Challenges for eGFR equations in the developing world.

The populations in countries that have the highest number of individuals with chronic kidney disease (CKD) are the low and middle-income countries which are ethnically diverse. The regional and international data highlighting the need for continuous monitoring of renal function warrants that such countries use equations that give the best estimates of glomerular filtration rate for their settings. While chronic disease conditions such as diabetes and hypertension are the main conditions associated with CKD in adult populations and complicated urinary tract infections and congenital anomalies in the kidney and the urinary tract in the young, the management of patients with CKD at any age can be impacted by medical and non-biological factors. This communication seeks to posit issues that may be germane to consider when using the CKD-EPI 2021 equations in the adult and young adult populations. These equations, by excluding the race factor, have put the spotlight on the relevance of the cultural and economic context concerning the management of renal patents. The social determinants of health, how an individual defines their gender, the cultural acceptance of such or the lack thereof, factors influencing the choice of the test, communication, and technology among others may all affect renal care. These issues together may have a greater impact on renal patient care and outcome than racial disparity. While the racial divide may have been a driver for differential treatment in developed nations with different ethnic groups they may be less so when compared with more homogenous populations.

Barriers to the treatment of clubfoot in low- and middle-income countries: A guide to improve compliance.

The Ponseti method of clubfoot treatment is ideal for low- and middle-income countries since it is minimally invasive and easily implementable through non-surgeon providers. However, variables related to the socioeconomic status of the community, patient-related factors, treatment provider-related factors, and health system-related factors may influence the outcome of this deformity. These barriers need a two-pronged approach, a top-down (involvement at the policy level) as well as a bottom-up method (involvement at an individual level). Improving the knowledge level of the caregiver as well as the provider and addressing the issues regarding financial constraints will help in eliminating various barriers to the treatment of clubfoot. Furthermore, regular audits help in identifying the efficacy of various solutions employed as well as identifying new barriers to treatment. Integration at the policy level with the involvement of governmental as well as non-governmental organisations helps to remove health system-level bottlenecks.

Substantial contribution of transported emissions to organic aerosol in Beijing.

Haze in Beijing is linked to atmospherically formed secondary organic aerosol, which has been shown to be particularly harmful to human health. However, the sources and formation pathways of these secondary aerosols remain largely unknown, hindering effective pollution mitigation. Here we have quantified the sources of organic aerosol via direct near-molecular observations in central Beijing. In winter, organic aerosol pollution arises mainly from fresh solid-fuel emissions and secondary organic aerosols originating from both solid-fuel combustion and aqueous processes, probably involving multiphase chemistry with aromatic compounds. The most severe haze is linked to secondary organic aerosols originating from solid-fuel combustion, transported from the Beijing-Tianjing-Hebei Plain and rural mountainous areas west of Beijing. In summer, the increased fraction of secondary organic aerosol is dominated by aromatic emissions from the Xi'an-Shanghai-Beijing region, while the contribution of biogenic emissions remains relatively small. Overall, we identify the main sources of secondary organic aerosol affecting Beijing, which clearly extend beyond the local emissions in Beijing. Our results suggest that targeting key organic precursor emission sectors regionally may be needed to effectively mitigate organic aerosol pollution.