Spatially and temporally consistent vegetation structure time-series have great potential to improve the capacity for national land cover monitoring, to reduce latency and cost of international ...reporting, and to harmonize regional land cover characterizations. Here we present a semi-automatic, operational algorithm for mapping and monitoring of woody vegetation canopy cover and height at a regional scale using freely available Landsat time-series data. The presented algorithm employs automatic data processing and mapping using a set of lidar-based vegetation structure prediction models. Changes in vegetation cover are detected separately and integrated into the structure time-series. Sample-based validation and inter-comparison with existing datasets demonstrates the spatial and temporal consistency of our regional data time-series. The dataset reliably reflects changes in tree cover (tree cover loss user's accuracy of 0.84 and producer's accuracy of 0.75) and can serve as a tool to map annual forest extent (user's accuracy of 0.98 and producer's accuracy of 0.81 for 10% canopy cover threshold to define the forest class). The tree height estimates are consistent with a GLAS-based global map (mean average error of 3.7 m, the correlation coefficient of 0.92 and the R2 of 0.85). The algorithm was prototyped within the Lower Mekong region where it revealed an intensive woody vegetation dynamic. Of the year 2000 forest area (defined using canopy cover threshold of 10% and tree height threshold of 5 m), 9.4% was deforested by the year 2017, and 16.6% was affected by stand-replacement disturbance followed by reforestation. The average annual area of stand-level forest disturbance within the region was 2.34 Mha, and increased by 34% from 2001 (1.85 Mha) to 2017 (2.48 Mha). Total forest area decreased by 6.2% within the region, and 11.1% of year 2000 primary forest area was lost by 2017. At the national level, Cambodia demonstrated the highest rate of deforestation, with a net forest area loss of 22.5%. We estimated that 21.3% of 2017 forest cover had an age of 17 years or less, illustrating the intensive forest land uses within the region. The time-series product is suitable for mapping annual land cover and inter-annual land cover change using customized class definitions. The regionally-consistent data are publicly available for download (https://glad.umd.edu/), and online analysis (https://rlcms-servir.adpc.net/en/forest-monitor/), and serve as an input to the SERVIR-Mekong Regional Land Cover Monitoring System.
•Woody vegetation structure mapped through integration of lidar, Landsat, and MODIS.•A semi-automatic, operational algorithm for forest structure monitoring prototyped•The value of land surface phenology data and annual change detection is demonstrated.•Analysis-ready vegetation structure 2000–2017 time-series produced for Mekong region•The regional time-series data is suitable for annual forest monitoring and reporting.
In the treatment of severe malaria, intravenous artesunate is more rapidly acting than intravenous quinine in terms of parasite clearance, is safer, and is simpler to administer, but whether it can ...reduce mortality is uncertain.
We did an open-label randomised controlled trial in patients admitted to hospital with severe falciparum malaria in Bangladesh, India, Indonesia, and Myanmar. We assigned individuals intravenous artesunate 2·4 mg/kg bodyweight given as a bolus (n=730) at 0, 12, and 24 h, and then daily, or intravenous quinine (20 mg salt per kg loading dose infused over 4 h then 10 mg/kg infused over 2–8 h three times a day; n=731). Oral medication was substituted when possible to complete treatment. Our primary endpoint was death from severe malaria, and analysis was by intention to treat.
We assessed all patients randomised for the primary endpoint. Mortality in artesunate recipients was 15% (107 of 730) compared with 22% (164 of 731) in quinine recipients; an absolute reduction of 34·7% (95% CI 18·5–47·6%; p=0·0002). Treatment with artesunate was well tolerated, whereas quinine was associated with hypoglycaemia (relative risk 3·2, 1·3–7·8; p=0·009).
Artesunate should become the treatment of choice for severe falciparum malaria in adults.
Cancer cells acquire several traits that allow for their survival and progression, including the ability to evade the host immune response. However, the mechanisms by which cancer cells evade host ...immune responses remain largely elusive. Here we study the phenomena of immune evasion in malignant melanoma cells. We find that the tumor suppressor phosphatase and tensin homolog (PTEN) is an important regulator of the host immune response against melanoma cells. Mechanistically, PTEN represses the expression of immunosuppressive cytokines by blocking the phosphatidylinositide 3-kinase (PI3K) pathway. In melanoma cells lacking PTEN, signal transducer and activator of transcription 3 activates the transcription of immunosuppressive cytokines in a PI3K-dependent manner. Furthermore, conditioned media from PTEN-deficient, patient-derived short-term melanoma cultures and established melanoma cell lines blocked the production of the interleukin-12 (IL-12) in human monocyte-derived dendritic cells. Inhibition of IL-12 production was rescued by restoring PTEN or using neutralizing antibodies against the immunosuppressive cytokines. Furthermore, we report that PTEN, as an alternative mechanism to promote the host immune response against cancer cells, represses the expression of programmed cell death 1 ligand, a known repressor of the host immune response. Finally, to establish the clinical significance of our results, we analyzed malignant melanoma patient samples with or without brisk host responses. These analyses confirmed that PTEN loss is associated with a higher percentage of malignant melanoma samples with non-brisk host responses compared with samples with brisk host responses. Collectively, these results establish that PTEN functions as a melanoma tumor suppressor in part by regulating the host immune response against melanoma cells and highlight the importance of assessing PTEN status before recruiting melanoma patients for immunotherapies.
Objectives
This study aimed to assess the oral health and the prevalence of pre‐existing oral colonization with respiratory pathogens in dependent elderly, and whether these factors influence ...pneumonia development.
Materials and Methods
Participants residing in a long‐term care facility received bedside oral examinations, and information on their oral health (caries status, calculus index and debris index) was obtained. Samples from the tongue and teeth were collected at baseline and at time of pneumonia development. Sputum was collected at the time of pneumonia diagnosis. Samples were assessed for Haemophilus influenzae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus pneumoniae by polymerase chain reaction.
Results
This was a 1‐year longitudinal study of 60 dependent elderly (mean age: 64.2 ± 14.1 years). Seventeen patients (28.3%) developed pneumonia. The mean Decayed, Missing and Filled Teeth and Simplified Oral Hygiene Index were 22.8 ± 9.2 and 4.0 ± 1.0, respectively. At baseline, 48.3% were orally colonized with ≥1 respiratory pathogens. The presence of H. influenzae (P = .002) and P. aeruginosa (P = .049) in the sputum was significantly associated with their colonization on the tongue at baseline. In the bivariate analyses, pneumonia development was associated with naso‐gastric feeding tube (P = .0001), H. influenzae (P = .015) and P. aeruginosa (P = .003) tongue colonization at baseline and calculus index (P = .002). Multivariate analyses revealed that calculus index (P = .09) and the presence of tracheostomy (P = .037) were associated with pneumonia.
Conclusions
The calculus amount and tongue colonization with respiratory pathogens are risk factors for pneumonia development. Oral hygiene measures to remove tongue biofilm and calculus may reduce pneumonia development.
The purpose of this study was to compare clinical outcomes between open repair and thoracic endovascular aortic repair (TEVAR) in traumatic ruptured thoracic aorta.
A comprehensive search was ...undertaken of the four major databases (PubMed, Embase, Scopus, and Ovid) to identify all published data comparing open vs endovascular repair. Databases were evaluated to July 2018. Odds ratios (ORs), weighted mean differences, or standardized mean differences and their 95% confidence intervals (CIs) were analyzed. The primary outcomes were stroke, paraplegia, and 30-day mortality rates; secondary outcomes were requirement for reintervention and 1-year and five-year mortality rates.
A total of 1968 patients were analyzed in 21 articles. TEVAR was performed in 29% (n = 578) and open repair in 71% (n = 1390). TEVAR and open repair did not differ in the mean age of patients (42.1 ± 14 years vs 44.1 ± 14 years; P = .48). There was no difference in duration of intensive care and total hospital stay between TEVAR and open repair groups (12.7 ± 11.1 days vs 12.6 ± 8 days P = .35 and 27.5 ± 14.6 days vs 25.9 ± 11 days P = .80, respectively). Similarly, no statistically significant difference in postoperative paraplegia or stroke rate was noted between TEVAR and open repair (1.4% vs 2.3% OR, 1.27; 95% CI, 0.59-2.70; P = .54 and 1% vs 0.5% OR, 0.63; 95% CI, 0.18-2.18; P = .46). Lower 30-day and 1-year mortality was noted in TEVAR (7.9% vs 20% OR, 2.94; 95% CI, 1.92-4.49; P < .00001 and 8.7% vs 17% OR, 2.11; 95% CI, 0.99-4.52; P = .05). There was no difference in 5-year mortality (23% vs 17%; OR, 0.07; 95% CI, −0.07 to 0.20; P = .33). However, there was a higher rate of reintervention at 1 year in the endovascular group (0% vs 6%; OR, 0.17; 95% CI, 0.03-0.96; P = .04).
TEVAR carries lower in-hospital mortality and provides satisfactory perioperative outcomes compared with open repair in traumatic ruptured thoracic aorta. It also provides a favorable 1-year survival at the expense of higher reintervention rates.
Tuberculosis (TB) is a major global health threat, infecting one-third of the world's population. Despite this prominence, the age, origin and spread of the disease have been topics of contentious ...debate. Molecular studies suggest that
Mycobacterium tuberculosis ‘sensu stricto’
, the most common strain of TB infecting humans today, originated in Africa and from there spread into Europe and Asia. The
M. tuberculosis
strains most commonly found across the Pacific and the Americas today are most closely related to European strains, supporting a hypothesis that the disease only reached these regions relatively recently via European sailors or settlers. However, this hypothesis is inconsistent with palaeopathological evidence of TB-like lesions in human remains from across the Pacific that predate European contact. Similarly, genetic evidence from pre-European South American mummies challenges the notion of a European introduction of the disease into the Pacific. Here, we review the complex evidence for the age and origin of TB in the Pacific, and discuss key gaps in our knowledge and how these may be addressed.
This article is part of the theme issue ‘Insights into health and disease from ancient biomolecules’.
Aim: To compare anterior chamber depth measurements by three non-contact devices—the IOLMaster, scanning peripheral anterior chamber depth analyser (SPAC), and Visante anterior segment optical ...coherence tomography (AS-OCT) Methods: Prospective, cross sectional study of 497 phakic subjects over 50 years of age attending a community clinic in Singapore. Anterior chamber depth of the right eye was measured using all three techniques by the same investigator. Depth measurements were made from the corneal epithelium to the anterior lens surface. The values obtained were compared using Bland–Altman analysis. Results: 232 men and 265 women were examined (mean (SD) age, 63.4 (7.9) years). Mean anterior chamber depth was 3.08 (0.36) mm with IOLMaster, 3.10 (0.44) mm with SPAC, and 3.14 (0.34) mm with AS-OCT. A significant difference was present between the anterior chamber depth measurements recorded by the three devices (p<0.0001). Mean differences between the measurements were: AS-OCT v IOLMaster, 0.062 (0.007) mm (95% limits of agreement, −0.37 to 0.25 mm) (p<0.0001); AS-OCT v SPAC, 0.035 (0.011) mm (−0.44 to 0.51 mm) (p = 0.0001); SPAC v IOLMaster, 0.027 (0.012) mm (−0.57 to 0.50 mm) (p = 0.027). Conclusions: AS-OCT gave systematically deeper anterior chamber measurements than SPAC and IOL-Master. However, as the differences found were small they are unlikely to be clinically important.
We performed a genome-wide association study for primary open-angle glaucoma (POAG) in 1,007 cases with high-pressure glaucoma (HPG) and 1,009 controls from southern China. We observed genome-wide ...significant association at multiple SNPs near ABCA1 at 9q31.1 (rs2487032; P = 1.66 × 10(-8)) and suggestive evidence of association in PMM2 at 16p13.2 (rs3785176; P = 3.18 × 10(-6)). We replicated these findings in a set of 525 HPG cases and 912 controls from Singapore and a further set of 1,374 POAG cases and 4,053 controls from China. We observed genome-wide significant association with more than one SNP at the two loci (P = 2.79 × 10(-19) for rs2487032 representing ABCA1 and P = 5.77 × 10(-10) for rs3785176 representing PMM2). Both ABCA1 and PMM2 are expressed in the trabecular meshwork, optic nerve and other ocular tissues. In addition, ABCA1 is highly expressed in the ganglion cell layer of the retina, a finding consistent with it having a role in the development of glaucoma.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The problems of modeling in the CAE-system of panels forming processes in the creep mode with the use of reconfigurable rod punch are considered. The geometrical and contact nonlinearity are taken ...into account in the model of the problem. For the formulation of rational deformation problems the damage parameter is taken as an optimization criterion. A discrete optimal control problem is formulated, which is solved by the method of dynamic programming with improvement by the method of local variations
CONTEXT Fungal keratitis is a potentially blinding condition that is rarely seen with contact lens wear. OBJECTIVE To describe a nationwide outbreak of fungal keratitis caused by Fusarium species ...among contact lens wearers in Singapore. DESIGN, SETTING, AND PATIENTS Nationwide, hospital-based case series. All cases of fungal keratitis among contact lens wearers in all ophthalmology departments in Singapore were reviewed along with the charts of all contact lens wearers with culture-proven fungal keratitis from March 2005 through May 2006. A standardized telephone interview was conducted to obtain additional clinical information. MAIN OUTCOME MEASURE Diagnosis of Fusarium keratitis associated with contact lens wear. RESULTS During the study period, 66 patients (68 affected eyes) were diagnosed with Fusarium keratitis associated with contact lens wear; the estimated annual national incidence is 2.35 cases per 10 000 contact lens wearers (95% confidence interval, 0.62-7.22). Patients ranged in age from 13 to 44 years (mean SD, 27.1 8.4 years), of which 32 (48.5%) were men. The vast majority (65 patients; 98.5%) wore soft, disposable contact lenses; 62 patients (93.9%) reported using 1 brand of contact lens cleaning solution (ReNu, Bausch & Lomb, Rochester, NY), including 42 patients (63.6%) who recalled using ReNu with MoistureLoc. Most patients (81.8%) reported poor contact lens hygiene practices, including overnight use of daily wear contact lenses (19.7%), and use of contact lenses past the replacement date (43.9%). The final best-corrected visual acuity ranged from 20/20 to 20/80. Five patients (5 eyes; 7.4%) required emergency therapeutic or tectonic corneal transplantation. CONCLUSIONS A new and evolving epidemic of Fusarium keratitis associated with contact lens wear was found in Singapore. Physicians and eye care practitioners worldwide need to be aware of the likelihood of similar outbreaks emerging among contact lens wearers.
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