TLR4 genetic variation is associated with inflammatory responses in Gram-positive sepsis

Objectives

To identify important pathogen recognition receptor (PRR) pathways regulating innate immune responses and outcome in Staphylococcus aureus sepsis.

Complex systems for evaluation of public health interventions: a critical review

Background

There has been a growth in interest in applying systems thinking to public health research, including greater consideration of the complex and changing nature of real-world environments where public health interventions take place. We aimed to assess how a systems approach could be applied in the context of public health evaluation.

Does genetic risk of obesity modify associations between the neighbourhood environment and body-mass index? A cross-sectional analysis of the UK Biobank dataset

Background

In studies of gene–environment interactions and obesity, the term environment usually refers to individual behavioural factors that influence energy balance. However, evidence suggests that the built environments in which individuals live, work, and play are associated with obesity and may therefore be environmental triggers of genetic risk. No studies have explored whether individual response to such environmental determinants of obesity varies with genetic risk. We aimed to examine whether genetic risk of obesity modifies associations between various neighbourhood characteristics and body-mass index (BMI).

“Dual-gene” malaria-resistance: Therapeutically-rational exchange (T-REX) of group-O sickle trait and group-O C-traittrait red blood cells can be evaluated in Benin and Nigeria

BackgroundUsing indicators of disease severity, clinicians can predict which Plasmodium falciparum (Pf) malaria patients being treated with artesunate or quinine are likely to die despite these drugs. Effective “rescue adjuncts” are needed when drugs alone are inadequate. “Therapeutically-rational exchange” (T-REX) of special malaria-resistant red blood cells (RBCs) has been proposed to optimize adjunctive exchange transfusion.MethodsStudies were reviewed that (1) quantified how group-O status and “sickle-trait” (HbAS) and “C-trait” (HbAC) hemoglobins affect Pf mortality, risk of thrombosis, or birth outcomes for women with pregnancy associated malaria (PAM), (2) reported prevalences of “dual-gene” malaria-resistant RBCs, or (3) reflected the level of exchange-transfusion and malaria-related expertise in Benin and Nigeria.ResultsData show that the malaria- and thrombosis-resistance of RBCs depend on specific genes and the patient’s clinical status and medical history. In malaria-endemic Benin and Nigeria, prevalences of “dual-gene” malaria-resistant group-O HbAS and group-O HbAC RBCs are substantial, and both malaria- and exchange-related expertise are outstanding.ConclusionsT-REX of “dual-gene” malaria-resistant RBCs is feasible in Benin and Nigeria and warrants evaluation as a rescue adjunct for 3 subsets of Pf-malaria patients. For therapeutic use, group-O HbAS RBCs are likely to be more effective than non-O HbAS RBCs for Pf-infected patients who (1) have a history of thrombosis or (2) are taking birth-control hormones while group-O HbAC RBCs may substantially improve birth outcomes for women with PAM. Studies suggest it is prudent to assume – until proven otherwise – that T-REX of “dual-gene” malaria-resistant RBCs can improve (“personalize”) rescue of these patient subsets.     

Modification of the impact of access to water on childhood diarrhoea by socioeconomic status in the Gaza Strip from 2000 to 2014: a cross-sectional study

Background

Access to unsafe water is a concern in the Gaza Strip, where water supplies continue to degrade owing to regional sanctions, bombardment, and mismanagement. Our previous study found that decreased access to public water networks was associated with increased diarrhoea prevalence in children younger than 5 years in the Gaza Strip. This study examined the role of socioeconomic status as an effect modifier in this association.

热带地区驻军医务人员职业紧张对生命质量的影响

目的评价热带地区驻军医务人员的生命质量,探讨职业紧张对其心理、生理健康及生命质量的影响。方法采用简单随机抽样的方法随机抽取海南、广州驻军医院五所医院医务人员,采用SF-36、OSI-R测量工具进行调查。结果职业任务紧张、个体紧张反应与生命质量呈显著的负相关关系（r=-0.384,R=-0.521 and r=-0.479,P〈0.01）;个体应对资源与生命质量呈显著的正相关关系（r=0.366、r=0.464and r=0.439,P〈0.01）;职业任务紧张、个体紧张反应、个体应对资源与心理健康相关系数大于生理健康。结论热带地区驻军医务人员职业紧张水平越高,其生命质量越差。个体应对资源可以缓解职业紧张,进而提高职业生命质量。     

Quantifying the hurricane risk to offshore wind turbines

The U.S. Department of Energy has estimated that if the United States is to generate 20% of its electricity from wind, over 50 GW will be required from shallow offshore turbines. Hurricanes are a potential risk to these turbines. Turbine tower buckling has been observed in typhoons, but no offshore wind turbines have yet been built in the United States. We present a probabilistic model to estimate the number of turbines that would be destroyed by hurricanes in an offshore wind farm. We apply this model to estimate the risk to offshore wind farms in four representative locations in the Atlantic and Gulf Coastal waters of the United States. In the most vulnerable areas now being actively considered by developers, nearly half the turbines in a farm are likely to be destroyed in a 20-y period. Reasonable mitigation measures--increasing the design reference wind load, ensuring that the nacelle can be turned into rapidly changing winds, and building most wind plants in the areas with lower risk--can greatly enhance the probability that offshore wind can help to meet the United States' electricity needs.     

我国2000—2019年主要热带病的流行与防治概况

近二十年来我国各行各业发展迅猛,国民经济日新月异,科学技术突飞猛进,我国公共卫生和传染病防治工作显著提升,尤其在热带传染病防控领域成绩卓著。早在2005年在全国范围内就消除了丝虫病,截至2017年,全国450个血吸虫病流行县中,50%达到消除标准,30%达到传播阻断标准,到2019年年底曾经肆虐一时的疟疾已连续三年无本地原发病例,达到了消除疟疾的指标要求,等待世界卫生组织的确认,麻风病和黑热病也得到了很好的控制,有效保障了公众健康和社会稳定,为经济发展作出了重要贡献。然而,伴随全球气候变暖、工业污染、人口增长、自然疫源地的商业开发、抗生素和杀虫剂大量使用等诸多因素,同时随着中国“一带一路”倡议地不断推进、旅游业和国际交流的快速发展,也给热带传染病的防控带来了诸多问题和挑战。     

Leptospirosis: A clinical review of evidence based diagnosis,treatment and prevention

Leptospirosis is a zoonotic disease with worldwide distribution and increasing prevalence. Infection is caused by the spirochete Leptospira, with common exposure being contaminated fresh water. Most infections are asymptomatic, but symptoms range from a mild, self-limiting, non-specific febrile illness to fulminant respiratory and renal failure with a high mortality rate. The combination of jaundice, renal failure, and hemorrhage is known as Weil’s disease and is the most characteristic pattern associated with severe leptospirosis. Clinical suspicion alone may be enough to warrant empiric antibiotic treatment in many cases. Serological methods are the most commonly used means of confirming a diagnosis of leptospirosis. The “gold standard” is the microscopic agglutination test. Typical treatment for mild causes is oral doxycycline, though azithromycin and oral penicillins are reasonable alternatives. Intravenous penicillin G has long been the standard of care for severe cases though limited studies show no benefit compared to third generation cephalosporins. We review the clinical presentation, diagnosis, treatment and prevention of leptospirosis.     

Use of in-vivo confocal microscopy to assess the association of dendritiform cells with progressive trachomatous conjunctival scarring

Background

Trachoma is the most common infectious cause of blindness worldwide. In-vivo confocal microscopy (IVCM) provides high-resolution images of the ocular surface. We have previously reported a grading system for the quantitative assessment of these images in scarring trachoma. We found that the presence of trachomatous scarring was strongly associated with the presence of dendritiform cells (DFCs). The present study assessed whether there is an association between DFCs and clinical progression in scarring.