Infections with human parechoviruses (HPeVs) are prevalent in young children and have been associated with mild gastroenteritis and, less frequently, with meningitis and neonatal sepsis. To ...investigate the involvement of these viruses in respiratory disease, a highly sensitive nested PCR was used to screen a large archive of respiratory specimens, collected between January and December 2007. Respiratory samples had previously been tested for eight respiratory viruses, including respiratory syncytial virus and adenovirus, by PCR. HPeV was detected in 34 of 3,844 specimens, representing 27 of 2,220 study subjects (1.2%). HPeV types were identified by sequencing the VP3/VP1 junction amplified by PCR directly from clinical specimens. The assay could amplify all HPeV types examined with high sensitivity (types 1 and 3 to 6) and also identified HPeV types in all but one of the screen-positive study specimens (25 HPeV1 and eight HPeV6 specimens). Infections with both HPeV1 and HPeV6 were seasonal, with highest frequencies in July and August, and restricted to children aged between 6 months and 5 years. Other respiratory viruses were frequently codetected in HPeV-positive specimens, with significant overrepresentation of adenovirus coinfections (37%). Most HPeV-positive specimens were referred from emergency departments, although no association with specific respiratory symptoms or disease was found. In summary, the low frequency of detection and lack of clear disease associations indicate that HPeV1 and -6 are not major pathogens in individuals presenting with respiratory disease. However, the screening and typing methods developed will be of value in further HPeV testing, including testing for meningitis cases and other suspected HPeV-associated disease presentations.
Atmospheric measurements show that emissions of hydrofluorocarbons (HFCs) and hydrochlorofluorocarbons are now the primary drivers of the positive growth in synthetic greenhouse gas (SGHG) radiative ...forcing. We infer recent SGHG emissions and examine the impact of future emissions scenarios, with a particular focus on proposals to reduce HFC use under the Montreal Protocol. If these proposals are implemented, overall SGHG radiative forcing could peak at around 355 mW m−2 in 2020, before declining by approximately 26% by 2050, despite continued growth of fully fluorinated greenhouse gas emissions. Compared to “no HFC policy” projections, this amounts to a reduction in radiative forcing of between 50 and 240 mW m−2 by 2050 or a cumulative emissions saving equivalent to 0.5 to 2.8 years of CO2 emissions at current levels. However, more complete reporting of global HFC emissions is required, as less than half of global emissions are currently accounted for.
Key Points
Measurements of all the major synthetic greenhouse gases have been compiled
These measurements have been used to infer recent global emissions trends
Based on these trends, future emissions scenarios have been investigated
Rhinovirus infections are the most common cause of viral illness in humans, and there is increasing evidence of their etiological role in severe acute respiratory tract infections (ARTIs). Human ...rhinoviruses (HRVs) are classified into two species, species A and B, which contain over 100 serotypes, and a recently discovered genetically heterogeneous third species (HRV species C). To investigate their diversity and population turnover, screening for the detection and the genetic characterization of HRV variants in diagnostic respiratory samples was performed by using nested primers for the efficient amplification of the VP4-VP2 region of HRV (and enterovirus) species and serotype identification. HRV species A, B, and C variants were detected in 14%, 1.8%, and 6.8%, respectively, of 456 diagnostic respiratory samples from 345 subjects (6 samples also contained enteroviruses), predominantly among children under age 10 years. HRV species A and B variants were remarkably heterogeneous, with 22 and 6 different serotypes, respectively, detected among 73 positive samples. Similarly, by using a pairwise distance threshold of 0.1, species C variants occurring worldwide were provisionally assigned to 47 different types, of which 15 were present among samples from Edinburgh, United Kingdom. There was a rapid turnover of variants, with only 5 of 43 serotypes detected during both sampling periods. By using divergence thresholds and phylogenetic analysis, several species A and C variants could provisionally be assigned to new types. An initial investigation of the clinical differences between rhinovirus species found HRV species C to be nearly twice as frequently associated with ARTIs than other rhinovirus species, which matches the frequencies of detection of respiratory syncytial virus. The study demonstrates the extraordinary genetic diversity of HRVs, their rapid population turnover, and their extensive involvement in childhood respiratory disease.
Human enteroviruses (EV) and parechoviruses (HPeV) within the family Picornaviridae are the most common causes of viral central nervous system (CNS)-associated infections including meningitis and ...neonatal sepsis-like disease. The frequencies of EV and HPeV types identified in clinical specimens collected in Scotland over an eight-year period were compared to those identified in sewage surveillance established in Edinburgh. Of the 35 different EV types belonging to four EV species (A to D) and the four HPeV types detected in this study, HPeV3 was identified as the most prevalent picornavirus in cerebrospinal fluid samples, followed by species B EV. Interestingly, over half of EV and all HPeV CNS-associated infections were observed in young infants (younger than three months). Detection of species A EV including coxsackievirus A6 and EV71 in clinical samples and sewage indicates that these viruses are already widely circulating in Scotland. Furthermore, species C EV were frequently identified EV in sewage screening but they were not present in any of 606 EV-positive clinical samples studied, indicating their likely lower pathogenicity. Picornavirus surveillance is important not only for monitoring the changing epidemiology of these infections but also for the rapid identification of spread of emerging EV and/or HPeV types.
To inform clinical practice, we sought to identify racial and ethnic differences in the medical management of common poststroke complications.
A cohort of acutely hospitalized, first-time ...non-Hispanic White (NHW), non-Hispanic Black, and Hispanic patients with stroke was identified from electronic medical records of 51 large health care organizations (January 1, 2003 to December 5, 2022). Matched propensity scores were used to account for baseline differences. Primary outcomes included receipt of medication(s) associated with the management of the following poststroke complications: arousal/fatigue, spasticity, mood, sleep, neurogenic bladder, neurogenic bowel, and seizure. Differences were measured at 14, 90, and 365 days. Subgroup analyses included differences restricted to patients with ischemic stroke, younger age (<65 years), and stratified by decade (2003-2012 and 2013-2022). Before matching, the final cohort consisted of 348 286 patients with first-time stroke. Matching resulted in 63 722 non-Hispanic Black-NHW pairs and 24 009 Hispanic-NHW pairs. Non-Hispanic Black (versus NHW) patients were significantly less likely to be treated for all poststroke complications, with differences largest for arousal/fatigue (relative risk (RR), 0.58 95% CI, 0.54-0.62), spasticity (RR, 0.64 95% CI, 0.0.62-0.67), and mood disorders (RR, 0.72 95% CI, 0.70-0.74) at 14 days. Hispanic-NHW differences were similar, albeit with smaller magnitudes, with the largest differences present for spasticity (RR, 0.67 95% CI, 0.63-0.72), arousal/fatigue (RR, 0.77 95% CI, 0.70-0.85), and mood disorders (RR, 0.79 95% CI, 0.77-0.82). Subgroup analyses revealed similar patterns for ischemic stroke and patients aged <65 years. Disparities for the current decade remained significant but with smaller magnitudes compared with the prior decade.
There are significant racial and ethnic disparities in the treatment of poststroke complications. The differences were greatest at 14 days, outlining the importance of early identification and management.
Methane (CH4) and nitrous oxide (N2O) have strong radiative properties in the Earth's atmosphere and both are regulated through the United Nations Framework Convention on Climate Change. Through this ...convention the United Kingdom is obliged to report an inventory of annual emission estimates from 1990. This paper describes a methodology that estimates emissions of CH4 and N2O completely independent of the inventory values. Emissions have been estimated for each year 1990–2007 for the United Kingdom and for NW Europe. The methodology combines high‐frequency observations from Mace Head, a monitoring site on the west coast of Ireland, with an atmospheric dispersion model and an inversion system. The sensitivities of the inversion method to the modeling assumptions are reported. The 20 year Northern Hemisphere midlatitude baseline mixing ratios, growth rates, and seasonal cycles of both gases are also presented. The results indicate reasonable agreement between the inventory and inversion results for the United Kingdom for N2O over the entire period. For CH4 the agreement is poor in the 1990s but good in the 2000s. The UK CH4 inventory reported reduction from 1990–1992 to 2005–2007 (over 50%) is dominated by changes to landfill and coal mine emissions and is more than double the corresponding drop in the inversion estimated emissions (24%). The inversion results suggest that the United Kingdom has met its Kyoto commitment (−12.5%) but by a smaller margin (−14.3%) than reported (−17.3%). The results for NW Europe with the United Kingdom removed show reasonable agreement in trend, on average the inversion results for N2O are 25% lower and for CH4 21% higher.
The conservation of harbor porpoises (
Phocoena phocoena
) appears to be failing in Europe. There are particular concerns about this species in the Baltic Proper, Black, and Mediterranean Seas, as ...well as in the Northeast Atlantic, including the Iberian population, off the Spanish and Portuguese coasts. The Baltic Proper porpoise is “critically endangered,” with a population only in the low hundreds, and the Scientific Committee of the International Whaling Commission has repeatedly called for action to ensure its survival. In 2020, the Committee issued a series of recommendations relating to it and the Iberian population. Similarly, the Black Sea harbor porpoise,
Phocoena phocoena
ssp.
relicta
, is classified by the IUCN as endangered. Another population which may be genetically distinct is the West Greenland harbor porpoise, which is hunted without quotas or close seasons. European cetaceans and their habitats are covered by a number of international and regional conventions and agreements and, under European Union law, are “highly protected.” In practice, however, these legal protections have failed to generate effective conservation. For example, Special Areas of Conservation (SACs) are required for them and, although sites have been designated in some marine areas/countries, in the absence of appropriate management plans, SACs cannot be expected to help improve the harbor porpoise's conservation status. Compared to many other species, porpoises are relatively long-lived with low reproductive capacity and only poor public recognition. Conservation and management efforts are caught up in a complicated nexus of interactions involving a web of commitments under international conventions and agreements, European environmental laws, and European fisheries policy. However, public disinterest, lack of political will to implement conservation measures, and complicated fishing-related issues hinder any real progress. More positively, recent advice from the International Council for the Exploration of the Seas (ICES) provides a new scientific foundation for conservation action to address fisheries bycatch in the Baltic Proper harbor porpoise population. Populations of other porpoise species (family Phocoenidae) are also threatened, most notably the global population of the critically endangered vaquita, or Gulf of California porpoise (
Phocoena sinus
). The common threats and factors affecting porpoise populations are discussed and recommendations offered.
Enterovirus 71 (EV71) is responsible for frequent large-scale outbreaks of hand, foot, and mouth disease worldwide and represent a major etiological agent of severe, sometimes fatal neurological ...disease. EV71 variants have been classified into three genogroups (GgA, GgB, and GgC), and the latter two are further subdivided into subgenogroups B1 to B5 and C1 to C5. To investigate the dual roles of recombination and evolution in the epidemiology and transmission of EV71 worldwide, we performed a large-scale genetic analysis of isolates (n = 308) collected from 19 countries worldwide over a 40-year period. A series of recombination events occurred over this period, which have been identified through incongruities in sequence grouping between the VP1 and 3Dpol regions. Eleven 3Dpol clades were identified, each specific to EV71 and associated with specific subgenogroups but interspersed phylogenetically with clades of coxsackievirus A16 and other EV species A serotypes. The likelihood of recombination increased with VP1 sequence divergence; mean half-lives for EV71 recombinant forms (RFs) of 6 and 9 years for GgB and GgC overlapped with those observed for the EV-B serotypes, echovirus 9 (E9), E30, and E11, respectively (1.3 to 9.8 years). Furthermore, within genogroups, sporadic recombination events occurred, such as the linkage of two B4 variants to RF-W instead of RF-A and of two C4 variants to RF-H. Intriguingly, recombination events occurred as a founding event of most subgenogroups immediately preceding their lineage expansion and global emergence. The possibility that recombination contributed to their subsequent spread through improved fitness requires further biological and immunological characterization.
PDF
