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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

Tatton-Brown-Rahman syndrome (TBRS; OMIM 615879), also known as the DNMT3A-overgrowth syndrome, is an overgrowth intellectual disability syndrome first described in 2014 with a report of 13 individuals with constitutive heterozygous DNMT3A variants. Here we have undertaken a detailed clinical study of 55 individuals with de novo DNMT3A variants, including the 13 previously reported individuals. An intellectual disability and overgrowth were reported in >80% of individuals with TBRS and were designated major clinical associations. Additional frequent clinical associations (reported in 20-80% individuals) included an evolving facial appearance with low-set, heavy, horizontal eyebrows and prominent upper central incisors; joint hypermobility (74%); obesity (weight ³2SD, 67%); hypotonia (54%); behavioural/psychiatric issues (most frequently autistic spectrum disorder, 51%); kyphoscoliosis (33%) and afebrile seizures (22%). One individual was diagnosed with acute myeloid leukaemia in teenage years. Based upon the results from this study, we present our current management for individuals with TBRS

Viewing and illumination geometry has a strong influence on optical measurements of natural surfaces due to their anisotropic reflectance properties. Typically, cameras on-board unmanned aerial vehicles (UAVs) are affected by this because of their relatively large field of view (FOV) and thus large range of viewing angles. In this study, we investigated the magnitude of reflectance anisotropy effects in the 500–900 nm range, captured by a frame camera mounted on a UAV during a standard mapping flight. After orthorectification and georeferencing of the images collected by the camera, we calculated the viewing geometry of all observations of each georeferenced ground pixel, forming a dataset with multi-angular observations. We performed UAV flights on two days during the summer of 2016 over an experimental potato field where different zones in the field received different nitrogen fertilization treatments. These fertilization levels caused variation in potato plant growth and thereby differences in structural properties such as leaf area index (LAI) and canopy cover. We fitted the Rahman–Pinty–Verstraete (RPV) model through the multi-angular observations of each ground pixel to quantify, interpret, and visualize the anisotropy patterns in our study area. The Θ parameter of the RPV model, which controls the proportion of forward and backward scattering, showed strong correlation with canopy cover, where in general an increase in canopy cover resulted in a reduction of backward scattering intensity, indicating that reflectance anisotropy contains information on canopy structure. In this paper, we demonstrated that anisotropy data can be extracted from measurements using a frame camera, collected during a typical UAV mapping flight. Future research will focus on how to use the anisotropy signal as a source of information for estimation of physical vegetation properties.

Renewal and Reform have been the most discussed and dominant themes of Muslim intelligentsia, as they lived through the subjection of the greater part of the Muslim world by the Western colonial powers during the 18th and 19th centuries. The intellectual discourse on reform by the early Muslim reformers pivoted to the adoption of Western science and values and to the struggle of developing a new ilm al kalām (theology) complementary to modern science and western ideologies. The subsequent reformers, however, were more critical of Western ideas of civilization. Fazlur Rahman and Mohammed Arkoun belonged to the later wave of Muslim reformist movement of the 20th century and are the most well-known trail blazers of this reformist discourse, which centered on the Qur’ān. This article provides insight into the reform strategies of Dr. Fazlur Rahman and Mohammed Arkoun by mapping out key concepts in their discourses and their influence on later generations of reformers. Fazlur Rahman identified the stagnant intellectual legacy as the sole cause of the downfall of Muslim Civilization, caused by the absence of Ijtihād (independent legal reasoning). In his opinion, blind imitation based on precedence and consensus has only created a new hierarchy of traditional ulama (religious scholar) whose retrogressive mindset monopolized the interpretation of the Qur’ān. Making the Qur’ān as the center point for reform, he advocated its rereading based on the comprehension of the élan (spirit) of the Qur’ān. Similarly, Mohammed Arkoun, being trained in postmodern literary theory, adopted post structural methods for re-reading the Qur’ānic text. Arkoun’s critique and approach is interwoven with complex terminologies. He advocated desacralizing the text and the radical rethinking of Islam as a cultural and religious system. This appraisal promotes a philosophical perspective in combination with an anthropological and historical approach. Both these reformers have their own set of advocates and detractors. Undeniably, however, as this paper argues, Arkoun’s approach of understanding the Qur’ān can disturb the conventional prevalent belief system.

Background: The absolute number of older individuals needing medical care and long-term care (LTC) is increasing globally due to the growing ageing population. However, it is uncertain who and what proportion of the population has access to care. Therefore, a systematic review and meta-analysis of the prevalence and reasons for unmet needs for healthcare and long-term care among older people, 65 years old and above, across countries was conducted. Methods: An information specialist performed a comprehensive search of four major databases (PubMed, EMBASE, Web of Science, and CINAHL) from inception to June 2020 without restrictions on language and date. We did random-efects meta-analysis to obtain pooled prevalence. We stratifed the meta-analysis by reasons for unmet need categorized by barrier dimension (availability, accessibility, afordability, and acceptability), survey year, geographic location, and socio-demographic characteristics of the older individual. Results: After screening 3912 articles, we included 101 studies published between 1996 and 2020. Of the 101 studies, 87 studies reported unmet healthcare needs and 14 studies reported unmet LTC needs. Overall, 10.4% (95% CI, 7.3-13.9) of the older population had unmet needs for healthcare. The common reasons for unmet healthcare needs were cost of treatment, lack of health facilities, lack of/conficting time, health problem not viewed as serious, and mistrust/fear of provider. A signifcant variation in pooled prevalence of unmet healthcare needs due to cost was found by gender (male [10.9, 95% CI, 8.9-13.1] vs female [14.4, 95% CI, 11.8-17.3]), educational level (primary or less [13.3, 95% CI, 9.6-17.6] vs higher [7.5, 95% CI, 5.9-9.3]), self-reported health (poor [23.2, 95% CI, 18.8-27.8] vs good [4.4, 95% CI, 3.4-5.5]), insurance status (insured [9.0, 95% CI, 7.5-10.6] vs uninsured [27.7, 95% CI, 24.0-31.5]), and economic status of population (poorest [28.2, 95% CI, 14.1-44.9] vs richest [7.1, 95% CI, 3.8-11.3]). One in four (25.1, 95% CI, 17.1-34.2) older people had unmet needs in LTC. Rural residents had a higher prevalence of unmet needs in LTC compared to their urban counterparts. Conclusion: With the population ageing globally, it is necessary to improve access to health care and LTC for older people. Ensuring afordability of health services, reducing geographical barriers, and improving acceptability, will be critical in reducing unmet need. Unmet needs for healthcare were concentrated in population with no education, poor economic group, outpatient health facility user, and uninsured group. With education and economic-based inequalities at the forefront, all countries should focus on improving access to health services by reducing the burden related to healthcare costs.

Abstract Lately, Islamicists have called to discard \"religion\" as a conceptual tool and/or to use the \"Qurʾānic term\" dīn instead, arguing that \"religion\" entails Eurocentric bias. Analyzing how Fazl-ur-Rahman Ansari conceptualized Islam and religion in the late 1930s and early 1940s, this article presents a threefold argument. Firstly, I argue that a global history approach which examines in a poststructuralist framework how \"Islam\" and \"religion\" are used in concrete contexts is better suited to address the problem of Eurocentrism in both Religious Studies and Islamic Studies. Secondly, I challenge the scholarly thesis that twentieth-century Southeast Asian intellectual debates which referred to Islam as religion were mere emulators of debates conducted in the \"West.\" Instead of assuming isolated histories and ignoring Southeast Asian debates, I contend that the current use of and debates about conceptualizations of Islam as/and religion are the product of one and the same discourse - a result of global negotiation processes in which Europeans were as involved as Southeast Asia-based non-Europeans, even if they did not speak from the same position of power. Finally, I submit that the approach of global religious history opens new perspectives on contemporary Malaysian politics.

The widespread use of metal oxide nanoparticles (NPs) in industrial and household products has raised concerns about their potential soil contamination and its ecological consequences. The purpose of this study was to examine and compare the effects of iron oxide nanoparticles (FeONPs) and zinc oxide nanoparticles (ZnONPs) on the microbial activity and biochemical properties of differently textured soils. A mesocosm experiment was conducted using three soil types–clay loam (CL), sandy clay loam (SCL), and sandy loam (SL) amended with farmyard manure (FYM), ZnONPs and/or FeONPs. The results revealed significant differences in microbial colony-forming units (CFUs) and carbon dioxide (CO[sub.2]) emissions in the order of SL > SCL > CL. Compared with those from the unfertilized control, the CO[sub.2] emissions from the FYM increased by 112%, 184% and 221% for CL, SCL and SL, respectively. The addition of ZnONPs and FeONPs notably increased the microbial biomass Zn/Fe, which reflected their consumption by the soil microbes. As a result, microbial CFUs were considerably reduced, which led to a 24%, 8% and 12% reduction in cumulative CO[sub.2] emissions after the addition of ZnONPs to the CL, SCL and SL soils, respectively. The respective decrements in the case of FeONPs were 19%, 2% and 12%. The temporal dynamics of CO[sub.2] emissions revealed that the CO[sub.2] emissions from CL with or without FYM/NPs did not differ much during the first few days and later became pronounced with time. Almost all the studied chemical characteristics of the soils were not strongly affected by the ZnONPs/FeONPs, except EC, which decreased with the addition of these nanomaterials to the manure-amended soils. Principal component analysis revealed that the ZnONPs and FeONPs are negatively corelated with microbial CFUs, and CO[sub.2] emission, with ZnONPs being more toxic to soil microbes than FeONPs, though their toxicity is strongly influenced by soil texture. Hence, these findings suggest that while both these NPs have the potential to impair microbial activity, their effects are mediated by soil texture.

Fazlur Rahman, the renowned Muslim thinker who lived in the second half of the twentieth century, impacted young scholars and students of Islam of his generation and those of the next, both from the Muslim world and the West. Many research scholars and thinkers who have written on Islam have been highly impressed by his methodology of interpreting the Qur’ān which is why there has been so much focus on this aspect of his work in the context of his contribution to Islamic scholarship. However, while one is drawn to examine this aspect of his work, there are other equally interesting aspect of his thoughts that have not been given the equal treatment, such as a study of the evolution of his thought over various decades of his life and career etc. The present article is meant to present a critical survey of the works of Islamicists on Fazlur Rahman’s thought and contribution.