = 0.0002). Mo-DCs matured with the PE/PPE peptide pool + cocktail achieved better containment than the ECAT peptide pool + cocktail [50%, (IQR:39-75) versus 46%, (IQR:15-62); p = 0.02]. In patients with pre-XDR/XDR-TB, an effector response primed by mo-DCs matured with an ECAT or PE/PPE peptide pool + cocktail was capable of restricting the growth of M. tb in vitro
An assessment of interobserver agreement on lesion size, morphology and clinical phenotype in cutaneous leishmaniasis caused by Leishmania aethiopica in Ethiopia
Get PDFIntroduction Cutaneous leishmaniasis (CL) remains a major public health challenge, especially in endemic regions like Ethiopia, where an estimated 40,000 new cases occur annually. Effective treatment evaluation for CL relies on consistent clinical assessments, yet variability in lesion descriptions can complicate reliable outcome measures. Methods We conducted an inter-reliability study of clinicians’ evaluations of CL lesion morphology and size at ALERT Hospital, Addis Ababa. Twelve clinicians independently examined 12 patients with parasitologically confirmed CL, each clinician assessing lesion morphology, size, and severity. Results We found high consistency in reporting major morphological categories (e.g., plaques) but significant variability in secondary features like dyspigmentation and scale, as well as mucosal involvement. Lesion size measurements showed limited variability, suggesting its reliability as a potential measure for future clinical trials. Disparities in severity assessments highlight the need for a standardized scoring system in CL. Discussion Our findings underscore the importance of training for consistent, high-quality clinical evaluations of CL and suggests that lesion size could be a reproducible outcome measure in treatment efficacy trials.</ns4:p
Age-Specific Socioeconomic Inequalities in Treatment in Patients with Stage III Colon Cancer in England 2012-2016: A Population-Based Study with Mediation Analysis.
Get PDFAIMS: It is unclear whether inequalities in guidelines-recommended treatment among patients with stage III colon cancer existed and differed by age in England. MATERIALS AND METHODS: Using data from cancer registry in England between 2012 and 2016, we included all patients with stage III colon cancer and applied multivariable multinominal logistic regression, including an interaction between age and deprivation, to investigate age-specific socioeconomic inequalities in receipt of the NICE-recommend treatment - surgery combined with adjuvant chemotherapy. We also examined the mediating roles of tumour factors on the inequalities in treatment. RESULTS: Among 20,368 included patients, socioeconomic inequalities in receipt of the NICE-recommend treatment were observed at all ages but wider in patients aged between 65 and 85 years old. For a 70-year-old patient, the probability of receiving the NICE-recommend treatment was 70.8% (95% CI: 68.6, 73.1) for the least vs. 59.4% (53.7, 65.1) for the most deprived quintile. When both groups were unlikely to receive the NICE-recommended treatment (85+ years old), patients from less deprived areas had a higher probability of receiving some alternative treatments like surgery while those with the most deprived backgrounds received none. Tumour factors explained little of inequalities in receipt of surgery or adjuvant chemotherapy. CONCLUSION: Patients from deprived areas tended to receive inferior treatment options, and tumour factors explained little of these inequalities. Guidelines need to ensure that the NICE-recommended treatment modality is available to all to reduce the survival gap
Help-Seeking for Illicit Drug Use in Adolescents: A Qualitative Study From India
Get PDFIllicit drug use is a growing concern in India, with a treatment gap of 73%. Explanatory models can offer valuable insights into patients’ understanding of their condition and inform help-seeking and treatment strategies. This study aims to develop an explanatory model to identify barriers and facilitators for help-seeking, desired resources, and treatment strategies among adolescents struggling with illicit substance misuse. Semi-structured interviews were conducted with 23 adolescents seeking treatment for drug use and 25 healthcare providers across three Indian sites. Thematic analysis revealed barriers to help-seeking, such as stigma, lack of awareness, and financial constraints. Family awareness was crucial for recovery, and adolescents sought personalized, comprehensive treatment. Healthcare providers emphasized the need for more government funding and flexible treatment options. These findings provide valuable insights into help-seeking behaviors and treatment preferences, which could enhance treatment engagement and outcomes for adolescents with drug use disorders
Mental health and violence against women in Afghanistan, India and Sri Lanka: a situation analysis
Get PDFBackground
Globally, 10–53% of ever-partnered women have experienced physical or sexual intimate partner violence over their lifetime. Women survivors of violence are at high risk of poor mental health. In this study, we investigate women’s exposure to violence and mental health conditions in Afghanistan, India and Sri Lanka, while considering the policy and service contexts.
Methods
A situation analysis tool was developed for the study. We extracted information from grey and peer-reviewed literature and other publicly available data investigating the prevalence of violence against women and mental health conditions, policies addressing violence against women and mental health conditions in each country and the services available to women exposed to violence and women with mental health conditions.
Results
Forty-six per cent of women in Afghanistan, 21% of women in India and 5% of women in Sri Lanka reported experiencing physical violence within the last 12 months of the most recent survey. Meanwhile, 7% of ever-partnered women in Afghanistan, 6% of women in India and 7% of women in Sri Lanka reported experiencing sexual violence during their lifetime. In India, 6.9% of disability-adjusted life-years were attributed to childhood sexual abuse and 4.6% to intimate partner violence. In Sri Lanka, 14.6% of women exposed to physical or sexual violence by a partner had engaged in self-harm. We found no data on conflict-related sexual violence and trafficking. All three countries have made commitments to gender equality or preventing violence against women. Implementation of some of these policies, however, is unclear. The countries also have had mental health policies and services, but there is currently little intersection between mental health and violence against women.
Limitations
The situation analysis is limited by the data available and the generalisability of findings.
Conclusion
The three countries have limited data, policies and legislation on the intersection between all forms of violence against women and poor mental health as well as a paucity of mental health service provision.
Future work
Future research should focus on integrating mental health care within social services; translating trauma-informed approaches into service provision and addressing family violence within violence against women.
Funding
This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Global Health Research programme as award number 17/63/47
Plasma Neutrophil Gelatinase-Associated Lipocalin as a Biomarker of Kidney Injury and Potential Predictor of Hypoxic Brain Injury in Severe Plasmodium falciparum Malaria: Insights From India.
Get PDFSevere malaria is associated with kidney and brain injury, yet potential mechanisms linking both complications remain understudied. We investigated the associations between kidney and brain injuries in a cohort of Indian adults and children with severe Plasmodium falciparum malaria. We found that acute kidney injury was prevalent in both adults (64.4%) and children (71.4%). We also found that plasma levels of the structural kidney injury biomarker neutrophil gelatinase-associated lipocalin (NGAL) were strongly associated with acute kidney injury severity (P 300 ng/mL). These results suggest that plasma NGAL may play a critical role in structural kidney injury and could serve as a predictive marker for hypoxic brain injury in the context of severe malaria
ACE-RT, A Cloud-Based Tool for Remote Radiotherapy Contouring Support in Lower-Resourced Settings: A Pilot Evaluation.
Get PDFAIMS: Digital learning tools designed to improve radiotherapy contouring skills could help to increase training capacity in low- and middle-income countries (LMICs), where trainees face barriers to learning such as few clinicians and high workloads. Previous efforts to implement software to remotely review radiotherapy plans in LMICs have faced challenges such as poor internet connectivity and insufficient information technology infrastructure. We developed and evaluated a new cloud-based software to support radiotherapy planning, designed specifically for use in lower-resourced settings. MATERIALS AND METHODS: A cloud-based training software, 'ACE-RT', was co-designed with radiotherapy professionals in Ghana, Zambia and the United Kingdom to facilitate remote feedback on contours and form a portfolio to record a clinician's skill development. The co-development involved assessing bandwidth, user interface, and functionality to meet needs in an LMIC setting. The software is noncommercial, designed for educational use. ACE-RT was evaluated by a radiation oncology consultant and trainee in Indonesia between April and September 2023. RESULTS: The resident successfully uploaded and received feedback on six plans over the evaluation period. Both consultant and trainee found ACE-RT made it easier to provide and receive tailored feedback compared to their previous practice and that the quality of feedback improved. The trainee reported that the quantity of feedback was greater when using ACE-RT. Both found the portfolio function useful, appreciating the educational value of reviewing previous contours. The main implementation barriers identified were poor internet connectivity and the complexity of exporting files from the treatment planning system. CONCLUSION: This evaluation of a cloud-based educational portfolio tool to improve training in radiotherapy contouring found it to be feasible, acceptable, and appropriate for use in a resource-limited setting. Unstable internet connectivity was the main barrier identified. Further work is recommended to improve the software's performance with variable internet speeds and evaluate the implementation in a range of centres
Sexual harassment in early adolescence: findings from a cross-sectional survey in secondary schools in England
No full textThere is little research on sexual harassment among younger adolescents or on how rates vary by gender and other student/school characteristics. Drawing on data from 50 English schools, we explored the prevalence and patterning of victimization in the past year among students aged 12–13. Of 7,060 participants, almost a tenth had experienced sexual harassment. Girls, non-binary students, and sexual-minority students reported the highest rates. Student commitment to school was associated with reduced victimization, particularly among straight students and in higher-attaining schools. Sexual harassment is a priority area for intervention, particularly for students facing the highest risk