From online entries to online results

From online entries to online result

Infant home respiratory monitoring using pulse oximetry

Respiratory rate (RR) is a valuable early marker of illness in vulnerable infants, but current monitoring methods are unsuitable for sustained home use. We have demonstrated accurate measurement of RR from brief recordings of pulse oximeter plethysmogram (pleth) trace in full-term neonates in hospital. This study assessed the feasibility of this method in preterm infants during overnight recordings in the home. We collected simultaneous overnight SpO2, pleth and respiratory inductive plethysmography (RIP) on 24 preterm infants in the home. RR from pleth analysis was compared with RR from RIP bands; pleth quality was assessed by the presence of visible artefact. Median (range) RR from RIP and pleth were not significantly different at 42 (25-65) and 42 (25-64) breaths/min. Median (range) % of epochs rejected due to artefact was 20 (8-75) for pleth and 10 (3-53) for RIP. Our results suggest that home RR monitoring by pulse oximeter pleth signal is accurate and feasible

Ionic Liquid-Based Microemulsions in Catalysis

The design and properties of surface-active ionic liquids that are able to form stable microemulsions with heptane and water are presented, and their promise as reaction media for thermomorphic palladium-catalyzed cross-coupling reactions is demonstrated

Designing a Planetary Health Watch: A System for Integrated Monitoring of the Health Effects of, and Responses to, Environmental Change

In the new geological epoch of the Anthropocene impacts of human activity on the Earth’s systems may pose major risks to human health. We propose the development of a Planetary Health Watch (PHW) system for integrated monitoring of health effects of, and responses to, global environmental changes. The PHW system will harness new capabilities emerging from the digital revolution to motivate and enable effective responses to threats posed by the transgression of planetary boundaries. It will build on the existing monitoring initiatives as a system aimed at integrated monitoring of environmental change, health effects, and intermediating factors along with the drivers of change and policy responses to protect health. In July 2019, we held a two-day engagement workshop at the Wellcome Trust in London, UK. We convened 59 experts, representatives of existing monitoring initiatives, and potential users of the system to discuss and make recommendations on key aspects of the design of such a system, particularly its scope, opportunities for building on existing initiatives, target users and use cases, strategies for generating impact and key communities for engagement. The scope of monitoring was defined by a framework integrating eight planetary boundaries (climate change, ocean acidification, atmospheric aerosol loading, novel entities, freshwater use, biogeochemical flows, land system change and biosphere integrity) with human health outcomes. (Discussion of the ninth boundary – ozone layer depletion – was omitted because the ozone hole is now healing as a result of the implementation of the Montreal protocol.) As the initial crosscutting areas for the prototype development of PHW, we selected cities, food systems, and links between land use change and human health (emerging diseases and air pollution) to act as foci for the discussion. To build on the existing monitoring efforts, PHW will purse three levels of integration: (1) across health and environmental monitoring, (2) across top down and bottom up monitoring approaches, (3) between advancing knowledge and action that can be taken to protect planetary health. Existing data platforms, large-scale initiatives and networks such as the Multi-Country Multi-City Collaborative Research Network, INDEPTH network of health and demographic surveillance sites in low- and middle-income countries, Resource Watch, Global Burden of Disease project, C40, Global Covenant of Mayors, Sustainable Development Solutions Network and many others will be essential to this process. PHW will aim to add to - the evidence on the emerging risks for human health and the most effective solutions by engaging researchers as a key user community; - awareness of the evidence on impacts and solutions by investing in an outreach strategy that includes clear messages, narratives, and strategically selected messengers; - action to protect planetary health by motivating and enabling decision-makers who influence relevant policies and their implementation across sectors to incorporate planetary health as a priority. The strategies for generating impact will include generation of clear messages comprised of both data and narratives compelling to the individual users, proposing solutions and engaging with those in power to implement them. Scientific oversight and inclusive governance processes will ensure the system’s credibility and legitimacy. The next steps involve engagement with key stakeholders, facilitation of new partnerships, and development of a long-term funding strategy

Biologics for paediatric severe asthma: Trick or TREAT?

No abstract available

Environmental risk factors for respiratory infection and wheeze in young children:A multicentre birth cohort study

introduction: Respiratory infections and wheeze have a considerable impact on the health of young children and consume significant healthcare resources. We aimed to evaluate the effect of environmental factors on respiratory infections and symptoms in early childhood.Methods: Environmental risk factors including: daycare attendance; breastfeeding; siblings; damp within the home; environmental tobacco smoke (ETS); child's bedroom flooring; animal exposure; road traffic density around child's home; and solid fuel pollution within home were assessed in children recruited to the GO-CHILD multicentre prospective birth cohort study. Follow-up information on respiratory infections (bronchiolitis, pneumonia, otitis media and cold or flu), wheeze and cough symptoms, healthcare utilisation and medication prescription was collected by postal questionnaires at 12 and 24 months. Log binomial and ordered logistic regression models were fitted to the data.Results: Follow-up was obtained on 1344 children. Daycare was associated with increased odds of pneumonia (odds ratio [OR] = 2.39, 95% confidence interval [CI]: 1.04-5.49), bronchiolitis (OR = 1.40, 1.02-1.90), otitis media (OR = 1.68, 1.32-2.14) and emergency department attendance for wheeze (RR = 1.81, 1.17-2.80). Breastfeeding beyond 6 months was associated with a reduced odds of bronchiolitis (OR = 0.55, 0.39-0.77) and otitis media (OR = 0.75, 0.59-0.99). Siblings at home was associated with an increased odds of bronchiolitis (OR = 1.65, 1.18-2.32) and risk of reliever inhaler prescription (RR = 1.37, 1.02-1.85). Visible damp was associated with an increased odds of wheeze (OR = 1.85, 1.11-3.19), and risk of reliever inhaler (RR = 1.73, 1.04-2.89) and inhaled corticosteroid prescription (RR = 2.61, 1.03-6.59). ETS exposure was associated with an increased odds of primary care attendance for cough or wheeze (OR = 1.52, 1.11-2.08). Dense traffic around the child's home was associated with an increased odds of bronchiolitis (OR = 1.32, 1.08-2.29).Conclusion: Environmental factors likely influence the wide variation in infection frequency and symptoms observed in early childhood. Larger population studies are necessary to further inform and guide public health policy to decrease the burden of respiratory infections and wheeze in young children.</p

A strategy for the next decade to address data deficiency in neglected biodiversity

Measuring progress toward international biodiversity targets requires robust information on the conservation status of species, which the International Union for Conservation of Nature (IUCN) Red List of Threatened Species provides. However, data and capacity are lacking for most hyperdiverse groups, such as invertebrates, plants, and fungi, particularly in megadiverse or high-endemism regions. Conservation policies and biodiversity strategies aimed at halting biodiversity loss by 2020 need to be adapted to tackle these information shortfalls after 2020. We devised an 8-point strategy to close existing data gaps by reviving explorative field research on the distribution, abundance, and ecology of species; linking taxonomic research more closely with conservation; improving global biodiversity databases by making the submission of spatially explicit data mandatory for scientific publications; developing a global spatial database on threats to biodiversity to facilitate IUCN Red List assessments; automating preassessments by integrating distribution data and spatial threat data; building capacity in taxonomy, ecology, and biodiversity monitoring in countries with high species richness or endemism; creating species monitoring programs for lesser-known taxa; and developing sufficient funding mechanisms to reduce reliance on voluntary efforts. Implementing these strategies in the post-2020 biodiversity framework will help to overcome the lack of capacity and data regarding the conservation status of biodiversity. This will require a collaborative effort among scientists, policy makers, and conservation practitioners.Peer reviewe