Access To Sources Research Articles

Access to medicines, the Unified Health System, and intersectional injustices.

To estimate the prevalence of general and public access to prescription drugs in the Brazilian population aged 15 or older in 2019, and to identify inequities in access, according to intersections of gender, color/race, socioeconomic level, and territory. We analyzed data from the 2019 National Health Survey with respondents aged 15 years or older who had been prescribed a medication in a healthcare service in the two weeks prior to the interview (n = 19,819). The outcome variable was access to medicines, subdivided into general access (public, private and mixed), public access (via the Unified Health System - SUS) for those treated by the SUS, and public access (via the SUS) for those not treated by the SUS. The study's independent variables were used to represent axes of marginalization: gender, color/race, socioeconomic level, and territory. The prevalence of general and public access in the different groups analyzed was calculated and the association of the outcomes with the aforementioned axes was estimated with odds ratios (OR) using logistic regression models. There was a high prevalence of general access (84.9%), when all sources of access were considered, favoring more privileged segments of the population, such as men, white, and those of high socioeconomic status. When only the medicines prescribed in the SUS were considered, there was a low prevalence (30.4% access) that otherwise benefited marginalized population segments, such as women, black, and people from low socioeconomic backgrounds. Access to medicines through the SUS proves to be an instrument for combating intersectional inequities, lending credence to the idea that the SUS is an efficient public policy for promoting social justice.

The burden and trends of child and maternal malnutrition across the regions in Ethiopia, 1990-2019: The Global Burden of Disease Study 2019.

Child malnutrition is the main contributor to the disease burden in Ethiopia. The objective of this study was to determine the prevalence and trends of child malnutrition and maternal anemia in Ethiopia at the national and regional state levels between 1990 and 2019. We used all accessible data sources and analyzed prevalence, death, and years of life lost (YLL) due to child malnutrition and maternal anemia across nine regions and two chartered cities in Ethiopia, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The burden and trends of child and maternal malnutrition and anemia at the national level, across the regions, and in cities were assessed. Point estimates with 95% uncertainty intervals (UI) are presented. Of the 190,173 total under-5 deaths in Ethiopia in 2019, 108,864 (95% UI: 83,544-141,718; 57·2%, 51·3-62·7) were attributed to malnutrition. The prevalence of stunting, underweight, and wasting was 37·0%, 27·0%, and 7·0%, respectively, in 2019. The YLL rate attributable to child malnutrition declined from 251,964 per 100,000 population (95% UI: 218,720-287,559) in 1990 to 57,615 (95% UI: 44,190-75,015) in 2019. The YLL rate of wasting, stunting, and underweight in Ethiopia was 18,566 per 100,000 population (95% UI: 12,950-26,123), 3,290 (95% UI: 1,443-5,856), and 5,240 (95% UI: 3,608-7,312) in 2019, respectively. Gambella showed the highest YLL rate reduction among regions, with a 98·2% change for stunting, 95·9% for wasting, and 97·9% for underweight between 1990 and 2019. The prevalence of anemia among under-5 children in Ethiopia was 62·0% (95% UI: 59·1%-65·1%) in 2019. Somali has the highest child anemia prevalence, 84·4% (95% UI: 79·8%-88·8%), compared to others in 2019. The prevalence of anemia in women of reproductive age (15-49 years) in Ethiopia was 20·4% (95% UI: 19·0%-21·8%) in 2019. The prevalence of child malnutrition and maternal anemia in Ethiopia remains high compared to national, WHO, and UNICEF 2030 targets in all indicators of child malnutrition and anemia despite several interventions in the last three decades. The YLL rate due to child malnutrition was high, with regional variations. In conjunction with other sectors, especially agriculture, the National Nutrition Program and other nutrition initiatives must make greater efforts with short-term and long-term interventions to improve access and better nutrition.

Stereodivergent Synthesis of Pyridyl Cyclopropanes via Enzymatic Activation of Pyridotriazoles.

Hemoproteins have recently emerged as powerful biocatalysts for new-to-nature carbene transfer reactions. Despite this progress, these strategies have remained largely limited to diazo-based carbene precursor reagents. Here, we report the development of a biocatalytic strategy for the stereoselective construction of pyridine-functionalized cyclopropanes via the hemoprotein-mediated activation of pyridotriazoles (PyTz) as stable and readily accessible carbene sources. This method enables the asymmetric cyclopropanation of a variety of olefins, including electron-rich and electrodeficient ones, with high activity, high stereoselectivity, and enantiodivergent selectivity, providing access to mono- and diarylcyclopropanes that incorporate a pyridine moiety and thus two structural motifs of high value in medicinal chemistry. Mechanistic studies reveal a multifaceted role of 7-halogen substitution in the pyridotriazole reagent toward favoring multiple catalytic steps in the transformation. This work provides the first example of asymmetric olefin cyclopropanation with pyridotriazoles, paving the way to the exploitation of these attractive and versatile reagents for enzyme-catalyzed carbene-mediated reactions.

Science journalism in the Kingdom of Saudi Arabia: news sources engagement and [lack of] science accountability

In this article we explore normative professional expectations around science journalists in Saudi Arabia (KSA) and how news reporters do access, engage with, and use news sources. Against broader and more universal normative expectations, we found that journalists in that country used a low diversity of sources in science news reporting and depended on official and public relations sources. These findings point to a current lack of criticality in science media reporting in KSA and limited ability for media to hold science to account. In so doing, we offer explanations for the divergence and gaps.

Integrating metaheuristics and artificial intelligence for healthcare: basics, challenging and future directions

Accurate and rapid disease detection is necessary to manage health problems early. Rapid increases in data amount and dimensionality caused challenges in many disciplines, with the primary issues being high computing costs, memory costs, and low accuracy performance. These issues will arise since Machine Learning (ML) classifiers are mostly used in these fields. However, noisy and irrelevant features have an impact on ML accuracy. Therefore, to choose the best subset of features and decrease the dimensionality of the data, Metaheuristics (MHs) optimization algorithms are applied to Feature Selection (FS) using various modalities of medical imaging or disease datasets with different dimensions. The review starts by giving a general overview of the many approaches to AI algorithms, followed by a general overview of the various MH algorithms for healthcare applications, an analysis of MHs boosted AI for healthcare applications, and using a wide range of research databases as a data source for access to numerous field publications. The final section of this review discusses the problems and challenges facing healthcare application development.

Circulating tumor cells in metastatic breast cancer patients treated with immune checkpoint inhibitors - a biomarker analysis of the ALICE and ICON trials.

Immune checkpoint inhibitors (ICIs) have been introduced in breast cancer (BC) treatment and better biomarkers are needed to predict benefit. Circulating tumor cells (CTCs) are prognostic in BC, but knowledge is limited on CTCs in the context of ICI therapy. In this study, serial sampling of CTCs (CellSearch system) was evaluated in 82 patients with metastatic BC enrolled in two randomized trials investigating ICI plus chemotherapy. Programmed death-ligand 1 (PD-L1) expression on CTCs was also measured. Patients with ≥ 2 CTCs per 7.5 mL at baseline had gene expression profiles in tumor suggestive of increased T-cell activity, including increased tumor inflammation signature (TIS) in both triple-negative (P = 0.010) and hormone receptor-positive (P = 0.024) disease. Patients with luminal A BC had higher CTC levels. The association between CTC status and outcome was most apparent 4 weeks into therapy. PD-L1 expression in CTCs was observed in 6/17 CTC-positive patients and was associated with inferior survival. In conclusion, our study indicates that CTC numbers may inform on tumor immune composition, as well as prognosis. These findings suggest a potential of using CTCs as an accessible biomarker source in BC patients treated with immunotherapy.

Environment random interaction of rime optimization with Nelder-Mead simplex for parameter estimation of photovoltaic models

As countries attach importance to environmental protection, clean energy has become a hot topic. Among them, solar energy, as one of the efficient and easily accessible clean energy sources, has received widespread attention. An essential component in converting solar energy into electricity are solar cells. However, a major optimization difficulty remains in precisely and effectively calculating the parameters of photovoltaic (PV) models. In this regard, this study introduces an improved rime optimization algorithm (RIME), namely ERINMRIME, which integrates the Nelder-Mead simplex (NMs) with the environment random interaction (ERI) strategy. In the later phases of ERINMRIME, the ERI strategy serves as a complementary mechanism for augmenting the solution space exploration ability of the agent. By facilitating external interactions, this method improves the algorithm’s efficacy in conducting a global search by keeping it from becoming stuck in local optima. Moreover, by incorporating NMs, ERINMRIME enhances its ability to do local searches, leading to improved space exploration. To evaluate ERINMRIME's optimization performance on PV models, this study conducted experiments on four different models: the single diode model (SDM), the double diode model (DDM), the three-diode model (TDM), and the photovoltaic (PV) module model. The experimental results show that ERINMRIME reduces root mean square error for SDM, DDM, TDM, and PV module models by 46.23%, 59.32%, 61.49%, and 23.95%, respectively, compared with the original RIME. Furthermore, this study compared ERINMRIME with nine improved classical algorithms. The results show that ERINMRIME is a remarkable competitor. Ultimately, this study evaluated the performance of ERINMRIME across three distinct commercial PV models, while considering varying irradiation and temperature conditions. The performance of ERINMRIME is superior to existing similar algorithms in different irradiation and temperature conditions. Therefore, ERINMRIME is an algorithm with great potential in identifying and recognizing unknown parameters of PV models.

Probabilistic volumetric speckle suppression in OCT using deep learning.

We present a deep learning framework for volumetric speckle reduction in optical coherence tomography (OCT) based on a conditional generative adversarial network (cGAN) that leverages the volumetric nature of OCT data. In order to utilize the volumetric nature of OCT data, our network takes partial OCT volumes as input, resulting in artifact-free despeckled volumes that exhibit excellent speckle reduction and resolution preservation in all three dimensions. Furthermore, we address the ongoing challenge of generating ground truth data for supervised speckle suppression deep learning frameworks by using volumetric non-local means despeckling-TNode- to generate training data. We show that, while TNode processing is computationally demanding, it serves as a convenient, accessible gold-standard source for training data; our cGAN replicates efficient suppression of speckle while preserving tissue structures with dimensions approaching the system resolution of non-local means despeckling while being two orders of magnitude faster than TNode. We demonstrate fast, effective, and high-quality despeckling of the proposed network in different tissue types that are not part of the training. This was achieved with training data composed of just three OCT volumes and demonstrated in three different OCT systems. The open-source nature of our work facilitates re-training and deployment in any OCT system with an all-software implementation, working around the challenge of generating high-quality, speckle-free training data.

Green synthesis of carbon dots from mature green tea leaves for label-free fluorescence sensing of chromium(VI)

Hexavalent chromium (Cr(VI)) has been established as a highly carcinogenic and mutagenic entity. Therefore, there has been a persistent demand for affordable, sensitive, and quick sensors to monitor the presence of Cr(VI) in aqueous systems. A straightforward, cost-efficient, and eco-friendly approach has been reported in this work in terms of blue-fluorescent carbon dots (CDs, 5.2 nm) being realized in a single-step hydrothermal process. For this purpose, fully grown green tea leaves as the main carbon source were deployed due to being cheap, and environmentally sustainable and readily accessible sources. These CDs exhibit good water solubility, photo-stability and photo-emission (maximal emission at 438 nm for 360 nm excitation wavelength), anti-interference, and low cytotoxicity. The article demonstrates a straightforward fluorescent test for the precise detection and determination of Cr(VI). This was realized through the construction of a non-luminous complex which led to fluorescence quenching via the inner filter effect (IFE). Accordingly, the system can be employed as a label-free nanosensor. Under optimal condition (pH 4 and 5 min reaction time), the fluorescence quenching efficiency of CDs exhibited a well-defined linear correlation in the 0.01–8 mg/L concentration range of Cr(VI). A linear equation represents the system sensor as F0/F = 0.2101x + 1.0016 (R2 = 0.99). The limit of detection (LOD) has been as minimal as 0.004 mg/L (s/k = 3). These findings infer CDs as a potential cost-effective nanosensor for Cr(VI) identification in tap water specimens.

Robust Chemical Testing for Food Safety: Assessing and Identifying Dye Adulterants in Blueberry Juice: A Comprehensive Case Study with Statistical Measures and Correlation Analysis

In the food sector, the problem of food fraud—which encompasses the more focused category of adulteration driven by economic gain—is becoming more widely acknowledged and is raising concerns. Both the government and the industry are accountable for avoiding food adulteration, regardless of where the food danger originated. Food adulteration can result from incidents concerning food safety, food fraud, and food defence, which poses serious risks to the general public's health. In contrast to inadvertent injury in food safety events and intentional harm in food defence incidents, food fraud entails intentional activities for financial gain. Although financially motivated adulteration may have financial motivations, the unusual nature of contaminants frequently makes the related public health hazards more dangerous than traditional food safety threats. Establishing and executing a database that aggregates reports of food component fraud available for publicly accessible sources is an essential task. For governments, agencies, and individual enterprises assessing the possible dangers associated with certain items created in specific regions and those disseminated and sold elsewhere, this database provides essential information and useful data. The paper also describes current analytical tools for identifying food fraud and highlights new developments and trends in the food production industry and the food production bad sector.

Experimental, theoretical and computational studies of oxalyl dihydrazide as a novel corrosion inhibitor for mild steel in neutral saline solution

In this work, the corrosion inhibition performance and mechanism of oxalyl dihydrazide (ODH) for mild steel in neutral saline solution are in-depth studied using weight-loss and electrochemical tests, surface characterizations, theoretical calculation and computational simulations. Results indicate that ODH can act as a novel and superior mixed-type corrosion inhibitor for mild steel in neutral saline solution, its corrosion inhibition efficiency increases with the rising ODH concentration, and the optimum value reaches 88.7 % with adding 200 mg/L. Its corrosion inhibition ability becomes better with immersion time. A compact corrosion product film mainly consisting of Fe, O, N and Cl elements formed on metal surface after adding ODH. ODH molecules adsorb on metal surface in an orderly fashion to form a hydrophobic film, which is belonging to the physicochemical adsorption and obeys the Langmuir adsorption isotherm model. The corrosion inhibition process of ODH molecule on mild steel is the endothermic process, which enlarges the activation energy barrier of corrosion reactions. ODH molecule can expel the adsorbed water molecules on metal surface and form copolymers with increasing of ODH concentration, retarding the diffusion of water molecule thus protecting metal from corrosion. ODH is proved to be an effective organic corrosion inhibitor for protecting mild steel in neutral saline solution, and contributes toward research and application of easily accessible sources for organic corrosion inhibitors.

Apoptotic Extracellular Vesicles from Supernumerary Tooth-Derived Pulp Stem Cells Transfer COL1A1 to Promote Angiogenesis via PI3K/Akt/VEGF Pathway.

Angiogenesis is a tightly controlled process that initiates the formation of new vessels and its dysfunction can lead to life-threatening diseases. Apoptotic extracellular vesicles (ApoEVs) have emerged as a proangiogenic agent with high safety and isolation efficiency profile, and ApoEVs from supernumerary tooth-derived pulp stem cells (SNTSC-ApoEVs) have their unique advantages with an easily accessible parental cell source and non-invasive cell harvesting. However, the detailed characteristics of SNTSC-ApoEVs are largely unknown. This study aimed to investigate the proangiogenic capacity and function molecule of SNTSC-ApoEVs. SNTSC-ApoEVs were isolated and characterized. In vitro effects of SNTSC-ApoEVs on the proliferation, migration, and tube formation of human umbilical vein endothelial cells (HUVECs) were evaluated by CCK-8, wound healing, transwell, and tube formation assays. The mRNA and protein levels of proangiogenic genes were quantified by qRT-PCR, Western blot, and immunofluorescence analysis. A Matrigel plug model was established in 6-week-old male nu/nu mice for one week, and the in vivo impact of SNTSC-ApoEVs on micro-vessel formation was assessed by histological analysis. Proteomic analysis and RNA sequencing were performed to explore the active ingredients and underlying mechanisms. SNTSC-ApoEVs enhanced the proliferation, migration, and angiogenesis of HUVECs in vitro. In the Matrigel plug model in vivo, SNTSC-ApoEVs promoted CD31-positive luminal structure formation. Apart from expressing general ApoEV markers, SNTSC-ApoEVs were enriched with multiple proteins related to extracellular matrix-cell interactions. Mechanistically, SNTSC-ApoEVs transferred COL1A1 to HUVECs and promoted endothelial functions by activating the PI3K/Akt/VEGF cascade. SNTSC-ApoEVs can promote angiogenesis by transferring the functional molecule COL1A1 and activating the PI3K/Akt/VEGF pathway, making SNTSC-ApoEVs a promising strategy for the treatment of angiogenesis-related diseases.

Auricular Chondrocytes as a Cell Source for Scaffold-Free Elastic Cartilage Tissue Engineering.

Current tissue engineering (TE) methods utilize chondrocytes primarily from costal or articular sources. Despite the robust mechanical properties of neocartilages sourced from these cells, the lack of elasticity and invasiveness of cell collection from these sources negatively impact clinical translation. These limitations invited the exploration of naturally elastic auricular cartilage as an alternative cell source. This study aimed to determine if auricular chondrocytes (AuCs) can be used for TE scaffold-free neocartilage constructs and assess their biomechanical properties. Neocartilages were successfully generated from a small quantity of primary neonatal AuCs of three minipig donors (n = 3). Neocartilage constructs had instantaneous moduli of 200.5 kPa ± 43.34 and 471.9 ± 92.8 kPa at 10% and 20% strain, respectively. TE constructs' relaxation moduli (Er) were 36.99 ± 6.47 kPa Er and 110.3 ± 16.99 kPa at 10% and 20% strain, respectively. The Young's modulus was 2.0 MPa ± 0.63, and the ultimate tensile strength was 0.619 ± 0.177 MPa. AuC-derived neocartilages contained 0.144 ± 0.011 µg collagen, 0.185 µg ± 0.002 glycosaminoglycans per µg dry weight, and 1.7e-3 µg elastin per µg dry weight. In conclusion, this study shows that AuCs can be used as a reliable and easily accessible cell source for TE of biomimetic and mechanically robust elastic neocartilage implants.

A global perspective: Access to mental health care for perinatal populations

Perinatal mental health care differs around the world. We provide a global perspective on the current status of service provision, barriers and facilitators to access, and strategies to improve access in high-income and low- and middle-income countries across five continents (Asia, Africa, Europe, North America and South America). Many of the countries considered do not have universal healthcare coverage. This poses a challenge to perinatal mental health care access. However, there are other social and structural barriers to access, including stigma and other sources of marginalization and discrimination. Yet there are opportunities discussed herein to learn more about what perinatal mental health services work for what populations* and in what circumstances, by adopting a global lens to examine innovative solutions utilized across geographical settings.

Early evaluation of a natural language processing tool to improve access to educational resources for surgical patients.

Accessible patient information sources are vital in educating patients about the benefits and risks of spinal surgery, which is crucial for obtaining informed consent. We aim to assess the effectiveness of a natural language processing (NLP) pipeline in recognizing surgical procedures from clinic letters and linking this with educational resources. Retrospective examination of letters from patients seeking surgery for degenerative spinal disease at a single neurosurgical center. We utilized MedCAT, a named entity recognition and linking NLP, integrated into the electronic health record (EHR), which extracts concepts and links them to systematized nomenclature of medicine-clinical terms (SNOMED-CT). Investigators reviewed clinic letters, identifying words or phrases that described or identified operations and recording the SNOMED-CT terms as ground truth. This was compared to SNOMED-CT terms identified by the model, untrained on our dataset. A pipeline linking clinic letters to patient-specific educational resources was established, and precision, recall, and F1 scores were calculated. Across 199 letters the model identified 582 surgical procedures, and the overall pipeline after adding rules a total of 784 procedures (precision = 0.94, recall = 0.86, F1 = 0.91). Across 187 letters with identified SNOMED-CT terms the integrated pipeline linking education resources directly to the EHR was successful in 157 (78%) patients (precision = 0.99, recall = 0.87, F1 = 0.92). NLP accurately identifies surgical procedures in pre-operative clinic letters within an untrained subspecialty. Performance varies among letter authors and depends on the language used by clinicians. The identified procedures can be linked to patient education resources, potentially improving patients' understanding of surgical procedures.

Google star ratings of Canadian hospitals: a nationwide cross-sectional analysis

BackgroundData on patients’ self-reported hospital experience can help guide quality improvement. Traditional patient survey programmes are resource intensive, and results are not always publicly accessible. Unsolicited online hospital reviews are...

PORTRAYAL OF WOMEN'S ASPIRATIONS AND STRUGGLE IN ANITA NAIR'S LESSONS IN FORGETTING

Literature is one of the most accessible sources of information about the cultural, social and socio-political history of the society. This paper focuses on the aspirations and struggle of women portrayed in the novel ‘Lessons in Forgetting’ by Anita Nair. This novel deals with the suppression, subordination, Betrayal in relationship, aspirations, struggle and seeking individuality of women in contemporary society. This article attempts to explore how aspirations and struggle help people to overcome from the predicament and to establish one’s identity.Anita Nair is a popular Indian postmodern English writer. She is considered to be bold and straight forward writer; Anita Nair exhibits confidence in tackling new themes and experiments with new techniques. Her novels depict the real life of her characters without hiding anything from the readers and she reveals the effect of social conditioning on women and how they survive in the patriarchal society and find solution to come out from their suffering especially, This novel has a strong feminine flavor where the author portrays her female protagonist as strong, determined in the same hand. She has stressed about marriage being an integral part of a woman’s life or no one cares about it. She is concerned with the studies, family, love and striving for fame and fortunes. She has portrayed such a life in this novel.

The Global Psychedelic Survey: Consumer characteristics, patterns of use, and access in primarily anglophone regions around the world

ObjectivesDespite advancements in policies governing psychedelic substances globally, our understanding of real-world psychedelic use and its variations across international jurisdictions remains limited. We implemented the Global Psychedelic Survey (GPS) to capture information about psychedelic consumer characteristics, access, and usage patterns around the world. MethodsThe GPS was administered online in Spring 2023 to English-speaking adults (≥21 years) who use(d) psychedelics. We categorized survey responses into major catchment regions (Canada/US, Europe/UK, Australia/NZ, All Other). We used descriptive and bivariable statistics to characterize consumers’ socio-demographic characteristics, psychedelic access sources, and usage patterns. We examined regional differences in psychedelic use patterns using multinomial logistic regression. ResultsWe analyzed 6379 responses from 85 countries including Canada/US (n = 4434), Europe/UK (n = 771), Australia/NZ (n = 864), and Other (n = 310). Psilocybin, LSD, and MDMA were the most used psychedelics and personal growth was the most common use motive across all catchments. There were significant regional differences in psychedelic use patterns, including types of psychedelics used (e.g., less ibogaine use in Europe/UK and Australia/NZ relative to Canada/US), frequency of use (e.g., lower frequency use in Australia/NZ relative to Canada/US), motivations for use (e.g., less therapeutic use in Europe/UK and Other relative to Canada/US), and types of dosing regimens (e.g., more “micro”-dosing in Canada/US). DiscussionIn this large sample of adult psychedelic consumers from regions around the world, infrequent psychedelic use centered around life enhancement was common. Respondents indicated preference for legal access via quality-controlled sources. Jurisdictional differences in access and usage patterns likely reflect region-specific regulations and traditional practices. Further research should explore opportunities to increase representation of non-White respondents in psychedelic research via translation of studies into several languages and incorporation of culturally reflective, community-based study development.

Not just candy: A herbivore‐induced defence‐related plant protein in honeydew enhances natural enemy fitness

Abstract Herbivore feeding often increases secondary metabolite production in plants. These herbivore‐induced plant proteins might end up in honeydew excreted by phloem‐feeding insects. This is important because honeydew is one of the most abundant and accessible carbohydrate sources for natural enemies in many agroecosystems and these proteins can thus mediate many tri‐trophic interactions. Here, we hypothesized that defensive metabolites induced in the phloem by herbivory accumulate in the honeydew excreted by phloem‐feeding insects and, consequently, affect the fitness of the herbivores' natural enemies that feed on it. We used a tri‐trophic system consisting of citrus plants, the mealybug Planococcus citri and its primary parasitoid Anagyrus vladimiri. First, we assessed A. vladimiri fitness when fed on P. citri honeydew. We then collected honeydew of seven phloem‐feeding insects, including P. citri, and analysed their protein content. Finally, we analysed the effect of superoxide dismutase (SOD), an antioxidant enzyme associated with plant defences that was commonly found in the analysed honeydews, on A. vladimiri fitness. The fitness of A. vladimiri increased when fed on honeydew compared to a sucrose‐based diet, demonstrating that honeydew can contain compounds that benefit natural enemies. Proteomic analyses showed that defence‐related plant proteins were present in honeydew of seven phloem‐feeding insects analysed. Among these, the enzyme SOD was present in honeydew of all of them. Moreover, the levels of SOD were 10‐fold higher in the phloem of plants infested by P. citri than in that of uninfested plants. SOD was also actively excreted in P. citri honeydew, and we proved that it increases the fecundity of the parasitoid A. vladimiri. We conclude that enzymatic proteins induced by herbivory in the phloem and involved in plant defence, accumulate in the honeydew excreted by phloem‐feeding insects and, contrary to the current paradigm, at least some of these can have positive effects on the third trophic level. Read the free Plain Language Summary for this article on the Journal blog.

Whole genome sequencing as a ticket to cancer treatment in the Netherlands: Are inequalities in access to molecular diagnostics unfair?

Whole genome sequencing (WGS) of a tumour may sometimes reveal additional potential targets for medical treatment. Practice variation in the use of WGS is therefore a source of unequal access to targeted therapies and, as a consequence, of disparities in health outcomes. Moreover, this may even be more significant if patients seek access to WGS by paying a relatively limited amount of money out of pocket, and sometimes effectively buy themselves a ticket to (very) expensive publicly funded treatments. Should resulting unequal access to WGS be considered unfair? Drawing from current practice in the Dutch healthcare system, known as egalitarian, we argue that differences in employment of WGS between hospitals are the consequence of the fact that medical innovation and its subsequent uptake inevitably takes time. Consequently, temporal inequalities in access can be deemed acceptable, or at least tolerated, because and insofar as, ultimately, all patients benefit. However, we argue against allowing a practice of out-of-pocket payments for WGS in publicly funded healthcare systems, for four reasons: because allowing private spending favours patients with higher socio-economic status significantly more than practice variation between hospitals does, may lead to displacement of publicly funded health care, does not help to ultimately benefit all, and may undermine the solidaristic ethos essential for egalitarian healthcare systems.