Literacy and international development

Literacy is a complex and dynamic phenomenon that varies across history, language, and geography. The present review considers the roles of literacy in an international development perspective. First, an overview is provided of the history and definitions of literacy, considering its evolution from a dichotomous concept (literate/illiterate) to a continuum of writing, reading, and numeracy across the life span. Second, key contemporary aspects of literacy are described, including the effects of language of instruction policies, technology, and emergent crises on literacy acquisition in low-and-middle income countries. In conclusion, considerations and recommendations for literacy promotion are linked to broader issues in educational planning and international development. © 2023 Elsevier Ltd. All rights reserved.

Medication adherence evaluated through electronic monitors during the COVID19 pandemic lockdown in Switzerland

Introduction: During the lockdown enforced from March to June 2020 by authorities due to the COVID19 pandemic in Switzerland, patients included in the Interprofessional Medication Adherence Programme (IMAP) in Lausanne and Bern continued to use electronic monitors (EM), which register daily doses intake. Objective(s): The aim of this study is to use EM data to understand to what extent patients' medication implementation, described as the extent to which the patient takes the daily prescribed regimen, was impacted by the lockdown. The authors hypothesised that medication implementation might be lower during and after the lockdown compared to before. Method(s): Included participants attending the IMAP were diagnosed with diabetic kidney disease (DKD), solid cancer, HIV and miscellaneous long-term diseases. Patients' implementation was defined through a proxy: if all EM of each patient were at least opened once daily, implementation was considered optimal (= 1);and suboptimal (= 0) otherwise. 1) Implementation before (from December 2019 to March 2020), during (March to June 2020) and after (June to September 2020) the lockdown was compared. Subanalyses were also performed according to sub-groups of patients. 2) As comparison, implementation of included patients using at least one EM the year before, in 2019, during the same time frame, defined as winter, spring and summer periods, was analysed. A logistic regression model was used to estimate medication implementation according to the period, using 'before the lockdown' or 'winter' as the reference. The model was fitted using generalized estimating equation. Result(s): 1) In 2020, implementation of the 118 patients did not differ statistically before and during (OR = 0.97, CI: 0.84 - 1.15, p = 0.789), and before and after (OR = 0.91, CI: 0.79 - 1.06, p = 0.217) the lockdown. These findings remain stable even when analysing separately the implementation of patients with HIV (n = 61), DKD (n = 25) or miscellaneous long-term diseases (n = 22). Too few patients with cancer (n = 10) were included in the analysis to interpret their results. 2) In 2019, implementation of the 61/118 (51.7%) patients was statistically significantly lower during summertime compared to winter (OR = 0.73, CI: 0.59 - 0.89, p = 0.002). Conclusion(s): The authors results infirm their hypothesis as the implementation remained steady during and after the lockdown in 2020 in comparison to the period before. Still, adherence in 2020 was different compared to 2019 as the decreased implementation during summertime 2019 was not observed after the lockdown in summer 2020. Because of the COVID-19 pandemic, many patients slowed down their activities, travelled less, and may have been more cautious in managing their treatment due to the fear of developing a complication of their disease in a difficult sanitary context. Moreover, during the pandemic, continuity of care was ensured by medical teleconsultation between patients and their health care providers, mailing medications to patients' home by the pharmacy and leading interviews by phone calls for patients included in IMAP. The IMAP before, during and after the lockdown may have supported the adherence of complex patients across the pandemic in 2020. Interprofessional adherence programmes should support patients during routine-disturbance periods, such as a lockdown in a pandemic context or during summertime.

TACROLIMUS-RESISTANT SARS-COV-2-SPECIFIC T-CELL PRODUCTS TO PREVENT AND TREAT SEVERE COVID-19 IN IMMUNOSUPPRESSED PATIENTS

As solid organ transplant (SOT) recipients receive therapeutic immunosuppression that compromises their immune response to infections and vaccines, they have a high risk of developing severe COVID-19 and an increased risk of COVID-19-related death. The constant immunosuppression may result in reduction of efficiency of immunotherapy. Thus, a therapy is required that enables efficient viral clearance against SARS-CoV-2 whilst simultaneously maintaining immunosuppressive treatment in transplant patients to prevent transplant rejection. Here, we propose adoptive transfer of SARS-CoV-2-specific T-cells rendered resistant to the common immunosuppressant Tacrolimus to optimize performance in immunosuppressed patients. By using a GMP-compatible, vector-free CRISPR-Cas9-based, gene-editing approach, we knocked out the cell-intrinsic adaptor protein FKBP12, which is required for the immunosuppressive function of Tacrolimus, and generated Tacrolimus-resistant SARS-CoV-2-reactive T-cell products (TCPs) from the blood of SARS-CoV-2 convalescent donors. Functional and phenotypical characterization of these products in depth, including single cell CITE- and TCR sequencing analyses, showed that the gene modification did not impact the functional potency of the Tacrolimus-resistant SARS-CoV-2-specific TCPs compared to unmodified SARS-CoV-2-specific TCPs, but confirmed resistance to Tacrolimus and sensitivity to alternative immunosuppressive drugs from the same class (safety switch). Based on the promising results, we aim to clinically validate this approach in transplant recipients. Our strategy has the potential to prevent or ameliorate severe COVID-19 in the SOT setting whilst preventing allogeneic organ rejection. Our platform technology allows targeting of different SARS-CoV-2 variants and other viruses, thus multiplying its potential therapeutic use.

Implications of the COVID-19 pandemic on the Internet traffic

In this paper, we report on a measurement study by researchers from several institutions that collected and analyzed network data to assess the impact of the first wave of COVID-19 (February-June 2020) on the Internet traffic. The datasets from Internet Service Providers, Internet Exchange Points, and academic networks, primarily in Europe, provide a unique view on the changes of Internet traffic due to pandemic and the lockdown that forced hundreds of millions of citizens to stay and work from home. The analysis shows that the increase of Internet traffic was about 15-20 % within a couple of weeks, an increase that is typically spread over multiple months under typical operation. However, traffic during peak hours does not increase by more than 5 %. The increase was noticeably higher for specific applications, e.g., remote work applications, teleconferencing, video on demand;in some cases up to 200 %. However, overall, the Internet reacted well to these unprecedented times. © VDE VERLAG GMBH · Berlin · Offenbach

A year in lockdown: How the waves of COVID-19 impact internet traffic

In March 2020, the World Health Organization declared the Corona Virus 2019 (COVID-19) outbreak a global pandemic. As a result, billions of people were either encouraged or forced by their governments to stay home to reduce the spread of the virus. This caused many to turn to the Internet for work, education, social interaction, and entertainment. With the Internet demand rising at an unprecedented rate, the question of whether the Internet could sustain this additional load emerged. To answer this question, this paper will review the impact of the first year of the COVID-19 pandemic on Internet traffic in order to analyze its performance. In order to keep our study broad, we collect and analyze Internet traffic data from multiple locations at the core and edge of the Internet. From this, we characterize how traffic and application demands change, to describe the "new normal,"and explain how the Internet reacted during these unprecedented times. © 2021 Owner/Author.

Marine Genetic Resources in Areas Beyond National Jurisdiction: Promoting Marine Scientific Research and Enabling Equitable Benefit Sharing

Growing human activity in areas beyond national jurisdiction (ABNJ) is driving increasing impacts on the biodiversity of this vast area of the ocean. As a result, the United Nations General Assembly committed to convening a series of intergovernmental conferences (IGCs) to develop an international legally-binding instrument (ILBI) for the conservation and sustainable use of marine biological diversity of ABNJ [the biodiversity beyond national jurisdiction (BBNJ) agreement] under the United Nations Convention on the Law of the Sea. The BBNJ agreement includes consideration of marine genetic resources (MGR) in ABNJ, including how to share benefits and promote marine scientific research whilst building capacity of developing states in science and technology. Three IGCs have been completed to date with the fourth delayed by the Covid pandemic. This delay has allowed a series of informal dialogues to take place between state parties, which have highlighted a number of areas related to MGR and benefit sharing that require technical guidance from ocean experts. These include: guiding principles on the access and use of MGR from ABNJ;the sharing of knowledge arising from research on MGR in ABNJ;and capacity building and technology transfer for developing states. In this paper, we explain what MGR are, the methods required to collect, study and archive them, including data arising from scientific investigation. We also explore the practical requirements of access by developing countries to scientific cruises, including the sharing of data, as well as participation in research and development on shore whilst promoting rather than hindering marine scientific research. We outline existing infrastructure and shared resources that facilitate access, research, development, and benefit sharing of MGR from ABNJ;and discuss existing gaps. We examine international capacity development and technology transfer schemes that might facilitate or complement non-monetary benefit sharing activities. We end the paper by highlighting what the ILBI can achieve in terms of access, utilization, and benefit sharing of MGR and how we might future-proof the BBNJ Agreement with respect to developments in science and technology. © Copyright © 2021 Rogers, Baco, Escobar-Briones, Gjerde, Gobin, Jaspars, Levin, Linse, Rabone, Ramirez-Llodra, Sellanes, Shank, Sink, Snelgrove, Taylor, Wagner and Harden-Davies.

Natural language processing of radiology reports to investigate the effects of the COVID-19 pandemic on the incidence and age distribution of fractures.

OBJECTIVE: During the COVID-19 pandemic, the number of patients presenting in hospitals because of emergency conditions decreased. Radiology is thus confronted with the effects of the pandemic. The aim of this study was to use natural language processing (NLP) to automatically analyze the number and distribution of fractures during the pandemic and in the 5 years before the pandemic. MATERIALS AND METHODS: We used a pre-trained commercially available NLP engine to automatically categorize 5397 radiological reports of radiographs (hand/wrist, elbow, shoulder, ankle, knee, pelvis/hip) within a 6-week period from March to April in 2015-2020 into "fracture affirmed" or "fracture not affirmed." The NLP engine achieved an F1 score of 0.81 compared to human annotators. RESULTS: In 2020, we found a significant decrease of fractures in general (p < 0.001); the average number of fractures in 2015-2019 was 295, whereas it was 233 in 2020. In children and adolescents (p < 0.001), and in adults up to 65 years (p = 0.006), significantly fewer fractures were reported in 2020. The number of fractures in the elderly did not change (p = 0.15). The number of hand/wrist fractures (p < 0.001) and fractures of the elbow (p < 0.001) was significantly lower in 2020 compared with the average in the years 2015-2019. CONCLUSION: NLP can be used to identify relevant changes in the number of pathologies as shown here for the use case fracture detection. This may trigger root cause analysis and enable automated real-time monitoring in radiology.

[2020 oncology update]

The COVID-19 pandemic that has swept around the world in early 2020 has changed our daily practice and habits. Fortunately, however, 2020 also brings its share of new approaches and therapeutic combinations as well as new therapies. These advances are improving the outcomes and quality of life of our patients across the spectrum of oncological diseases. This article summarises the latest oncological advances and novelties for 2020 in the following tumor entities : lung, breast, digestive, gynecological, urological and ENT.

[COVID-19 associated pneumonia despite repeatedly negative PCR-analysis from oropharyngeal swabs]. / COVID-19-assoziierte Pneumonie trotz persistierend negativen PCR-Tests aus oropharyngealen Abstrichen.

PATIENT HISTORY AND CLINICAL FINDINGS: A 46-year old construction worker presented at the emergency department with two orthostatic syncopes. The patient complained of prolonged fever and coughs for 7 days which had not improved after oral treatment with sultamicillin for 5 days, prescribed by the patient's general practitioner. Physical examination showed high blood pressure due to previously known hypertension. Other vital signs without pathological findings. Pulmonary auscultation showed basal soft crackling noises of the left lung. FINDINGS AND DIAGNOSIS: Laboratory examination showed increased values for LDH, pro-BNP and CRP and normal values for leucocytes and procalcitonin. Conventional X-Ray of the chest showed bipulmonal lateral atypical infiltrates. After the first PCR turned in negative another PCR-analysis for SARS-CoV-2 of a deep oral swab-sample was performed since the clinical, laboratory and radiological findings were typical for COVID-19. Again, SARS-CoV-2-RNA was not detected. A CT-scan of the chest showed bipulmonal lateral ground-glass attenuation, again typical for COVID-19 associated pneumonia. After a third attempt for a PCR-analysis of a deep oral swab-sample was negative, analysis of a sputum was performed which finally confirmed the diagnosis of COVID-19 associated pneumonia. THERAPY AND COURSE OF EVENTS: The patient was admitted for evaluation of syncopes and suspect of COVID-19 associated pneumonia. The patient was prophylactically isolated while the result of SARS-CoV-2-PCR from a deep oral swab was pending. Suspecting a possible secondary bacterial infection at the beginning, intravenous antibiotic treatment with ampicillin/sulbactam was initiated. While further examinations showed no indication for bacterial infection, antibiotics were discontinued after 3 days. Due to clinical recovery antiviral therapy was not performed after confirming the diagnosis. The patient was discharged 17 days after onset of first symptoms without any requirements for further isolation. CONCLUSION: This casuistic describes a case of COVID-19 associated pneumonia presenting with typical clinical features, laboratory and radiological findings. Detection of viral RNA was not successful from deep oral swab-samples despite repeated attempts. Finally, PCR-analysis of sputum confirmed the diagnosis. Analysis of deeper airway samples (sputum, bronchoalveolar lavage, tracheal secretions) or stool for SARS-CoV-2 should be performed in cases of evident clinical suspicion of COVID-19 and negative PCR results from deep oral swabs.