A Systematic Review and Meta-Analysis of Interventions Used to Reduce Exposure to House Dust and Their Effect on the Development and Severity of Asthma

We assessed whether any household dust reduction intervention has the effect of increasing or decreasing the development or severity of atopic disease. Electronic searches on household intervention and atopic disease were conducted in 2007 in EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials. We included randomized controlled trials comparing asthma outcomes in a household intervention group with either placebo intervention or no intervention. Meta-analyses on the prevention studies found that the interventions made no difference to the onset of wheeze but made a significant reduction in physician-diagnosed asthma. Meta-analysis of lung function outcomes indicated no improvement due to the interventions but found a reduction in symptom days. Qualitatively, health care was used less in those receiving interventions. However, in one study that compared intervention, placebo, and control arms, the reduction in heath care use was similar in the placebo and intervention arms. This review suggests that there is not sufficient evidence to suggest implementing hygiene measures in an attempt to improve outcomes in existing atopic disease, but interventions from birth in those at high risk of atopy are useful in preventing diagnosed asthma but not parental-reported wheeze

Quasiexcitons in Incompressible Quantum Liquids

Photoluminescence (PL) has been used to study two-dimensional incompressible electron liquids in high magnetic fields for nearly two decades. However, some of the observed anomalies coincident with the fractional quantum Hall effect are still unexplained. We show that emission in these systems occurs from fractionally charged "quasiexciton" states formed from trions correlated with the surrounding electrons. Their binding and recombination depend on the state of both the electron liquid and the involved trion, predicting discontinuities in PL and sensitivity to sample parameters.Comment: 4 pages, 4 figure

Taxonomy and conservation of grassland earless dragons:New species and an assessment of the first possible extinction of a reptile on mainland Australia

Taxonomic research is of fundamental importance in conservation management of threatened species, providing an understanding of species diversity on which management plans are based. The grassland earless dragon lizards (Agamidae: <i>Tympanocryptis</i>) of south-eastern Australia have long been of conservation concern but there have been ongoing taxonomic uncertainties. We provide a comprehensive taxonomic review of this group, integrating multiple lines of evidence, including phylogeography (mtDNA), phylogenomics (SNPs), external morphology and micro x-ray CT scans. Based on these data we assign the lectotype of <i>T. lineata</i> to the Canberra region, restrict the distribution of <i>T. pinguicolla</i> to Victoria and name two new species: <i>T. osbornei sp. nov.</i> (Cooma) and <i>T. mccartneyi sp. nov.</i> (Bathurst). Our results have significant conservation implications. Of particular concern is <i>T. pinguicolla</i>, with the last confident sighting in 1969, raising the possibility of the first extinction of a reptile on mainland Australia. However, our results are equivocal as to whether <i>T. pinguicolla</i> is extant or extinct, emphasizing the immediate imperative for continued surveys to locate any remaining populations of <i>T. pinguicolla</i>. We also highlight the need for a full revision of conservation management plans for all the grassland earless dragons

Changing incidence and characteristics of non-tuberculous mycobacterial infections in Scotland and comparison with Mycobacterium tuberculosis complex incidence (2011 to 2019)

BACKGROUND: An increase in infections with nontuberculous mycobacteria (NTM) has been noted globally, and their incidence has overtaken that of Mycobacterium tuberculosis complex (MTBc) in many countries. Using data from a national reference laboratory, we aimed to determine if this trend could be observed in Scotland. METHODS: We undertook a retrospective review of all NTM isolates received by the Scottish Mycobacteria Reference Laboratory (SMRL) over 9 years from 2011 to 2019 inclusive. Clinical episodes were defined as per 2017 British Thoracic Society and 2020 American Thoracic Society/European Respiratory Society/European Society of Clinical Microbiology and Infectious Diseases/Infectious Diseases Society of America NTM guidelines. These rates were compared with Scottish tuberculosis rates over the same period. RESULTS: Of 8552 NTM isolates from 4586 patients in 2011 to 2019, 7739 (90.5%) were considered clinically relevant. These represented 2409 episodes of NTM infection, with M. avium, M. intracellulare, and M. abscessus complex being most common. A total of 1953 (81.1%) were pulmonary NTM infection episodes from 1470 patients and 456 extrapulmonary episodes from 370 patients. We estimated a rise in incidence from 3.4 to 6.5 per 100 000 person-years (2011–2019 inclusive), with an increase in NTM incidence over MTBc incidence in Scotland by 2017. CONCLUSIONS: The incidence of NTM infection in Scotland has overtaken MTBc incidence. NTM infection leads to a costly health care burden, possibly as much as UK£1.47 million (US$ and €1.73 million) annually. We recommend standardization of isolate referral with clinical surveillance and implementation of agreed standards of care delivered through multidisciplinary teams. This would improve diagnosis and patient management as well as assessment of diagnostics and novel treatments through clinical trials

An fMRI investigation of the effects of attempted naming on word retrieval in aphasia

In healthy controls, picture naming performance can be facilitated by a single prior exposure to the same picture ("priming"). This priming phenomenon is utilized in the treatment of aphasia, which often includes repeated picture naming as part of a therapeutic task. The current study sought to determine whether single and/or multiple exposures facilitate subsequent naming in aphasia and whether such facilitatory effects act through normal priming mechanisms. A functional magnetic resonance imaging paradigm was employed to explore the beneficial effects of attempted naming in two individuals with aphasia and a control group. The timing and number of prior exposures was manipulated, with investigation of both short-term effects (single prior exposure over a period of minutes) and long-term effects (multiple presentations over a period of days). Following attempted naming, both short-term and long-term facilitated items showed improvement for controls, while only the long-term condition showed benefits at a behavioral level for the participants with aphasia. At a neural level, effects of long-term facilitation were noted in the left precuneus for one participant with aphasia, a result also identified for the equivalent contrast in controls. It appears that multiple attempts are required to improve naming performance in the presence of anomia and that for some individuals with aphasia the source of facilitation may be similar to unimpaired mechanisms engaged outside the language network

Integrating Survey and Molecular Approaches to Better Understand Wildlife Disease Ecology

Infectious wildlife diseases have enormous global impacts, leading to human pandemics, global biodiversity declines and socio-economic hardship. Understanding how infection persists and is transmitted in wildlife is critical for managing diseases, but our understanding is limited. Our study aim was to better understand how infectious disease persists in wildlife populations by integrating genetics, ecology and epidemiology approaches. Specifically, we aimed to determine whether environmental or host factors were stronger drivers of Salmonella persistence or transmission within a remote and isolated wild pig (Sus scrofa) population. We determined the Salmonella infection status of wild pigs. Salmonella isolates were genotyped and a range of data was collected on putative risk factors for Salmonella transmission. We a priori identified several plausible biological hypotheses for Salmonella prevalence (cross sectional study design) versus transmission (molecular case series study design) and fit the data to these models. There were 543 wild pig Salmonella observations, sampled at 93 unique locations. Salmonella prevalence was 41% (95% confidence interval [CI]: 37-45%). The median Salmonella DICE coefficient (or Salmonella genetic similarity) was 52% (interquartile range [IQR]: 42-62%). Using the traditional cross sectional prevalence study design, the only supported model was based on the hypothesis that abundance of available ecological resources determines Salmonella prevalence in wild pigs. In the molecular study design, spatial proximity and herd membership as well as some individual risk factors (sex, condition score and relative density) determined transmission between pigs. Traditional cross sectional surveys and molecular epidemiological approaches are complementary and together can enhance understanding of disease ecology: abundance of ecological resources critical for wildlife influences Salmonella prevalence, whereas Salmonella transmission is driven by local spatial, social, density and individual factors, rather than resources. This enhanced understanding has implications for the control of diseases in wildlife populations. Attempts to manage wildlife disease using simplistic density approaches do not acknowledge the complexity of disease ecology

Analytic Markovian Rates for Generalized Protein Structure Evolution

A general understanding of the complex phenomenon of protein evolution requires the accurate description of the constraints that define the sub-space of proteins with mutations that do not appreciably reduce the fitness of the organism. Such constraints can have multiple origins, in this work we present a model for constrained evolutionary trajectories represented by a Markovian process throughout a set of protein-like structures artificially constructed to be topological intermediates between the structure of two natural occurring proteins. The number and type of intermediate steps defines how constrained the total evolutionary process is. By using a coarse-grained representation for the protein structures, we derive an analytic formulation of the transition rates between each of the intermediate structures. The results indicate that compact structures with a high number of hydrogen bonds are more probable and have a higher likelihood to arise during evolution. Knowledge of the transition rates allows for the study of complex evolutionary pathways represented by trajectories through a set of intermediate structures

"In the interests of justice?" The International Criminal Court, peace talks and the failed quest for war crimes accountability in northern Uganda

This article analyzes the first peace talks to take place against the backdrop of an International Criminal Court (ICC) investigation: the Juba Talks between the Lord’s Resistance Army and the Government of Uganda (2006–2008). Drawing on field research and original source material, it departs from well-worn peace versus justice debates and provides new empirical material to explore how the presence of the court shaped domestic political dynamics at Juba. It argues that at the level of broad rhetoric, the presence of the court created significant discord between negotiating parties. On a practical level, however, it created space for consensus, but not the type envisaged by international justice promoters. The court came to be seen by both sides as an intervention that needed to be contained and controlled. This resulted in the politically expedient Agreement on Accountability and Reconciliation, which showcased a transitional justice “tool-kit,” but was based on a shared desire to evade the jurisdiction of international criminal justice. Given its practical complexity, the transitional justice agreement was ultimately rejected by Joseph Kony, who became increasingly distrustful of his own negotiating team at Juba. In findings relevant to other contexts, the article presents in-depth analyses of how domestic political dynamics around the ICC intervention produced a national transitional justice framework designed to protect both parties from war crimes accountability

Epidemiology, prehospital care and outcomes of patients arriving by ambulance with dyspnoea: An observational study

Background: This study aimed to determine epidemiology and outcome for patients presenting to emergency departments (ED) with shortness of breath who were transported by ambulance. Methods: This was a planned sub-study of a prospective, interrupted time series cohort study conducted at three time points in 2014 and which included consecutive adult patients presenting to the ED with dyspnoea as a main symptom. For this sub-study, additional inclusion criteria were presentation to an ED in Australia or New Zealand and transport by ambulance. The primary outcomes of interest are the epidemiology and outcome of these patients. Analysis was by descriptive statistics and comparisons of proportions. Results: One thousand seven patients met inclusion criteria. Median age was 74 years (IQR 61-68) and 46.1 % were male. There was a high rate of co-morbidity and chronic medication use. The most common ED diagnoses were lower respiratory tract infection (including pneumonia, 22.7 %), cardiac failure (20.5%) and exacerbation of chronic obstructive pulmonary disease (19.7 %). ED disposition was hospital admission (including ICU) for 76.4 %, ICU admission for 5.6 % and death in ED in 0.9 %. Overall in-hospital mortality among admitted patients was 6.5 %. Discussion: Patients transported by ambulance with shortness of breath make up a significant proportion of ambulance caseload and have high comorbidity and high hospital admission rate. In this study, >60 % were accounted for by patients with heart failure, lower respiratory tract infection or COPD, but there were a wide range of diagnoses. This has implications for service planning, models of care and paramedic training. Conclusion: This study shows that patients transported to hospital by ambulance with shortness of breath are a complex and seriously ill group with a broad range of diagnoses. Understanding the characteristics of these patients, the range of diagnoses and their outcome can help inform training and planning of services