Exposure to urban green spaces and mental health during the COVID-19 pandemic: evidence from two low and lower-middle-income countries

INTRODUCTION: The COVID-19 pandemic has had a significant impact on mental health globally, with limited access to mental health care affecting low- and middle-income countries (LMICs) the most. In response, alternative strategies to support mental health have been necessary, with access to green spaces being a potential solution. While studies have highlighted the role of green spaces in promoting mental health during pandemic lockdowns, few studies have focused on the role of green spaces in mental health recovery after lockdowns. This study investigated changes in green space access and associations with mental health recovery in Bangladesh and Egypt across the pandemic. METHODS: An online survey was conducted between January and April 2021 after the first lockdown was lifted in Bangladesh (n = 556) and Egypt (n = 660). We evaluated indoor and outdoor greenery, including the number of household plants, window views, and duration of outdoor visits. The quantity of greenness was estimated using the normalized difference vegetation index (NDVI). This index was estimated using satellite images with a resolution of 10x10m during the survey period (January-April 2021) with Sentinel-2 satellite in the Google Earth Engine platform. We calculated averages within 250m, 300m, 500m and 1000m buffers of the survey check-in locations using ArcGIS 10.3. Multiple linear regression models were used to evaluate relationships between changes in natural exposure and changes in mental health. RESULTS: The results showed that mental health improved in both countries after the lockdown period. People in both countries increased their time spent outdoors in green spaces after the lockdown period, and these increases in time outdoors were associated with improved mental health. Unexpectedly, changes in the number of indoor plants after the lockdown period were associated with contrasting mental health outcomes; more plants translated to increased anxiety and decreased depression. Refocusing lives after the pandemic on areas other than maintaining indoor plants may assist with worrying and feeling panicked. Still, indoor plants may assist with depressive symptoms for people remaining isolated. CONCLUSION: These findings have important implications for policymakers and urban planners in LMICs, highlighting the need to increase access to natural environments in urban areas to improve mental health and well-being in public health emergencies

Experimental models for the autoimmune and inflammatory blistering disease, Bullous pemphigoid

Bullous pemphigoid (BP) is a subepidermal skin blistering disease characterized immunohistologically by dermal-epidermal junction (DEJ) separation, an inflammatory cell infiltrate in the upper dermis, and autoantibodies targeted toward the hemidesmosomal proteins BP230 and BP180. Development of an IgG passive transfer mouse model of BP that reproduces these key features of human BP has demonstrated that subepidermal blistering is initiated by anti-BP180 antibodies and mediated by complement activation, mast cell degranulation, neutrophil infiltration, and proteinase secretion. This model is not compatible with study of human pathogenic antibodies, as the human and murine antigenic epitopes are not cross-reactive. The development of two novel humanized mouse models for the first time has enabled study of disease mechanisms caused by BP autoantibodies, and presents an ideal in vivo system to test novel therapeutic strategies for disease management

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Exploring factors contributing to fatigability in people with multiple sclerosis: A moderation model analysis

Background: Fatigability in people with multiple sclerosis (PwMS) arises from increased perceived and performance fatigability, contributing to functional decline. Objectives: To explore factors influencing fatigability and the moderating role of fear of falling on balance confidence. Methods: In total, 66 PwMS participated in this study. Perceived fatigability was assessed after a 10-minute walk test by dividing the tiredness rating by the distance walked. Performance fatigability was calculated as the change in walking speed (at 2.5 and 10 min) divided by the distance walked. Participants completed the International Physical Activity Questionnaire (IPAQ), Modified Falls Efficacy Scale (MFES), Fatigue Severity Scale (FSS), and Activities-specific Balance Confidence (ABC) Scale. Statistical analyses comprised correlation, linear regression, and moderation analyses. Results: Perceived and performance fatigability were positively correlated with the number of falls and FSS score and negatively correlated with IPAQ, MFES, and ABC scores. Regression analysis revealed that the ABC score [β = −0.41; 95 % confidence interval (CI): −0.25 to −0.02; p < 0.02] and number of falls (β = 0.37; 95 % CI: 1.76–4.67; p < 0.000) were key predictors of perceived fatigability. The MFES score (β = −0.40; 95 % CI: −0.33 to 0.00; p < 0.05) and number of falls (β = 0.29; 95 % CI: 0.09–0.50; p < 0.005) predicted performance fatigability. Fear of falling moderated the relationship between balance confidence and perceived fatigability (β = 0.040; 95 % CI: 0.008–0.072; p = 0.014). Conclusions: These findings highlight the need to address fear of falling and confidence. Fall education strategies may improve fatigability and functional mobility

Rus detachment in Dammam Dome, Eastern Saudi Arabia: a new soft-sediment structure as a ‘sensitive stress sensor’ for the Zagros collision

AbstractThis paper describes in detail hydroplastic structures, which are ‘odd’ kinematic indicators in the basal part of the Eocene Middle Rus Formation. Such structures were previously ignored or falsely interpreted. These hydroplastic structures are found in the massive limestone exposures on the King Fahd University of Petroleum and Minerals (KFUPM) campus. They occur in relation to a principal displacement zone along the boundary/interface between the Lower/Middle Rus, which is referred to as the Rus soft-sediment detachment. The structures are fist-sized vugs associated with carrot- or comet-trail imprints (VCT structures) which were previously translated calcite geodes that have been weathered out. VCT structures show transport/slip towards the NNW (345°) and are found on flat to low-dipping surfaces classified as Y, R and P shears with respect to the orientation of the Rus detachment. Palaeostress analysis indicates an Andersonian transtension stress regime, though it does not facilitate the activation of the Rus soft-sediment detachment. Detachment activity occurred due to the negative effective principal stress σ3′ and the abnormally low frictional coefficient caused by fluid pressure. The soft-sediment Rus detachment can be considered a ‘sensitive stress sensor’ for the Zagros collision since it indicates the Arabian platform’s instability in the wider area of the Dammam Dome during the Late Eocene. This instability is attributed to the inception of the Zagros collision, which was previously considered to occur during the Oligocene based on the well-established pre-Neogene unconformity.</jats:p