Human migration is increasing in magnitude and scope. The majority of migrants arriving in high-income countries originate from countries with a high prevalence of infectious diseases. The risk and ...burden of infectious diseases are not equally distributed among migrant groups and vary with migration stage.
A broad literature review was conducted on the drivers for infectious diseases and associated health outcomes among migrants across different stages of migration. The aim was to provide practitioners with an overview of the key infectious disease risks at each stage to guide health promotion strategies.
A complex interaction of factors leads to infectious diseases and associated poor health outcomes among migrants. The most important drivers are the epidemiology of infectious diseases in their countries of origin, the circumstances and conditions of the migration journey and barriers accessing healthcare post-arrival. During the recent large waves of forced migration into Europe, the primary health concerns on arrival were psychological, traumatic and chronic non-communicable diseases. In the early settlement period, crowded and unhygienic living conditions in reception camps facilitated outbreaks of respiratory, gastrointestinal, skin infections and vaccine preventable diseases. After re-settlement, undetected and untreated latent infections due to tuberculosis, viral hepatitis, HIV, chronic helminthiasis and Chagas' disease led to poor health outcomes. Migrants are disproportionally affected by preventable travel-related diseases such as malaria, typhoid and hepatitis due to poor uptake of pre-travel prophylaxis and vaccination. Infectious diseases among migrants can be decreased at all migration stages with health promotion strategies adapted to their specific needs and delivered in a linguistically and culturally sensitive manner.
Tailored health promotion and screening approaches and accessible and responsive health systems, regardless of legal status, will be needed at all migration stages to limit the burden and transmission of infectious diseases in the migrant population.
Coronavirus disease 2019 (COVID‐19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been described in patients with severe respiratory ...distress. Here, we described the case of a 60‐year‐old patient with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection but only mild respiratory abnormalities who developed an akinetic mutism attributable to encephalitis. Magnetic resonance imaging was negative, whereas electroencephalography showed generalized theta slowing. Cerebrospinal fluid analyses during the acute stage were negative for SARS‐CoV‐2, positive for pleocytosis and hyperproteinorrachia, and showed increased interleukin‐8 and tumor necrosis factor‐α concentrations. Other infectious or autoimmune disorders were excluded. A progressive clinical improvement along with a reduction of cerebrospinal fluid parameters was observed after high‐dose steroid treatment, thus arguing for an inflammatory‐mediated brain involvement related to COVID‐19. ANN NEUROL 2020;88:423–427.
More than 244 million international migrants were estimated to live in a foreign country in 2015, leaving apart the massive number of people that have been relocated in their own country. ...Furthermore, a substantial proportion of international migrants from southern countries do not reach western nations but resettle in neighbouring low-income countries in the same geographical area. Migration is a complex phenomenon, where 'macro'-, 'meso'- and 'micro'-factors act together to inform the final individual decision to migrate, integrating the simpler previous push-pull theory.Among the 'macro-factors', the political, demographic, socio-economic and environmental situations are major contributors to migration. These are the main drivers of forced migration, either international or internal, and largely out of individuals' control.Among the 'meso-factors', communication technology, land grabbing and diasporic links play an important role. In particular, social media attract people out of their origin countries by raising awareness of living conditions in the affluent world, albeit often grossly exaggerated, with the diaspora link also acting as an attractor. However, 'micro-factors' such as education, religion, marital status and personal attitude to migration also have a key role in making the final decision to migrate an individual choice. The stereotype of the illiterate, poor and rural migrant reaching the borders of affluent countries has to be abandoned. The poorest people simply do not have the means to escape war and poverty and remain trapped in their country or in the neighbouring one.Once in the destination country, migrants have to undergo a difficult and often conflictive integration process in the hosting community. From the health standpoint, newly arrived migrants are mostly healthy (healthy migrant effect), but they may harbour latent infections that need appropriate screening policies. Cultural barriers may sometimes hamper the relation between the migrant patient and the health care provider. The acquisition of western lifestyles is leading to an increase of non-communicable chronic diseases that require attention.Destination countries have to reconsider the positive medium/long-term potential of migration and need to be prepared to receive migrants for the benefit of the migrants themselves and their native population.
The Coronavirus disease 2019 (COVID-19) pandemic poses a great threat to global public health. The original wild-type strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has ...genetically evolved, and several variants of concern (VOC) have emerged. On 26 November 2021, a new variant named Omicron (B.1.1.529) was designated as the fifth VOC, revealing that SARS-CoV-2 has the potential to go beyond the available therapies. The high number of mutations harboured on the spike protein make Omicron highly transmissible, less responsive to several of the currently used drugs, as well as potentially able to escape immune protection elicited by both vaccines and previous infection. We reviewed the latest publication and the most recent available literature on the Omicron variant, enlightening both reasons for concern and high hopes for new therapeutic strategies.
•A stochastic model for the optimal operation of virtual power plants is developed.•The scenario tree contains both market and renewable generation scenarios.•An ad-hoc decomposition method ...drastically reduces the computational time.•Despite optimal solution, PV generation is partially curtailed.•Cogeneration plant can effectively participate in more markets.
As more uncontrollable renewable energy sources are present in the power generation portfolio, the need of more detailed and reliable tools for the optimal operation of energy systems has increased in the last years. This work presents a multi-stage stochastic Mixed Integer Linear Program with binary recourse for optimizing the day-ahead unit commitment of power plants and virtual power plants operating in the day-ahead and ancillary services markets. Scenarios reproduce the uncertainty of the ancillary services market requests, and production of photovoltaic panels. A novel decomposition algorithm is proposed to tackle the challenging multistage stochastic program. The methodology is tested on three types of large power plants: a natural gas-fired combined cycle, a combined heat and power combined cycle with thermal storage, and a virtual power plant integrating a combined cycle with battery and photovoltaic fields. Compared to the typical deterministic unit commitment approach, the proposed stochastic optimization approach allows to increase the revenues of the conventional power plant up to 13.58% and, for the combined heat and power and virtual power plant case, it allows finding a feasible and efficient operational scheduling.
Among the
family,
is the most notorious genus. Several DNA viruses belonging to this group are known to produce human disease from the life-threatening variola virus (VARV) (the causative agent of ...smallpox), monkeypox virus (MPXV), cowpox virus (CPXV), and vaccinia virus (VACV). These
still remain a public health concern as VACV or CPXV still cause emerging endemic threads, especially in developing countries. MPXV is able to cause sporadic human outbreaks of a smallpox-like zoonotic disease and, in May 2022, hundreds of cases related to MPXV have been reported from more than 30 countries around the globe. At the end of July, monkeypox (MPX) outbreak was even declared a global health emergency by the World Health Organization (WHO). Many aspects remain unclear regarding this outbreak and a deep understanding of
might have crucial and evident implications. During the era in which people under 45 years old are not protected against VACV, the potential use of
as a biological weapon raises global concern considering the rapid spreading of the current MPX outbreak in vulnerable populations. Hence, we review the most recent evidence about phylogenesis, pathogenesis, prevention, and treatment for this concerning disease.
Dynamic posturography combined with wearable sensors has high sensitivity in recognizing subclinical balance abnormalities in patients with Parkinson's disease (PD). However, this approach is ...burdened by a high analytical load for motion analysis, potentially limiting a routine application in clinical practice. In this study, we used machine learning to distinguish PD patients from controls, as well as patients under and not under dopaminergic therapy (i.e., ON and OFF states), based on kinematic measures recorded during dynamic posturography through portable sensors. We compared 52 different classifiers derived from Decision Tree, K-Nearest Neighbor, Support Vector Machine and Artificial Neural Network with different kernel functions to automatically analyze reactive postural responses to yaw perturbations recorded through IMUs in 20 PD patients and 15 healthy subjects. To identify the most efficient machine learning algorithm, we applied three threshold-based selection criteria (i.e., accuracy, recall and precision) and one evaluation criterion (i.e., goodness index). Twenty-one out of 52 classifiers passed the three selection criteria based on a threshold of 80%. Among these, only nine classifiers were considered "optimum" in distinguishing PD patients from healthy subjects according to a goodness index ≤ 0.25. The Fine K-Nearest Neighbor was the best-performing algorithm in the automatic classification of PD patients and healthy subjects, irrespective of therapeutic condition. By contrast, none of the classifiers passed the three threshold-based selection criteria in the comparison of patients in ON and OFF states. Overall, machine learning is a suitable solution for the early identification of balance disorders in PD through the automatic analysis of kinematic data from dynamic posturography.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is spreading worldwide with different clinical manifestations. Age and comorbidities may explain severity in critical cases and ...people living with human immunodeficiency virus (HIV) might be at particularly high risk for severe progression. Nonetheless, current data, although sometimes contradictory, do not confirm higher morbidity, risk of more severe COVID-19 or higher mortality in HIV-infected people with complete access to antiretroviral therapy (ART). A possible protective role of ART has been hypothesized to explain these observations. Anti-viral drugs used to treat HIV infection have been repurposed for COVID-19 treatment; this is also based on previous studies on severe acute respiratory syndrome virus (SARS-CoV) and Middle East respiratory syndrome virus (MERS-CoV). Among them, lopinavir/ritonavir, an inhibitor of viral protease, was extensively used early in the pandemic but it was soon abandoned due to lack of effectiveness in clinical trials. However, remdesivir, a nucleotide analog that acts as reverse-transcriptase inhibitor, which was tested early during the pandemic because of its wide range of antiviral activity against several RNA viruses and its safety profile, is currently the only antiviral medication approved for COVID-19. Tenofovir, another nucleotide analog used extensively for HIV treatment and pre-exposure prophylaxis (PrEP), has also been hypothesized as effective in COVID-19. No data on tenofovir’s efficacy in coronavirus infections other than COVID-19 are currently available, although information relating to SARS-CoV-2 infection is starting to come out. Here, we review the currently available evidence on tenofovir’s efficacy against SARS-CoV-2.
The epidemic curve of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is silently rising again. Worldwide, the dominant SARS-CoV-2 variant of concern (VOC) is Omicron, and its ...virological characteristics, such as transmissibility, pathogenicity, and resistance to both vaccine- and infection-induced immunity as well as antiviral drugs, are an urgent public health concern. The Omicron variant has five major sub-lineages; as of February 2022, the BA.2 lineage has been detected in several European and Asian countries, becoming the predominant variant and the real antagonist of the ongoing surge. Hence, although global attention is currently focused on dramatic, historically significant events and the multi-country monkeypox outbreak, this new epidemic is unlikely to fade away in silence. Many aspects of this lineage are still unclear and controversial, but its apparent replication advantage and higher transmissibility, as well as its ability to escape neutralizing antibodies induced by vaccination and previous infection, are rising global concerns. Herein, we review the latest publications and the most recent available literature on the BA.2 lineage of the Omicron variant.
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