Who is dominant? Occupational Health and Safety management in Chinese shipping

This paper investigates the implementation of the International Safety Management (ISM) Code in the Chinese chemical shipping industry. In particular, it examines the tension between management focus on speedy production and seafarers’ participation in safety related decision making and analyses how this tension is managed. It shows that while on paper companies have policies stating safety commitment in compliance with the ISM Code, in practice shore management tends to prioritise efficient production. When Occupational Health and Safety (OHS) and ship’s sailing schedules are in conflict, managers implicitly request shipmasters to prioritise the ‘core interest’ of the company. Although the ISM Code endows shipmasters with overriding authorities in relation to shipboard safety management, they tend to read between the lines and tacitly follow managers’ intentions. The study suggests that if the ISM implementation makes a difference, it is the practice that managers become more subtle in giving orders to exert their dominance. The study further reveals that the management’s practice is not only irresponsive to seafarers’ safety concerns but also makes rather limited contributions to promote OHS Management

Mainstreaming marine biodiversity into the SDGs: The role of other effective area-based conservation measures (SDG 14.5)

This article explores the concept of “other effective area-based conservation measures” (OECMs) in the context of the UN Convention on Biological Diversity (CBD) Aichi Biodiversity Target 11 on marine protected areas and OECMs and its linkages to the Sustainable Development Goals (SDGs). It argues that mainstreaming biodiversity through CBD Aichi Biodiversity Targets’ implementation into the SDGs can contribute to a more systemic and comprehensive implementation of SDG 14.5 on conservation of at least 10% of marine and coastal areas. It argues that OECMs can complement MPAs and contribute to ecologically representative and effectively managed marine protected areas systems integrated into broader governance systems such as marine spatial planning. Selected global and local sectoral conservation measures are therefore highlighted in this analysis as potential forms of OECMs. At the local level, a case study of ecologically or biologically significant marine areas managed as locally managed marine areas (LMMAs) in Mozambique is discussed. This case study explores how multiple-use LMMAs, which respond to short-term fisher's needs and targeted biodiversity conservation, could contribute to the achievement of specific SDGs on food security, poverty elimination and resilient ecosystems if properly supported by long-term investments, strong institutions and integrated oceans management

Cohort profile of BIOMArCS: The BIOMarker study to identify the Acute risk of a Coronary Syndrome-a prospective multicentre biomarker study conducted in the Netherlands

__Purpose:__ Progression of stable coronary artery disease (CAD) towards acute coronary syndrome (ACS) is a dynamic and heterogeneous process with many intertwined constituents, in which a plaque destabilising sequence could lead to ACS within short time frames. Current CAD risk assessment models, however, are not designed to identify increased vulnerability for the occurrence of coronary events within a precise, short time frame at the individual patient level. The BIOMarker study to identify the Acute risk of a Coronary Syndrome (BIOMArCS) was designed to evaluate whether repeated measurements of multiple biomarkers can predict such 'vulnerable periods'. __Participants:__ BIOMArCS is a multicentre, prospective, observational study of 844 patients presenting with ACS, either with or without ST-elevation and at least one additional cardiovascular risk factor. __Methods and analysis:__ We hypothesised that patterns of circulating biomarkers that reflect the various pathophysiological components of CAD, such as distorted lipid metabolism, vascular inflammation, endothelial dysfunction, increased thrombogenicity and ischaemia, diverge in the days to weeks before a coronary event. Divergent biomarker patterns, identified by serial biomarker measurements during 1-year follow-up might then indicate 'vulnerable periods' during which patients with CAD are at high short-Term risk of developing an ACS. Venepuncture was performed every fortnight during the first half-year and monthly thereafter. As prespecified, patient enrolment was terminated after the primary end point of cardiovascular death or hospital admission for nonfatal ACS had occurred in 50 patients. A case-cohort design will explore differences in temporal patterns of circulating biomarkers prior to the repeat ACS

Temporal Trends and Patterns in Heart Failure with Improved Left Ventricular Ejection Fraction: A Retrospective Cohort Study

Heart failure (HF) with reduced ejection fraction (HFrEF) remains a leading cause of morbidity and mortality. Heart failure withimproved ejection fraction (HFimpEF) has better prognosis and outcomes. However, improvement only occurs in a subpopulationof HFrEF

High Diversity of Giardia duodenalis Assemblages and Sub-Assemblages in Asymptomatic School Children in Ibadan, Nigeria

Giardia duodenalis is a significant contributor to the burden of diarrheal disease in sub-Saharan Africa. This study assesses the occurrence and molecular diversity of G. duodenalis and other intestinal parasites in apparently healthy children (n = 311) in Ibadan, Nigeria. Microscopy was used as a screening method and PCR and Sanger sequencing as confirmatory and genotyping methods, respectively. Haplotype analyses were performed to examine associations between genetic variants and epidemiological variables. At microscopy examination, G. duodenalis was the most prevalent parasite found (29.3%, 91/311; 95% CI: 24.3-34.7), followed by Entamoeba spp. (18.7%, 58/311; 14.5-23.4), Ascaris lumbricoides (1.3%, 4/311; 0.4-3.3), and Taenia sp. (0.3%, 1/311; 0.01-1.8). qPCR confirmed the presence of G. duodenalis in 76.9% (70/91) of the microscopy-positive samples. Of them, 65.9% (60/91) were successfully genotyped. Assemblage B (68.3%, 41/60) was more prevalent than assemblage A (28.3%, 17/60). Mixed A + B infections were identified in two samples (3.3%, 2/60). These facts, together with the absence of animal-adapted assemblages, suggest that human transmission of giardiasis was primarily anthroponotic. Efforts to control G. duodenalis (and other fecal-orally transmitted pathogens) should focus on providing safe drinking water and improving sanitation and personal hygiene practices.This research was funded by the Health Institute Carlos III (ISCIII), Spanish Ministry of Economy and Competitiveness, grant number PI19CIII/00029.S

Proximate Levels and Phytochemical Contents in Selected Cereals Sold in Wukari Local Government Area of Taraba State

Research has indicated that consumption of whole grain foods can significantly reduce the risk of some chronic health conditions such as type II diabetes, cardiovascular disease, and cancer Therefore, the present study evaluated the proximate constituents and the levels of phytochemicals in rice, maize and millet procured from Wukari Local Government Area of Taraba state. Three cereal samples were procured (rice, maize and millet), air dried and analyzed for proximate and phytochemical contents using AOAC and HPLC respectively. The result for proximate analysis revealed the presence of six proximate components in their respective amounts. These were ether extract, crude protein, crude fibre, Ash, Moisture, nitrogen free extract (soluble Carbohydrates). The results of protein showed no significant difference at p ≥ 0.05 in all the samples, except millet 2 and millet 3 that showed significant difference with rice (1 to 3) and maize 1. Results of fat showed no significant difference between rice (1 to 3), maize (1 to 3) and millet 2, while millet 1 and 2 significantly differ from all the samples except millet 2. The results of fibre showed no significant difference rice (1 to 3) and millet (1 to 3), while maize (1 to 3) showed significant difference with millet 1 and rice (2 and 3) at p ≤ 0.05. There is no significant difference (p>0.05) in ash content of maize and rice samples, while millet showed significant difference at p ≤ 0.05 with rice (1 to 3) and maize (2 and 3). The results of alkaloids and tannins showed significant difference rice, maize and millet. However, there is significant difference in saponins presence in rice, maize and millet at p ≤ 0.05. There is significant difference in oxalates, phytates, tarpenes, glycosides and flavonoids present in all the samples, while phenolics showed no significant difference among all the samples. This study revealed the varying and appreciable levels of food constituents and health promoting components in sample analyzed. This indicated the nutritional qualities of the samples analyzed

Subsequent Event Risk in Individuals with Established Coronary Heart Disease:Design and Rationale of the GENIUS-CHD Consortium

BACKGROUND: The "GENetIcs of sUbSequent Coronary Heart Disease" (GENIUS-CHD) consortium was established to facilitate discovery and validation of genetic variants and biomarkers for risk of subsequent CHD events, in individuals with established CHD. METHODS: The consortium currently includes 57 studies from 18 countries, recruiting 185,614 participants with either acute coronary syndrome, stable CHD or a mixture of both at baseline. All studies collected biological samples and followed-up study participants prospectively for subsequent events. RESULTS: Enrollment into the individual studies took place between 1985 to present day with duration of follow up ranging from 9 months to 15 years. Within each study, participants with CHD are predominantly of self-reported European descent (38%-100%), mostly male (44%-91%) with mean ages at recruitment ranging from 40 to 75 years. Initial feasibility analyses, using a federated analysis approach, yielded expected associations between age (HR 1.15 95% CI 1.14-1.16) per 5-year increase, male sex (HR 1.17, 95% CI 1.13-1.21) and smoking (HR 1.43, 95% CI 1.35-1.51) with risk of subsequent CHD death or myocardial infarction, and differing associations with other individual and composite cardiovascular endpoints. CONCLUSIONS: GENIUS-CHD is a global collaboration seeking to elucidate genetic and non-genetic determinants of subsequent event risk in individuals with established CHD, in order to improve residual risk prediction and identify novel drug targets for secondary prevention. Initial analyses demonstrate the feasibility and reliability of a federated analysis approach. The consortium now plans to initiate and test novel hypotheses as well as supporting replication and validation analyses for other investigators

Remote monitoring titration clinic to implement guideline-directed therapy for heart failure patients with reduced ejection fraction: a pilot quality-improvement intervention

IntroductionGuideline-directed medical therapy (GDMT) is the recommended treatment for heart failure with reduced ejection fraction (HFrEF). However, the implementation remains limited, with suboptimal use and dosing. The study aimed to assess the feasibility and effect of a remote monitoring titration program on GDMT implementation.MethodsHFrEF patients were randomly assigned to receive either usual care or a quality-improvement remote titration with remote monitoring intervention. The intervention group used wireless devices to transmit heart rate, blood pressure, and weight data daily, which were reviewed by physicians and nurses every 2–4 weeks. Medication tolerance was assessed via phone, and dosage instructions were given. This workflow was repeated until target doses were reached or further adjustments were not tolerated. A 4-GDMT score measured use and target dosage, with the primary endpoint being the score at 6 months follow-up.ResultsBaseline characteristics were similar (n = 55). A median of 85% of patients complied with transmitting device data every week. At the 6-month follow-up, the intervention group had a 4-GDMT score of 64.6% compared to 56.5% in the usual care group (p = 0.01), with a difference of 8.1% (95% CI: 1.7%–14.5%). Similar results were seen at the 12-month follow-up [difference 12.8% (CI: 5.0%–20.6%)]. The intervention group showed a positive trend in ejection fraction and natriuretic peptides, with no significant difference between groups.ConclusionsThe study suggests that a full-scale trial is feasible and that utilizing a remote titration clinic with remote monitoring has the potential to enhance the implementation of guideline-directed therapy for HFrEF

[18F]AV-1451 binding in vivo mirrors the expected distribution of TDP-43 pathology in the semantic variant of primary progressive aphasia

INTRODUCTION: Semantic dementia, including the semantic variant of primary progressive aphasia (svPPA), is strongly associated with TAR-DNA binding protein 43 (TDP-43) type C pathology. It provides a useful model in which to test the specificity of in vivo binding of the putative tau ligand [18F]AV-1451, which is elevated in frontotemporal lobar degeneration tauopathies. METHODS AND RESULTS: Seven patients (five with svPPA and two with ‘right’ semantic dementia) and 12 healthy controls underwent positron emission tomography brain imaging with [18F]AV-1451. Two independent preprocessing methods were used. For both methods, all patients had clearly elevated binding potential (BPND (non-displaceable binding potential)) in temporal lobes, lateralising according to their clinical syndrome and evident in raw images. Region of interest analyses confirmed that BPND was significantly increased in temporal regions, insula and fusiform gyrus, consistent with those areas known to be most affected in semantic dementia. Hierarchical cluster analysis, based on the distribution of [18F]AV-1451 binding potential, separated semantic dementia from controls with 86% sensitivity and 100% specificity. CONCLUSIONS:[18F]AV-1451 binds in vivo regions that are likely to contain TDP-43 and not significant tau pathology. While this suggests a non-tau target for [18F]AV-1451, the pathological regions in semantic dementia do not normally contain significant levels of recently proposed ‘off target’ binding sites for [18F]AV-1451, such as neuronal monoamine oxidase or neuromelanin. Postmortem and longitudinal data will be useful to assess the utility of [18F]AV-1451 to differentiate and track different types of frontotemporal lobar degeneration.This work was supported by the National Institute for Health Research Biomedical Research Centre and Biomedical Research Unit in Dementia; the Wellcome Trust (JBR 103838); the Association of British Neurologists and the Patrick Berthoud Charitable Trust (TEC)

A screening tool to prioritize public health risk associated with accidental or deliberate release of chemicals into the atmosphere

The Chemical Events Working Group of the Global Health Security Initiative has developed a flexible screening tool for chemicals that present a risk when accidentally or deliberately released into the atmosphere. The tool is generic, semi-quantitative, independent of site, situation and scenario, encompasses all chemical hazards (toxicity, flammability and reactivity), and can be easily and quickly implemented by non-subject matter experts using freely available, authoritative information. Public health practitioners and planners can use the screening tool to assist them in directing their activities in each of the five stages of the disaster management cycle