Seasonality and Children’s Blood Lead Levels: Developing a Predictive Model Using Climatic Variables and Blood Lead Data from Indianapolis, Indiana, Syracuse, New York, and New Orleans, Louisiana (USA)

On a community basis, urban soil contains a potentially large reservoir of accumulated lead. This study was undertaken to explore the temporal relationship between pediatric blood lead (BPb), weather, soil moisture, and dust in Indianapolis, Indiana; Syracuse, New York; and New Orleans, Louisiana. The Indianapolis, Syracuse, and New Orleans pediatric BPb data were obtained from databases of 15,969, 14,467, and 2,295 screenings, respectively, collected between December 1999 and November 2002, January 1994 and March 1998, and January 1998 and May 2003, respectively. These average monthly child BPb levels were regressed against several independent variables: average monthly soil moisture, particulate matter < 10 μm in diameter (PM(10)), wind speed, and temperature. Of temporal variation in urban children’s BPb, 87% in Indianapolis (R(2) = 0.87, p = 0.0004), 61% in Syracuse (R(2) = 0.61, p = 0.0012), and 59% in New Orleans (R(2) = 0.59, p = 0.0000078) are explained by these variables. A conceptual model of urban Pb poisoning is suggested: When temperature is high and evapotranspiration maximized, soil moisture decreases and soil dust is deposited. Under these combined weather conditions, Pb-enriched PM(10) dust disperses in the urban environment and causes elevated Pb dust loading. Thus, seasonal variation of children’s Pb exposure is probably caused by inhalation and ingestion of Pb brought about by the effect of weather on soils and the resulting fluctuation in Pb loading

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Safety and immunogenicity of the malaria candidate vaccines FP9 CS and MVA CS in adult Gambian men.

We assessed the safety and immunogenicity of prime-boost vectors encoding the Plasmodium falciparum circumsporozoite (CS) protein expressed either in the attenuated fowl-pox virus (FP9) or modified vaccinia virus Ankara (MVA). Thirty-two adult Gambians in groups of four to eight received one, two or three doses of FP9 CS and/or MVA CS. No serious adverse event was observed following vaccination. The most immunogenic regimen was two doses of FP9 followed by a single dose of MVA 4 weeks later (an average of 1000 IFN-gamma spot forming units/million PBMCs). This level of effector T-cell responses appears higher than that seen in previously reported studies of CS-based candidate malaria vaccines

Platform regulations: how platforms are regulated and how they regulate us

This book is the Official 2017 Outcome of the UN IGF Dynamic Coalition on Platform Responsibility (DCPR), which is a multistakeholder group fostering a cooperative analysis of online platforms’ responsibility to respect human rights, while putting forward solutions to protect platform-users’ rights. This book offers responses to the DCPR’s call for multistakeholder dialogue, made ever more pressing by the diverse and raising challenges generated by the platformisation of our economy and, more generally, our society. The analyses featured in this book critically explore the human rights dimension of the digital platform debate, subsequently focusing on the governance of personal data and, lastly, suggesting new solutions for the new roles played by online platforms. This volume includes the Recommendations on Terms of Service and Human Rights, which were elaborated through a multistakeholder participatory process, facilitated by the DCPR. In accordance with the UN Guiding Principles on Business and Human Rights, the Recommendations provide guidance for terms of service that may deemed as “responsible” due to their respect of internationally agreed human rights standards

Moving beyond the conceptual: specificity in regional climate change adaptation actions for biodiversity in South East Queensland, Australia

While many scientific assessments have been recommending general strategies for biodiversity conservation under climate change, translation of these recommendations into specific actions and practice has been limited. Focusing on two biomes, rainforest and wetlands in biodiverse South East Queensland, Australia, we demonstrate how general principles can be translated into specific actions for stakeholders and responsible agencies. We synthesize research that is contextualizing protection of refugia and habitat connectivity, establishing baseline data sets to detect change and developing strategic conservation planning scenarios to adjust reserve boundaries or situate new reserves. This has been achieved by coupling spatial information on biological assets (i.e. ecosystems and species) with future climate scenarios and process models to anticipate movement of critical habitats. Conservation planning software is also being used to prioritize investment to meet specific objectives. This approach is enabling us to identify at-risk biological assets, opportunities to ameliorate threats and obstacles to delivering regional adaptation actions. A larger total reserved area is needed, with proactive planning to capture areas further inland and along watercourses. Major obstacles include conflict between urbanization and priorities for habitat conservation and the need for greater levels of investment for monitoring programmes and to protect landward shifted wetlands on private lan

Feeding Very-Low-Birth-Weight Infants: Our Aspirations versus the Reality in Practice

Recently, new guidelines for enteral feedings in premature infants were issued by the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. Nevertheless, practice proves difficult to attain suggested intakes at all times, and occurrence of significant potential cumulative nutritional deficits 'lies in wait' in the neonatal intensive care unit. This review describes several aspects that are mandatory for optimizing nutritional intake in these vulnerable infants. These aspects range from optimal infrastructure to the initiation of parenteral nutrition with proper transition to enteral breast or formula feedings. Proper monitoring of nutritional tolerance includes serum biochemistry although proper specific markers are unknown and safety reference values are lacking. Although a lot of progress has been made through research during the last few decades, numerous questions still remain unanswered as to what would be the optimal quantity and quality of the various macronutrients. The inevitable suboptimal intake may, however, contribute significantly to the incidence of neonatal diseases, including impaired neurodevelopment. Therefore, it is pivotal that all hospital staff acknowledges that preterm birth is a nutritional emergency and that all must be done, both in clinical practice as well as in research, to reduce nutritional deficit