At The Water\u27s Edge: Legal Protections And Funding For A New Generation Of Climate Change Refugees

As climate change stimulates a rise in sea level, coastal communities and islands are experiencing destructive erosion of land and flooding of habitation. As a result, residents of low-lying communities and small islands are, and will continue to be, displaced due to the gradual, steady rise of sea level and its associated problems, such as increased destruction from flooding and other natural disasters. Millions of people will lose their homes and livelihoods, forcing them to seek alternative shelter within their own country, or cross borders in the hope of finding a new home and work. Climate change displacement is predicted to affect approximately 200 million people by 2050. The enormity of climate change displacement demands financial resources that vulnerable populations lack. Currently, people displaced by climate change are not recognized by international law as a group that receives protection and assistance. In contrast, refugees who flee their countries of nationality due to persecution on account of, for example, race or religion, gain internationally recognized status under the United Nations Convention Relating to the Status of Refugees. In an effort to fill the void, scholars have endeavored to redefine “refugee” and “internally displaced persons” (IDPs) in light of the climate change catalyst, and propose international funding mechanisms to rectify the negative effects of the mass human migration. First, I will outline the current state of sea level rise and the projected displacement in developing low-lying coastal communities and islands. Second, I will analyze new “refugee” and “IDP” definitions and possible funding mechanisms. Third, I will argue that the Green Climate Fund, born out of the Copenhagen Accord, is an appropriate funding mechanism to assist people displaced by climate change; therefore, a portion of the Green Climate Fund should be allocated specifically toward mitigating forced displacement due to rising sea level

At The Water\u27s Edge: Legal Protections And Funding For A New Generation Of Climate Change Refugees

As climate change stimulates a rise in sea level, coastal communities and islands are experiencing destructive erosion of land and flooding of habitation. As a result, residents of low-lying communities and small islands are, and will continue to be, displaced due to the gradual, steady rise of sea level and its associated problems, such as increased destruction from flooding and other natural disasters. Millions of people will lose their homes and livelihoods, forcing them to seek alternative shelter within their own country, or cross borders in the hope of finding a new home and work. Climate change displacement is predicted to affect approximately 200 million people by 2050. The enormity of climate change displacement demands financial resources that vulnerable populations lack. Currently, people displaced by climate change are not recognized by international law as a group that receives protection and assistance. In contrast, refugees who flee their countries of nationality due to persecution on account of, for example, race or religion, gain internationally recognized status under the United Nations Convention Relating to the Status of Refugees. In an effort to fill the void, scholars have endeavored to redefine “refugee” and “internally displaced persons” (IDPs) in light of the climate change catalyst, and propose international funding mechanisms to rectify the negative effects of the mass human migration. First, I will outline the current state of sea level rise and the projected displacement in developing low-lying coastal communities and islands. Second, I will analyze new “refugee” and “IDP” definitions and possible funding mechanisms. Third, I will argue that the Green Climate Fund, born out of the Copenhagen Accord, is an appropriate funding mechanism to assist people displaced by climate change; therefore, a portion of the Green Climate Fund should be allocated specifically toward mitigating forced displacement due to rising sea level

CD154 Induces Interleukin-6 Secretion by Kidney Tubular Epithelial Cells under Hypoxic Conditions: Inhibition by Chloroquine

Funder: MSDAvenirInflammation is a major contributor to tubular epithelium injury in kidney disorders, and the involvement of blood platelets in driving inflammation is increasingly stressed. CD154, the ligand of CD40, is one of the mediators supporting platelet proinflammatory properties. Although hypoxia is an essential constituent of the inflammatory reaction, if and how platelets and CD154 regulate inflammation in hypoxic conditions remain unclear. Here, we studied the control by CD154 of the proinflammatory cytokine interleukin- (IL-) 6 secretion in short-term oxygen (O2) deprivation conditions, using the HK-2 cell line as a kidney tubular epithelial cell (TEC) model. IL-6 secretion was markedly stimulated by CD154 after 1 to 3 hours of hypoxic stress. Both intracellular IL-6 expression and secretion were stimulated by CD154 and associated with a strong upregulation of IL-6 mRNA and increased transcription. Searching for inhibitors of CD154-mediated IL-6 production by HK-2 cells in hypoxic conditions, we observed that chloroquine, a drug that has been repurposed as an anti-inflammatory agent, alleviated this induction. Therefore, CD154 is a potent early stimulus for IL-6 secretion by TECs in O2 deprivation conditions, a mechanism likely to take part in the deleterious inflammatory consequences of platelet activation in kidney tubular injury. The inhibition of CD154-induced IL-6 production by chloroquine suggests the potential usefulness of this drug as a therapeutic adjunct in conditions associated with acute kidney injury

Sexually transmitted infections in seafarers: 2020’s perspectives based on a literature review from 2000–2020

Background: Seafarers are a special population. The issue of sexually transmitted diseases among seafarers is as old as navigation itself, and is a public health issue and a matter of concern for seafarers themselves. The purpose of this article is to review the literature on sexually transmitted infections (STIs) in professional seafarers in the 21st century, with a view to guiding maritime physicians in their practice.Materials and methods: This is a Medline® and Scopus® literature review covering publications between 01/01/2000 and 31/12/2019. Out of the 224 articles, 26 were selected. Results: This review showed that at the beginning of the 21st century, attention has been focused mainly on human immunodeficiency virus (HIV). Few seroprevalence data were available. Between 10% and 91% of seafarers had been tested for STIs. Several risk behaviours were identified: out of 4022 seafarers surveyed, 34.3% said they had several sexual partners; out of 3722 seafarers surveyed, 19.5% engaged with sex workers; out of 3493 seafarers surveyed, 63.3% did not always use condoms, while 58.0% were aware of the relevance of this protection. There was a lot of misunderstanding about STIs: 28.3% of seafarers believed that a healthy-looking person could not be HIV-positive.Conclusions: The main pathology studied was HIV. Many seafarers had no specific training and only learned about STIs and HIV through media such as television. Maritime doctors could use new technologies to disseminate the right information on STI prevention

Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019

Abstract Background Coronavirus disease 2019 (COVID-19)-associated acute kidney injury (AKI) frequency, severity and characterization in critically ill patients has not been reported. Methods Single-centre cohort performed from 3 March 2020 to 14 April 2020 in four intensive care units in Bordeaux University Hospital, France. All patients with COVID-19 and pulmonary severity criteria were included. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. A systematic urinary analysis was performed. The incidence, severity, clinical presentation, biological characterization (transient versus persistent AKI; proteinuria, haematuria and glycosuria) and short-term outcomes were evaluated. Results Seventy-one patients were included, with basal serum creatinine (SCr) of 69 ± 21 µmol/L. At admission, AKI was present in 8/71 (11%) patients. Median [interquartile range (IQR)] follow-up was 17 (12–23) days. AKI developed in a total of 57/71 (80%) patients, with 35% Stage 1, 35% Stage 2 and 30% Stage 3 AKI; 10/57 (18%) required renal replacement therapy (RRT). Transient AKI was present in only 4/55 (7%) patients and persistent AKI was observed in 51/55 (93%). Patients with persistent AKI developed a median (IQR) urine protein/creatinine of 82 (54–140) (mg/mmol) with an albuminuria/proteinuria ratio of 0.23 ± 20, indicating predominant tubulointerstitial injury. Only two (4%) patients had glycosuria. At Day 7 after onset of AKI, six (11%) patients remained dependent on RRT, nine (16%) had SCr >200 µmol/L and four (7%) had died. Day 7 and Day 14 renal recovery occurred in 28% and 52%, respectively. Conclusion Severe COVID-19-associated AKI is frequent, persistent, severe and characterized by an almost exclusive tubulointerstitial injury without glycosuria

Interaction between near-annual and ENSO modes in a CGCM simulation: role of equatorial background mean state

International audienceA 260-yr-long coupled general circulation model (CGCM) simulation is used to investigate the interaction between ENSO mode and near-annual variability and its sensitivity to the equatorial background mean stratification and seasonal cycles. Although the thermocline mean vertical structure of the model favors the high-order baroclinic modes that are associated with the slow time scales of the coupled variability, the simulated ENSO oscillates at a dominant quasi-biennial frequency. Biases of the climatological velocity field are favorable to the dominance of the zonal advective feedback over the thermocline feedback, the model exhibiting an overenergetic westward seasonal zonal current in the central-western equatorial Pacific, and an upwelling rate that is about half the observations. This sets the conditions for the enhancement of a near-annual mode that is observed to oscillate at an 8-month period in the model. Using an intermediate coupled model of the tropical Pacific where the climatological fields are prescribed to the ones derived from the CGCM, it is demonstrated that the quasi-biennial ENSO variability simulated by the CGCM is mostly due to the biases in the climatological currents of the CGCM. These biases favor the dominance of the fast "zonal advective feedback" over the slow "thermocline feedback" in the coupled system and enhance a fast coupled basin mode. This fast mode differs from the theoretical Pacific Ocean basin mode in that, besides mean temperature advection by the zonal current anomalies, it is also driven by anomalous temperature advection by the total current. Results suggest that the near-annual mode destabilizes the ENSO mode to produce overenergetic quasi-biennial oscillations in the model. It also contributes to the ENSO asymmetry and the cold bias of the CGCM mean state by nonlinear accumulation of temperature zonal advection, which works toward the cold in the western Pacific more than the warm in the east. It is suggested that the model equilibrium results from the interaction between the ENSO mode, the near-annual mode, and the mean state

Single-Molecule Force Spectroscopy of Mycobacterial Adhesin-Adhesin Interactions▿

The heparin-binding hemagglutinin (HBHA) is one of the few virulence factors identified for Mycobacterium tuberculosis. It is a surface-associated adhesin that expresses a number of different activities, including mycobacterial adhesion to nonphagocytic cells and microbial aggregation. Previous evidence indicated that HBHA is likely to form homodimers or homopolymers via a predicted coiled-coil region located within the N-terminal portion of the molecule. Here, we used single-molecule atomic-force microscopy to measure individual homophilic HBHA-HBHA interaction forces. Force curves recorded between tips and supports derivatized with HBHA proteins exposing their N-terminal domains showed a bimodal distribution of binding forces reflecting the formation of dimers or multimers. Moreover, the binding peaks showed elongation forces that were consistent with the unfolding of α-helical coiled-coil structures. By contrast, force curves obtained for proteins exposing their lysine-rich C-terminal domains showed a broader distribution of binding events, suggesting that they originate primarily from intermolecular electrostatic bridges between cationic and anionic residues rather than from specific coiled-coil interactions. Notably, similar homophilic HBHA-HBHA interactions were demonstrated on live mycobacteria producing HBHA, while they were not observed on an HBHA-deficient mutant. Together with the fact that HBHA mediates bacterial aggregation, these observations suggest that the single homophilic HBHA interactions measured here reflect the formation of multimers that may promote mycobacterial aggregation