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20user guide

20user guide




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Loan No. 42486-IND: Madhya Pradesh Urban Services Improvement Program [MPUSIP 6D REBIDDING]




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Shandong Qixia Ecological Function Conservation Demonstration Project

Extending across seven provinces and two autonomous regions, the Yellow River Ecological Corridor (YREC) comprises the second largest river basin in the People's Republic of China (PRC) with a population of 120 million. The basin is critical for food security yet faces complex ecological and environmental challenges. The region suffers from severe water scarcity, impacts from climate change and environmentally unsustainable development.




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Integrated Services and Livelihood for Displaced People from Myanmar and Host Communities Improvement Project

The project will continue the support of the Asian Development Bank (ADB) to Bangladesh in managing the influx of around one million displaced people from Myanmar (DPFM) since 2017. Now a protracted situation, the crisis is putting significant pressure on infrastructure and causing substantial challenges in terms of food, shelter, health, security, water, sanitation, and other services in the DPFM camps and host communities.




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Climate-smart Health Services System Enhancement Project

The project will be aligned with the following impacts: (i) modern public health service system ensuring well-being of all Thais in an effective, fair, sufficient, and sustainable manner developed; and (ii) UHC, including access to essential health care services, sustained. The outcome is: access to quality public hospital services by all in selected provinces improved.




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Almaty–Bishkek Economic Corridor Regional Improvement of Border Services Project

The project will build and equip 3 climate-resilient and energy-efficient border crossing points (BCP) between the Kyrgyz Republic and Kazakhstan on the Kyrgyz side of the border and a training center for the Kyrgyz Border Service (the project EA). The project with the total loan and grant financing of $37 Million will help facilitate trade and tourism between the Kyrgyz Republic and Kazakhstan and will contribute to the sustainable economic development along the Almaty-Bishkek Economic Corridor.




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Climate Resilient Urban Services Project – Tham Luong Ben Cat

The project will support Ho Chi Minh City People's Committee and their government to finance sound wastewater and drainage system in the remaining catchments, thereby strengthening its foundation as the socioeconomic growth pole of southern Viet Nam. The impact of the project will be improved surface water quality and drainage capacity in HCMC. The outcome will be increased wastewater and drainage collection and treatment capacity in key catchments in HCMC.




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Climate-Resilient Water and Sanitation Services Project

Project objectives. The proposed project will assist the government in addressing climate vulnerabilities and enhancing public health and economic conditions by ensuring inclusive access to safe, reliable, climate-resilient, and sustainable WSS services for the residents of Andijan, Djizzak and Fergana provinces; and the Republic of Karakalpakstan. The project will help upgrade and expand the WSS infrastructure in the project regions and support regional suvtaminots in implementing transformational changes.




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Stunningly preserved pterosaur fossils reveal how they soared

The largest pterosaurs, ancient reptiles that were the first vertebrates to master flight, may have mostly soared while smaller ones flapped their wings, a pattern that persists in today's birds




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Some fish regrow injured fins and we’re closer to understanding how

Unravelling the complex biological process that allows fish to regrow injured fins could help advance regenerative medicine in humans




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Paramotorists collect rare plant species from Peruvian desert oases

Kew scientists use paramotorists to collect rare plant species from Peruvian desert oases




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Preserved tracks suggest non-avian dinosaurs used their wings to run

Not all winged dinosaurs were necessarily capable of full flight, but this anatomical feature may have enabled them to travel further by flapping or gliding




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We are closer than ever to finally proving the multiverse exists

One hundred years ago, we discovered there were other galaxies beyond our own. Now, we might be on the verge of another discovery: that there are other universes




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Doughnut-shaped swirls of laser light can be used to transmit images

Ultra-fast pulses of laser light can be shaped into vortices similar to smoke rings – when chained together, they can carry enough information to transmit a simple image




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X-ray laser fires most powerful pulse ever recorded

The Linac Coherent Light Source in California fired an X-ray pulse that lasted only a few hundred billionths of a billionth of a second but carried nearly a terawatt of power




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We are closer than ever to finally proving the multiverse exists

One hundred years ago, we discovered there were other galaxies beyond our own. Now, we might be on the verge of another discovery: that there are other universes




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Laser helps turn an electron into a coil of mass and charge

Researchers have reshaped single electrons into spiralling matter waves with distinct handedness that could be used to study and control materials




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Gold hydrogen: Is there a huge reserve of clean fuel in Earth's crust?

Geologists think there may be vast natural stores of hidden hydrogen gas within Earth, but no one is sure how much there is or how much could be recovered for energy




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Ocean thunderstorms generate the most intense lightning ever observed

An analysis of satellite observations has identified some extreme thunderstorms over the Indian Ocean and Gulf of Mexico with lightning flashes so frequent that the sky would appear continuously lit




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Striking image shows well-preserved wreck of Shackleton’s doomed ship

Endurance sank beneath the ice during Ernest Shackleton’s legendary Antarctic expedition. More than a hundred years later, researchers document their own saga of how they found the vessel




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Striking image shows well-preserved wreck of Shackleton’s doomed ship

Endurance sank beneath the ice during Ernest Shackleton’s legendary Antarctic expedition. More than a hundred years later, researchers document their own saga of how they found the vessel




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Human brains have been mysteriously preserved for thousands of years

Intact human brains 12,000 years old or more have been found in unexpected places such as shipwrecks and waterlogged graves, but it is unclear what preserved them




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Amazingly preserved Bronze Age village reveals life in ancient England

A settlement in the east of England burned down in a fire 3000 years ago, falling into a muddy waterway that preserved everything inside the houses including tools, fabric, cooking pots and more




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Ancient humans lived inside a lava tube in the Arabian desert

Underground tunnels created by lava flows provided humans with shelter for thousands of years beneath the hot desert landscape of Saudi Arabia




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AI discovers hundreds of ancient Nazca drawings in Peruvian desert

Archaeologists have used AI to discover hundreds of large-scale drawings depicting figures like llamas, decapitated human heads and killer whales armed with knives




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Study Links Gene to Serious Eye Disease

Title: Study Links Gene to Serious Eye Disease
Category: Health News
Created: 8/25/2010 6:10:00 PM
Last Editorial Review: 8/26/2010 12:00:00 AM




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Some Antibiotics Linked to Serious Nerve Damage

Title: Some Antibiotics Linked to Serious Nerve Damage
Category: Health News
Created: 8/28/2013 11:00:00 AM
Last Editorial Review: 8/28/2013 12:00:00 AM




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Could a Laser Skin Test Someday Replace Biopsy to Spot Melanoma?

Title: Could a Laser Skin Test Someday Replace Biopsy to Spot Melanoma?
Category: Health News
Created: 8/21/2015 12:00:00 AM
Last Editorial Review: 8/24/2015 12:00:00 AM




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Scientists Get Closer to Long-Lasting Flu Vaccine

Title: Scientists Get Closer to Long-Lasting Flu Vaccine
Category: Health News
Created: 8/24/2015 12:00:00 AM
Last Editorial Review: 8/25/2015 12:00:00 AM




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Serious Heart Problem a Family Matter

Title: Serious Heart Problem a Family Matter
Category: Health News
Created: 8/25/2016 12:00:00 AM
Last Editorial Review: 8/25/2016 12:00:00 AM




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Serious Reactions to Vaccines Rarely Recur: Review

Title: Serious Reactions to Vaccines Rarely Recur: Review
Category: Health News
Created: 8/28/2017 12:00:00 AM
Last Editorial Review: 8/28/2017 12:00:00 AM




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Serious Problems at Florida Stem Cell Clinic

Title: Serious Problems at Florida Stem Cell Clinic
Category: Health News
Created: 8/29/2017 12:00:00 AM
Last Editorial Review: 8/29/2017 12:00:00 AM




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FDA Warns of Serious Genital Infection With Diabetes Meds

Title: FDA Warns of Serious Genital Infection With Diabetes Meds
Category: Health News
Created: 8/30/2018 12:00:00 AM
Last Editorial Review: 8/30/2018 12:00:00 AM




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Even at Low Levels, Toxic Metals Put Heart at Serious Risk: Study

Title: Even at Low Levels, Toxic Metals Put Heart at Serious Risk: Study
Category: Health News
Created: 8/30/2018 12:00:00 AM
Last Editorial Review: 8/30/2018 12:00:00 AM




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How to Make a Richer, Healthier Chocolate Dessert

Title: How to Make a Richer, Healthier Chocolate Dessert
Category: Health News
Created: 8/27/2019 12:00:00 AM
Last Editorial Review: 8/27/2019 12:00:00 AM




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Every Sudden Infant Death Deserves a Closer Look: Report

Title: Every Sudden Infant Death Deserves a Closer Look: Report
Category: Health News
Created: 8/26/2019 12:00:00 AM
Last Editorial Review: 8/27/2019 12:00:00 AM




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Conservative Talk Show Host Who Railed Against Vaccines Dies of COVID

Title: Conservative Talk Show Host Who Railed Against Vaccines Dies of COVID
Category: Health News
Created: 8/23/2021 12:00:00 AM
Last Editorial Review: 8/23/2021 12:00:00 AM




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AHA News: Star Wrestler-Turned-Coach Discovers Serious Heart Problem at 24

Title: AHA News: Star Wrestler-Turned-Coach Discovers Serious Heart Problem at 24
Category: Health News
Created: 8/24/2021 12:00:00 AM
Last Editorial Review: 8/24/2021 12:00:00 AM




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Bedsores Can Cause Serious Harm — Are U.S. Nursing Homes Hiding Cases?

Title: Bedsores Can Cause Serious Harm — Are U.S. Nursing Homes Hiding Cases?
Category: Health News
Created: 8/17/2022 12:00:00 AM
Last Editorial Review: 8/18/2022 12:00:00 AM




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Pot Users Are Less Prone to Sinus Problems

Title: Pot Users Are Less Prone to Sinus Problems
Category: Health News
Created: 8/1/2022 12:00:00 AM
Last Editorial Review: 8/2/2022 12:00:00 AM




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How Do I Increase Serotonin?

Title: How Do I Increase Serotonin?
Category: Diseases and Conditions
Created: 5/24/2021 12:00:00 AM
Last Editorial Review: 7/5/2022 12:00:00 AM




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Evidence-based management of symptoms in serious respiratory illness: what is in our toolbox?

Extract

Living with a respiratory illness requires patients to manage a wide range of symptoms, many of which will worsen as a disease progresses. Breathlessness is a hallmark feature of respiratory conditions, occurring in almost all individuals with COPD and interstitial lung disease (ILD) [1, 2]. Cough is present in 78% of people with ILD and is frequently distressing, with physical, social and emotional impacts [1, 3].




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Treating central sleep apnoea in heart failure: is positive airway pressure and adaptive servo-ventilation in particular the gold standard?

Extract

We read with great interest the review article by Randerath et al. [1] recently published in the European Respiratory Review. We would like to congratulate the authors on this clearly structured review, which emphasises the urgent need for an increasingly differentiated view of central sleep apnoea (CSA) in the context of precision medicine.




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Multicomponent services for symptoms in serious respiratory illness: a systematic review and meta-analysis

Background

People living with serious respiratory illness experience a high burden of symptoms. This review aimed to determine whether multicomponent services reduce symptoms in people with serious illness related to respiratory disease.

Methods

Electronic databases were searched to identify randomised controlled trials (RCTs) evaluating multicomponent services that enrolled patients due to symptoms, rather than underlying disease, and provided at least one nonpharmacological intervention. The primary outcome was chronic breathlessness and secondary outcomes were health-related quality of life (HRQoL), cough, fatigue and adverse events. At least two authors independently screened studies, assessed risk of bias and extracted data.

Results

Five RCTs, involving 439 patients, were included. In comparison to usual care, multicomponent services improved breathlessness mastery (Chronic Respiratory Questionnaire (CRQ) mastery scale, mean difference (MD) 0.43 points, 95% CI 0.20–0.67, three RCTs, 327 participants) and HRQoL (CRQ total score, MD 0.24 points, 95% CI 0.04–0.40, two RCTs, 237 participants). Fatigue did not improve with multicomponent services and no studies evaluated cough. No serious adverse events were reported. The one study evaluating mortality found increased survival in those accessing a multicomponent service. The certainty of evidence was very low, mainly due to detection and reporting bias.

Conclusion

Multicomponent services improve breathlessness mastery and HRQoL, with minimal risk. These findings support the use of multicomponent symptom-directed services for people living with serious respiratory illness.




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The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review

Background

In adults with serious respiratory illness, fatigue is prevalent and under-recognised, with few treatment options. The aim of this review was to assess the impact of graded exercise therapy (GET) on fatigue in adults with serious respiratory illness.

Methods

Electronic databases were searched to identify randomised controlled trials (RCTs) testing GET (involving incremental increases in exercise from an established baseline) in adults with serious respiratory illness. The primary outcome was fatigue and secondary outcomes were health-related quality of life (HRQoL) and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data.

Results

76 RCTs were included with 3309 participants, most with a diagnosis of COPD or asthma. Reductions in fatigue measured by the Chronic Respiratory Disease Questionnaire fatigue domain score were demonstrated following GET consisting of aerobic with/without resistance training (mean difference (MD) 0.53 points, 95% CI 0.41–0.65, 11 RCTs, 624 participants) and GET using resistance training alone (MD 0.58 points, 95% CI 0.21–0.96, two RCTs, 82 participants) compared with usual care. Although the mean effect exceeded the minimal important difference, the lower end of the confidence intervals did not always exceed this threshold so the clinical significance could not be confirmed. GET consistently improved HRQoL in people with a range of chronic respiratory diseases on multiple HRQoL measures. No serious adverse events related to GET were reported.

Conclusion

GET may improve fatigue alongside consistent improvements in HRQoL in people with serious respiratory illness. These findings support the use of GET in the care of people with serious respiratory illness.




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Breathing techniques to reduce symptoms in people with serious respiratory illness: a systematic review

Background

In adults with serious respiratory illness, breathlessness is prevalent and associated with reduced health-related quality of life. The aim of this review was to assess the impact of breathing techniques on breathlessness in adults with serious respiratory illness.

Methods

Electronic databases were searched to identify randomised controlled trials testing breathing techniques (techniques that aim to alter the respiratory pattern, excluding respiratory muscle training) in people with serious respiratory illness. The primary outcome was breathlessness and secondary outcomes were health-related quality of life and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data.

Results

73 randomised controlled trials were included with 5479 participants, most with COPD or asthma. Breathing exercises (pursed lip and/or diaphragmatic breathing) reduced breathlessness measured by the modified Medical Research Council scale compared to usual care (mean difference (MD) –0.40 points, 95% CI –0.70– –0.11, eight studies, n=323), although the effect did not exceed the minimal important difference. Yoga breathing also improved modified Medical Research Council score compared to usual care (MD –1.05 points, 95% CI –2.45–0.35, three studies, n=175). Breathing techniques consistently improved health-related quality of life in people with COPD and asthma on multiple health-related quality of life measures in comparison to usual care, with effects that generally exceeded the minimal important difference. No adverse events related to breathing techniques were reported.

Conclusion

Breathing techniques may improve breathlessness, and consistently improve health-related quality of life, in people with serious respiratory illness. These findings support the use of breathing exercises in the care of people with serious respiratory illness.




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Opioids for the palliation of symptoms in people with serious respiratory illness: a systematic review and meta-analysis

Background

People living with serious respiratory illness experience a high burden of distressing symptoms. Although opioids are prescribed for symptom management, they generate adverse events, and their benefits are unclear.

Methods

We examined the efficacy and safety of opioids for symptom management in people with serious respiratory illness. Embase, MEDLINE and the Cochrane Central Register of Controlled Trials were searched up to 11 July 2022. Reports of randomised controlled trials administering opioids to treat symptoms in people with serious respiratory illness were included. Key exclusion criteria included <80% of participants having a nonmalignant lung disease. Data were extracted regarding study characteristics, outcomes of breathlessness, cough, health-related quality of life (HRQoL) and adverse events. Treatment effects were pooled using a generic inverse variance model with random effects. Risk of bias was assessed using the Cochrane Risk of Bias tool version 1.

Results

Out of 17 included trials, six were laboratory-based exercise trials (n=70), 10 were home studies measuring breathlessness in daily life (n=788) and one (n=18) was conducted in both settings. Overall certainty of evidence was "very low" to "low". Opioids reduced breathlessness intensity during laboratory exercise testing (standardised mean difference (SMD) –0.37, 95% CI –0.67– –0.07), but not breathlessness measured in daily life (SMD –0.10, 95% CI –0.64–0.44). No effects on HRQoL (SMD –0.42, 95% CI –0.98–0.13) or cough (SMD –1.42, 95% CI –3.99–1.16) were detected. In at-home studies, opioids led to increased frequency of nausea/vomiting (OR 3.32, 95% CI 1.70–6.51), constipation (OR 3.08, 95% CI 1.69–5.61) and drowsiness (OR 1.37, 95% CI 1.01–1.86), with serious adverse events including hospitalisation and death identified.

Conclusions

Opioids improved exertional breathlessness in laboratory exercise studies, but did not improve breathlessness, cough or HRQoL measured in daily life at home. There were significant adverse events, which may outweigh any benefits.




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Prevalence of Dental Caries and Utilization of Dental Services among WIC-participating Children: A scoping review

Purpose Low-income children experience disproportionately high rates of dental caries and challenges in accessing dental care compared to their higher-income peers. The purpose of this scoping review was to examine the prevalence of dental caries and dental service utilization among Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrolled children.Methods The literature search and review were conducted between September 2023 and February 2024. The review followed the PRISMA-ScR reporting guidelines and included three databases: PubMed, CINAHL, and Dentistry & Oral Sciences Source. The study focused on children aged one to five participating in WIC within the United States (US) and aimed to determine the prevalence of dental service utilization and dental caries in the targeted population.Results This review includes twelve articles that are quantitative observational studies conducted from February 2001 to February 2023. Most of the studies were conducted in WIC programs in the Southern and Midwest regions of the US. Dental caries rates decreased by 61.8% from 2004 to 2016, with the highest prevalence in 2004, and the lowest prevalence in 2016. Dental service utilization among WIC children increased by 56.9% from 1992 to 2020.Conclusion There has been an increase in dental service utilization among WIC-enrolled children, with an overall decrease in dental caries over the last two decades. However, the prevalence of dental caries remains disproportionately high for children enrolled in WIC when compared to non-participants. To develop effective dental interventions for children enrolled in WIC, it is fundamental to identify the unique determinants of dental caries in this population.




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Characterizing the Distribution of a Stimulator of Interferon Genes Agonist and Its Metabolites in Mouse Liver by Matrix-Assisted Laser Desorption/Ionization Imaging Mass Spectrometry [Special Section on New and Emerging Areas and Technologies in Drug Met

A STING (stimulator of interferon genes) agonist GSK3996915 under investigation in early discovery for hepatitis B was orally dosed to a mouse model for understanding the parent drug distribution in liver, the target organ. Matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) was used to quantify the distribution of GSK3996915 in liver collected from mice administered a single oral dose at 90 mg/kg. GSK3996915 was detected with a zonal distribution localized in the portal triad and highly concentrated in the main bile ducts, indicating clearance through biliary excretion. High spatial resolution imaging showed the distribution of the parent drug localized to the cellular populations in the sinusoids, including the Kupffer cells. Additionally, a series of drug-related metabolites were observed to be localized in the central zones of the liver. These results exemplify the potential of utilizing MALDI IMS for measuring not only quantitative drug distribution and target exposure but also drug metabolism and elimination in a single suite of experiments.

SIGNIFICANCE STATEMENT

An integrated imaging approach utilizing matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI IMS) complemented with immunohistochemistry (IHC) and histology was used to address the question of target exposure at the cellular level. Localized quantification of the parent drug in the target organ and identification of potential metabolites in the context of tissue histology were also achieved in one experimental suite to support characterization of pharmacokinetic properties of the drug in the early discovery stage.:




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Maturity Assessment of the Health Information System Using Stages of Continuous Improvement Methodology: Results From Serbia

ABSTRACTIntroduction:Since the health information system (HIS) in public health care services in Serbia was introduced in 2009, it has gradually expanded. However, it is unclear how well the HIS components have developed and the whole system’s stage of maturity.Method:In June–September 2021, a maturity assessment of the Serbian HIS was conducted for the first time using the HIS Stages of Continuous Improvement (SOCI) toolkit. The toolkit measures HIS status across 5 HIS domains: leadership and governance, management and workforce, information and communication technology (ICT), standards and interoperability, and data quality and use. The domains were further divided into 13 components and 39 subcomponents whose maturity stage was assessed on a 5-point Likert scale, indicating the level of development: (1) emerging/ad hoc; (2) repeatable; (3) defined; (4) managed; and (5) optimized. The toolkit was applied in a working group of 32 professionals and experts who were engaged in developing the new national eHealth strategy and action plan.Results:The overall maturity score of the Serbian HIS was 1.6, which indicates a low level. The highest baseline score (2) was given to the standards and interoperability domain, and the lowest (1.1) was given to ICT infrastructure. The remaining 3 domains (leadership and governance, Management and Workforce, and Data Quality and Use) were similarly rated (1.7, 1.7, and 1.6, respectively).Conclusion:A baseline assessment of the maturity level of Serbian HIS indicates that the majority of components are between the emerging/ad hoc stage and repeatable, which represent isolated, ad hoc efforts, with some basic processes in place and existing and accessible policies. This exercise provided an opportunity to address identified weaknesses in the upcoming national eHealth strategy.