Identifying urban hotspots of dengue, chikungunya, and zika transmission in Mexico to support risk stratification efforts : a spatial analysis

The study identifies persistent Aedes-borne disease hotspots in Mexican cities. In this spatial analysis, geocoded cases of dengue, chikungunya, and Zika from nine endemic cities were aggregated at the census-tract level. Findings show an overlap between hotspots of 61.7% for dengue and Zika and 53.3% for dengue and chikungunya. Dengue hotspots (2008–16) were significantly associated with those detected during 2017–20 in five of the nine cities. Heads of vector control confirmed hotspot areas as problem zones for arbovirus transmission. This study provides evidence of the overlap of Aedes-borne diseases within geographical hotspots and a methodological framework for the stratification of arbovirus transmission risk.USAIDUS Centers for Disease Control and PreventionCanadian Institutes of Health ResearchFondo Mixto CONACyT (Mexico)-Gobierno del Estado de YucatanUS National Institutes of Healt

Impacto antrópico en el Manto Acuífero Barva (Heredia, Costa Rica) con énfasis en el uso del suelo (1992-2006)

The advance of urbanization in the Central Valley of Costa Rica is having negative impacts on land use and stresses the environment with a high demand of natural resources, particularly water resources. One example is the Barva Water Table, one of the main water suppliers of semi-urban areas of the Greater Metropolitan Area of Costa Rica, which leads to conflicts between social actors involved with this resource. Comparing land use maps of the area defined by Act LXV of 1888, as well as the literature, we found that forest cover is decreasing while area covered by crops and pastures has increased from 1992 and 2006. At the same time, the forest area has undergone a process of fragmentation, and the increasing number of forest patches has an edge effect in all classes of land use. We recommend sustainable governance of water resources in the protected area’s buffer zone, with the participation of the local government, development associations, and other related public and private institutions.El gran avance de la urbanización en el Valle Central de Costa Rica está generando impactos negativos sobre el uso del suelo y está sometiendo al ambiente a intensas presiones debido a la gran demanda de los recursos naturales, particularmente del hídrico. El Manto Acuífero Barva, una de las principales fuentes de agua que abastece zonas urbanas y semiurbanas de la Gran Área Metropolitana, actualmente se encuentra bajo una fuerte presión de cambio de uso en el suelo, lo que a su vez genera conflictos entre diferentes actores sociales involucrados con este recurso. Comparando los mapas de uso de suelo de 1992 y 2006 referentes a la zona delimitada por la Ley LXV de 1888, así como diversas fuentes bibliográficas, se observa que el área boscosa está disminuyendo mientras que la zona de cultivos y pasturas ha aumentado. Asimismo, la región ha sufrido un proceso de fragmentación, lo que se refleja en el aumento de parches, así como del efecto de borde en todas las clases de uso de suelo. Se recomienda iniciar un proceso de gestión participativa y de gobernabilidad sostenible del recurso hídrico en la zona de amortiguamiento del área protegida y así desarrollar acciones de manera conjunta con las comunidades ubicadas en la zona de influencia, con los gobiernos locales, asociaciones de desarrollo, instituciones públicas y privadas interesadas o directamente relacionadas con la protección, conservación y manejo sostenible de los recursos hídricos.

Dengue contingency planning: from research to policy and practice

Background Dengue is an increasingly incident disease across many parts of the world. In response, an evidence-based handbook to translate research into policy and practice was developed. This handbook facilitates contingency planning as well as the development and use of early warning and response systems for dengue fever epidemics, by identifying decision-making processes that contribute to the success or failure of dengue surveillance, as well as triggers that initiate effective responses to incipient outbreaks. Methodology/Principal findings Available evidence was evaluated using a step-wise process that included systematic literature reviews, policymaker and stakeholder interviews, a study to assess dengue contingency planning and outbreak management in 10 countries, and a retrospective logistic regression analysis to identify alarm signals for an outbreak warning system using datasets from five dengue endemic countries. Best practices for managing a dengue outbreak are provided for key elements of a dengue contingency plan including timely contingency planning, the importance of a detailed, context-specific dengue contingency plan that clearly distinguishes between routine and outbreak interventions, surveillance systems for outbreak preparedness, outbreak definitions, alert algorithms, managerial capacity, vector control capacity, and clinical management of large caseloads. Additionally, a computer-assisted early warning system, which enables countries to identify and respond to context-specific variables that predict forthcoming dengue outbreaks, has been developed. Conclusions/Significance Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensified vector control as their outbreak response, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication. The Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response seeks to provide countries with evidence-based best practices to justify the declaration of an outbreak and the mobilization of the resources required to implement an effective dengue contingency plan

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

The rotational Raman spectra and cross sections of H2O, D2O, and HDO

17 pages, 4 figures, 6 tables.We report the experimental rotational Raman spectra of H2O, and of a mixture of D2O and HDO in the vapor phase at room temperature, and their interpretation in terms of rotational–vibrational energies, wavefunctions, and transition moments of the molecular polarizability. These transition moments are based on high-level ab initio calculations of the wavelength dependent polarizability surface, and on wavefunctions where the rotational–vibrational coupling is considered in detail. As a byproduct of this analysis several tables have been compiled including scattering strengths and assignments for individual rotational transitions of the three species. From these tables the rotational Raman spectra can be simulated over the range of temperatures up to 2000 K for H2O, and up to 300 K for D2O and HDO.This work was supported by the Spanish DGES, Research Project PB97-1203. We are indebted to the Centro de Supercomputaci on de Galicia (CESGA), for the use of extensive computation time.Peer reviewe

The Raman spectra and cross-sections of the v2 band of H2O, D2O, and HDO

15 pages, 5 figures, 6 tables.We report the experimental Raman spectra of the ν2 band of H2O, D2O, and HDO in the vapor phase at room temperature. A complete interpretation of the Raman intensities is carried out employing the variational rovibrational wavefunctions obtained from a Hamiltonian in Radau coordinates and an ab initio polarizability surface at 514.5 nm. We show the importance of the rotation–vibration coupling to obtain the correct line intensities. Several tables with the assignments of the individual rotational–vibrational transitions and their Raman scattering strengths are reported. From these tables, the ν2 Raman spectra can be simulated up to 2000 K for H2O, and up to 300 K for D2O and HDO.This work was supported by the Spanish DGES, research Project PB97-1203. We are indebted to the Centro de Supercomputaci on de Galicia (CESGA), for the use of extensive computation time.Peer reviewe

The Raman spectra and cross-sections of H2O, D2O, and HDO in the OH/OD stretching regions

28 pages, 9 figures, 4 tables.We report the OH and OD stretching regions of the vapor phase Raman spectra of H2O, and of a D2O/HDO mixture, at room temperature. Also, the corresponding spectrum of H2O at 2000 K in a methane/air flame is reported. These spectra are interpreted in terms of transition moments of the molecular polarizability, based on high-level ab initio calculations of the polarizability surface, and on variational wavefunctions considering the rotational–vibrational coupling in full. As a byproduct of this analysis several tables have been compiled including scattering strengths and assignments for individual rotational transitions of the three species. From these tables the Raman spectra in the OH/OD stretching regions can be simulated over the range of temperatures up to 2000 K for H2O, and up to 300 K for D2O and HDO.This work was supported by the Spanish DGES, research project PB97-1203. We are indebted to the Centro de Supercomputacio´n de Galicia (CESGA), for the use of extensive computation time.Peer reviewe

Ro-vibrational Raman Cross Sections of Water Vapor in the OH Stretching Region

16 pages, 6 figures, 7 tables.The Raman spectrum of H2O, in the gas phase at 26 mbar and 295 K, has been recorded from 3400 to 4130 cm−1 using an improved spectrometer of very high sensitivity. This spectrum is analyzed in terms of the wavefunctions and energy levels of Flaud and Camy-Peyret [J. Mol. Spectrosc. 51, 142 (1974)], and of the polarizability derivatives with respect to the dimensionless normal coordinates q1 and q3. It is shown that the anharmonic coupling between the vibrational states ν1 and ν3 has to be considered for a correct simulation of the observed spectrum. Tables with scattering strengths and energies of ro-vibrational transitions are provided in order to simulate the Raman spectrum of water vapor over a broad range of temperatures, from few Kelvin, under supersonic expansions, to high temperature, in combustion processes.the Spanish DGICYT for financial support (Research Projects PB 91-0133 and PB 94-1526).Peer reviewe