Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 111
Filtrar
1.
Sci Data ; 11(1): 58, 2024 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-38200056

RESUMO

Bite force is a decisive performance trait in animals because it plays a role for numerous life history components such as food consumption, inter- and intraspecific interactions, and reproductive success. Bite force has been studied across a wide range of vertebrate species, but only for 32 species of insects, the most speciose animal lineage. Here we present the insect bite force database with bite force measurements for 654 insect species covering 476 genera, 111 families, and 13 orders with body lengths ranging from 3.76 to 180.12 mm. In total we recorded 1906 bite force series from 1290 specimens, and, in addition, present basal head, body, and wing metrics. As such, the database will facilitate a wide range of studies on the characteristics, predictors, and macroevolution of bite force in the largest clade of the animal kingdom and may serve as a basis to further our understanding of macroevolutionary processes in relation to bite force across all biting metazoans.


Assuntos
Insetos , Animais , Força de Mordida , Estatura , Bases de Dados Factuais
2.
J Virol ; 97(10): e0127123, 2023 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-37819131

RESUMO

IMPORTANCE: The respiratory tract of humans is constantly exposed to potentially harmful agents, such as small particles or pathogens, and thus requires protective measures. Respiratory mucus that lines the airway epithelia plays a major role in the prevention of viral infections by limiting the mobility of viruses, allowing subsequent mucociliary clearance. Understanding the interplay between respiratory mucus and viruses can help elucidate host and virus characteristics that enable the initiation of infection. Here, we tested a panel of primary influenza A viruses of avian or human origin for their sensitivity to mucus derived from primary human airway cultures and found that differences between virus strains can be mapped to viral neuraminidase activity. We also show that binding of influenza A viruses to decoy receptors on highly glycosylated mucus components constitutes the major inhibitory function of mucus against influenza A viruses.


Assuntos
Vírus da Influenza A , Influenza Humana , Muco , Neuraminidase , Animais , Humanos , Aves , Vírus da Influenza A/metabolismo , Muco/metabolismo , Neuraminidase/metabolismo , Sistema Respiratório/metabolismo
3.
mSphere ; 8(5): e0022623, 2023 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-37594288

RESUMO

Multiple respiratory viruses, including influenza A virus (IAV), can be transmitted via expiratory aerosol particles, and aerosol pH was recently identified as a major factor influencing airborne virus infectivity. Indoors, small exhaled aerosols undergo rapid acidification to pH ~4. IAV is known to be sensitive to mildly acidic conditions encountered within host endosomes; however, it is unknown whether the same mechanisms could mediate viral inactivation within the more acidic aerosol micro-environment. Here, we identified that transient exposure to pH 4 caused IAV inactivation by a two-stage process, with an initial sharp decline in infectious titers mainly attributed to premature attainment of the post-fusion conformation of viral protein haemagglutinin (HA). Protein changes were observed by hydrogen-deuterium exchange coupled to mass spectrometry (HDX-MS) as early as 10 s post-exposure to acidic conditions. Our HDX-MS data are in agreement with other more labor-intensive structural analysis techniques, such as X-ray crystallography, highlighting the ease and usefulness of whole-virus HDX-MS for multiplexed protein analyses, even within enveloped viruses such as IAV. Additionally, virion integrity was partially but irreversibly affected by acidic conditions, with a progressive unfolding of the internal matrix protein 1 (M1) that aligned with a more gradual decline in viral infectivity with time. In contrast, no acid-mediated changes to the genome or lipid envelope were detected. Improved understanding of respiratory virus fate within exhaled aerosols constitutes a global public health priority, and information gained here could aid the development of novel strategies to control the airborne persistence of seasonal and/or pandemic influenza in the future. IMPORTANCE It is well established that COVID-19, influenza, and many other respiratory diseases can be transmitted by the inhalation of aerosolized viruses. Many studies have shown that the survival time of these airborne viruses is limited, but it remains an open question as to what drives their infectivity loss. Here, we address this question for influenza A virus by investigating structural protein changes incurred by the virus under conditions relevant to respiratory aerosol particles. From prior work, we know that expelled aerosols can become highly acidic due to equilibration with indoor room air, and our results indicate that two viral proteins are affected by these acidic conditions at multiple sites, leading to virus inactivation. Our findings suggest that the development of air treatments to quicken the speed of aerosol acidification would be a major strategy to control infectious bioburdens in the air.


Assuntos
Vírus da Influenza A , Influenza Humana , Humanos , Vírus da Influenza A/fisiologia , Aerossóis e Gotículas Respiratórios , Concentração de Íons de Hidrogênio
4.
Sci Rep ; 13(1): 7133, 2023 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-37130920

RESUMO

The variability and trend of ozone (O3) in the Upper troposphere and Lower Stratosphere (UTLS) over the Asian region needs to be accurately quantified. Ozone in the UTLS radiatively heats this region and cools the upper parts of the stratosphere. This results in an impact on relative humidity, static stability in the UTLS region and tropical tropopause temperature. A major challenge for understanding ozone chemistry in the UTLS is sparse observations and thus the representation of precursor gases in model emission inventories. Here, we evaluate ozonesonde measurements during August 2016 at Nainital, in the Himalayas, against ozone from multiple reanalyses and the ECHAM6-HAMMOZ model. We find that compared to measurements both reanalyses and ECHAM6-HAMMOZ control simulation overestimate ozone mixing ratios in the troposphere (20 ppb) and in the UTLS (55 ppb). We performed sensitivity simulations using the ECHAM6-HAMMOZ model for a 50% reduction in the emission of (1) NOx and (2) VOCs. The model simulations with NOX reduction agree better with the ozonesonde observations in the lower troposphere and in the UTLS. Thus, neither reanalyses nor ECHAM6-HAMMOZ results can reproduce observed O3 over the South Asian region. For a better representation of O3 in the ECHAM6-HAMMOZ model, NOX emission should be reduced by 50% in the emission inventory. A larger number of observations of ozone and precursor gases over the South Asian region would improve the assessment of ozone chemistry in models.

5.
Phys Chem Chem Phys ; 25(16): 11055-11074, 2023 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-37039675

RESUMO

The liquid-air surface tension of aqueous solutions is a fundamental quantity in multi-phase thermodynamics and fluid dynamics and thus relevant in many scientific and engineering fields. Various models have been proposed for its quantitative description. This Perspective gives an overview of the most popular models and their ability to reproduce experimental data of ten binary aqueous solutions of electrolytes and organic molecules chosen to be representative of different solute types. In addition, we propose a new model which reproduces sigmoidal curve shapes (Sigmoid model) to empirically fit experimental surface tension data. The surface tension of weakly surface-active substances is well reproduced by all models. In contrast, only few models successfully model the surface tension of aqueous solutions with strongly surface-active substances. For substances with a solubility limit, usually no experimental data is available for the surface tension of supersaturated solutions and the pure liquid solute. We discuss ways in which these can be estimated and emphasize the need for further research. The newly developed Sigmoid model best reproduces the surface tension of all tested solutions and can be recommended as a model for a broad range of binary mixtures and over the entire concentration range.

6.
Thorac Cardiovasc Surg ; 71(8): 609-613, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37031680

RESUMO

OBJECTIVE: To evaluate the experience with a new peer review method, "Select Crowd Review" (SCR): anonymized PDFs of manuscripts are accessible to a reviewer crowd via an online platform. It has access for 10 days to enter anonymized comments directly into the manuscript. A SCR-Editor summarizes the annotations, giving a recommendation. Both reviewed PDF and summary are sent back to authors. Upon submission, authors are given a choice to accept or decline SCR. DESIGN: All manuscript submissions since introduction in July 2021 until July 2022 were analyzed regarding acceptance and quality. Manuscripts were sent to a crowd of 45 reviewers and regular double-blinded peer review at the same time. Efficiency and performance of the crowd's reviews were compared with those of regular review. For thoracic manuscripts, a crowd was not yet available. RESULTS: SCR was accepted by the authors for 73/179 manuscripts (40.8%). After desk rejections, 51 cardiac manuscripts entered SCR. For five manuscripts, the crowd did not respond. In all remaining papers, the crowd's recommendation concurred with that of the normal reviewers. Regular peer review took up to 6 weeks. Twelve manuscripts underwent repeated SCR after revision. A median of 2 (0-9) crowd members sent in reviews. In revisions, average response was one reviewer responding. CONCLUSION: SCR encountered good acceptance by authors. As the first experience showed concordant recommendations compared with traditional review, we have extended SCR to thoracic manuscripts for more experience. SCR may become the sole review method for eligible manuscripts. Efficiency should be increased, especially for re-review of revisions.


Assuntos
Editoração , Cirurgiões , Humanos , Revisão da Pesquisa por Pares , Resultado do Tratamento , Eficiência
8.
MethodsX ; 10: 102040, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36793672

RESUMO

The use of very high-resolution (VHR) optical satellites is gaining momentum in the field of wildlife monitoring, particularly for whales, as this technology is showing potential for monitoring the less studied regions. However, surveying large areas using VHR optical satellite imagery requires the development of automated systems to detect targets. Machine learning approaches require large training datasets of annotated images. Here we propose a standardised workflow to annotate VHR optical satellite imagery using ESRI ArcMap 10.8, and ESRI ArcGIS Pro 2.5., using cetaceans as a case study, to develop AI-ready annotations.•A step-by-step protocol to review VHR optical satellite images and annotate the features of interest.•A step-by-step protocol to create bounding boxes encompassing the features of interest.•A step-by-step guide to clip the satellite image using bounding boxes to create image chips.

9.
Environ Sci Technol ; 57(1): 486-497, 2023 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-36537693

RESUMO

Respiratory viruses, including influenza virus and SARS-CoV-2, are transmitted by the airborne route. Air filtration and ventilation mechanically reduce the concentration of airborne viruses and are necessary tools for disease mitigation. However, they ignore the potential impact of the chemical environment surrounding aerosolized viruses, which determines the aerosol pH. Atmospheric aerosol gravitates toward acidic pH, and enveloped viruses are prone to inactivation at strong acidity levels. Yet, the acidity of expiratory aerosol particles and its effect on airborne virus persistence have not been examined. Here, we combine pH-dependent inactivation rates of influenza A virus (IAV) and SARS-CoV-2 with microphysical properties of respiratory fluids using a biophysical aerosol model. We find that particles exhaled into indoor air (with relative humidity ≥ 50%) become mildly acidic (pH ∼ 4), rapidly inactivating IAV within minutes, whereas SARS-CoV-2 requires days. If indoor air is enriched with nonhazardous levels of nitric acid, aerosol pH drops by up to 2 units, decreasing 99%-inactivation times for both viruses in small aerosol particles to below 30 s. Conversely, unintentional removal of volatile acids from indoor air may elevate pH and prolong airborne virus persistence. The overlooked role of aerosol acidity has profound implications for virus transmission and mitigation strategies.


Assuntos
Poluição do Ar em Ambientes Fechados , COVID-19 , Aerossóis e Gotículas Respiratórios , Humanos , Concentração de Íons de Hidrogênio , SARS-CoV-2 , Inativação de Vírus , Transmissão de Doença Infecciosa
10.
Front Public Health ; 11: 1327187, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38283293

RESUMO

Spraying is a common way to distribute occupational products, but it puts worker's health at risk by exposing them to potentially harmful particles and gases. The objective of this study is to use time-resolved measurements to gain an understanding of spray applications at the process level and to compare them to predictions of exposure models. We used proton transfer reaction time-of-flight mass spectrometry (PTR-ToF-MS) at 1-s time resolution to monitor the gas phase concentration of the solvents acetone, ethanol, butyl acetate, xylene and 1-methoxy-2-propy acetate during outdoor spraying and indoor drying of metal plate under various conditions of outdoor air supply. We found that during spraying, gas-phase exposure was dominated by the more volatile solvents acetone and ethanol, which exhibited strong concentration variations due to the outdoor winds. During drying, exposure strongly depended on the strength of ventilation. Under conditions with high supply of outdoor air, our measurements show a near-exponential decay of the solvent concentrations during drying. Conversely, under conditions without outdoor air supply, the drying process required hours, during which the less volatile solvents passed through a concentration maximum in the gas phase, so that the exposure during drying exceeded the exposure during spraying. The concentrations measured during spraying were then compared for each of the substances individually with the predictions of the exposure models ECETOC TRA, Stoffenmanager, and ART using TREXMO. For these conditions, ECETOC TRA and Stoffenmanager predicted exposures in the measured concentration range, albeit not conservative for all solvents and each application. In contrast, ART largely overestimated the exposure for the more volatile solvents acetone and ethanol and slightly underestimated exposure to 1M2PA for one spraying. ECETOC TRA and ART do not have options to predict exposure during drying. Stoffenmanager has the option to predict drying together with spraying, but not to predict the drying phase independently. Our study demonstrates the importance of considering both the spray cloud and solvent evaporation during the drying process. To improve workplace safety, there is a critical need for enhanced exposure models and comprehensive datasets for calibration and validation covering a broader range of exposure situations.


Assuntos
Acetona , Prótons , Espectrometria de Massas , Pintura , Solventes , Etanol
11.
Phys Chem Chem Phys ; 24(44): 27086-27104, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36326041

RESUMO

The chemical and physical properties of atmospheric aerosol particles change upon oxidative ageing, influencing their interaction with radiation, their propensity to serve as nuclei for cloud condensation and ice formation, and their adverse effects on human health. The investigation of atmospheric aerosol oxidation processes is complicated by low oxidant concentrations and long timescales, which are difficult to represent in laboratory studies. Experimental work often attempts to compensate for short timescales with elevated concentrations of oxidative agents, assuming that the ageing progress depends only on the oxidant exposure, i.e. on the product of oxidant concentration and time, [Ox] × t, and not on [Ox] or t independently. The application of electrodynamic balance-mass spectrometry of single particles allows the validity of this assumption to be investigated, since it provides information on the molecular composition of aerosol particles for a wide range of reaction durations under well-defined oxidation conditions. Here, we demonstrate the capabilities of a new setup on levitated oleic acid droplets reacting with ozone at mixing ratios of 0.2 and 15 ppm, i.e. spanning almost two orders of magnitude in [Ox]. We show that the reactive removal of oleic acid can be accurately expressed as a function of ozone exposure [Ox] × t, whereas the product concentrations depend on [Ox] and t independently. As the underlying reason for the breakdown of the exposure metric, we suggest a competition between evaporation of volatile first-generation products and their accretion reactions with reactive Criegee intermediates, converting them into low-volatility dimers and oligomers. This hypothesis is supported by kinetic model simulations using the aerosol process model KM-SUB, which explicitly resolves the competition between evaporation and secondary chemistry as a function of the experimental timescale and ozone mixing ratio. The model successfully reproduces final product distributions. The findings are further supported by the recorded changes of droplet sizes during oxidation. As a heuristic, the breakdown of the exposure metric in a chemical reaction system is possible, when competition between first- and second-order processes of reactive intermediates determines important system properties.


Assuntos
Ácido Oleico , Ozônio , Humanos , Ácido Oleico/química , Oxidantes , Aerossóis , Ozônio/química , Espectrometria de Massas
12.
Front Res Metr Anal ; 7: 1034595, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36386276

RESUMO

In recent years, research funding agencies, universities, and governments have become increasingly concerned with promoting the reuse of research datasets. Enabling researchers to evaluate the trustworthiness and fitness-for-use of research datasets produced by others is critical for facilitating the reuse of these datasets. Understanding how researchers make these evaluations is crucial for developing digital infrastructure and tools, such as data repositories and metadata schema, in a way that better supports researchers in making these evaluations. Physical samples such as rocks are critical for generating datasets in many scientific domains. Often, samples are collected on field expeditions conducted by large infrastructural projects. These projects comprise many human and non-human components that affect the quality and integrity of samples. However, little is known about whether and how prospective dataset users evaluate the samples' trustworthiness and sample collection processes underlying these datasets. Researchers'strategies for evaluating sample trustworthiness are explored through a longitudinal qualitative case study (ethnographic observation, interviews (n = 66), and document analysis) of subseafloor biosphere research, an earth sciences domain. Domain researchers use rock samples collected on research cruises conducted by the International Ocean Discovery Program (IODP). Subseafloor biosphere researchers are primarily concerned about samples being compromised by microbiological contamination. Researchers vary regarding the components of IODP infrastructure they consider when evaluating sample trustworthiness. These components include methods to process samples, people handling samples, IODP policies and procedures, and IODP organizational politics. Researchers'strategies vary according to their disciplinary background, with microbiologists employing more fine-grained judgments about methods; whether researchers have participated in IODP expeditions, with those who have employing more fine-grained judgments about people involved; and whether researchers have ever been involved in organizing cruises or serving on IODP committees, with those who have employing more fine-grained judgments about many aspects of cruises. Researchers who make less complex decisions may be prone to erroneously trusting contaminated samples; researchers who make more complex decisions may be prone to erroneously discarding uncontaminated samples. The paper concludes by considering implications for the design of digital infrastructures to support researchers in evaluating sample trustworthiness.

14.
Pan Afr Med J ; 41: 272, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35784593

RESUMO

Introduction: in Nigeria, the incidence of breast cancer has increased by over 80% in the last four decades. This study quantifies the out-of-pocket (OOP) cost of breast cancer management and the associated rate of catastrophic healthcare expenditure (CHE) at a public tertiary care facility in Ile-Ife, Nigeria. Methods: patients treated between December 2017 - August 2018 were identified from a prospective breast cancer database. A questionnaire was developed to capture the total cost of care, including direct and indirect expenses. Three commonly used thresholds for a CHE were used in this analysis. The cost of radiotherapy and targeted therapy were captured separately. Results: data was collected from 22 eligible patients. Sixty-eight percent had no form of health insurance. The mean cost of diagnosis and treatment was $2,049 (SD $1,854). At a threshold of 10% and 25% of annual income, 95% and 86% of households experienced a CHE. Based on a household´s capacity-to-pay, 90% experienced a CHE. The mean cost of radiotherapy was $462 (SD $223) and the mean cost of trastuzumab was $6,568 (SD $2,766). Cost precluded surgery in 14% of patients with resectable disease. As a result of accessing treatment, 72% of households had to borrow money and 9% of households interrupted a child´s education. Conclusion: the out-of-pocket cost of breast cancer care in Nigeria is significant. This results in a CHE for 68-95% of households, which has significant health and economic sequelae. Greater financial protection is essential as the burden of breast cancer increases in Nigeria.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/terapia , Criança , Feminino , Gastos em Saúde , Humanos , Nigéria , Estudos Prospectivos , Centros de Atenção Terciária
15.
Environ Int ; 166: 107325, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35716508

RESUMO

Organic aerosol (OA) is a key component of total submicron particulate matter (PM1), and comprehensive knowledge of OA sources across Europe is crucial to mitigate PM1 levels. Europe has a well-established air quality research infrastructure from which yearlong datasets using 21 aerosol chemical speciation monitors (ACSMs) and 1 aerosol mass spectrometer (AMS) were gathered during 2013-2019. It includes 9 non-urban and 13 urban sites. This study developed a state-of-the-art source apportionment protocol to analyse long-term OA mass spectrum data by applying the most advanced source apportionment strategies (i.e., rolling PMF, ME-2, and bootstrap). This harmonised protocol was followed strictly for all 22 datasets, making the source apportionment results more comparable. In addition, it enables quantification of the most common OA components such as hydrocarbon-like OA (HOA), biomass burning OA (BBOA), cooking-like OA (COA), more oxidised-oxygenated OA (MO-OOA), and less oxidised-oxygenated OA (LO-OOA). Other components such as coal combustion OA (CCOA), solid fuel OA (SFOA: mainly mixture of coal and peat combustion), cigarette smoke OA (CSOA), sea salt (mostly inorganic but part of the OA mass spectrum), coffee OA, and ship industry OA could also be separated at a few specific sites. Oxygenated OA (OOA) components make up most of the submicron OA mass (average = 71.1%, range from 43.7 to 100%). Solid fuel combustion-related OA components (i.e., BBOA, CCOA, and SFOA) are still considerable with in total 16.0% yearly contribution to the OA, yet mainly during winter months (21.4%). Overall, this comprehensive protocol works effectively across all sites governed by different sources and generates robust and consistent source apportionment results. Our work presents a comprehensive overview of OA sources in Europe with a unique combination of high time resolution (30-240 min) and long-term data coverage (9-36 months), providing essential information to improve/validate air quality, health impact, and climate models.

16.
Pediatr Crit Care Med ; 23(6): 444-452, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35190502

RESUMO

OBJECTIVES: To identify associations between augmented renal clearance (ARC) in pediatric patients treated for suspected sepsis and vancomycin pharmacokinetics. ARC has been associated with lower serum drug levels in both adult and pediatric cohorts for multiple drugs. We hypothesize that presence of ARC is associated with subtherapeutic initial vancomycin trough level (VTL). DESIGN: Retrospective study, with patients divided into two groups based on the presence of ARC (estimated glomerular filtration rate [eGFR] above 130 mL/min/1.73 m2) in comparison with VTL. Multivariable logistic regression analysis was performed to evaluate the association between eGFR and subtherapeutic VTL. SETTING: Tertiary children's hospital. PATIENTS: Hospitalized children (0-18 yr) initiated on empiric vancomycin therapy for suspected sepsis. INTERVENTIONS: Retrospective measurement of VTL, eGFR, and clinical variables. MEASUREMENTS AND MAIN RESULTS: Seventy-three patients were treated with empiric vancomycin for sepsis. ARC was present in 32 patients (44%). Subtherapeutic first VTL was present in 40 patients (55%). Higher eGFR was independently associated with subtherapeutic VTL in the multivariable logistic regression analysis. CONCLUSIONS: Subtherapeutic VTL is associated with ARC in our single-center retrospective cohort of children with suspected sepsis. This problem may present a potential risk of treatment failure in Gram-positive sepsis or longer time to clinical response. Prospective studies to investigate the clinical significance and effect of optimizing vancomycin dose in patients with ARC are recommended.


Assuntos
Sepse , Vancomicina , Adulto , Antibacterianos , Criança , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Sepse/tratamento farmacológico
17.
J Investig Med ; 70(3): 829-836, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34880049

RESUMO

HIV infections are prevalent among adolescents and young adults, of whom 44% remain unaware of their diagnosis. HIV screening presents numerous challenges including stigma, fear, and concerns about confidentiality, which may influence young people's acceptance of HIV screening and linkage to care differently from individuals in other age groups. It is imperative to understand which care delivery models are most effective in facilitating these services for youth. This systematic review analyzes the rates of HIV test acceptance and linkage to care by care delivery model for adolescents and young adults. Studies were classified into emergency department (ED), primary care/inpatient setting, community-based program, or sexually transmitted infection clinic models of care. From 6395 studies initially identified, 59 met criteria for inclusion in the final analyses. Rate of test acceptance and linkage to care were stratified by model of care delivery, gender, race, age ranges (13-17, 18-24 years) as well as site (North America vs rest of the world). A significant difference in acceptance of HIV testing was found between care models, with high rates of test acceptance in the ED setting in North America and primary care/hospital setting in the rest of the world. Similarly, linkage to care differed by model of care, with EDs having high rates of linkages to HIV care in North America. Future studies are needed to test mechanisms for optimizing outcomes for each care delivery model in addressing the unique challenges faced by adolescents and young adults.


Assuntos
Infecções por HIV , Adolescente , Serviço Hospitalar de Emergência , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Teste de HIV , Humanos , Programas de Rastreamento , Adulto Jovem
18.
PLoS One ; 16(11): e0258882, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34735488

RESUMO

INTRODUCTION: There is a substantial burden of respiratory disease in infants in the sub-Saharan Africa region. Many health care providers (HCPs) that initially receive infants with respiratory distress may not be adequately skilled to differentiate between mild, moderate and severe respiratory symptoms, which may contribute to poor management and outcome. Therefore, respiratory severity scores have the potential to contributing to address this gap. OBJECTIVES: to field-test the use of two existing standardized bronchiolitis severity scores (LIBSS and ReSViNET) in a population of Rwandan infants (1-12 months) presenting with respiratory illnesses to urban, tertiary, pediatric hospitals and to assess the severity of respiratory distress in these infants and the treatments used. METHODS: A cross-sectional, validation study, was conducted in four tertiary hospitals in Rwanda. Infants presenting with difficulty in breathing were included. The LIBSS and ReSViNET scores were independently employed by nurses and residents to assess the severity of disease in each infant. RESULTS: 100 infants were recruited with a mean age of seven months. Infants presented with pneumonia (n = 51), bronchiolitis (n = 36) and other infectious respiratory illnesses (n = 13). Thirty-three infants had severe disease and survival was 94% using nurse applied LIBSS. Regarding inter-rater reliability, the intra-class correlation coefficient (ICC) for LIBSS and ReSViNET between nurses and residents was 0.985 (95% CI: 0.98-0.99) and 0.980 (0.97-0.99). The convergent validity (Pearson's correlation) between LIBSS and ReSViNET for nurses and residents was R = 0.836 (p<0.001) and R = 0.815 (p<0.001). The area under the Receiver Operator Curve (aROC) for admission to PICU or HDU was 0.956 (CI: 0.92-0.99, p<0.001) and 0.880 (CI: 0.80-0.96, p<0.001) for nurse completed LIBSS and ReSViNET respectively. CONCLUSION: LIBSS and ReSViNET were designed for infants with bronchiolitis in resource-rich settings. Both LIBSS and ReSViNET demonstrated good reliability and validity results, in this cohort of patients presenting to tertiary level hospitals. This early data demonstrate that these two scores have the potential to be used in conjunction with clinical reasoning to identify infants at increased risk of clinical deterioration and allow timely admission, treatment escalation and therefore support resource allocation in Rwanda.


Assuntos
Bronquiolite/diagnóstico , Síndrome do Desconforto Respiratório/diagnóstico , Infecções Respiratórias/diagnóstico , Índice de Gravidade de Doença , Bronquiolite/patologia , Estudos Transversais , Feminino , Pessoal de Saúde , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Masculino , Síndrome do Desconforto Respiratório/epidemiologia , Síndrome do Desconforto Respiratório/patologia , Sistema Respiratório/patologia , Infecções Respiratórias/epidemiologia , Ruanda/epidemiologia , Centros de Atenção Terciária
19.
Science ; 374(6570): eabi9756, 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34793203

RESUMO

Our study on the exact timing and the potential climatic, environmental, and evolutionary consequences of the Laschamps Geomagnetic Excursion has generated the hypothesis that geomagnetism represents an unrecognized driver in environmental and evolutionary change. It is important for this hypothesis to be tested with new data, and encouragingly, none of the studies presented by Picin et al. undermine our model.

20.
Science ; 374(6570): eabh3655, 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34793228

RESUMO

Our paper about the impacts of the Laschamps Geomagnetic Excursion 42,000 years ago has provoked considerable scientific and public interest, particularly in the so-called Adams Event associated with the initial transition of the magnetic poles. Although we welcome the opportunity to discuss our new ideas, Hawks' assertions of misrepresentation are especially disappointing given his limited examination of the material.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA