High quality of diabetes care in Greenland since the launch of Steno Diabetes Center Greenland 2020 - geographical disparities need attention

The aim of this study was to estimate the prevalence of diagnosed diabetes in Greenland and evaluate quality of care according to sex, region and healthcare unit within regions. Data on all inhabitants registered with diabetes were extracted from the electronic medical record. We found a crude prevalence of diagnosed diabetes in the population aged ≥ 20 years to be 4.7%, and the prevalence of diabetes standardised to the WHO world population was 4.0%. Compared to males, a significantly higher proportion of females had mean glycated haemoglobin (HbA1c) level below 7% (68.9% vs. 57.5%) and blood pressure below 140/90 mmHg (83.4% vs. 73.5%). Regarding healthcare unit within regions, quality of care was higher in regional cities compared to smaller cities, concerning proportion of persons having blood pressure measured regularly (86.0% vs. 71.7%), urine tested for albuminuria (70.6% vs. 51.2%), receiving eye examination (86.9% vs. 79.5%) and foot examination (87.9% vs. 79.4%). In conclusion, the prevalence of diagnosed diabetes in Greenland is the highest reported yet. The overall quality of diabetes care was high and significantly improved compared to 2018. We observed geographical inequality in diabetes care and improvements in the quality of care in specific remote locations are necessary to minimise health care disparities.

Improving health-care planning for fracture patients in Türkiye: insights from a nationwide study

BACKGROUND

The distribution of fractures may vary according to age and gender. In a country like Türkiye, which has high population density and covers a large geographical area, it is important to understand the regional variations in fractures and identify the health institutions in which patients seek treatment to plan new health-care investments effectively. The objective of our study was to investigate the distribution of fractures across the seven regions of Türkiye considering age, gender, and the level of health institutions the patients visited.

METHODS

Between January 2021 and May 2023, the total number of fractures, locations of the fractures, patient age and gender, geographical regions, and levels of the health-care institutions to which the patients presented were examined through the e-Nabız personal health record system. Age groups were divided into pediatric (0-19 years), adult (20-64 years), and geriatric (≥65 years) categories. Geographical regions included the Marmara, Central Anatolia, Black Sea, Eastern Anatolia, Aegean, Mediterranean, and Southeastern Anatolia regions.

RESULTS

A total of 2,135,701 patients with 2,214,213 fractures were analyzed. Upper extremity fractures were the most common among all considered fracture groups (1,154,819 fractures, 52.2%). There were 643,547 fractures in the pediatric group, 1,191,364 fractures in the adult group, and 379,302 fractures in the geriatric group. While the total number of fractures was higher among men with 1,256,884 fractures (58.9%), the rate among women was higher in the geriatric group (67.2%). Geographically, the highest number of fractures was observed in the Marmara region (714,146 fractures), and 67.92% of all patients presented to secondary health-care institutions (1,500,780 fractures). The most commonly diagnosed fracture in the study population was distal radius fractures. The most common fracture in the geriatric group was femur fractures while distal radius fractures were the most common fractures in the adult and the pediatric groups.

CONCLUSION

By understanding the distribution of fractures in Türkiye based on fracture site, geographical region, age, and gender, it becomes possible to improve the planning of patient access to health-care services. In regions with limited health resources, a more successful resource distribution can be achieved by considering fracture distributions and age groups.

The European NUTS-level election dataset: A tool to map European electoral geography

Datasets on subnational election results in Europe frequently do not match with regional statistics available for cross-national research, mainly because territorial statistical units change over time and do not map onto the national electoral districts. This hinders consistent comparative research across time. This research note introduces EU-NED, a new dataset on subnational election data that covers national and European parliamentary elections for European countries over the past 30 years. EU-NED's major contribution is that it provides election results on disaggregated levels of the statistical territorial units used by Eurostat with an unprecedented consistency and temporospatial scope. Moreover, EU-NED is integrated with the Party Facts platform, allowing for a seamless integration of party-level data. Using EU-NED, we present first descriptive evidence on the European electoral geography and suggest avenues of how EU-NED can facilitate future comparative political science research in Europe.

Attitudes toward immigration in Europe: Cross-regional differences

Background: This article investigates how European public opinion has responded to short-term variations in regional immigration over the past decade (2010-2019). Methods: Combining data from the European Social Survey and the European Union Labour Force Survey and using multilevel modelling, we test how natives' opinions over migration policy and the contribution of immigrants to society have changed with the net rate of international migrants in 183 EU regions from 21 countries. Results: We find that while European natives living in regions with a higher share of foreign-born populations are generally less anti-immigrant, a short-term increase in the number of immigrants within a given region is associated with more negative attitudes. Conclusion: Our findings demonstrate the importance of temporal dynamics for attitudes to immigration. They also point to the relevance of regional variations in attitudes beside cross-country differences.

Influence of the maternity unit and region of delivery on episiotomy practice in France: a nationwide population-based study

INTRODUCTION

Our objective was to identify factors associated with episiotomy practice in France, in particular, characteristics of the maternity units and regions of delivery.

MATERIAL AND METHODS

We performed a national cross-sectional population-based study in all French maternity units in 2016 including 9284 women with vaginal delivery. Our outcome was the performance of an episiotomy. After stratification for parity, associations of episiotomy practice with individual and organizational characteristics and the region of delivery were estimated with multilevel logistic regression models. The variability in maternity unit episiotomy rates explained by the characteristics studied was estimated by the proportional change in variance.

RESULTS

A total of 19.9% of the women had an episiotomy. The principal factors associated with episiotomy practice were maternal and obstetric and delivery in a maternity unit with <2000 annual deliveries. After adjusting for individual, obstetric and organizational characteristics, the practice of episiotomy was strongly associated with women's region of delivery. Additionally, women's individual characteristics did not explain the significant variability in episiotomy rates between maternity units (P < 0.001) but maternity unit characteristics partly did (proportion of variance explained: 7.2% for primiparas and 13.6% for multiparas) and regional differences still more (18% and 30.7%, respectively).

CONCLUSIONS

Episiotomy practices in France in 2016 varied strongly between maternity units, largely due to regional differences. Targeted actions by the regional perinatal care networks may reduce the national episiotomy rate and standardize practices.

Description and nomenclature of organ subdivisions in the Terminologia Anatomica and in anatomical education: Comparison with cancer classifications

Terminology is the basis for communication among medical professionals. For anatomists, their daily work is based on the Terminologia Anatomica (TA), while pathologists cite the Tumor Node Metastasis (TNM) classification when referring to the anatomical boundaries and regions of malignant tumors. Terminologia Anatomica and clinical-based classifications, including the TMN classification of tumors, use a world-wide standardized nomenclature, which has been revised regularly to incorporate new anatomical discoveries and clinically relevant structures. In medical education, students are familiarized with medical nomenclatures in anatomy textbooks and online learning platforms. Sometime, descriptions and illustrations in anatomy teaching materials put a different focus on the importance of anatomical subdivisions and their borders than is found in cancer classifications. This discrepancy contrasts with the efforts of medical societies to define and implement clinically relevant anatomical structures, including organ subdivisions and their boundaries, in daily clinical practice. Here, we illustrate this problem using the larynx and pancreas as examples. Anatomy education should coordinate teaching content with the requirements of the clinical disciplines.

Assessment of 'Cabernet Sauvignon' Grape Quality Half-Véraison to Maturity for Grapevines Grown in Different Regions

Grapes are widely cultivated around the world and their quality has distinct regional characteristics. In this study, the qualitative characteristics of the 'Cabernet Sauvignon' grape variety in seven regions, from half-véraison to maturity, were analyzed comprehensively at physiological and transcriptional levels. The results indicated that the quality traits of 'Cabernet Sauvignon' grapes in different regions were significantly different with obvious regionality. Total phenols, anthocyanins, and titratable acids were the main factors of the regionality of berry quality, which were very sensitive to changes in the environment. It should be noted that the changes in titrating acids and total anthocyanin of berries vary greatly from half-véraison to maturity between regions. Moreover, the transcriptional analysis showed that the co-expressed genes between regions characterized the core transcriptome of berry development, while the unique genes of each region reflected the regionality of berries. The differentially expressed genes (DEGs) between half-véraison and maturity can be used to demonstrate that the environment of the regions could promote or inhibit gene expression. The functional enrichment suggested that these DEGs help to understand the interpretation of the plasticity of the quality composition of grapes according to the environment. Taken together, the information generated by this study could contribute to the development of viticultural practices aimed at making better use of native varieties for the development of wines with regional characteristics.

The impact of health resource enhancement and its spatiotemporal relationship with population health

Objective

This study investigated the impact of health resource enhancement on health and spatiotemporal variation characteristics from 2000 to 2010 at the county level.

Methods

Multiscale Geographically Weighted Regression and curve fitting were used to explore the characteristics of spatiotemporal impact and divergence mechanism of health resource enhancement on population health.

Results

From 2000 to 2010, China's population health continued to rise steadily, and health resource allocation improved. Population health demonstrated the significant spatial autocorrelation, and its spatial clustering patterns were relatively fixed. Health resource allocation was relatively equal. Health technicians per 1,000 persons had a significant positive effect on population health in 2000 and 2010. Meanwhile, its impact tends to be consistent across regions, and the impact scale has been continuously expanding. A quantitative relationship exists between population health and health resource inputs. When life expectancy ranged from 73.68 to 84.08 years, the death rate ranged from 6.27 to 9.00%, and the infant mortality rate ranged from 0.00 to 6.33%, investments in health resources, especially related to health technicians, were beneficial for population health.

Conclusions

The government should improve the science and rationality of health resource planning. Planning meets regional realities by combining the impacts of economy and geography. The influence of health resources on population health depends on the overall allocation of health technicians. The number of health technicians needs to be further increased to improve the health resources' effective allocation between regions.

Trajectories of sustainable working life in nine Swedish residential regions: A longitudinal twin cohort study

OBJECTIVE

To investigate trajectories of sustainable working life (SWL, ie, no interruptions or transitions in working life due to sickness absence (SA), disability pension (DP), or unemployment) in Swedish residential regions using a population-based twin cohort, while assessing sociodemographics and twin pair similarity.

METHODS

Sample of 60 998 twins born in 1925-1958. SWL was assessed through main labor market status in each year in 1998-2016 based on > 180 days with SA/DP, > 180 days with unemployment, or >half of yearly income from old-age pension for not in SWL, and employment (in paid work and did not fulfill the criteria SA/DP, unemployment, or old-age pension) for SWL. Residential regions were classified into nine groups based on Swedish municipalities. Group-based trajectory models and multinomial logistic regression were applied separately for all regions.

RESULTS

In all regions, the largest trajectory group was sustainable working life. Three to four trajectory groups developed toward unsustainable working life with different exit points from sustainable working life. A small proportion were grouped with partial stable or increase in sustainable working life. Increased age, being a woman, <12 years of education, and history of unstable working life increased, and being married and twin pair similarity decreased the likelihood of belonging to trajectories toward unsustainable working life.

CONCLUSIONS

In all regions, most of the individuals followed a sustainable working life trajectory. A reasonable proportion of individuals followed trajectories developing toward unsustainable working life. The influence of sociodemographic and familial factors on trajectory groups was similar in all regions.

R&D investments and employment decisions as a function of enterprise size and regional population density before and during COVID-19

Norwegian data show that from 2018 to 2020, enterprises in densely populated regions increased R&D investments relative to those in sparsely populated regions, but not from 2016 to 2018. Therefore, COVID-19 likely induced the shift. The findings imply that densely populated regions have become more R&D-intensive, while sparsely populated regions have become less R&D-intensive during the pandemic. Small enterprises increased both R&D investments and employment from 2018 to 2020 relative to large enterprises and the analyses control for regression toward the mean effects. The findings were similar to those observed in the period from 2016 to 2018, which rules out COVID-19 as an explanation. Instead, the waves of data indicate a long-term trend where small enterprises increased R&D investments and employment.

Alarming Rise of Primary HIV Drug Resistance in Major Regions of Russia

OBJECTIVE

The study aimed to compare the prevalence of surveillance HIV drug resistance mutations (SDRMs) across the main federal districts of Russia.

METHODS

A pooled analysis was conducted to examine data on HIV primary drug resistance (HIV PrimDR). The analysis was based on published results primarily from Russian regional clinical and scientific laboratories, covering a span of 20 years.

RESULTS

The findings indicate that three surveyed regions, namely Central, Far Eastern, and Volga, exhibit a low level of HIV PrimDR prevalence (not exceeding 5%), and this prevalence does not show a tendency to increase. In contrast, three major regions, namely Northwestern, Southern, and Siberian, demonstrate a significant and progressive increase in HIV PrimDR prevalence, with recent values surpassing 10%.

CONCLUSION

Consequently, it was concluded that a change in the HIV treatment strategy in these regions is imperative, emphasizing the need to expedite the transition to the utilization of secondgeneration integrase inhibitors.

Healthcare in Russia: Macroeconomic Parameters and Structural Issues

The epidemiological crisis of 2020-2021 has revealed a number of imbalances and "bottlenecks" that have developed in the Russian healthcare system over the past 20 years as a result of a policy of limiting development to breakthroughs in individual areas accompanied by optimization of the sector. It became evident that one of the most acute problems is interregional disparity in terms of personnel and resource availability in the healthcare system, which determines the system's ability to respond to challenges and shocks. Solving these problems requires a comprehensive approach: simply increasing the sector's financing is not sufficient and must be accompanied by structural changes, in particular, modifying the education system and training new highly qualified personnel, creating an effective system of territorial distribution of personnel, and radically increasing the availability of high-end equipment, i.e., a transition to a new model of healthcare.

High Levels of PM10 Reduce the Physical Activity of Professional Soccer Players

The aim of this study is to determine the impact of air quality, analyzed on the basis of the PM10 parameter in three regions of Poland, on the physical activity of soccer players from the Polish Ekstraklasa. The study material consisted of 4294 individual match observations of 362 players during the 2019/2020 domestic season. The measured indices included the parameter of air quality-PM10-and players' physical activities: total distance (TD) and high-speed running (HSR). Poland was divided into three regions (North, Central, South). The statistical analysis of particulate matter (PM) and athletes' physical activities, compared by region, revealed the effects in relation to the PM10 (H = 215.6566(2); p = 0.0001) and TD (H = 28.2682(2); p = 0.0001). Players performed better in regards to physical parameters in the North Region, where air pollution is significantly lower than in other regions. This means that even a short stay in more polluted regions can reduce the performance of professional footballers, which can indirectly affect the outcome of the match. Therefore, greater actions should be taken to improve air quality, especially through changes in daily physical activity, as this will reduce the carbon footprint.

Regional and Seasonal Variability of Mineral Patterns in Some Organs of Slaughtered One-Humped Camels [Camelus dromedarius] from Saudi Arabia

Camel products are receiving great interest worldwide because of their high functional properties and nutritive values. Therefore, this study was focused on the variation of copper [Cu], zinc [Zn], manganese [Mn], selenium [Se], iron [Fe], iodine [I], and some heavy metals, cobalt [Co], lead [Pb], and cadmium [Cd], in the blood and tissues of slaughtered camels from five regions in Saudi Arabia [SA] during the summer and winter seasons, because environmental factors vary from region to region. Whole blood, meat, liver, rumen fluid, and rumen tissues were collected from the slaughterhouse in each region during the two seasons. Moreover, samples were prepared and analyzed for trace mineral and heavy metal concentrations using ICP-MS. The data were statistically analyzed as part of a complete randomized design and correlation analysis for season and location using SAS. The findings revealed a pattern in the minerals, with Ca being the only mineral that was unrelated to other minerals in the liver. For lead and cadmium, our mean value in liver [0.40 µg/g] was below the limit of the EU standard for cadmium [0.50 µg/g], while in meat and liver, lead contents [1.62 µg/g and 2.57 µg/g, respectively] were above the limit of the EU standard [0.10 and 0.20 µg/g, respectively]. For meat, the significantly highest positive correlations were observed between P and Mg [R² = 0.928], Fe and Mn [R² = 0.860], and Co and Mn [R² = 0.821]. For rumen tissues, P and Mg were highly correlated [R² = 0.958] as well as Zn and Mg [R² = 0.857], Zn and P [R² = 0.836], and Fe and Ca [R² = 0.802]. As a result, a region and season reflect variations in mineral concentrations in SA during the summer and winter seasons. Further intensive research is needed to investigate the minerals' biological mechanisms in camels under different environmental conditions.

Where did it hit harder? Understanding the geography of excess mortality during the COVID-19 pandemic

The health impact of the COVID-19 pandemic across OECD (Organisation for Economic Co-operation and Development) and European regions has been strikingly uneven. In 2020, excess mortality rates in the hardest-hit regions were, on average, 17 percentage points higher than those in the least affected regions of the same country. This paper shows that low health system capacity, followed by population density, air pollution, the share of elderly people, and low institutional quality were associated with higher excess mortality during the first year of the pandemic. Finally, reduced home-to-work mobility, following governments' COVID-19 responses, was associated with lower excess mortality 2 months after implementation of the measures.

Uncooperative society, uncooperative politics or both? Trust, polarization, populism and COVID-19 deaths across European regions

Why have some territories performed better than others in the fight against COVID-19? This paper uses a novel dataset on excess mortality, trust and political polarization for 165 European regions to explore the role of social and political divisions in the remarkable regional differences in excess mortality during the first wave of the COVID-19 pandemic. First, we investigate whether regions characterized by a low social and political trust witnessed a higher excess mortality. Second, we argue that it is not only levels, but also polarization in trust among citizens - in particular, between government supporters and non-supporters - that matters for understanding why people in some regions have adopted more pro-healthy behaviour. Third, we explore the partisan make-up of regional parliaments and the relationship between political division - or what we refer to as 'uncooperative politics'. We hypothesize that the ideological positioning - in particular those that lean more populist - and ideological polarization among political parties is also linked to higher mortality. Accounting for a host of potential confounders, we find robust support that regions with lower levels of both social and political trust are associated with higher excess mortality, along with citizen polarization in institutional trust in some models. On the ideological make-up of regional parliaments, we find that, ceteris paribus, those that lean more 'tan' on the 'GAL-TAN' spectrum yielded higher excess mortality. Moreover, although we find limited evidence of elite polarization driving excess deaths on the left-right or GAL-TAN spectrums, partisan differences on the attitudes towards the European Union demonstrated significantly higher deaths, which we argue proxies for (anti)populism. Overall, we find that both lower citizen-level trust and populist elite-level ideological characteristics of regional parliaments are associated with higher excess mortality in European regions during the first wave of the pandemic.

[The intermediate outcomes of delegation of obligations of medicinal support of patients with rare diseases to the Federal level in 2019-2020]

Lately, in case of a number of life-threatening and chronic progressive rare (orphan) diseases, resulting in decreasing of life expectancy of citizens or their disability, the powers to support patients with medications were transferred from regional to federal level. Among these diseases are hemolytic uremic syndrome, mucopolysaccharidose type I, II, VI, juvenile arthritis with systemic onset, unspecified aplastic anemia, hereditary deficiency of factors II (fibrinogen), VII (labile), X (Stuart-Prauer). The article considers data concerning hemolytic uremic syndrome, mucopolysaccharidosis type I, II, VI, juvenile arthritis with systemic onset - the diseases for which medication support provision was transferred to Federal level in the first place and for which at the time of preparation of the article there were sufficient data to analyze.

Comparative Analysis of Triglycerides From Different Regions and Mature Lactation Periods in Chinese Human Milk Project (CHMP) Study

The kinds and proportions of triglycerides of human mature milk play an independent role in the growth of infants. In this study, the human milk samples obtained from eight different Chinese cities (Chengdu, Weihai, Lanzhou, Jinhua, Beijing, Guangzhou, Zhengzhou, and Harbin) and six sequential mature lactation times (30, 60, 90, 120, 150, and 180 days) were detected for the triglycerides. The result demonstrated that total 66 triglycerides were detected in mature human milk, with acyl carbon number (ACN) numbers were locating in the range of 34–54 and double bond (DB) numbers were locating in the range of 0–6. In addition, the percentage of OPO, OPL, and OOO was relatively higher than others, accounted for more than 4% of total triglycerides in all the lactation areas and times, and the percentage of U2S and LLL triglycerides was also richest in mature milk. Furthermore, it was obvious that lactation regions had more significant effect on the triglycerides compared with lactation time and the triacylglycerols (TAGs) of human milk in Guangzhou were clearly different from that in other regions. Therefore, the results of this study will provide data reference for the design of infant formula suitable for Chinese babies.

S3 and Recovery and Resilience Funds: A Case Study Built on the Experience of 10 Spanish Regions

The EU's response to the COVID-19 crisis, namely the approval of the Next Generation package, provides an opportunity to explore to what extent the existing Smart Specialisation regional strategies and related ecosystems have been taken into account in the highly relevant territorial context in which the national Recovery Plans have been designed. According to our results the potential of the Smart Specialisation approach (S3) in relation with its place-based strategic prioritisation may have been overlooked in the process. The research is based on a desk review of relevant documents and recent literature in this field; followed by semi-structured interviews with regional planners and practitioners from 10 Spanish regions (autonomous communities); complemented, in a second phase, by the organisation of a focus group to validate the initial results. During our research we identified the main contributions that the Smart Specialisation approach has so far made to the regions (mainly in terms of participative governance and creation of regional ecosystems); and the unanimous perception shared by all the practitioners interviewed that the S3 approach has led to a change of vision in public intervention. However, all of the interviewed regions have confirmed that the drafting of the national recovery and resilience plan lacked an ex-ante alignment with the regional S3 strategies, and failed to consider the existing regional S3 ecosystems. The separation of the recovery logic (based on the operation of public consultations at national level to identify strategic projects) from the S3 logic (based on a strategic prioritisation exercise conducted by each regional ecosystem) confirms that an opportunity may have been missed in the recovery planning process to consolidate the multi-actor, multilevel and place-based S3 approach. Although there is a certain degree of disappointment among regional practitioners as a result of this misalignment, the majority of them believe in the possibility of an ex-post alignment between the two processes, that can protect existing regional shared visions. However, without clear recognition of the S3 ecosystems and the S3 managing bodies, the significant role that Smart Specialisation could play in the recovery process may be at risk.

Mutual Influence of Innovation and Human Capital on Regional Growth in Neighboring Countries: The Case of Russia and Kazakhstan

The aim is to assess the impact on regional growth of spending on R&D, technological innovation, healthcare, education, and socioeconomic conditions, their spillovers between the country regions, and, primarily, from the neighboring country regions. In existing studies, the authors examined other regions’ impact on regional growth. However, this approach does not reveal the effect the neighboring country’s regions had on the regions’ economic growth. Our approach novelty is that we assessed the impact of regional growth factors from the country and the neighboring country separately. The panel data analysis method applied to the endogenous growth model made it possible to assess these effects on regional economic growth and identify regional convergence. Our results are consistent with other studies regarding regional drivers and their spillovers to other regions within each country. Moreover, our results confirmed the technological innovation cost stream hypothesis in the Russian regions from Kazakhstan regions. And they confirmed the hypothesis that R&D costs flow to the Kazakhstan regions from the Russian regions. Thus, the study revealed a synergistic effect from the regional growth in spending on R&D and technological innovation between Russia and Kazakhstan, which is asymmetric. The proposed approach to analyzing interregional mutual influence is also applicable to three or more countries.

Spatial-temporal distribution and sequence diversity of group a human respiratory syncytial viruses in Kenya preceding the emergence of ON1 genotype

Background

Human respiratory syncytial virus (HRSV) is a major cause of severe viral acute respiratory illness and contributes significantly to severe pneumonia cases in Africa. Little is known about its spatial–temporal distribution as defined by its genetic diversity.

Methods

A retrospective study conducted utilizing archived nasopharyngeal specimens from patients attending outpatient clinics in hospitals located in five demographically and climatically distinct regions of Kenya; Coast, Western, Highlands, Eastern and Nairobi. The viral total RNA was extracted and tested using multiplex real time RT‐PCR (reverse transcriptase polymerase chain reaction). A segment of the G‐gene was amplified using one‐step RT‐PCR and sequenced by Sanger di‐deoxy method. Bayesian analysis of phylogeny was utilized and subsequently median joining methods for haplotype network reconstruction.

Results

Three genotypes of HRSVA were detected; GA5 (14.0%), GA2 (33.1%), and NA1 (52.9%). HRSVA prevalence varied by location from 33% to 13.2% in the Highlands and the Eastern regions respectively. The mean nucleotide diversity (Pi[π]) varied by genotype: highest of 0.018 for GA5 and lowest of 0.005 for NA1. A total of 58 haplotypes were identified (GA5 10; GA2 20; NA1 28). These haplotypes were introduced into the population locally by single haplotypes and additional subsidiary seeds amongst the GA2 and the NA1 haplotypes.

Conclusions

HRSVA was found across all the regions throughout the study period and comprised three genotypes; GA5, GA2, and NA1 genotypes. The genotypes were disproportionately distributed across the regions with GA5 gradually increasing toward the Western zones and decreasing toward the Eastern zones of the country.

Comparative Evaluation of Forsythiae Fructus From Different Harvest Seasons and Regions by HPLC/NIR Analysis and Anti-inflammatory and Antioxidant Assays

Forsythiae Fructus (FF), the dry fruit of Forsythia suspensa (Thunb.) Vahl, has a long history of use in traditional Chinese Medicine for its heat-clearing and detoxifying properties. It possesses clinical therapeutic effects and biological functions showing efficacy in handling different diseases. To investigate the FF differences in Henan, Shanxi, and Shaanxi in August and October, the surface morphology, mid-infrared and near-infrared spectrums, and HPLC were analyzed. Concurrently, the anti-inflammatory and antioxidant effects on LPS-induced J774A.1 cells were evaluated by western blot and RT-qPCR. The results showed that FF from different Harvest Seasons and Regions are provided with different microstructures and mid-infrared and near-infrared spectrums, and the levels of forsythiaside A and phillyrin of FF from Shanxi in August and phillygenin of FF from Shaanxi in August were the highest. Meanwhile, FF from Shanxi and Shaanxi in August markedly reduced the levels of inflammatory cytokines and mediators (TNF-α, IL-1β, NF-κB, and iNOS) and the protein expression levels of phosphorylated total IKKα/β and nuclear NF-κB. In August, SXFF and SAXFF also promoted the mRNA expression levels of HO-1 and NQO1 and the protein expression levels of HO-1 and nuclear Nrf2 and suppressed the protein expression levels of KEAP1. Spearman correlation analysis showed that phillygenin had a strong correlation with the protein expression on LPS-induced J774A.1 cells. In summary, our results showed that FF from harvest seasons and regions contributed to the distinct differences in microstructure, the mid-infrared and near-infrared spectrums, and compound content. More importantly, FF from Shanxi and Shaanxi in August showed marked anti-inflammatory and antioxidant activities, but with some differences, which may be because of different contents of phillygenin and phillyrin of lignans in FF.

Cortical Cartography: Mapping Arealization Using Single-Cell Omics Technology

The cerebral cortex derives its cognitive power from a modular network of specialized areas processing a multitude of information. The assembly and organization of these regions is vital for human behavior and perception, as evidenced by the prevalence of area-specific phenotypes that manifest in neurodevelopmental and psychiatric disorders. Generations of scientists have examined the architecture of the human cortex, but efforts to capture the gene networks which drive arealization have been hampered by the lack of tractable models of human neurodevelopment. Advancements in "omics" technologies, imaging, and computational power have enabled exciting breakthroughs into the molecular and structural characteristics of cortical areas, including transcriptomic, epigenomic, metabolomic, and proteomic profiles of mammalian models. Here we review the single-omics atlases that have shaped our current understanding of cortical areas, and their potential to fuel a new era of multi-omic single-cell endeavors to interrogate both the developing and adult human cortex.

The "second wave" of the COVID-19 pandemic in the Arctic: regional and temporal dynamics

This article focuses on the "second wave" of the COVID-19 pandemic in the Arctic and examines spatiotemporal patterns between July 2020 and January 2021. We analyse available COVID-19 data at the regional (subnational) level to elucidate patterns and typology of Arctic regions with respect to the COVID-19 pandemic. This article builds upon our previous research that examined the early phase of the COVID-19 pandemic between February and July 2020. The pandemic's "second wave" observed in the Arctic between September 2020 and January 2021 was severe in terms of COVID-19 infections and fatalities, having particularly strong impacts in Alaska, Northern Russia and Northern Sweden. Based on the spatiotemporal patterns of the "second wave" dynamics, we identified 5 types of the pandemic across regions: Shockwaves (Iceland, Faroe Islands, Northern Norway, and Northern Finland), Protracted Waves (Northern Sweden), Tidal Waves (Northern Russia), Tsunami Waves (Alaska), and Isolated Splashes (Northern Canada and Greenland). Although data limitations and gaps persist, monitoring of COVID-19 is critical for developing a proper understanding of the pandemic in order to develop informed and effective responses to the current crisis and possible future pandemics in the Arctic. Data used in this paper are available at https://arctic.uni.edu/arctic-covid-19.

Contraceptive Use, Access to Methods, and Program Efforts in Urban Areas

This article uses two large sets of internationally comparable national surveys to analyze urban patterns of contraceptive use, access to methods, and fertility. Urban areas show higher use of contraception and lower fertility rates than rural areas, with substantial differences in the method mix. Urban women tend more toward the long-term methods of the intrauterine device (IUD), implant, and sterilization and less toward short-term, resupply methods. The overall use increases with education and with higher wealth quintiles. By regions, contraceptive use is unbalanced between urban and rural sectors especially in sub-Saharan Africa, where the overall levels of use are lowest. Overall, the urban fertility rate is only 70% of the rural rate. Across countries, the fertility rate correlates negatively with contraceptive use. National family planning programs tend to raise contraceptive use and to improve access to the methods. About half of the unmarried, sexually active women use contraception, with great diversity in which method is preferred. This holds for all married women as well: regions and countries show quite different patterns of use. Therefore, planners and donors should focus on the circumstances in individual countries.

The only certainty is uncertainty: An analysis of the impact of COVID-19 uncertainty on regional stock markets

Uncertainty surrounding COVID-19 is widespread. We investigate the timing and quantify the impact of COVID-19 related uncertainty on returns and volatility for regional market aggregates using ARCH/GARCH models. Drawing upon economic psychology, COVID-19 related uncertainty is measured by searches for information as reflected by Google search trends. Asian markets are more resilient than others. Latin American markets are most impacted in terms of returns and volatility. For most regions, there is evidence of an increasing impact of COVID-19 related uncertainty which dissipates as the crisis evolves. We confirm that Google search trends capture uncertainty by comparing this measure against alternative uncertainty measures.

Is Current Research on How Climate Change Impacts Global Food Security Really Objective?

Global food insecurity is becoming more severe under the threat of rising global carbon dioxide concentrations, increasing population, and shrinking farmlands and their degeneration. We acquired the ISI Web of Science platform for over 31 years (1988-2018) to review the research on how climate change impacts global food security, and then performed cluster analysis and research hotspot analysis with VosViewer software. We found there were two drawbacks that exist in the current research. Firstly, current field research data were defective because they were collected from various facilities and were hard to integrate. The other drawback is the representativeness of field research site selection as most studies were carried out in developed countries and very few in developing countries. Therefore, more attention should be paid to developing countries, especially some African and Asian countries. At the same time, new modified mathematical models should be utilized to process and integrate the data from various facilities and regions. Finally, we suggested that governments and organizations across the world should be united to wrestle with the impact of climate change on food security.

Hypertension among Mongolian adults in China: A cross-sectional study of prevalence, awareness, treatment, control, and related factors: Hypertension among Mongolian adults in China

The objectives of the study were to comprehend the prevalence of hypertension (HTN) and prehypertension (PHT), awareness, treatment, and control of HTN and its distribution in urban, agricultural, pastoral, and semi-agricultural/semi-pastoral areas, and to explore the related factors of HTN among Mongolian adults in China. From August 2018 to August 2020, a multi-stage stratified cluster random sampling method was conducted to investigate the prevalence of HTN among Mongolian adults aged ≥18 years living in China (n = 2558). Inclusion criteria for HTN were systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg and/or had hypertensive history and/or taking antihypertensive drugs for HTN. The prevalence rates of HTN and PHT were 44.77% and 32.03%, respectively. The prevalence rates of PHT in urban, agricultural, pastoral, and semi-agricultural/semi-pastoral areas were 34.93%, 34.73%, 26.03%, and 33.44%, respectively, and the prevalence rates of HTN were 35.97%, 40.15%, 49.68%, and 48.07%, respectively. The awareness, treatment and control rates of HTN were 66.48%, 58.93%, and 16.48%, respectively. In this survey, the overweight, obesity, and central obesity rates were 34.30%, 30.67%, and 58.08%, respectively. Compared with Chinese adults ≥18 years, the prevalence rate of HTN among Mongolian adults in China aged ≥ 18 years was relatively high; the prevalence rate of PHT and HTN awareness, treatment, and control rates were similar. The prevalence of HTN and the rates of obesity and central obesity were higher in pastoral regions than in the other three types of regions, and the rate of overweight was highest in agricultural regions.

Institutions and the uneven geography of the first wave of the COVID-19 pandemic

This paper examines the uneven geography of COVID-19-related excess mortality during the first wave of the pandemic in Europe, before assessing the factors behind the geographical differences in impact. The analysis of 206 regions across 23 European countries reveals a distinct COVID-19 geography. Excess deaths were concentrated in a limited number of regions-expected deaths exceeded 20% in just 16 regions-with more than 40% of the regions considered experiencing no excess mortality during the first 6 months of 2020. Highly connected regions, in colder and dryer climates, with high air pollution levels, and relatively poorly endowed health systems witnessed the highest incidence of excess mortality. Institutional factors also played an important role. The first wave hit regions with a combination of weak and declining formal institutional quality and fragile informal institutions hardest. Low and declining national government effectiveness, together with a limited capacity to reach out across societal divides, and a frequent tendency to meet with friends and family were powerful drivers of regional excess mortality.

Nutritional, anti-nutritional, antioxidant, physicochemical and functional characterization of Australian acacia seed: effect of species and regions

BACKGROUND

Acacia seed (AS) is an underutilized legume widely distributed in the world, with majority of the species (>70%) found in Australia. Generally, the seeds are not only rich in protein, dietary fibre and potassium, but also possess anti-nutritional compounds. In recent years, there have been an increase in the cultivation of some Australian acacia species such as Acacia victoriae, Acacia cowleana and Acacia coriacea from different regions. However, there is limited information on the composition, anti-nutrients, antioxidant and functional properties of flour from these widely grown Australian AS species. Thus, the present study aimed to assess the properties of these Australian AS species from different geographical regions.

RESULTS

The A. cowleana and A. coriacea were characterized by high protein, fat, potassium and soluble carbohydrate. However, higher starch and fibre contents were present in A. victoriae. Greater amounts of anti-nutrients, total phenolics and flavonoids were found in A. cowleana and A. coriacea seeds, whereas A. victoriae had higher 2,2-diphenyl-1-picrylhydrazyl radical-scavenging capacity. A. victoriae and A. coriacea demonstrated the highest water absorption and solubility index, respectively. However, A. cowleana showed the highest oil absorption index. There was less variation in the composition and properties within species from different regions.

CONCLUSION

All samples showed promising nutritional characteristics, although with sufficient diversity to indicate that Australian acacia seeds can be utilized to develop a range of new (functional) food products. Overall, the information obtained will help the food industries with the selection of AS species for food application.

The Height of Children and Adolescents in Colombia. A Review of More than Sixty Years of Anthropometric Studies, 1957-2020

In this article, we present a review of the studies on the heights of children and teenagers in Colombia published since 1957. We focus on examining the geographic coverage, features of the population studied, height measurement techniques, authors’ profiles, and growth patterns in children. This relatively recent literature has been developed mainly by medical doctors who carried out rigorous measurements with highly specific time and space horizons. The first studies emphasized the differences among socioeconomic levels. Later, there was an interest in minority groups, such as indigenous people and Afro-descendants. Although most of the research lacked long-term vision, the overall balance shows that the country has been improving in anthropometric indicators over time, across territories, and in different socioeconomic groups.

Analysis of Environmental Determinants of Heme and Nonheme Iron Intake in a National Sample of Polish Adolescents

Intake of sufficient amounts of iron by adolescents is a matter of great concern. Therefore, it is crucial to determine the factors that may influence iron intake in this specific population. The present study aimed to analyze the environmental determinants of the intake of heme and nonheme iron in a national homogenous sample of Polish adolescents. Adolescents (aged 15-20 years) were randomly chosen from all the regions of Poland by performing a sampling of secondary schools (random quota sampling). The total iron intake, as well as the intake of heme iron, nonheme iron, animal iron, plant iron, and iron from various food products, was assessed among 1385 female respondents and 1025 male respondents using the validated IRON Intake Calculation-Food Frequency Questionnaire (IRONIC-FFQ). The intake was compared between the subgroups stratified by meat intake in the region, gross domestic product (GDP) in the region, and size of the city (rural vs. urban environment). It was observed that meat intake in the region did not influence the intake of total iron, as well as the intake of heme iron, nonheme iron, animal iron, plant iron, and iron from various food products (p > 0.05). However, GDP and the size of the city were determined as the most influencing factors, as they were associated with iron intake in both female and male adolescents, with the most prominent differences between the subgroups found in the case of females. Female adolescents from high-GDP regions had significantly higher intake of heme iron (p = 0.0047) and animal iron (p = 0.0029), and lower intake of nonheme iron compared to those from low-GDP regions (p = 0.0342). The total iron intake was higher among female adolescents who were from medium cities than those from big cities (p = 0.0350), but significantly higher animal iron intake (p = 0.0404) and plant iron intake (p = 0.0385) were observed among females from villages and small towns compared to females from other groups. Based on the results, it may be concluded that size of the city and the economic status of the region are the most important environmental determinants of iron intake in adolescents and, hence, they should be taken into account while developing educational programs, especially for the female adolescent population.

COVID‐19 and the shifting industrial landscape

The COVID‐19 coronavirus pandemic has fuelled debate about domestic industry and manufacturing in light of shocks to global supply chains and shortages of medical and personal protective equipment (PPE). Nevertheless, debates have been poorly attuned to geography and history. Calls for reinvigorated domestic manufacturing conceal the degree to which industrial landscapes are already entwined in geometries of power. This is especially so at ports—increasingly privatised—that have become sites of policy focus and biosecurity panic. Crucial trading zones, ports are being refashioned as growth machines for commodity export, energy, and logistics, undergirding national manufacturing capacity via trade and material commodity flows. Yet ports have also always been vectors for disease transmission and are central places for COVID‐19 crises. Writing from Port Kembla, south of Sydney, Australia, we catalogue five themes warranting geographical analysis and global comparison in light of coronavirus: disruptions to supply chains (with implications for global production networks); domestic industrial capacity and the future of manufacturing; biosecuring industrial sites; precarious labour and work; and vernacular emergency response capacities within industrial communities. Amidst heightened geopolitical tensions, geographers reveal how industrial landscapes are contested. Logistical and biosecurity roles are enveloped by enduring infrastructural materialities, local histories, and regional legacies of skill and ingenuity.

Mid-Infrared Spectroscopy as a Rapid Tool to Qualitatively Predict the Effects of Species, Regions and Roasting on the Nutritional Composition of Australian Acacia Seed Species

In recent times, the popularity of adding value to under-utilized legumes have increased to enhance their use for human consumption. Acacia seed (AS) is an underutilized legume with over 40 edible species found in Australia. The study aimed to qualitatively characterize the chemical composition of 14 common edible AS species from 27 regions in Australia using mid-infrared (MIR) spectroscopy as a rapid tool. Raw and roasted (180 °C, 5, 7, and 9 min) AS flour were analysed using MIR spectroscopy. The wavenumbers (1045 cm⁻¹, 1641 cm⁻¹, and 2852–2926 cm⁻¹) in the MIR spectra show the main components in the AS samples. Principal component analysis (PCA) of the MIR data displayed the clustering of samples according to species and roasting treatment. However, regional differences within the same AS species have less of an effect on the components, as shown in the PCA plot. Statistical analysis of absorbance at specific wavenumbers showed that roasting significantly (p < 0.05) reduced the compositions of some of the AS species. The results provided a foundation for hypothesizing the compositional similarity and/or differences among AS species before and after roasting.

Hand Hygiene Behaviors in a Representative Sample of Polish Adolescents in Regions Stratified by COVID-19 Morbidity and by Confounding Variables (PLACE-19 Study): Is There Any Association?

The hand hygiene may possibly influence the course of the COVID-19 pandemic, but the multifactorial influence on hand hygiene knowledge and behaviors is proven. The aim of the study was to analyze hand hygiene behaviors in a national representative sample of Polish adolescents in regions stratified by COVID-19 morbidity, while taking socioeconomic status of the region, as well rural or urban environment, into account as possible interfering factors. The study was conducted Polish Adolescents’ COVID-19 Experience (PLACE-19) Study population (n = 2323) that was recruited based on a random sampling of schools, while the pair-matching procedure was applied within schools and age, in order to obtain adequate number of boys and girls, representative for the general Polish population (n = 1222). The participants were asked about their handwashing habits while using Handwashing Habits Questionnaire (HHQ) and about applied procedure of washing hands. The results were compared in subgroups that were stratified by region for COVID-19 morbidity, socioeconomic status of the region, and rural/urban environment. In regions of low COVID-19 morbidity, a higher share of adolescents, than in regions of high morbidity, declared washing their hands before meals (p = 0.0196), after meals (p = 0.0041), after preparing meals (p = 0.0297), before using the restroom (p = 0.0068), after using the restroom (p = 0.0014), after combing their hair (p = 0.0298), after handshaking (p = 0.0373), after touching animals (p = 0.0007), after contacting babies (p = 0.0278), after blowing nose (p = 0.0435), after touching sick people (p = 0.0351), and after cleaning home (p = 0.0234). For the assessed steps of the handwashing procedure, in regions of low COVID-19 morbidity, a higher share of adolescents included them to their daily handwashing, than in regions of high morbidity, that was stated for removing watch and bracelets (p = 0.0052), removing rings (p = 0.0318), and drying hands with towel (p = 0.0031). For the comparison in regions stratified by Gross Domestic Product, the differences were only minor and inconsistent. For the comparison in place of residence stratified by number of residents in city, there were some minor differences indicating better hand hygiene behaviors in the case of villages and small towns when compared with medium and large cities (p < 0.05). It may be concluded that, in a population-based sample of Polish adolescents, individuals from regions of low COVID-19 morbidity presented more beneficial hand hygiene habits than those from regions of high COVID-19 morbidity.

[РROBLEMS OF MEDICAL SERVICES EXPORT IN RUSSIA]

The relevance of the study is due to the fact that the export of medical services as one of the areas of the national project "Healthcare" is determined by the level of involvement of the constituent entities of the Russian Federation in the implementation of this project. The aim of the study is to identify how many medical institutions in Russia need qualified personnel for the export of medical services based on a survey of students in the educational cycle "Export of medical services" and an online survey. The analysis shows that at the moment, in medical institutions both in Moscow and the whole Russian Federation, there is a shortage of qualified managers in this area. 25 students of the educational cycle on the export of medical services were interviewed. 100% of the respondents do not know where to start exporting medical services and want to gain knowledge on promoting medical services in their organization. An online survey of 70 regions of the Russian Federation showed that representatives of medical organizations in 64 regions want to receive knowledge on this program, which is more than 90%, the remaining representatives of 6 regions gave not very specific answers. This is a serious problem hampering medical institutions to occupy their segment in the international market. The results of the study show that 100% of the respondents do not know where to start exporting medical services to a medical organization, they want to gain new knowledge and skills in the learning process in order to form their own project for their medical institution, to organize and promote medical services both for domestic and international market. All 25 respondents (100%) would like to receive new knowledge from specialists in this industry who know this problem from the inside, solving the key tasks step by step. The conditions associated with the COVID-19 epidemic make it possible to recommend medical organizations in Moscow and the constituent entities of the Russian Federation to implement the educational program in a remote format, providing for a regional component and methodological recommendations taking into account regional specifics.

Spatiotemporal dynamics of the COVID-19 pandemic in the arctic: early data and emerging trends

Since February 2020 the COVID-19 pandemic has been unfolding in the Arctic, placing many communities at risk due to remoteness, limited healthcare options, underlying health issues and other compounding factors. Preliminary analysis of available COVID-19 data in the Arctic at the regional (subnational) level suggests that COVID-19 infections and mortality were highly variable, but generally remained below respective national levels. Based on the trends and magnitude of the pandemic through July, we classify Arctic regions into four groups: Iceland, Faroe Islands, Northern Norway, and Northern Finland with elevated early incidence rates, but where strict quarantines and other measures promptly curtailed the pandemic; Northern Sweden and Alaska, where the initial wave of infections persisted amid weak (Sweden) or variable (Alaska) quarantine measures; Northern Russia characterised by the late start and subsequent steep growth of COVID-19 cases and fatalities and multiple outbreaks; and Northern Canada and Greenland with no significant proliferation of the pandemic. Despite limitations in available data, further efforts to track and analyse the pandemic at the pan-Arctic, regional and local scales are crucial. This includes understanding of the COVID-19 patterns, mortality and morbidity, the relationships with public-health conditions, socioeconomic characteristics, policies, and experiences of the Indigenous Peoples.

Data used in this paper are available at https://arctic.uni.edu/arctic-covid-19.

Qualitative and Quantitative Analysis of Regional Cerebral Free Fatty Acids in Rats Using the Stable Isotope Labeling Liquid Chromatography-Mass Spectrometry Method

Free fatty acids serve as important bioactive molecules in the brain. They are involved in message transfer in the brain. There are many reports available in the literature regarding the role of cerebral fatty acids in message transfer; however, most of the studies are mainly focused on limited fatty acid species or only a few specific brain regions. To understand the relationship between cerebral functions and free fatty acids, it is necessary to investigate the distribution of the free fatty acids among different regions in the whole brain. In this study, free fatty acids were extracted from different brain regions and analyzed qualitatively and quantitatively using the stable isotopic labeling liquid chromatography–mass spectrometry approach. In total, 1008 potential free fatty acids were detected in the whole brain out of which 38 were found to be commonly present in all brain regions. Among different brain regions, the highest and the smallest amounts of potential free fatty acids were detected in the olfactory bulb and cerebellum, respectively. From a statistical point of view, 4-methyl-2-oxovaleric acid, cis-11, 14-eicosadienoic acid, tridecanoic acid, myristic acid, nonadecanoic acid, and arachidic acid were found to significantly vary among the four different brain regions (olfactory bulb, occipital lobe, hippocampus, and cerebellum). The variation in the composition of free fatty acids among different brain regions may be very important for investigating the relationship between free fatty acids and functions of cerebral regions.

Surveillance of Antibiotic Resistance of Maltose-Negative Staphylococcus aureus in South African Dairy Herds

Antibiotic resistance has been reported since the 1940s in both human and veterinary medicine. Many years of monitoring milk samples in South Africa led to identification of a novel maltose-negative Staphylococcus aureus (S. aureus) strain, which appears to be an emerging pathogen. In this study, the susceptibility of this strain to antibiotics was evaluated over time, during diverse seasons in various provinces and according to somatic cell count (SCC) categories. A data set of 271 maltose-negative S. aureus isolates, from milk samples of 117 dairy herds, was examined using the disk diffusion method, between 2010 and 2017. This study also compared the susceptibility testing of 57 maltose-negative and 57 maltose-positive S. aureus isolated from 38 farms, from three provinces using minimum inhibitory concentration (MIC). The MIC results for the maltose-negative S. aureus isolates showed highest resistance to ampicillin (100%) and penicillin (47.4) and lowest resistance (1.8%) to azithromycin, ciprofloxacin and erythromycin. The maltose-negative S. aureus isolates showed overall significantly increased antibiotic resistance compared to the maltose-positive strains, as well as multidrug resistance. Producers and veterinarians should consider probability of cure of such organisms (seemingly non-chronic) when adapting management and treatment, preventing unnecessary culling.

Correlations between interictal extratemporal spikes and clinical features, imaging characteristics, and surgical outcomes in patients with mesial temporal lobe epilepsy

PURPOSE

The significance of interictal epileptiform discharges (IEDs) observed in the extratemporal lobe has not been fully evaluated in patients with mesial temporal lobe epilepsy (MTLE). This study aimed to evaluate the surgical outcomes, clinical features, and functional neuroimaging characteristics of patients in relation to the presence or absence of extratemporal IED in MTLE with hippocampal sclerosis (HS).

METHODS

A total of 165 patients with HS-induced MTLE who had undergone anterior temporal lobectomy were enrolled and stratified into the extratemporal interictal epileptiform discharges (ETD) and the temporal lobe discharges (TD) groups. We analyzed the differentiating features of pre- and postsurgical evaluation data between the two groups. For outcome assessment, only patients with a follow-up of at least 2 years were enrolled, and the outcomes were classified based on Engel classification.

RESULTS

The ETD group showed extensive glucose hypometabolism involving the temporal lobe and extratemporal regions (p < 0.001), and IEDs were observed bilaterally or contralateral to the ictal focus (p = 0.02). However, there was no difference in the surgical outcomes between the two groups. On multivariate analysis, statistically significant variables related to ETD occurrence including seizure onset age were not identified nevertheless.

CONCLUSION

Our results indicate that ETD had a surgical outcome comparable to that of TD. Therefore, a surgical intervention need not be delayed even if extratemporal IED may be found in presurgical long-term scalp EEG monitoring.

Eyes Outside a Boundary Line: An Example of the Willats Region-Drawing Theory?

A puzzling raised-line drawing of a head by a blind man with no experience in freehand drawing has eyes placed outside the boundary line of the head, not inside. After scribbling, in the John Willats theory of drawing development, 2D "regions" on the page stand for 3D "volumes" in the scene. If Willats is correct, in very early drawing development circles touching the boundary line from outside may show the eyes are "embedded," and very early drawing development may be similar in the blind and sighted.

The Gender Gap in Reaching "Old Age" in the Russian Federation: A Regional Approach

Reaching older age and longevity in later life is determined by health and mortality across the life course. In the case of Russia, the history of high male mortality skews the interaction between population aging and gender. These differentials can be viewed through a spatial lens in order to both understand their causes, and to better determine policy responses, especially in a federal political system. Using alternative conceptualizations of the "boundary to old age", we produce the first estimates of the gender gap in reaching "old age" for all Russian Federal Subjects using 2017 data. We identify some regional differentiations, but uncertainties around the consistency of registration as well as overall heterogeneity mean that clear-cut regional patterns are hard to ascribe. Our analysis shows the highly significant gender gap at the age of "becoming old" in Russia when disaggregated by region. When looking at the regional level and comparing to other countries, the range of male "boundaries to old age" is almost as great as the global range. We argue that when applying alternative "old-age thresholds", this gap represents a more accurate representation of interaction between space, gender, and mortality in Russia. We conclude with policy and research priorities to better understand and ameliorate the drivers of these spatial and gendered inequalities.

Understanding Differences in Cancer Survival between Populations: A New Approach and Application to Breast Cancer Survival Differentials between Danish Regions

Large variations in cancer survival have been recorded between populations, e.g., between countries or between regions in a country. To understand the determinants of cancer survival differentials between populations, researchers have often applied regression analysis. We here propose the use of a non-parametric decomposition method to quantify the exact contribution of specific components to the absolute difference in cancer survival between two populations. Survival differences are here decomposed into the contributions of differences in stage at diagnosis, population age structure, and stage-and-age-specific survival. We demonstrate the method with the example of differences in one-year and five-year breast cancer survival between Denmark’s five regions. Differences in stage at diagnosis explained 45% and 27%, respectively, of the one- and five-year survival differences between Zealand and Central Denmark for patients diagnosed between 2008 and 2010. We find that the introduced decomposition method provides a powerful complementary analysis and has several advantages compared with regression models: No structural or distributional assumptions are required; aggregated data can be used; and the use of absolute differences allows quantification of the survival that could be gained by improving, for example, stage at diagnosis relative to a reference population, thus feeding directly into health policy evaluation.

Climatic and regional antibiotic resistance patterns of Staphylococcus aureus in South African dairy herds

South Africa is a large country of approximately 1.22 million km2, made up of nine provinces with three climatic zones. Farming in the country is mostly defined by regional differences. Of the different organisms isolated from milk samples of dairy cows, Staphylococcus aureus poses a challenge to maintain udder health and wholesome dairy products for human consumption. Antibiotic resistant bacteria are therefore a potential health hazard. The objective of this study was to investigate the seasonal and regional relationships of antibiotic resistance of S. aureus, of which little is known. This study was undertaken to evaluate a data set of 3410 S. aureus isolates, taken from milk samples with a somatic cell count of > 400 000 cells/mL from commercial dairy herds. These isolates were tested for antimicrobial susceptibility using the Kirby Bauer method for ampicillin, cloxacillin, penicillin G, clindamycin, oxy-tetracycline, cephalexin, cefuroxime and tylosin. The samples were from 830 dairy herds, out of the estimated 2000 commercial dairy herds in South Africa. All the antibiotics tested, except for cephalosporins, showed a predicted prevalence of resistance of above 50% in most provinces, which is a concern. The lowest prevalence of resistance to the majority of the categories of antibiotics tested was present in KwaZulu-Natal during spring. The cephalosporins had the lowest levels of prevalence of bacterial resistance in Gauteng during winter. Resistance patterns of S. aureus to the eight antibiotics varied in the different seasons and provinces, possibly because of different weather conditions, and the action and spectrum of antibiotics.

High-resolution analysis of the HLA-A, -B, -C and -DRB1 alleles and national and regional haplotype frequencies based on 120 926 volunteers from the Italian Bone Marrow Donor Registry

HLA genes are highly polymorphic and structurally complex. They are located in the major histocompatibility complex (MHC) on chromosome 6, and the frequency of alleles and haplotypes varies widely among human populations. In this paper, we calculated the allele and haplotype frequencies using the HLA data of more than 120 000 Italian unrelated bone marrow donors enrolled in the national registry (IBMDR) and typed them with a high-resolution (HR) method for the HLA-A, -B, -C and -DRB1 alleles. The allele frequency data were obtained by manual counting; haplotype frequencies were calculated using the expectation maximisation (EM) algorithm. The total numbers of observed alleles were 226 for HLA-A, 343 for HLA-B, 201 for HLA-C and 210 for HLA-DRB1, which account for 5.4%, 6.7%, 5.2% and 8.5%, respectively, of each locus allele (IPD-IMGT/HLA Database Release 3.32, April 2018). The three most frequent Italian haplotypes were HLA-A*01:01~B*08:01~C*07:01~DRB1*03:01 (2.5%), A*02:01~B*18:01~C*07:01~DRB1*11:04 (1.1%) and A*30:01~B*13:02~C*06:02~DRB1*07:01 (1.1%). Moreover, for a relevant subset of the examined population (>100 000 individuals), the birthplace was available, and thus, we grouped the frequency data based on the corresponding Italian geographic areas, describing the HLA specificity of the Italian regional populations. The haplotype frequencies were also compared between national and regional data, and we observed remarkable differences in the regional haplotype frequencies, particularly in Sardinia. This study represents a valid tool to identify a more efficient haematopoietic stem cell unrelated donor recruitment and selection strategy, as well as for population genetic and HLA-disease association fields.

Regional variation in courage and entrepreneurship: The contrasting role of courage for the emergence and survival of start-ups in the United States

OBJECTIVE

There is growing evidence that certain regional personality differences function as important drivers of regional economic development (e.g., via effects on entrepreneurship and innovation activity). The present investigation examines the impact that regional variation in the trait courage has on entrepreneurship.

METHOD

Using data from a new large-scale internet-based study, we provide the first psychological map of courage across the United States (N = 390,341 respondents from 283 U.S. metropolitan regions). We apply regression analyses to relate regional courage scores to archival data on the emergence and survival of start-ups across American regions.

RESULTS

Our mapping approach reveals comparatively high levels of regional courage in the Eastern and Southern regions of the United States. Regional courage scores were positively related to entrepreneurial activity, but negatively related to start-up survival-even when controlling for a wide variety of standard economic predictors. Several robustness checks corroborated these results. Finally, regional differences in economic risk-taking accounted for significant proportions of variance in the relationship between regional courage and entrepreneurship.

CONCLUSION

Our results suggest that regional courage may contribute to a pattern of enterprising and also risky economic behavior, which can lead to high levels of entrepreneurial activity but also shorter start-up survival.

Availability of health workforce in urban and rural areas in relation to Canadian seniors

Geographic imbalances in health human resources exist in a health care system when the composition, level, or use of health care providers does not lead to the same optimal health-system goals in all regions. This can lead to inequitable distribution of health care services, particularly for rural and remote populations. This study aims to determine to what extent the distribution of regulated health professionals and seniors in urban and rural areas of the Canadian jurisdictions is different from one another and from the national average. Data used in this study are for the 2016 calendar year. Information about physicians was obtained from the Canadian Institute for Health Information (CIHI) Scott's Medical Database. The data for nurses (nurse practitioners, registered nurses, and licensed practical nurses) were also sourced from CIHI, Health Workforce Database. Geographic information is based on the postal code of physicians' preferred mailing address, and the residence in the case of nurses and the population. Using the Statistical Area Classification from Statistics Canada, each physician and nurse was assigned to either an urban metropolitan, urban non-metropolitan, or rural/remote area. Findings indicate that there were twice as many nurses per 1000 seniors in urban Canada than in rural Canada. However, this gap was threefold in the case of physicians. Provinces with the largest and lowest gap and international comparisons are also provided. Three broad strategies are offered for policymakers in order to mitigate this health workforce imbalance and reduce the regional shortage of nurses and physicians.

Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity

Polycystic ovarian syndrome (PCOS) is thought to be the most common endocrine disorder found in women. Common symptoms include irregular menstrual cycle, polycystic ovaries, and hirsutism, as well as an increased risk for a multitude of conditions, including insulin resistance, dyslipidemia and infertility. The prevalence of polycystic ovarian syndrome is generally thought to be between 3% and 10% but it is widely unknown for specific subpopulations based on geographical location and race/ethnicity. Based on the high degree of variability and inconsistencies between the different diagnostic criteria, there is a unique challenge that exists when determining the prevalence of this syndrome. There are a large percentage of individuals that remain undiagnosed even after visiting multiple health care providers. Most studies conducted across the world are limited by small sample size, selection bias, and lack of comparability across studies. There have been very few studies that have examined the prevalence of polycystic ovary syndrome across the United States. Based on the National Institutes of Health (NIH)’s diagnostic criteria, there is a similar prevalence of PCOS documented across the United States, the United Kingdom, Spain, Greece, Australia, and Mexico. Other studies have shown some differences between geographical location and race. The existing data is not conclusive enough to determine whether or not there is any significant differences in the prevalence of PCOS across geographical location, racial or ethnic groups. This review will seek to determine the prevalence of polycystic ovarian syndrome based on geographical location and race/ethnicity.

A Quality Control Study of the Adherence to Recommended Physiological Targets for the Management of Brain-Dead Organ Donors in South Australian Intensive Care Units

BACKGROUND

The Australian and New Zealand Intensive Care Society and the Australasian Transplant Coordinators Association provide recommendations on the physiological management of brain-dead donors.

PROBLEM STATEMENT

How often physiological targets are prescribed for brain-dead donors in Australian intensive care units (ICUs), and how well these compare to recommended targets is unknown. It is also unknown how often recommended targets are achieved, irrespective of prescribed targets.

METHODS

We performed a retrospective, observational quality control study in 81 adult (>18 years) brain-dead donors to describe how often physiological targets were prescribed, comparing these to current guidelines. We determined the proportion of observations within the recommended target range, irrespective of any prescribed target. We aimed to identify poor adherence to recommended targets to guide future quality improvement initiatives.

OUTCOMES

Seventy-four (91%) donors had at least 1 prescribed physiological target written on the ICU chart, with a median of 2 (range 2-5), and a maximum of 13 targets. Prescribed targets appeared to adhere well with recommended targets. Most recommended physiological targets were met irrespective of any prescribed target. However, one-quarter of serum sodium observations and one-third of blood glucose levels were above the recommended target.

IMPLICATIONS FOR PRACTICE

Quality improvement initiatives are required to improve the prescription of physiological targets in brain-dead donors in South Australia. Serum sodium and serum glucose targets were not met. However, this most likely reflects the need for current guidelines to be updated in line with current evidence.

Upper Urinary Tract Urothelial Cancer in Croatian and Bosnian Endemic Nephropathy Regions

Objectives

Endemic nephropathy (EN) is a chronic tubulointerstitial renal disease associated with increased incidence of upper urinary tract urothelial cancer (UTUC) occurring predominantly in geographically limited areas in villages along big Danube river. Based on results obtained by the research it is confirmed that aristolochic acid is causative agent of endemic nephropathy (EN).

Aim

The aim of this study was to determine characteristics of UTUC in two endemic areas and analyze trends in 5-year period.

Methods

This study included all patients with UTUC with or without synchronous/metachronous urothelial cancer in urinary bladder, from Croatian and Bosnian EN and non-EN regions. We analyzed archival data bases from all patients with UTUC who were admitted and operated in Department for surgery and urology, General Hospital Josip Bencevic Slavonski Brod in the time period between 2005 and 2010. Analyzed groups of patients were divided and compared as EN group (that includes patients from Croatian and Bosnian EN region) and non-EN group (that includes patients from Croatian and Bosnian non-EN region). All surgical specimens were processed according to standardized pathological procedures.

Results

Comparing patients basic characteristics from Croatian and Bosnian EN region there was no significant difference in gender (females were more frequently affected in both EN regions, p=0.99) or age (p=0.43) of patients. We found higher blood levels of urea and creatinine in group of patients from Croatian EN region when compared with group of patients from Bosnian EN region but the difference was not statistically significant (p=0.79 and p=0.44, respectively). In patients from Croatian EN group Hemoglobin levels were significantly lower than levels from Bosnian EN region patients, p=0.0049. In group of patients from Bosnian EN region ureteral tumors were more frequently observed than in Croatian group of patients, when compared with renal pelvis tumors but the difference was not statistically significant (p=0.258).

Conclusion

Our data showed some differences in tumor localization between to investigated, relatively nearly situated, EN regions in Croatia and Bosnia. Statistically significant difference in hemoglobin levels between Croatian and Bosnian EN regions that should be further analyzed to give some reasonable explanation.