35 research outputs found
Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium.
BACKGROUND
The Invasive Respiratory Infection Surveillance (IRIS) Consortium was established to assess the impact of the COVID-19 pandemic on invasive diseases caused by Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus agalactiae. We aimed to analyse the incidence and distribution of these diseases during the first 2 years of the COVID-19 pandemic compared to the 2 years preceding the pandemic.
METHODS
For this prospective analysis, laboratories in 30 countries and territories representing five continents submitted surveillance data from Jan 1, 2018, to Jan 2, 2022, to private projects within databases in PubMLST. The impact of COVID-19 containment measures on the overall number of cases was analysed, and changes in disease distributions by patient age and serotype or group were examined. Interrupted time-series analyses were done to quantify the impact of pandemic response measures and their relaxation on disease rates, and autoregressive integrated moving average models were used to estimate effect sizes and forecast counterfactual trends by hemisphere.
FINDINGS
Overall, 116â841 cases were analysed: 76â481 in 2018-19, before the pandemic, and 40â360 in 2020-21, during the pandemic. During the pandemic there was a significant reduction in the risk of disease caused by S pneumoniae (risk ratio 0·47; 95% CI 0·40-0·55), H influenzae (0·51; 0·40-0·66) and N meningitidis (0·26; 0·21-0·31), while no significant changes were observed for S agalactiae (1·02; 0·75-1·40), which is not transmitted via the respiratory route. No major changes in the distribution of cases were observed when stratified by patient age or serotype or group. An estimated 36â289 (95% prediction interval 17â145-55â434) cases of invasive bacterial disease were averted during the first 2 years of the pandemic among IRIS-participating countries and territories.
INTERPRETATION
COVID-19 containment measures were associated with a sustained decrease in the incidence of invasive disease caused by S pneumoniae, H influenzae, and N meningitidis during the first 2 years of the pandemic, but cases began to increase in some countries towards the end of 2021 as pandemic restrictions were lifted. These IRIS data provide a better understanding of microbial transmission, will inform vaccine development and implementation, and can contribute to health-care service planning and provision of policies.
FUNDING
Wellcome Trust, NIHR Oxford Biomedical Research Centre, Spanish Ministry of Science and Innovation, Korea Disease Control and Prevention Agency, Torsten Söderberg Foundation, Stockholm County Council, Swedish Research Council, German Federal Ministry of Health, Robert Koch Institute, Pfizer, Merck, and the Greek National Public Health Organization
Welche Macht darf es denn Sein? Tracing âPowerâ in German Foreign Policy Discourse
The relationship between âGermanyâ and âpowerâ remains a sensitive issue. While observers tend to agree that Germany has regained the status of the most powerful country in Europe, there is debate whether that is to be welcomed or whether that is a problem. Underpinning this debate are views, both within Germany and amongst its neighbours, regarding the kind of power Germany has, or should (not) have. Against this backdrop, the article reviews the dominant role conceptions used in the expert discourse on German foreign policy since the Cold War that depict Germany as a particular type of âpowerâ. Specifically, we sketch the evolution of three prominent conceptions (constrained power, civilian power, hegemonic power) and the recent emergence of a new one (shaping power). The article discusses how these labels have emerged to give meaning to Germanyâs position in international relations, points to their normative and political function, and to the limited ability of such role images to tell us much about how Germany actually exercises power
Applying Ecological Principles to Management of U.S. National Forests
he U.S. National Forest System is a diverse and unique resource that must be managed within the context of competing and shifting social expectations. The policies under which the system operates have changed over the century, along with the values society places on wood production, wilderness protection, recreation, and biodiversity conservation. Proposals for major changes in the management of the National Forests are once again being debated. The consensus among forest ecologists is that all forests, despite their complexity and variability, should be managed as ecosystems. Sustainable forest management practices must be based on an understanding of how natural forest ecosystems work.
We have identified major ecological considerations that should be incorporated in sound forest management policy and their potential impacts on current practice:
* Maintenance of soil quality and nutrient stocks that hold the key to current and future forest productivity may necessitate adjusting timber harvest rates and leaving more large woody debris on cutover sites.
* Protection of water quality and yield and prevention of flooding and landslides call for greater attention to the negative impacts of logging roads and the value of undisturbed buffer zones along streams and rivers.
* Conservation of forest biodiversity will often require reducing forest fragmentation by clearcuts and roads, avoiding harvest in vulnerable areas such as hardwood or old growth stands and riparian zones, and restoring natural structural complexity to cutover sites.
* Planning at the landscape level is needed to address ecological concerns such as biodiversity, water flows, and forest fragmentation. Repeated overcutting of National Forests lands in the past has been linked to lack of planning at the landscape scale.
* Increasing pressures on forests due to human population growth and global change oblige land managers to be alert for climate-related stresses as well as damage from ground-level ozone, acid rain, and acidification of soils and watersheds
Profiling the unique protective properties of intracranial arterial endothelial cells
Cardiovascular disorders, like atherosclerosis and hypertension, are increasingly known to be associated with vascular cognitive impairment (VCI). In particular, intracranial atherosclerosis is one of the main causes of VCI, although plaque development occurs later in time and is structurally different compared to atherosclerosis in extracranial arteries. Recent data suggest that endothelial cells (ECs) that line the intracranial arteries may exert anti-atherosclerotic effects due to yet unidentified pathways. To gain insights into underlying mechanisms, we isolated post-mortem endothelial cells from both the intracranial basilar artery (BA) and the extracranial common carotid artery (CCA) from the same individual (total of 15 individuals) with laser capture microdissection. RNA sequencing revealed a distinct molecular signature of the two endothelial cell populations of which the most prominent ones were validated by means of qPCR. Our data reveal for the first time that intracranial artery ECs exert an immune quiescent phenotype. Secondly, genes known to be involved in the response of ECs to damage (inflammation, differentiation, adhesion, proliferation, permeability and oxidative stress) are differentially expressed in intracranial ECs compared to extracranial ECs. Finally, Desmoplakin (DSP) and Hop Homeobox (HOPX), two genes expressed at a higher level in intracranial ECs, and Sodium Voltage-Gated Channel Beta Subunit 3 (SCN3B), a gene expressed at a lower level in intracranial ECs compared to extracranial ECs, were shown to be responsive to shear stress and/or hypoxia. With our data we present a set of intracranial-specific endothelial genes that may contribute to its protective phenotype, thereby supporting proper perfusion and consequently may preserve cognitive function. Deciphering the molecular regulation of the vascular bed in the brain may lead to the identification of novel potential intervention strategies to halt vascular associated disorders, such as atherosclerosis and vascular cognitive dysfunction
Groundwater in a future climate : The CLIWAT Handbook
This handbook is a product of the CLIWAT project (CLImate change and groundWATer) highlighting the main results and recommendations of the project for planners and practitioners at local, regional and national levels. CLIWAT is a transnational project in the North Sea region dealing with groundwater mapping and adaptive planning and solutions for the coming challenges caused by climate change. The project aims at bridging EU-science and policy on climate change impact and adaptation in the North Sea Region at a practical level. The research and analysis covers a broad spectrum of geoscience and focuses on gaining a better understanding of the effects of climate change on the quantity and quality of groundwater. The project started in September 2008 and ends in March 2012. The project involves sixteen partners from Germany, The Netherlands, Belgium and Denmark. The handbook is complimented by a number of scientific papers from all pilot areas in a special issue of the on-line journal âHydrology and Earth System Sciencesâ with the title âAssessing the impact of climate change for adaptive water management in coastal regionsâ