Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study.

OBJECTIVE: To examine the timing and duration of RSV bronchiolitis hospital admission among term and preterm infants in England and to identify risk factors for bronchiolitis admission. DESIGN: A population-based birth cohort with follow-up to age 1 year, using the Hospital Episode Statistics database. SETTING: 71 hospitals across England. PARTICIPANTS: We identified 296618 individual birth records from 2007/08 and linked to subsequent hospital admission records during the first year of life. RESULTS: In our cohort there were 7189 hospital admissions with a diagnosis of bronchiolitis, 24.2 admissions per 1000 infants under 1 year (95%CI 23.7-24.8), of which 15% (1050/7189) were born preterm (47.3 bronchiolitis admissions per 1000 preterm infants (95% CI 44.4-50.2)). The peak age group for bronchiolitis admissions was infants aged 1 month and the median was age 120 days (IQR = 61-209 days). The median length of stay was 1 day (IQR = 0-3). The relative risk (RR) of a bronchiolitis admission was higher among infants with known risk factors for severe RSV infection, including those born preterm (RR = 1.9, 95% CI 1.8-2.0) compared with infants born at term. Other conditions also significantly increased risk of bronchiolitis admission, including Down's syndrome (RR = 2.5, 95% CI 1.7-3.7) and cerebral palsy (RR = 2.4, 95% CI 1.5-4.0). CONCLUSIONS: Most (85%) of the infants who are admitted to hospital with bronchiolitis in England are born at term, with no known predisposing risk factors for severe RSV infection, although risk of admission is higher in known risk groups. The early age of bronchiolitis admissions has important implications for the potential impact and timing of future active and passive immunisations. More research is needed to explain why babies born with Down's syndrome and cerebral palsy are also at higher risk of hospital admission with RSV bronchiolitis

Herausforderung Climate Engineering – Bewertung neuer Optionen für den Klimaschutz

[Einleitung] Der Begriff Climate Engineering (CE) fasst verschiedene Technologien zusammen, mit denen bewusst in das Klimasystem der Erde eingegriffen wird, um den anthropogenen Klimawandel zu begrenzen. Dabei lassen sich die CE-Technologien von den herkömmlichen Vermeidungs- und Anpassungsmaßnahmen durch die Tatsache abgrenzen, dass sie ansetzen, nachdem Treibhausgase in die Atmosphäre emittiert wurden, aber bevor es zu einer Anpassung an die Auswirkungen des Klimawandels kommt (Keith 2000). Sie können danach in zwei Gruppen eingeteilt werden, je nachdem ob sie eingesetzt werden, um die atmosphärische Treibhausgaskonzentration zu senken - und damit die Ursache des Klimawandels zurückzuführen - oder ob sie eingesetzt werden, um in die Strahlungsbilanz der Erde einzugreifen und damit die Symptome des Klimawandels abzumildern. Die Technologien der ersten Gruppe werden als Carbon Dioxid Removal (CDR)-Technologien und jene der anderen als Radiation Management (RM)-Technologien bezeichnet. Dabei ist Radiation Management der weitere Begriff, da sowohl Technologien zur direkten Beeinflussung der kurzwelligen (SRM) als auch der langwelligen (TRM) Strahlung beinhaltet sind. Entsprechend könnten Technologien zur ursächlichen Rückführung des Klimawandels eigentlich auch als Concentration Management bezeichnet werden, da theoretisch die atmosphärische Konzentration verschiedener Treibhausgase manipuliert werden könnte (Rickels et al. 2011: 41). Da aber derzeit nur die Konzentration von Kohlendioxid (CO2) beeinflusst wird, wird in der vorliegenden Studie der engere Begriff CDR verwendet. [...

ECFS standards of care on CFTR-related disorders: Towards a comprehensive program for affected individuals

After three publications defining an updated guidance on the diagnostic criteria for people with cystic fibrosis transmembrane conductance regulator (CFTR)-related disorders (pwCFTR-RDs), establishing its relationship to CFTR-dysfunction and describing the individual disorders, this fourth and last paper in the series addresses some critical challenges facing health care providers and pwCFTR-RD. Topics included are: 1) benefits and obstacles to collect data from pwCFTR-RD are discussed, together with the opportunity to integrate them into established CF-registries; 2) the potential of infants designated CRMS/CFSPID to develop a CFTR-RD and how to communicate this information; 3) a description of the challenges in genetic counseling, with particular regard to phenotypic variability, unknown long-term evolution, CFTR testing and pregnancy termination 4) a proposal for the assessment of potential barriers to the implementation and dissemination of the produced documents to health care professionals involved in the care of pwCFTR-RD and a process to monitor the implementation of the CFTR-RD recommendations; 5) clinical trials investigating the efficacy of CFTR modulators in CFTR-RD and how endpoints and outcomes might be adapted to the heterogeneity of these disorders

Futures in the making: Practices to anticipate 'ubiquitous computing'

This paper addresses the discourse for a proactive thinking of futurity, intimately concerned with technology, which comes to an influential fruition in the discussion and representation of 'ubiquitous computing'. The imagination, proposal, or playing out of ubiquitous computing environments are bound up with particular ways of constructing futurity. This paper charts the techniques used in ubiquitous computing development to negotiate that futurity. In so doing, it engages with recent geographical debates around anticipation and futurity. The discussion accordingly proceeds in four parts. First, the spatial imagination engendered by the development of ubiquitous computing is explored. Second, particular techniques in ubiquitous computing research and development for anticipating future technology use, and their limits, are discussed through empirical findings. Third, anticipatory knowledge is explored as the basis for stable means of future orientation, which both generates and derives from the techniques for anticipating futures. Fourth, the importance of studying future orientation is situated in relation to the somewhat contradictory nature of anticipatory knowledges of ubicomp and related forms of spatial imagination. © 2012 Pion and its Licensors

A new scoring system in Cystic Fibrosis: statistical tools for database analysis – a preliminary report

<p>Abstract</p> <p>Background</p> <p>Cystic fibrosis is the most common fatal genetic disorder in the Caucasian population. Scoring systems for assessment of Cystic fibrosis disease severity have been used for almost 50 years, without being adapted to the milder phenotype of the disease in the 21^stcentury. The aim of this current project is to develop a new scoring system using a database and employing various statistical tools. This study protocol reports the development of the statistical tools in order to create such a scoring system.</p> <p>Methods</p> <p>The evaluation is based on the Cystic Fibrosis database from the cohort at the Royal Children's Hospital in Melbourne. Initially, unsupervised clustering of the all data records was performed using a range of clustering algorithms. In particular incremental clustering algorithms were used. The clusters obtained were characterised using rules from decision trees and the results examined by clinicians. In order to obtain a clearer definition of classes expert opinion of each individual's clinical severity was sought. After data preparation including expert-opinion of an individual's clinical severity on a 3 point-scale (mild, moderate and severe disease), two multivariate techniques were used throughout the analysis to establish a method that would have a better success in feature selection and model derivation: 'Canonical Analysis of Principal Coordinates' and 'Linear Discriminant Analysis'. A 3-step procedure was performed with (1) selection of features, (2) extracting 5 severity classes out of a 3 severity class as defined per expert-opinion and (3) establishment of calibration datasets.</p> <p>Results</p> <p>(1) Feature selection: CAP has a more effective "modelling" focus than DA.</p> <p>(2) Extraction of 5 severity classes: after variables were identified as important in discriminating contiguous CF severity groups on the 3-point scale as mild/moderate and moderate/severe, Discriminant Function (DF) was used to determine the new groups mild, intermediate moderate, moderate, intermediate severe and severe disease. (3) Generated confusion tables showed a misclassification rate of 19.1% for males and 16.5% for females, with a majority of misallocations into adjacent severity classes particularly for males.</p> <p>Conclusion</p> <p>Our preliminary data show that using CAP for detection of selection features and Linear DA to derive the actual model in a CF database might be helpful in developing a scoring system. However, there are several limitations, particularly more data entry points are needed to finalize a score and the statistical tools have further to be refined and validated, with re-running the statistical methods in the larger dataset.</p

Synthetic biology: ethical ramifications 2009

During 2007 and 2008 synthetic biology moved from the manifesto stage to research programs. As of 2009, synthetic biology is ramifying; to ramify means to produce differentiated trajectories from previous determinations. From its inception, most of the players in synthetic biology agreed on the need for (a) rationalized design and construction of new biological parts, devices, and systems as well as (b) the re-design of natural biological systems for specified purposes, and that (c) the versatility of designed biological systems makes them suitable to address such challenges as renewable energy, the production of inexpensive drugs, and environmental remediation, as well as providing a catalyst for further growth of biotechnology. What is understood by these goals, however, is diverse. Those assorted understandings are currently contributing to different ramifications of synthetic biology. The Berkeley Human Practices Lab, led by Paul Rabinow, is currently devoting its efforts to documenting and analyzing these ramifications as they emerge

Qualidade de tubérculos frescos de cultivares de batata em função da nutrição fosfatada

Phosphorus (P) is essential to increase tuber yield and nutritional quality of potato tubers. However, it is unclear whether the influence of P fertilization on quality of tubers produced can vary depending on the cultivar and P availability in soil. This study evaluated the effect of P fertilization on the quality and nutritional composition of marketable tubers of potato cultivars. Experiments in soils with low, medium and high P availability were conducted in a randomized block design, with four replications. Treatments consisted of a 2×5 factorial arrangement of two potato cultivars (Agata and Mondial) and five P2O5 rates (0, 125, 250, 500, and 1,000 kg ha–1). Phosphorus fertilization increased the contents of P and starch, the size and yield of marketable tubers, with more expressive response to higher P rates in the soils with low and medium P availability. The Mondial cultivar had the highest yield, due to a greater tuber weight and greater increases in this characteristic in response to P fertilization. The Mondial cultivar produced tubers with firmer pulp, with higher dry matter percentage and higher contents of Ca, Cu, and Zn than Agata. In the soil with low P availability, P fertilization reduced Zn content, but, in general, had little influence on the nutritional composition of potato tubers.Phosphorus (P) is essential to increase tuber yield and nutritional quality of potato tubers. However, it is unclear whether the influence of P fertilization on quality of tubers produced can vary depending on the cultivar and P availability in soil. This study evaluated the effect of P fertilization on the quality and nutritional composition of marketable tubers of potato cultivars. Experiments in soils with low, medium and high P availability were conducted in a randomized block design, with four replications. Treatments consisted of a 2×5 factorial arrangement of two potato cultivars (Agata and Mondial) and five P2O5 rates (0, 125, 250, 500, and 1,000 kg ha–1). Phosphorus fertilization increased the contents of P and starch, the size and yield of marketable tubers, with more expressive response to higher P rates in the soils with low and medium P availability. The Mondial cultivar had the highest yield, due to a greater tuber weight and greater increases in this characteristic in response to P fertilization. The Mondial cultivar produced tubers with firmer pulp, with higher dry matter percentage and higher contents of Ca, Cu, and Zn than Agata. In the soil with low P availability, P fertilization reduced Zn content, but, in general, had little influence on the nutritional composition of potato tubers.O fósforo (P) é essencial para aumentar a produtividade e a qualidade nutricional dos tubérculos de batata. Porém não se sabe se a influência da adubação fosfatada na qualidade dos tubérculos produzidos pode variar em função da cultivar e da disponibilidade de P no solo. O objetivo deste trabalho foi avaliar o efeito da adubação fosfatada sobre a qualidade e composição nutricional dos tubérculos comercializáveis de cultivares de batata. Foram conduzidos experimentos em solos com baixa, média e alta disponibilidade de P, utilizando delineamento de blocos ao acaso, no esquema fatorial 2 × 5, com quatro repetições. Os tratamentos foram constituídos por duas cultivares de batata (Agata e Mondial) e cinco doses de P2O5 (0, 125, 250, 500 e 1.000 kg ha–1). A adubação fosfatada aumentou o teor de P e de amido, o tamanho e a produtividade de tubérculos comercializáveis, com resposta mais expressiva às maiores doses nos solos com baixa e média disponibilidade de P. A cultivar Mondial foi mais produtiva, por apresentar maior massa média de tubérculos e maiores aumentos nessa característica em resposta a adubação fosfatada. A cultivar Mondial produziu tubérculos com polpa mais firme, com maior percentagem de matéria seca e com maiores teores de Ca, Cu e Zn do que a Agata. Em solo com baixo P disponível, a adubação fosfatada reduziu o teor de Zn mas, de maneira geral, teve pouca influência na composição nutricional dos tubérculos de batata.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Estadual Paulista, Centro de Raízes e Amidos Tropicais, Faculdade de Ciências Agronômicas de BotucatuUniversidade Estadual Paulista, Departamento de Produção e Melhoramento Vegetal, Faculdade de Ciências Agronômicas de BotucatuUniversidade Estadual Paulista, Departamento de Horticultura, Faculdade de Ciências Agronômicas de BotucatuFAPESP: 2010/04987-6FAPESP: 2012/12128-