The co-influence of noise and carbon dioxide on humans in the work and living environment

The aim of the paper is to investigate the co-influence of noise and carbon dioxide on people in different situations (inside/outside houses/classrooms) depending on the traffic intensity, the fuel used for heating in residential buildings etc.). All the measurements and the questionnaire have been carried out during the autumn of 2019 (at the mean temperature of 5–10 °C). Riga has a more intensive traffic compared to Tallinn and has greater problems of exceeding the permissible noise levels. The levels of carbon dioxide inside classrooms are also very high in Latvia (1,500–2,000 ppm). The concentration of carbon dioxide outside buildings is low in the forest areas (measured in the south of Estonia), being 340–350 ppm. In regional towns, it is 500 ppm (measured in autumn-winter near a busy street). The co-influence of noise and carbon dioxide on the residents has been investigated by using the Weinstein questionnaire. High carbon dioxide levels cause fatigue. Although it was not particularly pointed out by the residents questioned in a panel house with small apartments, the air was considered to be stuffy. The house is situated near a busy street, so the problems with noise are higher. ANOVA statistics has been used for the questionnaire (p < 0.001, α = 0.93). The decrease of noise and carbon dioxide levels help people stay healthy and the environmental impact from the investigation is emphasising the necessity and providing possibilities to decrease the concentration of CO2 in the ambient air

The visualisation of vitreous using surface modified poly(lactic-co-glycolic acid) microparticles

This paper is freely available online under the BMJ Journals unlocked scheme, see http:// bjo.bmj.com/site/about/unlocked.xhtmAims To demonstrate the potential use of in vitro poly (lactic-co-glycolic acid) (PLGA) microparticles in comparison with triamcinolone suspension to aid visualisation of vitreous during anterior and posterior vitrectomy. Methods PLGA microparticles (diameter 10-60 mu m) were fabricated using single and/or double emulsion technique(s) and used untreated or following the surface adsorption of a protein (transglutaminase). Particle size, shape, morphology and surface topography were assessed using scanning electron microscopy (SEM) and compared with a standard triamcinolone suspension. The efficacy of these microparticles to enhance visualisation of vitreous against the triamcinolone suspension was assessed using an in vitro set-up exploiting porcine vitreous. Results Unmodified PLGA microparticles failed to adequately adhere to porcine vitreous and were readily washed out by irrigation. In contrast, modified transglutaminase-coated PLGA microparticles demonstrated a significant improvement in adhesiveness and were comparable to a triamcinolone suspension in their ability to enhance the visualisation of vitreous. This adhesive behaviour also demonstrated selectivity by not binding to the corneal endothelium. Conclusion The use of transglutaminase-modified biodegradable PLGA microparticles represents a novel method of visualising vitreous and aiding vitrectomy. This method may provide a distinct alternative for the visualisation of vitreous whilst eliminating the pharmacological effects of triamcinolone acetonide suspension.Peer reviewedFinal Published versio

Prospective Prediction of Body Mass Index Trajectories using Multi-task Gaussian Processes

Clinicians often investigate the body mass index (BMI) trajectories of children to assess their growth with respect to their peers, as well as to anticipate future growth and disease risk. While retrospective modelling of BMI trajectories has been an active area of research, prospective prediction of continuous BMI trajectories from historical growth data has not been well investigated. Using weight and height measurements from birth to age 10 years from a longitudinal mother-offspring cohort, we leveraged a multi-task Gaussian processes model, called MagmaClust, to derive probabilistic predictions for BMI trajectories over various forecasting periods. Experiments were conducted to evaluate the accuracy, sensitivity to missing values, and number of clusters. The results were compared with cubic B-spline regression and a parametric Jenss-Bayley mixed effects model. A downstream tool computing individual overweight probabilities was also proposed and evaluated. In all experiments, MagmaClust outperformed conventional models in prediction accuracy while correctly calibrating uncertainty regardless of the missing data amount (up to 90\% missing) or the forecasting period (from 2 to 8 years in the future). Moreover, the overweight probabilities computed from MagmaClust's uncertainty quantification exhibited high specificity ($0.94$ to $0.96$) and accuracy ($0.86$ to $0.94$) in predicting the 10-year overweight status even from age 2 years. MagmaClust provides a probabilistic non-parametric framework to prospectively predict BMI trajectories, which is robust to missing values and outperforms conventional BMI trajectory modelling approaches. It also clusters individuals to identify typical BMI patterns (early peak, adiposity rebounds) during childhood. Overall, we demonstrated its potential to anticipate BMI evolution throughout childhood, allowing clinicians to implement prevention strategies.Comment: 17 pages, 9 figures, 5 table

Outbreak of Rift Valley fever affecting veterinarians and farmers in South Africa, 2008

BACKGROUND: During 2008, Rift Valley fever (RVF) virus re-emerged in South Africa as focal outbreaks in several provinces. Aims. To investigate an outbreak affecting cattle farmers and farm workers, and the staff and students of a veterinary school, assess the prevalence of infection during the outbreak, document the clinical presentation of cases, and identify potential risk factors. METHODS: We conducted a cross-sectional serological survey of exposed veterinarians and farmers, who were examined to determine the presence of current or recent illness. Blood specimens were collected for virus isolation, nucleic acid detection and serology. A subset was interviewed using a standardised questionnaire to obtain data on recent exposures and risk factors for infection. RESULTS: Of 53 participants potentially exposed to infected domestic ruminants, 15% had evidence of recent infection and 4% evidence of past exposure to the RVF virus. The prevalence of acute infection was 21% in veterinarians compared with 9% in farmers and farm workers. After a mean incubation period of 4.3 days, the most frequent symptoms experienced included myalgia (100%), headache (88%) and malaise (75%). No asymptomatic cases were identified. Transmission by direct contact with infected animals was the major risk factor in these professional groups. Performing animal autopsies was significantly associated with acute infection (risk ratio 16.3, 95% confidence interval 2.3 - 114.2). CONCLUSIONS: Increased risks associated with veterinary practices highlight a need for the use of personal protective equipment, and identify veterinarians as a primary target group for future vaccination

Conflict transformation and history teaching: social psychological theory and its contributions

The aim of this introductory chapter is to render intelligible how history teaching can be enriched with knowledge of social psychological theories that deal with the issue of conflict transformation and partcularly the notions of prejudice reduction and reconciliation. A major aim of history teaching is to engage students with historical texts, establish historical significance, identify continuity and change, analyse cause and consequence, take historical perspectives and understand the ethical dimensions of historical interpretations. Such teaching, enriched with social psychological theory, will enlarge the notion of historical literacy into a study of historical culture and historical consciousness in the classroom so that students become reflective of the role of collective memory and history teaching in processes of conflict transformation and understand the ways in which various forms of historical consciousness relate the past, present and future. This is what the editors of this volume call an interdisciplinary paradigm of transformative history teachin

Autism as a disorder of neural information processing: directions for research and targets for therapy

The broad variation in phenotypes and severities within autism spectrum disorders suggests the involvement of multiple predisposing factors, interacting in complex ways with normal developmental courses and gradients. Identification of these factors, and the common developmental path into which theyfeed, is hampered bythe large degrees of convergence from causal factors to altered brain development, and divergence from abnormal brain development into altered cognition and behaviour. Genetic, neurochemical, neuroimaging and behavioural findings on autism, as well as studies of normal development and of genetic syndromes that share symptoms with autism, offer hypotheses as to the nature of causal factors and their possible effects on the structure and dynamics of neural systems. Such alterations in neural properties may in turn perturb activity-dependent development, giving rise to a complex behavioural syndrome many steps removed from the root causes. Animal models based on genetic, neurochemical, neurophysiological, and behavioural manipulations offer the possibility of exploring these developmental processes in detail, as do human studies addressing endophenotypes beyond the diagnosis itself

Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK

Objective Globally, 20 million children are born with a birth weight below 2500 g every year, which is considered as a low birthweight (LBW) baby. This study investigates the contribution of modifiable risk factors in a nationally representative Welsh e-cohort of children and their mothers to inform opportunities to reduce LBW prevalence. Design A longitudinal cohort study based on anonymously linked, routinely collected multiple administrative data sets. Participants The cohort, (N=693 377) comprising of children born between 1 January 1998 and 31 December 2018 in Wales, was selected from the National Community Child Health Database. Outcome measures The risk factors associated with a binary LBW (outcome) variable were investigated with multivariable logistic regression (MLR) and decision tree (DT) models. Results The MLR model showed that non-singleton children had the highest risk of LBW (adjusted OR 21.74 (95% CI 21.09 to 22.40)), followed by pregnancy interval less than 1 year (2.92 (95% CI 2.70 to 3.15)), maternal physical and mental health conditions including diabetes (2.03 (1.81 to 2.28)), anaemia (1.26 (95% CI 1.16 to 1.36)), depression (1.58 (95% CI 1.43 to 1.75)), serious mental illness (1.46 (95% CI 1.04 to 2.05)), anxiety (1.22 (95% CI 1.08 to 1.38)) and use of antidepressant medication during pregnancy (1.92 (95% CI 1.20 to 3.07)). Additional maternal risk factors include smoking (1.80 (95% CI 1.76 to 1.84)), alcohol-related hospital admission (1.60 (95% CI 1.30 to 1.97)), substance misuse (1.35 (95% CI 1.29 to 1.41)) and evidence of domestic abuse (1.98 (95% CI 1.39 to 2.81)). Living in less deprived area has lower risk of LBW (0.70 (95% CI 0.67 to 0.72)). The most important risk factors from the DT models include maternal factors such as smoking, maternal weight, substance misuse record, maternal age along with deprivation—Welsh Index of Multiple Deprivation score, pregnancy interval and birth order of the child. Conclusion Resources to reduce the prevalence of LBW should focus on improving maternal health, reducing preterm births, increasing awareness of what is a sufficient pregnancy interval, and to provide adequate support for mothers’ mental health and well-being

What can we learn from consumer reports on psychiatric adverse drug reactions with antidepressant medication? Experiences from reports to a consumer association

Background According to the World Health Organization (WHO) the cost of adverse drug reactions   (ADRs) in the general population is high and under-reporting by health professionals   is a well-recognized problem. Another way to increase ADR reporting is to let the   consumers themselves report directly to the authorities. In Sweden it is mandatory   for prescribers to report serious ADRs to the Medical Products Agency (MPA), but there   are no such regulations for consumers. The non-profit and independent organization   Consumer Association for Medicines and Health, KILEN has launched the possibility   for consumers to report their perceptions and experiences from their use of medicines   in order to strengthen consumer rights within the health care sector. This study aimed   to analyze these consumer reports. Methods All reports submitted from January 2002 to April 2009 to an open web site in Sweden   where anyone could report their experience with the use of pharmaceuticals were analyzed   with focus on common psychiatric side effects related to antidepressant usage. More   than one ADR for a specific drug could be reported. Results In total 665 reports were made during the period. 442 reports concerned antidepressant   medications and the individual antidepressant reports represented 2392 ADRs and 878   (37%) of these were psychiatric ADRs. 75% of the individual reports concerned serotonin-reuptake   inhibitor (SSRI) and the rest serotonin-norepinephrine reuptake inhibitor (SNRI).   Women reported more antidepressant psychiatric ADRs (71%) compared to men (24%). More   potentially serious psychiatric ADRs were frequently reported to KILEN and withdrawal   symptoms during discontinuation were also reported as a common issue. Conclusions The present study indicates that consumer reports may contribute with important information   regarding more serious psychiatric ADRs following antidepressant treatment. Consumer   reporting may be considered a complement to traditional ADR reporting

Insights from linking police domestic abuse data and health data in South Wales, UK: a linked routine data analysis using decision tree classification

Background Exposure to domestic abuse can lead to long-term negative impacts on the victim's physical and psychological wellbeing. The 1998 Crime and Disorder Act requires agencies to collaborate on crime reduction strategies, including data sharing. Although data sharing is feasible for individuals, rarely are whole-agency data linked. This study aimed to examine the knowledge obtained by integrating information from police and health-care datasets through data linkage and analyse associated risk factor clusters. Methods This retrospective cohort study analyses data from residents of South Wales who were victims of domestic abuse resulting in a Public Protection Notification (PPN) submission between Aug 12, 2015 and March 31, 2020. The study links these data with the victims’ health records, collated within the Secure Anonymised Information Linkage databank, to examine factors associated with the outcome of an Emergency Department attendance, emergency hospital admission, or death within 12 months of the PPN submission. To assess the time to outcome for domestic abuse victims after the index PPN submission, we used Kaplan-Meier survival analysis. We used multivariable Cox regression models to identify which factors contributed the highest risk of experiencing an outcome after the index PPN submission. Finally, we created decision trees to describe specific groups of individuals who are at risk of experiencing a domestic abuse incident and subsequent outcome. Findings After excluding individuals with multiple PPN records, duplicates, and records with a poor matching score or missing fields, the resulting clean dataset consisted of 8709 domestic abuse victims, of whom 6257 (71·8%) were female. Within a year of a domestic abuse incident, 3650 (41·9%) individuals had an outcome. Factors associated with experiencing an outcome within 12 months of the PPN included younger victim age (hazard ratio 1·183 [95% CI 1·053–1·329], p=0·0048), further PPN submissions after the initial referral (1·383 [1·295–1·476]; p<0·0001), injury at the scene (1·484 [1·368–1·609]; p<0·0001), assessed high risk (1·600 [1·444–1·773]; p<0·0001), referral to other agencies (1·518 [1·358–1·697]; p<0·0001), history of violence (1·229 [1·134–1·333]; p<0·0001), attempted strangulation (1·311 [1·148–1·497]; p<0·0001), and pregnancy (1·372 [1·142–1·648]; p=0·0007). Health-care data before the index PPN established that previous Emergency Department and hospital admissions, smoking, smoking cessation advice, obstetric codes, and prescription of antidepressants and antibiotics were associated with having a future outcome following a domestic abuse incident. Interpretation The results indicate that vulnerable individuals are detectable in multiple datasets before and after involvement of the police. Operationalising these findings could reduce police callouts and future Emergency Department or hospital admissions, and improve outcomes for those who are vulnerable. Strategies include querying previous Emergency Department and hospital admissions, giving a high-risk assessment for a pregnant victim, and facilitating data linkage to identify vulnerable individuals

Sequential Metabolism of 7-Dehydrocholesterol to Steroidal 5,7-Dienes in Adrenal Glands and Its Biological Implication in the Skin

Since P450scc transforms 7-dehydrocholesterol (7DHC) to 7-dehydropregnenolone (7DHP) in vitro, we investigated sequential 7DHC metabolism by adrenal glands ex vivo. There was a rapid, time- and dose-dependent metabolism of 7DHC by adrenals from rats, pigs, rabbits and dogs with production of more polar 5,7-dienes as detected by RP-HPLC. Based on retention time (RT), UV spectra and mass spectrometry, we identified the major products common to all tested species as 7DHP, 22-hydroxy-7DHC and 20,22-dihydroxy-7DHC. The involvement of P450scc in adrenal metabolic transformation was confirmed by the inhibition of this process by DL-aminoglutethimide. The metabolism of 7DHC with subsequent production of 7DHP was stimulated by forscolin indicating involvement of cAMP dependent pathways. Additional minor products of 7DHC metabolism that were more polar than 7DHP were identified as 17-hydroxy-7DHP (in pig adrenals but not those of rats) and as pregna-4,7-diene-3,20-dione (7-dehydroprogesterone). Both products represented the major identifiable products of 7DHP metabolism in adrenal glands. Studies with purified enzymes show that StAR protein likely transports 7DHC to the inner mitochondrial membrane, that 7DHC can compete effectively with cholesterol for the substrate binding site on P450scc and that the catalytic efficiency of 3βHSD for 7DHP (Vm/Km) is 40% of that for pregnenolone. Skin mitochondria are capable of transforming 7DHC to 7DHP and the 7DHP is metabolized further by skin extracts. Finally, 7DHP, its photoderivative 20-oxopregnacalciferol, and pregnenolone exhibited biological activity in skin cells including inhibition of proliferation of epidermal keratinocytes and melanocytes, and melanoma cells. These findings define a novel steroidogenic pathway: 7DHC→22(OH)7DHC→20,22(OH)27DHC→7DHP, with potential further metabolism of 7DHP mediated by 3βHSD or CYP17, depending on mammalian species. The 5–7 dienal intermediates of the pathway can be a source of biologically active vitamin D3 derivatives after delivery to or production in the skin, an organ intermittently exposed to solar radiation