Water in Metro Cebu: The Case for Policy and Institutional Reforms

Over the past decade, Metro Cebu has been rapidly moving toward growth and industrialization contributing as much as 70 percent to Visayas’ industrial output. However, associated with this progress are the concerns of various sectors about the quality of water services. Only 23 percent of the total households and a very small portion of industrial and commercial sectors are serviced by the Metro Cebu Water District. Hence, the large majority of households, industrial and commercial firms have to rely on private wells and private water vendors. This paper examines the policy and institutional factors that may be preventing the efficient, equitable and sustainable Metro Cebu’s water resource management. It also provides policy areas through which policy and institutional reforms can be implemented.water sector, water allocation, governance

Urban Water Pricing: The Metro Manila and Metro Cebu Cases

Water is a critical commodity for human survival and a scarce resource that must be appropriately priced to ensure that it is not wastefully and unsuitably consumed. This Notes offers an optimal pricing scheme, together with suggestions on the improvement of the overall water resource management that could provide the proper environment by which such pricing scheme can succeed.urban management, water sector, water demand

Banning Commercial Foresting: What are the Costs?

The Philippines' forest cover has suffered from massive denudation through the years due to uncontrolled and indiscriminate commercial logging. Because of this, calls for a total logging ban had been raised in various fora, including in the legislature where bills that consider the possibility of a ban are being studied. However, the possible economic costs of such ban as espoused in some studies has delayed the passage of these bills. This Policy Notes provides some economic costing based on computations that may help in firming up decisions regarding the proposed ban.forestry sector, environmental issues, environmental management

The effectiveness of a multidisciplinary intervention strategy for the treatment of symptomatic joint hypermobility in childhood:A randomised, single Centre parallel group trial (The Bendy Study)

Introduction: Joint hypermobility is common in childhood and can be associated with musculoskeletal pain and dysfunction. Current management is delivered by a multidisciplinary team, but evidence of effectiveness is limited. This clinical trial aimed to determine whether a structured multidisciplinary, multisite intervention resulted in improved clinical outcomes compared with standard care. Method: A prospective randomised, single centre parallel group trial comparing an 8-week individualised multidisciplinary intervention programme (bespoke physiotherapy and occupational therapy in the clinical, home and school environment) with current standard management (advice, information and therapy referral if deemed necessary). The primary endpoint of the study was between group difference in child reported pain from baseline to 12 months as assessed using the Wong Baker faces pain scale. Secondary endpoints were parent reported pain (100 mm visual analogue scale), parent reported function (child health assessment questionnaire), child reported quality of life (child health utility 9-dimensional assessment), coordination (movement assessment battery for children version 2) and grip strength (handheld dynamometer). Results: 119 children aged 5 to 16 years, with symptomatic hypermobility were randomised to receive an individualised multidisciplinary intervention (I) (n = 59) or standard management (S) (n = 60). Of these, 105 completed follow up at 12 months. No additional significant benefit could be shown from the intervention compared to standard management. However, there was a statistically significant improvement in child and parent reported pain, coordination and grip strength in both groups. The response was independent of the degree of hypermobility. Conclusion: This is the first randomised controlled trial to compare a structured multidisciplinary, multisite intervention with standard care in symptomatic childhood hypermobility. For the majority, the provision of education and positive interventions aimed at promoting healthy exercise and self-management was associated with significant benefit without the need for more complex interventions. Trial registration: The trial was registered prospectively with the national database at the Clinical Research Network (UKCRN Portfolio 9366). The trial was registered retrospectively with ISRCTN (ISRCTN86573140)

Clinical impact of a targeted next-generation sequencing gene panel for autoinflammation and vasculitis.

BACKGROUND: Monogenic autoinflammatory diseases (AID) are a rapidly expanding group of genetically diverse but phenotypically overlapping systemic inflammatory disorders associated with dysregulated innate immunity. They cause significant morbidity, mortality and economic burden. Here, we aimed to develop and evaluate the clinical impact of a NGS targeted gene panel, the "Vasculitis and Inflammation Panel" (VIP) for AID and vasculitis. METHODS: The Agilent SureDesign tool was used to design 2 versions of VIP; VIP1 targeting 113 genes, and a later version, VIP2, targeting 166 genes. Captured and indexed libraries (QXT Target Enrichment System) prepared for 72 patients were sequenced as a multiplex of 16 samples on an Illumina MiSeq sequencer in 150bp paired-end mode. The cohort comprised 22 positive control DNA samples from patients with previously validated mutations in a variety of the genes; and 50 prospective samples from patients with suspected AID in whom previous Sanger based genetic screening had been non-diagnostic. RESULTS: VIP was sensitive and specific at detecting all the different types of known mutations in 22 positive controls, including gene deletion, small INDELS, and somatic mosaicism with allele fraction as low as 3%. Six/50 patients (12%) with unclassified AID had at least one class 5 (clearly pathogenic) variant; and 11/50 (22%) had at least one likely pathogenic variant (class 4). Overall, testing with VIP resulted in a firm or strongly suspected molecular diagnosis in 16/50 patients (32%). CONCLUSIONS: The high diagnostic yield and accuracy of this comprehensive targeted gene panel validate the use of broad NGS-based testing for patients with suspected AID

The feasibility of collecting information from people with Multiple Sclerosis for the UK MS Register via a web portal: characterising a cohort of people with MS.

BACKGROUND: A UK Register of people with Multiple Sclerosis has been developed to address the need for an increased knowledge-base about MS. The Register is being populated via: a web-based portal; NHS neurology clinical systems; and administrative data sources. The data are de-identified and linked at the individual level. At the outset, it was not known whether people with MS would wish to participate in the UK MS Register by personally contributing their data to the Register via a web-based system. Therefore, the research aim of this work was to build an internet-mounted recruitment and consenting technology for people with Multiple Sclerosis, and to assess its feasibility as a questionnaire delivery platform to contribute data to the UK MS Register, by determining whether the information provided could be used to describe a cohort of people with MS. METHODS: The web portal was developed using VB.net and JQuery with a Microsoft SQL 2008 database. UK adults with MS can self-register and enter data about themselves by completing validated questionnaires. Descriptive statistics were used to characterise the respondents. RESULTS: The web portal was launched in May 2011, and in first three months 7,279 individuals registered on the portal. The ratio of men to women was 1:2.4 (n = 5,899), the mean self-reported age at first symptoms was 33.8 (SD 10.5) years, and at diagnosis 39.6 (SD 10.3) years (n = 4,401). The reported types of MS were: 15% primary progressive, 63% relapsing-remitting, 8% secondary progressive, and 14% unknown (n = 5,400). These characteristics are similar to those of the prevalent MS population. Employment rates, sickness/disability rates, ethnicity and educational qualifications were compared with the general UK population. Information about the respondents' experience of early symptoms and the process of diagnosis, plus living arrangements are also reported. CONCLUSIONS: These initial findings from the MS Register portal demonstrate the feasibility of collecting data about people with MS via a web platform, and show that sufficient information can be gathered to characterise a cohort of people with MS. The innovative design of the UK MS register, bringing together three disparate sources of data, is creating a rich resource for research into this condition

Signs and symptoms of serious illness in infants aged up to 6 months:rapid review of clinical guidelines

BACKGROUND: There is a need to empower parents and carers of young infants to recognise signs of serious illness and to act on these appropriately. Compiling the signs and symptoms of serious illness in infants found in clinical guidelines will support the evidence-based update of the 30+-year-old content of the Baby Check App to empower parents and carers.OBJECTIVE: To systematically review clinical guidelines for signs and symptoms related to serious illness in infants aged 6 months and below.METHODS: A rapid review was carried out by searching PubMed, CINAHL, NICE, Cochrane and Embase for clinical guidelines reporting signs and symptoms of serious illness in young infants. The time period was restricted from 2018 to 2023. Only guidelines published in English were included.RESULTS: Fourteen clinical guidelines from 2307 retrieved articles were reviewed. Sixty signs and symptoms indicative of serious illness in infants were identified from the clinical guidelines. The guidelines originated from the UK (n=9, 65%), Italy (n=1, 7%), South Africa (n=1, 7%), Switzerland (n=1, 7%), USA (n=1, 7%), UK and USA (n=1, 7%). The 10 most frequent signs and symptoms were decreased consciousness, tachypnoea, looks seriously unwell to a health professional, high fever, central cyanosis, apnoea, seizures, frequent vomiting, non-blanching rash and noisy breathing.CONCLUSIONS: Knowledge of the most frequently occurring signs and symptoms that were found in the reviewed guidelines will contribute to the update of the content of the Baby Check App. This will ensure that guidance for parents and carers is consistent with the current evidence base.</p

Determination of Chitin and protein contents during the isolation of Chitin from shrimp waste

© 2006 WILEY-VCH Verlag GmbH & Co. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted Manuscript version of a Published Work that appeared in final form in Macromolecular Bioscience. To access the final edited and published work see https://doi.org/10.1002/mabi.200500233Accurate determination of chitin and protein contents in crustacean biomass and the intermediate products during the industrial isolation of chitin cannot be made directly from the total nitrogen content, unless the appropriate corrections are applied. This method, however, is affected by the presence of other nitrogen-containing chemical species that are formed endogenously or by the action of microorganisms during the handling of the sample. Therefore, an alternative rapid method to estimate the contents of these components can be very useful both in research and in various fields of application. An original method has been developed to address this problem. The method consists of the development of a set of equations based on the stoichiometric contents of nitrogen of chitin and protein whereby the amounts of each component can be estimated from the value of the total nitrogen content, provided the rest of the proximate composition of the sample is accurately known. In order to validate the procedure, a set of model mixtures of pure chitin and protein concentrate in the solid state, both extracted from shrimp head waste, are used. Excellent agreement between the predicted and real values of chitin and protein are obtained (R2=0.98, slope=0.90). When the proposed method is tested in the analysis of real samples obtained from five different processing protocols of pretreatment of raw shrimp head, it is found that in general, the values of protein and chitin contents throughout the various stages of the process vary as expected

Can the Philippines Achieve its CO2 Reduction Commitment with Renewable Energy?

The Philippines always aims to achieve economic growth, which requires expanding economic activities, resulting in increased pollution (Stern, 2017). The country signified its intention to reduce carbon dioxide (CO2) emissions by 75% in COP26 (United Nations Framework Convention on Climate Change [UNFCCC], 2021). Part of its strategy to combat CO2 emissions is by increasing its share of renewable energy (RE) sources to at least 35% of the total energy matrix (Department of Energy [DOE], 2021). The Philippines’ ability to reach its COP26 commitment through a scenario approach on the effects of increasing GDP and share of RE to CO2 emissions using Kaya Identity and EKC was investigated. Geometric growth and target-oriented forecasting were performed to generate the forecast period. The Kaya Identity computed the total factor CO2 emissions of the country. The EKC investigated whether increases in GDP, incorporated with the share of RE, result in declining CO2 emissions. Results showed that in scenarios 5 to 7, where GDP and share of RE are increasing based on targets, the Philippines enters post-industrialization stage 3 of environmental responsibility, wherein increases in GDP result in declining CO2 emissions. Evidence suggests the Philippines must remain aggressive in its RE investments to reach its COP26 carbon dioxide emissions reduction commitment

The Brazilian Network for HIV-1 Genotyping External Quality Control Assurance Programme

The Brazilian network for genotyping is composed of 21 laboratories that perform and analyze genotyping tests for all HIV-infected patients within the public system, performing approximately 25,000 tests per year. We assessed the interlaboratory and intralaboratory reproducibility of genotyping systems by creating and implementing a local external quality control evaluation. Plasma samples from HIV-1-infected individuals (with low and intermediate viral loads) or RNA viral constructs with specific mutations were used. This evaluation included analyses of sensitivity and specificity of the tests based on qualitative and quantitative criteria, which scored laboratory performance on a 100-point system. Five evaluations were performed from 2003 to 2008, with 64% of laboratories scoring over 80 points in 2003, 81% doing so in 2005, 56% in 2006, 91% in 2007, and 90% in 2008 (Kruskal-Wallis, p = 0.003). Increased performance was aided by retraining laboratories that had specific deficiencies. The results emphasize the importance of investing in laboratory training and interpretation of DNA sequencing results, especially in developing countries where public (or scarce) resources are used to manage the AIDS epidemic