Heating with biomass in the United Kingdom: Lessons from New Zealand

In this study we review the current status of residential solid fuel (RSF) use in the UK and compare it with New Zealand, which has had severe wintertime air quality issues for many years that is directly attributable to domestic wood burning in heating stoves. Results showed that RSF contributed to more than 40 μg m−3 PM10 and 10 μg m−3 BC in some suburban locations of New Zealand in 2006, with significant air quality and climate impacts. Models predict RSF consumption in New Zealand to decrease slightly from 7 PJ to 6 PJ between 1990 and 2030, whereas consumption in the UK increases by a factor of 14. Emissions are highest from heating stoves and fireplaces, and their calculated contribution to radiative forcing in the UK increases by 23% between 2010 and 2030, with black carbon accounting for more than three quarters of the total warming effect. By 2030, the residential sector accounts for 44% of total BC emissions in the UK and far exceeds emissions from the traffic sector. Finally, a unique bottom-up emissions inventory was produced for both countries using the latest national survey and census data for the year 2013/14. Fuel- and technology-specific emissions factors were compared between multiple inventories including GAINS, the IPCC, the EMEP/EEA and the NAEI. In the UK, it was found that wood consumption in stoves was within 30% of the GAINS inventory, but consumption in fireplaces was substantially higher and fossil fuel consumption is more than twice the GAINS estimate. As a result, emissions were generally a factor of 2–3 higher for biomass and 2–6 higher for coal. In New Zealand, coal and lignite consumption in stoves is within 24% of the GAINS inventory estimate, but wood consumption is more than 7 times the GAINS estimate. As a result, emissions were generally a factor of 1–2 higher for coal and several times higher for wood. The results of this study indicate that emissions from residential heating stoves and fireplaces may be underestimated in climate models. Emissions are increasing rapidly in the UK which may result in severe wintertime air quality reductions, as seen in New Zealand, and contribute to climate warming unless controls are implemented such as the Ecodesign emissions limits

The Drosophila melanogaster host model

The deleterious and sometimes fatal outcomes of bacterial infectious diseases are the net result of the interactions between the pathogen and the host, and the genetically tractable fruit fly, Drosophila melanogaster, has emerged as a valuable tool for modeling the pathogen–host interactions of a wide variety of bacteria. These studies have revealed that there is a remarkable conservation of bacterial pathogenesis and host defence mechanisms between higher host organisms and Drosophila. This review presents an in-depth discussion of the Drosophila immune response, the Drosophila killing model, and the use of the model to examine bacterial–host interactions. The recent introduction of the Drosophila model into the oral microbiology field is discussed, specifically the use of the model to examine Porphyromonas gingivalis–host interactions, and finally the potential uses of this powerful model system to further elucidate oral bacterial-host interactions are addressed

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

The morphological and molecular characterization of Myxobolus khaliji n. sp (Myxozoa: Myxosporea) from the double bar seabream Acanthopagrus bifasciatus (ForsskAyenl, 1775) in the Arabian Gulf, Saudi Arabia

Myxobolus khaliji n. sp., a new myxosporean, is described from the intestinal wall of the double bar seabream Acanthopagrus bifasciatus, collected from the Arabian Gulf off the coast of Saudi Arabia. It is characterized by the presence of ellipsoidal or round plasmodia of 2-4 mm in diameter. Mature spores were subspherical to elliptical in the frontal view, with a slightly pointed anterior end and a bluntly rounded posterior end, and measured 8.1 +/- 0.4 (7.2-9.5) mu m long, 6.3 +/- 0.6 (5.1-7.4) mu m wide, and 9.2 +/- 0.7 (8.3-10.2) thick. Spore valves are relatively thin, sometimes with a prominent thick caudal appendage. Two equal elliptical polar capsules were situated in the plane of the suture line at the anterior end of the spores and occupied above half of the spore length. Polar capsules measured 5.5 +/- 0.7 (4.1-6.1) mu m long and 3.2 +/- 0.2 (2.1-4.2) mu m wide. Polar filaments, wound in three to four coils, were situated perpendicularly to the longitudinal axis of the polar capsules. Combining the morphological characteristics, host specificity and geographical distribution, tissue tropism, and the molecular analysis of the partial sequence of the SSU ribosomal DNA gene, it was concluded that M. khaliji n. sp. was distinct from all previously described Myxobolus species. Phylogenetic analysis placed the present Myxobolus species in a marine Henneguya clade, which is a sister group of marine Myxobolus species. This is the first Myxobolus species with Henneguya-like spores from the marine environment to be found in the Saudi Arabian coasts of the Arabian Gulf.Myxobolus khaliji n. sp., a new myxosporean, is described from the intestinal wall of the double bar seabream Acanthopagrus bifasciatus, collected from the Arabian Gulf off the coast of Saudi Arabia. It is characterized by the presence of ellipsoidal or round plasmodia of 2-4 mm in diameter. Mature spores were subspherical to elliptical in the frontal view, with a slightly pointed anterior end and a bluntly rounded posterior end, and measured 8.1 +/- 0.4 (7.2-9.5) mu m long, 6.3 +/- 0.6 (5.1-7.4) mu m wide, and 9.2 +/- 0.7 (8.3-10.2) thick. Spore valves are relatively thin, sometimes with a prominent thick caudal appendage. Two equal elliptical polar capsules were situated in the plane of the suture line at the anterior end of the spores and occupied above half of the spore length. Polar capsules measured 5.5 +/- 0.7 (4.1-6.1) mu m long and 3.2 +/- 0.2 (2.1-4.2) mu m wide. Polar filaments, wound in three to four coils, were situated perpendicularly to the longitudinal axis of the polar capsules. Combining the morphological characteristics, host specificity and geographical distribution, tissue tropism, and the molecular analysis of the partial sequence of the SSU ribosomal DNA gene, it was concluded that M. khaliji n. sp. was distinct from all previously described Myxobolus species. Phylogenetic analysis placed the present Myxobolus species in a marine Henneguya clade, which is a sister group of marine Myxobolus species. This is the first Myxobolus species with Henneguya-like spores from the marine environment to be found in the Saudi Arabian coasts of the Arabian Gulf