The health effects of traffic-related air pollution (TRAP) continue to be of important public health interest. Following its well-cited 2010 critical review, the Health Effects Institute (HEI) ...appointed a new expert Panel to systematically evaluate the epidemiological evidence regarding the associations between long-term exposure to TRAP and selected adverse health outcomes. Health outcomes were selected based on evidence of causality for general air pollution (broader than TRAP) cited in authoritative reviews, relevance for public health and policy, and resources available.
The Panel used a systematic approach to search the literature, select studies for inclusion in the review, assess study quality, summarize results, and reach conclusions about the confidence in the evidence. An extensive search was conducted of literature published between January 1980 and July 2019 on selected health outcomes. A new exposure framework was developed to determine whether a study was sufficiently specific to TRAP.
In total, 353 studies were included in the review. Respiratory effects in children (118 studies) and birth outcomes (86 studies) were the most commonly studied outcomes. Fewer studies investigated cardiometabolic effects (57 studies), respiratory effects in adults (50 studies), and mortality (48 studies).
The findings from the systematic review, meta-analyses, and evaluation of the quality of the studies and potential biases provided an overall high or moderate-to-high level of confidence in an association between long-term exposure to TRAP and the adverse health outcomes all-cause, circulatory, ischemic heart disease and lung cancer mortality, asthma onsetin chilldren and adults, and acute lower respiratory infections in children. The evidence was considered moderate, low or very low for the other selected outcomes.
In light of the large number of people exposed to TRAP – both in and beyond the near-road environment - the Panel concluded that the overall high or moderate-to-high confidence in the evidence for an association between long-term exposure to TRAP and several adverse health outcomes indicates that exposures to TRAP remain an important public health concern and deserve greater attention from the public and from policymakers.
To conduct an extensive literature and toxicological database review on substitute compounds and available alternative medical products to replace polyvinyl chloride (PVC) and/or di(2-ethylhexyl) ...phthalate (DEHP), and conduct a DEHP-medical inventory analysis at a large metropolitan neonatal intensive care unit (NICU).
A systematic search for DEHP-free alternative products was performed using online databases. An informal audit of a large metropolitan NICU was undertaken in 2005 and 2006; 21 products were identified that could potentially contain DEHP. Availability of DEHP-free alternatives was determined through company websites and phone interviews.
Two alternative approaches are available for replacing DEHP in NICU medical products: (1) replacement by DEHP-free plasticizers; and (2) replacement of PVC entirely through the use of other polymers. Both approaches seem to provide less harmful substitutes to DEHP, but support PVC-free polymers as the preferred alternative. However, significant data gaps exist, particularly for the alternative polymers. In all, 10 out of 21 (48%) products in the NICU audit were DEHP-free; six consisted of alternative polymers and four of alternative plasticizers. Of the remaining 11 products, only three were available without DEHP at the time of the audit.
Because of significant data gaps, systematic toxicological testing of DEHP-free alternatives is imperative. Continued development of alternative products is also needed.
The initial aim was to study the effects of face masks worn by recently infected individuals on the airborne spread of SARS-CoV-2, but findings motivated us to proceed with comparing the presence of ...SARS-CoV-2 in air samples near infected individuals at home with those near infected intensive care unit (ICU) patients.
To assess the presence of SARS-CoV-2 in the air of homes of infected individuals and in ICU rooms of critically ill patients with COVID-19 who were undergoing different forms of potential aerosol-generating medical procedures.
A high-volume air sampler method was developed that used a household vacuum cleaner with surgical face masks serving as sample filters. SARS-CoV-2 RNA was harvested from these filters and analysed by polymerase chain reaction. Fog experiments were performed to visualize the airflow around the air sampler. Air samples were acquired in close proximity of infected individuals, with or without wearing face masks, in their homes. Environmental air samples remote from these infected individuals were also obtained, plus samples near patients in the ICU undergoing potential aerosol-generating medical procedures.
Wearing a face mask resulted in a delayed and reduced flow of the fog into the air sampler. Face masks worn by infected individuals were found to contain SARS-CoV-2 RNA in 71% of cases. SARS-CoV-2 was detected in air samples regardless of mask experiments. The proportion of positive air samples was higher in the homes (29/41; 70.7%) than in the ICU (4/17; 23.5%) (P < 0.01).
SARS-CoV-2 RNA could be detected in air samples by using a vacuum cleaner based air sampler method. Air samples in the home environment of recently infected individuals contained SARS-CoV-2 RNA nearly three times more frequently by comparison with those obtained in ICU rooms during potential aerosol-generating medical procedures.
Air quality is a serious and worsening problem in the rapidly growing cities of sub-Saharan Africa (SSA). However, the lack of ambient monitoring data, and particularly urban roadside concentrations ...for particulate matter in SSA cities severely hinders our ability to describe temporal and spatial patterns of concentrations, characterize exposure–response relationships for key health outcomes, estimate disease burdens, and promote policy initiatives to address air quality. As part of a collaborative transportation planning exercise between Columbia University and the University of Nairobi, air monitoring was carried out in February 2006 in Nairobi, Kenya. The objective of the monitoring was to collect pilot data on air concentrations (PM2.5 and black carbon) encountered while driving in the Nairobi metropolitan area, and to compare those data to simultaneous ‘urban background’ concentrations measured in Nairobi but away from roadways. For both the background and roadway monitoring, we used portable air sampling systems that collect integrated filter samples. Results from this pilot study found that roadway concentrations of PM2.5 were approximately 20-fold higher than those from the urban background site, whereas black carbon concentrations differed by 10-fold. If confirmed by more extensive sampling, these data would underscore the need for air quality and transportation planning and management directed at mitigating roadway pollution.
Leakage of the blood–brain barrier (BBB) is associated with various neurological disorders, including temporal lobe epilepsy (TLE). However, it is not known whether alterations of the BBB occur ...during epileptogenesis and whether this can affect progression of epilepsy. We used both human and rat epileptic brain tissue and determined BBB permeability using various tracers and albumin immunocytochemistry. In addition, we studied the possible consequences of BBB opening in the rat for the subsequent progression of TLE. Albumin extravasation in human was prominent after status epilepticus (SE) in astrocytes and neurons, and also in hippocampus of TLE patients. Similarly, albumin and tracers were found in microglia, astrocytes and neurons of the rat. The BBB was permeable in rat limbic brain regions shortly after SE, but also in the latent and chronic epileptic phase. BBB permeability was positively correlated to seizure frequency in chronic epileptic rats. Artificial opening of the BBB by mannitol in the chronic epileptic phase induced a persistent increase in the number of seizures in the majority of rats. These findings indicate that BBB leakage occurs during epileptogenesis and the chronic epileptic phase and suggest that this can contribute to the progression of epilepsy.
Very little data have been published on medical imaging services at disability games. 7.9 million euros (£6.6 million, US$11 million) were invested in setting up radiology facilities within purpose ...built polyclinics at the London 2012 Olympic and Paralympic games. This paper details imaging services at the 2012 Paralympic Games. Data analysis on imaging at 2012 Olympics has been published in a separate paper.
To analyse the workload on the polyclinics' radiology services, provided for the Paralympic athletes during the London 2012 Paralympic Games.
Data were prospectively collected during the period of the Paralympic games from the Picture Archive Communications System (PACS) and the Radiological Information System (RIS). Data were correlated with the medical encounter database (ATOS).
655 imaging episodes were recorded, which comprised 38.8% (n=254) MRI, 33% (n=216) plain radiographs, 24% (n=157) ultrasound scans and 4.2% (n=28) CT scans. Investigations on the Paralympic athletes accounted for 65.2% of workload, with the remainder divided between Paralympic family and workforce.
MRI was the most used imaging resource and CT was the least used imaging modality at the Paralympic village polyclinic. Analysis of demographic data provides a useful index for planning radiology infrastructure and manpower at future international competitions for athletes with a disability.
Despite the long-held belief that growth hormone supplementation provides psychosocial benefits to patients with Turner syndrome (TS), this assumption has never been rigorously tested in a randomized ...control trial. As a sub-study of the Canadian growth-hormone trial, parent-, and patient-completed standardized questionnaires were used to compare 70 girls with TS who received injections (GH group) and 61 similarly followed untreated TS controls (C) on multiple facets of psychosocial functioning. Questionnaires were given (i) at baseline (session 1, mean age = 10.4 y), (ii) before estrogen therapy for puberty induction (session 2, mean age = 13.0 y), (iii) after 1 year of estrogen therapy (session 3, mean age = 14.4 y), and (iv) when growth stopped (session 4, mean age = 16.3 y). Groups were compared for multiple facets of psychosocial function within social, behavioral, self-esteem, and academic domains. Results were also correlated with indices of adult height. We found no global (i.e., across-session) group differences on any scales or subscales of the four domains. In both GH and C groups, age-related improvements were seen for social problems, externalizing behavior problems, and school functioning and age-related declines for social competence and social relations. Both parents and patients claimed GH received less teasing than C but C had more friends than GH. Results from analyses conducted within individual sessions showed that while GH at early sessions claimed to be more popular, more socially engaged, better adapted, and to have higher self-esteem than C, C was reported to be less anxious, depressed, and withdrawn than GH at adult height. The correlation analyses revealed different effects of adult height and height gain on outcome for the two groups. In GH, both height parameters were correlated with multiple parent- and/or self-reported indices from the four psychosocial domains, whereas in C, only adult height and two indices (viz., total self-concept and school functioning), were correlated. The observed modest gains in psychosocial functioning for patients with TS treated with GH highlight the need for alternative approaches to assist them in coping with the challenges of their condition.
Guillain–Barré syndrome (GBS) is a post-infectious disease in which the human peripheral nervous system is affected after infection by specific pathogenic bacteria, including
Campylobacter jejuni
. ...GBS is suggested to be provoked by molecular mimicry between sialylated lipooligosaccharide (LOS) structures on the cell envelope of these bacteria and ganglioside epitopes on the human peripheral nerves, resulting in autoimmune-driven nerve destruction. Earlier, the
C. jejuni
sialyltransferase (Cst-II) was found to be linked to GBS and demonstrated to be involved in the biosynthesis of the ganglioside-like LOS structures. Apart from a role in pathogenicity, we report here that Cst-II-generated ganglioside-like LOS structures confer efficient bacteriophage resistance in
C. jejuni
. By bioinformatic analysis, it is revealed that the presence of sialyltransferases in
C. jejuni
and other potential GBS-related pathogens correlated significantly with the apparent degeneration of an alternative anti-virus system: type II
C
lusters of
R
egularly
I
nterspaced
S
hort
P
alindromic
R
epeat and
as
sociated genes (CRISPR-Cas). Molecular analysis of the
C. jejuni
CRISPR-Cas system confirmed the bioinformatic investigation. CRISPR degeneration and mutations in the
cas
genes
cas2
,
cas1
and
csn1
were found to correlate with Cst-II sialyltransferase presence (
p
< 0.0001). Remarkably, type II CRISPR-Cas systems are mainly found in mammalian pathogens. To study the potential involvement of this system in pathogenicity, we inactivated the type II CRISPR-Cas marker gene
csn1
, which effectively reduced virulence in primarily
cst
-II-positive
C. jejuni
isolates. Our findings indicate a novel link between viral defence, virulence and GBS in a pathogenic bacterium.
•Hunting wild animals supports human livelihoods, but is also a threat to animal conservation.•We created a database for bushmeat offtake, consumption and trade in West and Central Africa.•We ...collated data on 177 species from 275 sites across 11 countries collected over 30years.•The database enables analyses of spatial and temporal patterns, and of drivers of bushmeat harvesting.•Knowledge gaps and future research priorities for bushmeat harvesting can be identified using the database.
Unsustainable hunting threatens both biodiversity and local livelihoods. Despite high levels of research effort focused on understanding the dynamics of bushmeat trade and consumption, current research is largely site specific. Without synthesis and quantitative analysis of available case studies, the national and regional characteristics of bushmeat trade and consumption remain largely speculative, impeding efforts to inform national and regional policy on bushmeat trade. Here we describe the structure and content of the West and Central African bushmeat database which holds quantitative data on bushmeat sales, consumption and offtake for 177 species from 275 sites across 11 countries in two regions, spanning three decades of research. Despite this wealth of available data, we found important biases in research effort. The majority of studies in West and Central Africa have collected market data, which although providing a useful record of bushmeat sales, are limited in their ability to track changes in hunting offtake. In addition, few data exist for West Africa, and few studies have tracked changes over time, using repeat sampling. With new initiatives in the regions to track bushmeat hunting, this database represents an opportunity to synthesise current and future data on bushmeat hunting, consumption and trade in West and Central Africa, identify gaps in current understanding, and systematically target future monitoring efforts.
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