Improved Source-Reconstruction Through the Exploitation of Dose-Response Models

The emergency actions following an accidental or intentional release of a hazardous material (HazMat) are strongly influenced by what is known of the HazMat event and its evolution (e.g. mass flowrate of the release, location of the release, and the duration of the release). Thus, the availability of such information in a timely and accurate manner is of great importance for emergency crews both on-site and in the areas in the proximity of the site. This information aids in predicting the fate of the release and mitigating the possible threats imposed by it on human health. Characterizing the source of an atmospheric contaminant is typically regarded as an inverse problem, where one has to infer the source characteristics of the released HazMat from concentration or deposition measurements. The inverse solution is obtained by combining atmospheric dispersion models and concentration measurements in an optimal way, where dispersion models are used to produce concentration predictions in space and time using as input initial guesses of the source information. Furthermore, estimating the source parameters needed for atmospheric transport and dispersion modeling requires the application of deterministic and stochastic inversion techniques, such as the Bayesian frames employing Monte Carlo methods. Locating the source and determining its release rate based on downwind concentration measurements, however, is only viable for some cases like industrial accidents, where measurement data from monitoring stations are typically obtained on-site. For other release cases, such as transport accidents or malevolent attacks, there is a lack of input data (i.e. immediate concentration measurements). Hence, there is a necessity to develop new approaches for real cases where this information is probably not available to the required extent or at all. This work presents the development, application and assessment of computational algorithms used in reconstructing the source characteristics following an accidental release of an airborne hazard. A promising methodology is the utilization of the resulting health symptoms from exposure as indirect input for emergency response systems. In this work, a total of six scenarios were constructed and analyzed in terms of their ability to reconstruct the source rate in addition to the source location. The results revealed that the source term information can be identified with good agreement with the true source parameters when using the new scheme. However, the complexity of the information used as input was reflected on the minimum requirement of input data needed to reconstruct the source term. The results also revealed the necessity to explore other sophisticated sampling and inversion techniques

Effects of Biological Age on Athletic Adaptations to Combined Plyometric and Sprint with Change of Direction with Ball Training in Youth Soccer Players

There is evidence for the effectiveness of youth combined plyometric and sprint with change of direction (COD) training. However, the evidence is not well-known regarding the in-season effects of biological age (peak height velocity—PHV) on the motor adaptive processes following combined plyometric and COD with ball training (P-CODBT) in youth soccer players. This study aimed to examine the in-season effects of P-CODBT (8 weeks and twice a week) on the athletic performances of male youth soccer players, circa- and post-PHV. In a randomized controlled training study with pre-to-post measurements, forty-eight male players were assigned into two experimental (performing P-CODBT; n = 12 × circa-PHV and n = 12 × post-PHV) and two control groups (CONG; n = 12 × circa-PHV and n = 12 × post-PHV). The pre- and post-training participants were assessed for their anthropometric, linear sprinting with and without a ball, COD speed with and without a ball, vertical jump, dynamic balance, and endurance-intensive performances. After the intervention, the experimental condition induced significant (all p < 0.0001) and small to large effect size (ES = 0.263–3.471) additional gains only on explosive measures compared to CONG. Both the experimental (all p < 0.0001; ES = 0.338–1.908) and control (p = 0.011–0.0001; ES = 0.2–1.8) groups improved their athletic performances over the training period. The improvements generated by p-CODBT were not affected by biological age. In-season short-term P-CODBT (twice a week) could be safe way to generate benefits in explosive performances in youth soccer players, which are relevant components of match-winning actions in soccer

Brocchia cinerea (Delile) Vis. Essential Oil Antimicrobial Activity and Crop Protection against Cowpea Weevil Callosobruchus maculatus (Fab.)

Antibiotics and synthetic pesticides are now playing a role in the spread of resistant pathogens. They continue to have negative consequences for animal and plant health. The goal of this work is to identify the chemical composition of Brocchia cinerea (Delile) Vis. essential oil (EO) using GC-MS(Gas Chromatography-Mass Spectrometer), evaluate its antimicrobial properties, and investigate its insecticidal and repellent effectiveness against Callosobruchus maculatus (C. maculatus). The GC-MS indicated the presence of 21 chemicals, with thujone (24.9%), lyratyl acetate (24.32%), camphor (13.55%), and 1,8-cineole (10.81%) being the most prominent. For the antimicrobial assay, the yeast Candida albicans was very sensitive to the EO with a growth inhibition diameter of (42.33 mm), followed by Staphylococcus aureus (31.33 mm). Fusarium oxysporum is the mycelia strain that appeared to be extremely sensitive to the utilized EO (88.44%) compared to the two species of Aspergillus (A. flavus (48.44%); A. niger (36.55%)). The results obtained in the microdilution method show that Pseudomonas aeruginosa was very sensitive to the EO, inhibited by a very low dose (0.0018 mg/mL). The minimum inhibitory concentration (MIC) results were between 0.0149 and 0.06 mg/mL. B. cinerea EO also demonstrated a potent insecticidal effect and a medium repulsive effect against C. maculatus. Thus, the LC50 value in the contact test was 0.61 μL/L of air, lower than that observed in the inhalation test (0.72 μL/L of air). The present study reveals that B. cinerea EO has the potential to be an antimicrobial and insecticidal agent with a better performance against several pathogenic microorganisms

Brocchia cinerea (Delile) Vis. Essential Oil Antimicrobial Activity and Crop Protection against Cowpea Weevil Callosobruchus maculatus (Fab.)

Antibiotics and synthetic pesticides are now playing a role in the spread of resistant pathogens. They continue to have negative consequences for animal and plant health. The goal of this work is to identify the chemical composition of Brocchia cinerea (Delile) Vis. essential oil (EO) using GC-MS(Gas Chromatography-Mass Spectrometer), evaluate its antimicrobial properties, and investigate its insecticidal and repellent effectiveness against Callosobruchus maculatus (C. maculatus). The GC-MS indicated the presence of 21 chemicals, with thujone (24.9%), lyratyl acetate (24.32%), camphor (13.55%), and 1,8-cineole (10.81%) being the most prominent. For the antimicrobial assay, the yeast Candida albicans was very sensitive to the EO with a growth inhibition diameter of (42.33 mm), followed by Staphylococcus aureus (31.33 mm). Fusarium oxysporum is the mycelia strain that appeared to be extremely sensitive to the utilized EO (88.44%) compared to the two species of Aspergillus (A. flavus (48.44%); A. niger (36.55%)). The results obtained in the microdilution method show that Pseudomonas aeruginosa was very sensitive to the EO, inhibited by a very low dose (0.0018 mg/mL). The minimum inhibitory concentration (MIC) results were between 0.0149 and 0.06 mg/mL. B. cinerea EO also demonstrated a potent insecticidal effect and a medium repulsive effect against C. maculatus. Thus, the LC50 value in the contact test was 0.61 μL/L of air, lower than that observed in the inhalation test (0.72 μL/L of air). The present study reveals that B. cinerea EO has the potential to be an antimicrobial and insecticidal agent with a better performance against several pathogenic microorganisms

Genetic Influences on Cortical Regionalization in the Human Brain

SummaryAnimal data demonstrate that the development of distinct cortical areas is influenced by genes that exhibit highly regionalized expression patterns. In this paper, we show genetic patterning of cortical surface area derived from MRI data from 406 adult human twins. We mapped genetic correlations of areal expansion between selected seed regions and all other cortical locations, with the selection of seed points based on results from animal studies. “Marching seeds” and a data-driven, hypothesis-free, fuzzy-clustering approach provided convergent validation. The results reveal strong anterior-to-posterior graded, bilaterally symmetric patterns of regionalization, largely consistent with patterns previously reported in nonhuman mammalian models. Broad similarities in genetic patterning between rodents and humans might suggest a conservation of cortical patterning mechanisms, whereas dissimilarities might reflect the functionalities most essential to each species

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic