Heater choice, dampness and mould growth in 26 New Zealand homes: A study of propensity for mould growth using encapsulated fungal spores

The relationship between the use of unflued gas heaters (UGH, N = 14) and heat pump heaters (HP, N = 12) located in the living rooms, and mould growth on the living room and bedroom walls, of 26 New Zealand (NZ) occupied homes was investigated during winter. Two methods were employed to evaluate the potential of mould growth on walls: (i) measurement of daily hyphal growth rate using a fungal detector (encapsulated fungal spores); and (ii) estimation of fungal contamination based on a four level scale visual inspection. The average wall psychrometric conditions were significantly different between the two heater type groups, in both the living rooms and the bedrooms with the UGH user homes being colder and damper than HP user homes. The UGHs were found to be a significant additional source of moisture in the living rooms which dramatically increased the capacity for fungi to grow on wall surfaces. The average daily hyphal growth rates were 4 and 16 times higher in the living rooms and in the bedrooms of the UGH user homes, respectively. Results from both mould detection methods gave good agreement, showing that the use of a fungal detector was an efficient method to predict the potential of mould growth on the inside of the external walls in NZ homes

The respiratory health effects of nitrogen dioxide in children with asthma

There is growing evidence that asthma symptoms can be aggravated or events triggered by exposure to indoor nitrogen dioxide (NO2) emitted from unflued gas heating. The impact of NO2 on the respiratory health of children with asthma was explored as a secondary analysis of a randomised community trial, involving 409 households during the winter period in 2006 (June to September). Geometric mean indoor NO2 levels were 11.4 μg·m-3, while outdoor NO2 levels were 7.4 μg·m-3. Higher indoor NO2 levels (per logged unit increase) were associated with greater daily reports of lower (mean ratio 14, 95% CI 1.12-1.16) and upper respiratory tract symptoms (mean ratio 1.03, 95% CI 1.00-1.05), more frequent cough and wheeze, and more frequent reliever use during the day, but had no effect on preventer use. Higher indoor NO2 levels (per logged unit increase) were associated with a decrease in morning (-17.25 mL, 95% CI -27.63- -6.68) and evening (-13.21, 95% CI -26.03- -0.38) forced expiratory volume in 1 s readings. Outdoor NO2 was not associated with respiratory tract symptoms, asthma symptoms, medication use or lung function measurements. These findings indicate that reducing NO2 exposure indoors is important in improving the respiratory health of children with asthma. Copyright©ERS 2011

ICORG 10-14: NEOadjuvant trial in adenocarcinoma of the oEsophagus and oesophagoGastric junction international study (Neo-AEGIS)

Background: Neoadjuvant therapy is increasingly the standard of care in the management of locally advanced adenocarcinoma of the oesophagus and junction (AEG). In randomised controlled trials (RCTs), the MAGIC regimen of pre- and postoperative chemotherapy, and the CROSS regimen of preoperative chemotherapy combined with radiation, were superior to surgery only in RCTs that included AEG but were not powered on this cohort. No completed RCT has directly compared neoadjuvant or perioperative chemotherapy and neoadjuvant chemoradiation. The Neo-AEGIS trial, uniquely powered on AEG, and including comprehensive modern staging, compares both these regimens. Methods: This open label, multicentre, phase III RCT randomises patients (cT2-3, N0-3, M0) in a 1:1 fashion to receive CROSS protocol (Carboplatin and Paclitaxel with concurrent radiotherapy, 41.4Gy/23Fr, over 5 weeks). The power calculation is a 10% difference in favour of CROSS, powered at 80%, two-sided alpha level of 0.05, requiring 540 patients to be evaluable, 594 to be recruited if a 10% dropout is included (297 in each group). The primary endpoint is overall survival, with a minimum 3-year follow up. Secondary endpoints include: disease free survival, recurrence rates, clinical and pathological response rates, toxicities of induction regimens, post-operative pathology and tumour regression grade, operative in-hospital complications, and health-related quality of life. The trial also affords opportunities for establishing a bio-resource of pre-treatment and resected tumour, and translational research. Discussion: This RCT directly compares two established treatment regimens, and addresses whether radiation therapy positively impacts on overall survival compared with a standard perioperative chemotherapy regimen Sponsor: Irish Clinical Research Group (ICORG). Trial registration: NCT01726452 . Protocol 10-14. Date of registration 06/11/2012.</p

Additional file 1 of ICORG 10-14: NEOadjuvant trial in Adenocarcinoma of the oEsophagus and oesophagoGastric junction International Study (Neo-AEGIS)

Appendix A: Description of data: copy of consent form (DOCX 60 kb

Estimating global injuries morbidity and mortality: Methods and data used in the Global Burden of Disease 2017 study

Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future