Effect of smoking on lung function, respiratory symptoms and respiratory diseases amongst HIV-positive subjects: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Smoking prevalence in human immunodeficiency virus (HIV) positive subjects is about three times of that in the general population. However, whether the extremely high smoking prevalence in HIV-positive subjects affects their lung function is unclear, particularly whether smoking decreases lung function more in HIV-positive subjects, compared to the general population. We conducted this study to determine the association between smoking and lung function, respiratory symptoms and diseases amongst HIV-positive subjects.</p> <p>Results</p> <p>Of 120 enrolled HIV-positive subjects, 119 had an acceptable spirogram. Ninety-four (79%) subjects were men, and 96 (81%) were white. Mean (standard deviation [SD]) age was 43.4 (8.4) years. Mean (SD) of forced expiratory volume in one second (FEV₁) percent of age, gender, race and height predicted value (%FEV₁) was 93.1% (15.7%). Seventy-five (63%) subjects had smoked 24.0 (18.0) pack-years. For every ten pack-years of smoking increment, %FEV₁decreased by 2.1% (95% confidence interval [CI]: -3.6%, -0.6%), after controlling for gender, race and restrictive lung function (R²= 0.210). The loss of %FEV₁in our subjects was comparable to the general population. Compared to non-smokers, current smokers had higher odds of cough, sputum or breathlessness, after adjusting for highly active anti-retroviral therapy (HAART) use, odds ratio OR = 4.9 (95% CI: 2.0, 11.8). However respiratory symptom presence was similar between non-smokers and former smokers, OR = 1.0 (95% CI: 0.3, 2.8). All four cases of COPD (chronic obstructive pulmonary disease) had smoked. Four of ten cases of restrictive lung disease had smoked (p = 0.170), and three of five asthmatic subjects had smoked (p = 1.000).</p> <p>Conclusions</p> <p>Cumulative cigarette consumption was associated with worse lung function; however the loss of %FEV₁did not accelerate in HIV-positive population compared to the general population. Current smokers had higher odds of respiratory symptoms than non-smokers, while former smokers had the same odds of respiratory symptoms as non-smokers. Cigarette consumption was likely associated with more COPD cases in HIV-positive population; however more participants and longer follow up would be needed to estimate the effect of smoking on COPD development. Effective smoking cessation strategies are required for HIV-positive subjects.</p

OnabotulinumtoxinA for Treatment of Moderate to Severe Crow's Feet Lines: A Review

Lateral canthal lines or crow's feet lines (CFL) may be treated with onabotulinumtoxinA. We identified several key concepts important to understanding the use of onabotulinumtoxinA for treatment of moderate-to-severe CFL. To contextualize and integrate data on the recommended dose and injection patterns of onabotulinumtoxinA for treatment of CFL, we summarized data from pivotal clinical studies in the development of onabotulinumtoxinA for treatment of CFL. Data from key studies of onabotulinumtoxinA for CFL are presented. The efficacy and safety of onabotulinumtoxinA treatment of moderate-to-severe CFL were evaluated in 2 randomized, controlled phase 3 studies comprising 1362 patients. The 24U total dose of onabotulinumtoxinA used in these studies was based on a phase 2 dose-ranging trial. Two injection patterns were available to investigators; each involved 3 injection sites per side in the lateral orbicularis oculi muscle. A cross-sectional analysis of photographs from the phase 3 trials provided detailed information on the frequency of 4 distinct CFL patterns. In the primary efficacy analysis for each phase 3 trial, CFL responder rates were significantly greater with onabotulinumtoxinA vs placebo at day 30 ( P < .001). Eyelid edema (1%) was the only adverse event reported in ≥1% of patients receiving onabotulinumtoxinA, occurring more frequently with onabotulinumtoxinA than with placebo. The studies showed that onabotulinumtoxinA is effective and generally well-tolerated for CFL treatment. Additionally, 2 different injection patterns allow physicians to tailor treatment based on a patient's CFL pattern

Street-scale air quality modelling for Beijing during a winter 2016 measurement campaign

We examine the street-scale variation of NOx, NO2, O3 and PM2.5 concentrations in Beijing during the Atmospheric Pollution and Human Health in a Chinese Megacity (APHH-China) winter measurement campaign in November–December 2016. Simulations are performed using the urban air pollution dispersion and chemistry model ADMS-Urban and an explicit network of road source emissions. Two versions of the gridded Multi-resolution Emission Inventory for China (MEIC v1.3) are used: the standard MEIC v1.3 emissions and an optimised version, both at 3 km resolution. We construct a new traffic emissions inventory by apportioning the transport sector onto a detailed spatial road map. Agreement between mean simulated and measured pollutant concentrations from Beijing's air quality monitoring network and the Institute of Atmospheric Physics (IAP) field site is improved when using the optimised emissions inventory. The inclusion of fast NOx–O3 chemistry and explicit traffic emissions enables the sharp concentration gradients adjacent to major roads to be resolved with the model. However, NO2 concentrations are overestimated close to roads, likely due to the assumption of uniform traffic activity across the study domain. Differences between measured and simulated diurnal NO2 cycles suggest that an additional evening NOx emission source, likely related to heavy-duty diesel trucks, is not fully accounted for in the emissions inventory. Overestimates in simulated early evening NO2 are reduced by delaying the formation of stable boundary layer conditions in the model to replicate Beijing's urban heat island. The simulated campaign period mean PM2.5 concentration range across the monitoring network (∼15 µg m−3) is much lower than the measured range (∼40 µg m−3). This is likely a consequence of insufficient PM2.5 emissions and spatial variability, neglect of explicit point sources, and assumption of a homogeneous background PM2.5 level. Sensitivity studies highlight that the use of explicit road source emissions, modified diurnal emission profiles, and inclusion of urban heat island effects permit closer agreement between simulated and measured NO2 concentrations. This work lays the foundations for future studies of human exposure to ambient air pollution across complex urban areas, with the APHH-China campaign measurements providing a valuable means of evaluating the impact of key processes on street-scale air quality

Modelling spatiotemporal variations of the canopy layer urban heat island in Beijing at the neighbourhood scale

Information on the spatiotemporal characteristics of Beijing's urban–rural near-surface air temperature difference, known as the canopy layer urban heat island (UHI), is important for future urban climate management strategies. This paper investigates the variation of near-surface air temperatures within Beijing at a neighbourhood-scale resolution (∼ 100 m) during winter 2016 and summer 2017. We perform simulations using the urban climate component of the ADMS-Urban model with land surface parameters derived from both local climate zone classifications and OpenStreetMap land use information. Through sensitivity simulations, the relative impacts of surface properties and anthropogenic heat emissions on the temporal variation of Beijing's UHI are quantified. Measured UHI intensities between central Beijing (Institute of Atmospheric Physics) and a rural site (Pinggu) during the Atmospheric Pollution and Human Health in a Chinese Megacity (APHH-China) campaigns, peak during the evening at ∼ 4.5 ∘C in both seasons. In winter, the nocturnal UHI is dominated by anthropogenic heat emissions but is underestimated by the model. Higher-resolution anthropogenic heat emissions may capture the effects of local sources (e.g. residential buildings and adjacent major roads). In summer, evening UHI intensities are underestimated, especially during heatwaves. The inability to fully replicate the prolonged release of heat stored in the urban fabric may explain this. Observed negative daytime UHI intensities in summer are more successfully captured when surface moisture levels in central Beijing are increased. However, the spatial correlation between simulated air temperatures and satellite-derived land surface temperatures is stronger with a lower urban moisture scenario. This result suggests that near-surface air temperatures at the urban meteorological site are likely influenced by fine-scale green spaces that are unresolved by the available land cover data and demonstrates the expected differences between surface and air temperatures related to canopy layer advection. This study lays the foundations for future studies of heat-related health risks and UHI mitigation strategies across Beijing and other megacities

Introduction to Special Issue - In-depth study of air pollution sources and processes within Beijing and its surrounding region (APHH-2 Beijing)

Abstract. The Atmospheric Pollution and Human Health in a Chinese Megacity (APHH-Beijing) programme is an international collaborative project focusing on understanding the sources, processes and health effects of air pollution in the Beijing megacity. APHH-Beijing brings together leading China and UK research groups, state-of-the-art infrastructure and air quality models to work on four research themes: (1) sources and emissions of air pollutants; (2) atmospheric processes affecting urban air pollution; (3) air pollution exposure and health impacts; and (4) interventions and solutions. Themes 1 and 2 are closely integrated and support Theme 3, while Themes 1-3 provide scientific data for Theme 4 to develop cost-effective air pollution mitigation solutions. This paper provides an introduction to (i) the rationale of the APHH-Beijing programme, and (ii) the measurement and modelling activities performed as part of it. In addition, this paper introduces the meteorology and air quality conditions during two joint intensive field campaigns - a core integration activity in APHH-Beijing. The coordinated campaigns provided observations of the atmospheric chemistry and physics at two sites: (i) the Institute of Atmospheric Physics in central Beijing, and (ii) Pinggu in rural Beijing during 10 November – 10 December 2016 (winter) and 21 May- 22 June 2017 (summer). The campaigns were complemented by numerical modelling and automatic air quality and low-cost sensor observations in the Beijing megacity. In summary, the paper provides background information on the APHH-Beijing programme, and sets the scene for more focussed papers addressing specific aspects, processes and effects of air pollution in Beijing

Teaching and learning early number

Libro orientado a profesores en formación, en prácticas y ayudantes de aula en educación infantil y primaria para la enseñanza de los primeros conceptos sobre números y matemáticas. Incluye nuevos estudios sobre el proceso de cálculo y sobre las notas de los niños en matemáticas, actividades de cálculo en casa y como juego en el entorno escolar, la importancia de las representaciones matemáticas y de las tecnologías de la información y la comunicación (TIC) en la compresión de los números por los niños, errores y falsas ideas y la evaluación del conocimiento numérico de los niños.SCBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 planta; 28014 Madrid; Tel. +34917748000; [email protected]

Incarnation and animation: physical versus representational deficits of body integrity

Two apparently disparate phenomena of defective body integrity are reviewed. The first concerns dysmelia, characterized by the congenital absence or deformation of limbs, and the focus of the review is on phantom sensations of people with this kind of physical integrity disorder. The second phenomenon consists of non-psychotic individuals' desire to have a healthy limb amputated, which is interpreted as a mismatch between the physical integrity of a particular limb and its representation in multimodal cortical areas of the brain. We outlined commonalities and differences between the two conditions and note the absence, in both areas of research, of a unified theory that would account for the reported phenomenology. Phantom limbs in dysmelia and the desire for limb amputation most likely are the consequence of very early developmental dissociations between physical and phenomenal body shapes. They are mirror images of one another in that the former constitutes an "animation without incarnation" and, the latter, an "incarnation without animation"