严重急性呼吸综合征、中东呼吸综合征和2019冠状病毒病治疗研究进展

严重急性呼吸综合征2019(sever acute respiratory syndrome,SARS)、中东呼吸综合征(Middle East respiratory syndrome,MERS)和2019冠状病毒病(corona virus disease 2019,COVID-19)对全世界人民造成了严重的经济损...     

Nanobiotechnology in combating CoVid-19

Emergence of novel pandemic viral disease CoVid-19 and its mutational behaviour are alarming. The potential use of nano-biotechnology in combating CoVid-19 is promising. We glean available data to explore such possibility in this short note.     

Asthma and climatic conditions: experience from Bermuda,an isolated island community.

A retrospective study of patients attending the emergency department with acute asthma was performed in Bermuda. Climatic data (barometric pressure, rainfall, humidity, and wind strength and direction) were obtained and compared with frequency of exacerbations of asthma. Three factors--namely, relative humidity, average daily temperature, and northeasterly winds--were found to be related to worsening asthma. Owing to Bermuda''s lack of pollution and aeroallergens it was thought that these weather parameters had a direct effect on the asthmatic population.     

A five‐step risk management process for geriatric dental practice during SARS‐CoV‐2 pandemic

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is an RNA virus that causes coronavirus infection (COVID‐19). COVID‐19 is a highly contagious disease transmitted through respiratory droplets, saliva and other contact routes. Within 10 months of its outbreak, SARS‐CoV‐2 has infected more than 23 million people around the world. Evidence suggests that older adults are the most vulnerable to infection and have an increased risk of mortality. Reduced immunity and underlying medical conditions make them risk‐prone and vulnerable to critical care. Older adults affected with the SARS‐CoV‐2 virus present with distinct clinical manifestations necessitating specific treatment needs and management protocols. While it is crucial to prevent the spread of novel coronavirus (2019‐nCoV), the role of oral healthcare workers in addressing the specific needs of ageing adult patients by adopting specific guidelines and appropriate infection control protocols is timely. This paper aims to develop specific guidelines and protocols for the dental management of geriatric patients during the COVID‐19 pandemic.     

BCG vaccination early in life does not improve COVID-19 outcome of elderly populations,based on nationally reported data

The reported numbers of Covid-19 cases and deaths were compared for 18 countries (14 in Western Europe, plus Australia, Brazil, Israel and the USA) to assess the effect of historic and current national BCG immunizations. In view of the high death rate for Covid-19 patients over 70 years of age, and given the fact that BCG vaccination is typically given early in life, we compared countries that had introduced BCG in the 1950s with those that had not. No effect on Covid-19 case fatality rate (CFR) or number of deaths per population could be demonstrated. Since some countries test for Covid-19 more than others, the effect of tests performed per million population on reported deaths per million was also assessed, but again did not demonstrate an effect of BCG vaccination in the 1950s. Whether countries had never used the vaccine, had historically used it but since ceased to do so, or were presently vaccinating with BCG did not correlate with national total number of deaths or CFR. We conclude that there is currently no evidence for a beneficial effect of BCG vaccination on Covid-19 reported cases or fatalities.     

Changes in concentration of Alternaria and Cladosporium spores during summer storms

Fungal spores are known to cause allergic sensitization. Recent studies reported a strong association between asthma symptoms and thunderstorms that could be explained by an increase in airborne fungal spore concentrations. Just before and during thunderstorms the values of meteorological parameters rapidly change. Therefore, the goal of this study was to create a predictive model for hourly concentrations of atmospheric Alternaria and Cladosporium spores on days with summer storms in Szczecin (Poland) based on meteorological conditions. For this study we have chosen all days of June, July and August (2004–2009) with convective thunderstorms. There were statistically significant relationships between spore concentration and meteorological parameters: positive for air temperature and ozone content while negative for relative humidity. In general, before a thunderstorm, air temperature and ozone concentration increased, which was accompanied by a considerable increase in spore concentration. During and after a storm, relative humidity increased while both air temperature ozone concentration along with spore concentrations decreased. Artificial neural networks (ANN) were used to assess forecasting possibilities. Good performance of ANN models in this study suggest that it is possible to predict spore concentrations from meteorological variables 2 h in advance and, thus, warn people with spore-related asthma symptoms about the increasing abundance of airborne fungi on days with storms.     

Temporal Variability and Social Heterogeneity in Disease Transmission: The Case of SARS in Hong Kong

The extent to which self-adopted or intervention-related changes in behaviors affect the course of epidemics remains a key issue for outbreak control. This study attempted to quantify the effect of such changes on the risk of infection in different settings, i.e., the community and hospitals. The 2002–2003 severe acute respiratory syndrome (SARS) outbreak in Hong Kong, where 27% of cases were healthcare workers, was used as an example. A stochastic compartmental SEIR (susceptible-exposed-infectious-removed) model was used: the population was split into healthcare workers, hospitalized people and general population. Super spreading events (SSEs) were taken into account in the model. The temporal evolutions of the daily effective contact rates in the community and hospitals were modeled with smooth functions. Data augmentation techniques and Markov chain Monte Carlo (MCMC) methods were applied to estimate SARS epidemiological parameters. In particular, estimates of daily reproduction numbers were provided for each subpopulation. The average duration of the SARS infectious period was estimated to be 9.3 days (±0.3 days). The model was able to disentangle the impact of the two SSEs from background transmission rates. The effective contact rates, which were estimated on a daily basis, decreased with time, reaching zero inside hospitals. This observation suggests that public health measures and possible changes in individual behaviors effectively reduced transmission, especially in hospitals. The temporal patterns of reproduction numbers were similar for healthcare workers and the general population, indicating that on average, an infectious healthcare worker did not infect more people than any other infectious person. We provide a general method to estimate time dependence of parameters in structured epidemic models, which enables investigation of the impact of control measures and behavioral changes in different settings.     

Scientific research progress of COVID‐19/SARS‐CoV‐2 in the first five months

A cluster of pneumonia (COVID‐19) cases have been found in Wuhan China in late December, 2019, and subsequently, a novel coronavirus with a positive stranded RNA was identified to be the aetiological virus (severe acute respiratory syndrome coronavirus 2, SARS‐CoV‐2), which has a phylogenetic similarity to severe acute respiratory syndrome coronavirus (SARS‐CoV). SARS‐CoV‐2 transmits mainly through droplets and close contact and the elder or people with chronic diseases are high‐risk population. People affected by SARS‐CoV‐2 can be asymptomatic, which brings about more difficulties to control the transmission. COVID‐19 has become pandemic rapidly after onset, and so far the infected people have been above 2 000 000 and more than 130 000 died worldwide according to COVID‐19 situation dashboard of World Health Organization ( https://covid19.who.int ). Here, we summarized the current known knowledge regarding epidemiological, pathogenesis, pathology, clinical features, comorbidities and treatment of COVID‐19/ SARS‐CoV‐2 as reference for the prevention and control COVID‐19.     

Humid air increases airway resistance in asthmatic subjects.

Eight persons with asthma were exposed to seven air conditions varying in temperature (37 degrees C to 49 degrees C [98.6 degrees F to 120.2 degrees F]) and water content (44 mg H2O per liter to 79 mg H2Oper liter) . Normocapnic hyperventilation for three minutes at 40% maximal voluntary ventilation was carried out for each condition. A constant-volume body plethysmograph measured the functional residual capacity and specific airway conductance (SGaw), followed by two forced expiratory manuevers. Measurements were taken before and 1, 5, 10, and 20 minutes after each challenge. Air conditions with 100% relative humidity caused a fall in the SGaw that was maximal in 1 minute. Air conditions at 100% relative humidity caused a greater fall in both the forced expiratory volume in 1 second (FEV1) (P<.05) and the SGaw (P<.005) than did conditions of the same temperature but less water content. At 44 degrees C and 100% relative humidity, the mean percent change in FEV1 and SGaw was -2% and -40%, respectively, at 1 minute after challenge. Of the conditions examined, the optimal temperature was 44 degrees C, and we speculate that the optimal water content is less than 44 mg H2O per liter. Inhaled water concentrations exceeding 44 mg H2O per liter should probably not be used in patients with asthma.     

Rising Obesity-Related Hospital Admissions among Children and Young People in England: National Time Trends Study

Objective

To describe the trends in hospital admissions associated with obesity as a primary diagnosis and comorbidity, and bariatric surgery procedures among children and young people in England.

Design

National time trends study of hospital admissions data between 2000 and 2009.

Participants

Children and young people aged 5 to 19 years who were admitted to hospital with any diagnosis of obesity.

Main outcome measures

Age- and sex-specific admission rates per million children.

Results

Between 2000 and 2009, age- and sex-specific hospital admission rates in 5–19 year olds for total obesity-related diagnoses increased more than four-fold from 93.0 (95% CI 86.0 to 100.0) per million children to 414.0 (95% CI 410.7 to 417.5) per million children, largely due to rising admissions where obesity was mentioned as a co-morbidity. The median age of admission to hospital over the study period was 14.0 years; 5,566 (26.7%) admissions were for obesity and 15,319 (73.3%) mentioned obesity as a comorbidity. Admissions were more common in girls than boys (56.2% v 43.8%). The most common reasons for admission where obesity was a comorbid condition were sleep apnoea, asthma, and complications of pregnancy. The number of bariatric surgery procedures has risen from 1 per year in 2000 to 31 in 2009, with the majority were performed in obese girls (75.6%) aged 13–19 years.

Conclusions

Hospital admission rates for obesity and related comorbid conditions have increased more than four-fold over the past decade amongst children and young people. Although some of the increase is likely to be due to improved case ascertainment, conditions associated with obesity in children and young people are imposing greater challenges for health care providers in English hospitals. Most inpatient care is directed at dealing with associated conditions rather than primary assessment and management of obesity itself.     

美国黑核桃实生苗生态生理过程对环境因素响应的数值模拟(Ⅱ):气象要素日变化进程的数理模型

在建立植物生态生理模型（如光合作用、蒸腾作用数理模型）的过程中,气温、太阳辐射、相对湿度等气象要素的日变化及瞬时资料是必不可少的．本文根据常规台站的日常观测资料,建立了气温、太阳辐射、风速、相对湿度等气象要素日变化的数理模型．并应用实测资料对所建模型进行了验证．实践表明：（1）描述气温日变化的正弦一指数模型通常其模拟结果不甚理想,但通过引用最高温度的时间延迟参数及惯性系数,可增加模拟结果的准确性．（2）根据测量的太阳辐射日总量值以及太阳高度的日变化值等,可准确地模拟太阳辐射的日变化;（3）根据实际水汽压的日均值和气温常规资料可准确模拟相对湿度的日变化．如果区域参数已知或被正确估计。上述方法可得到较为理想的气象要素日变化的模拟结果．     

Aging and diabetes drive the COVID-19 forwards; unveiling nature and existing therapies for the treatment

Molecular and Cellular Biochemistry - Human SARS Coronavirus-2 (SARS-CoV-2) has infected more than 170 million people worldwide and resulted in more than 3.5 million deaths so far. The infection...     

Estimation of the Burden of Chronic and Allergic Pulmonary Aspergillosis in India

Background and Objectives

It would be of considerable interest to clinicians if the burden of chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA) in India were known. Herein, we estimate the burden of CPA following pulmonary tuberculosis (PTB), and ABPA (and severe asthma with fungal sensitization [SAFS]) complicating asthma.

Methods

We used the population estimates for India from the 2011 census data. The burden of asthma was estimated using three different methods (Global Initiative against Asthma [GINA] report statement, World Health Survey [WHS] estimates, Indian study on the epidemiology of asthma and chronic bronchitis [INSEARCH]). Global and India-specific figures were used for calculating the prevalence of ABPA and SAFS. The World Health Organization estimates were used for calculating PTB rates while the frequency of CPA was assessed from a previously published scoping review. Sensitivity analysis was performed to determine the burden in various scenarios.

Results

The total Indian population in 2011 was 1.2 billion. The asthma prevalence in adults was estimated at about 27.6 (range, 17–30) million. The burden of ABPA ranged from 0.12–6.09 million with different assumptions (best estimate, 1.38 [range, 0.86–1.52] million). The prevalence of SAFS was approximated at about 0.52–1.21 million (best estimate, 0.96 [range, 0.6–1.06] million). The incident TB cases were about 2.1 million while the annual incidence of CPA varied 27,000-0.17 million cases, with different estimates. If the mortality of CPA is estimated as 15% annually, the 5-year prevalence of CPA was placed at 290,147 cases with 5-year prevalence rate being 24 per 100,000.

Conclusion

There is a significant burden of ABPA, SAFS and CPA in India. Prospective community-based studies are required to accurately determine the prevalence of these disorders.     

Recommendations for school-going students post CoVid-19 in Bangladesh

The CoVid-19 pandemic caused by SARS-CoV-2 has taken more lives than any other pandemic so far, with non-pharmacological interventions such as lockdown, school closures, and travel bans, especially social distance, abounding around the world. With limited resources, these interventions pose the ultimate challenge to the education system in developing countries like Bangladesh, especially in providing uninterrupted education for all children in rural areas, where a significant number of students are enrolled in this area. However, the initiative to close schools for an extended period has affected children physically, emotionally, socially, and in various ways. Noteworthy, it demands to reopen to protect the future of children. Schools have reopened in many countries around the world. It is of interest to document recommendations for school-going students post CoVid-19 in Bangladesh using evidence-based data, information, and knowledge. We document such data in the context of Bangladesh to take such policy initiatives.     

2型固有淋巴细胞在哮喘发生中的作用研究进展

哮喘是世界公认的医学难题,困扰全球3亿、我国3 000万人口。哮喘发病机制多样且复杂。近年来,固有免疫在哮喘发生中的作用及地位受到广泛关注。2010年发现的2型固有淋巴细胞（ILC2s）具有堪比CD4⁺Th2细胞的强大的Th2型细胞因子分泌能力,是引起气道炎症和气道高反应性的关键固有免疫细胞。围绕ILC2s的来源、特性、生物学活性及其在支气管哮喘发生发展中的作用及作用机制进行综述。     

基于CVM的山东海洋保护区生态系统多样性维持服务价值评估

选取山东济南(代表内陆城市)和青岛(代表沿海城市),基于条件价值法(CVM),对两市城镇居民进行问卷调查,通过建立支付意愿多元线性回归方程用以评估山东省城镇居民对维持山东88个海洋保护区永续存在的支付意愿,进而估算山东海洋保护区的生态系统多样性维持服务价值。研究发现,人均年收入较高,支付意愿较大;文化程度较低,支付意愿较小;男性比女性的支付意愿高;内陆城镇居民对于海洋保护区的人均支付意愿为102.15元,比沿海城镇居民的支付意愿高23.05元。2014年,山东全部88个海洋保护区的生态系统多样性维持服务价值为43.7亿元,平均0.497亿元/个。其中,12个自然保护区的价值为16.14亿元,平均1.35亿元/个;30个海洋特别保护区的价值为14.47亿元,平均0.489亿元/个;46个水产种质资源保护区的价值为12.9亿元,平均0.28亿元/个。结果表明:海洋自然保护区的生态系统多样性维持服务价值比海洋特别保护区和水产种质资源保护区高。在修订我国各类保护区的选划标准和管理目标时,应增加生态系统多样性维持服务价值并作为关键的选划指标。具有最高生态系统多样性维持服务价值的海域,宜选划为自然保护区,实施最严格的管理措施,确保其生态系统多样性维持服务价值增加,至少不降低。具有较高生态系统多样性维持服务价值的海域,因地制宜选划为海洋特别保护区或者海洋水产种质资源保护区,实施较严格的管理措施,确保其生态系统多样性维持服务价值不降低。     

Known data on CoVid-19 infection linked to type-2 diabetes

It is of interest to document the known data on CoVid-19 infection linked to type-2 diabetes. Hyperglycemia, inhibition of neutrophil chemotaxis, altered cytokine synthesis, phagocytic cell dysfunction, impaired T cell-mediated immune responses, and inadequate microbia were all seen in people with Diabetes. Individuals with diabetes have also been shown to elevate levels of the proinflammatory cytokine, especially IL-1, IL-6, and tumor necrosis factor-alpha (TNF-alpha), and different markers such as C reactive protein, D-dimer, and fibrinogen. This will prolong the cytokine storms and lead to severe illness in diabetic individuals with COVID-19 infection. The role of acute glycemic control after COVID- 19 manifestation on clinical outcomes has not been known in detail. Known data shows that hyperglycemia facilitates local viral replication in the lungs and impairs anti-viral immune response. Thus, acute glycemic management plays an important role in limiting viral replication and disease progression in patients with diabetes. The available evidence implicates diabetes as important risk factors impacting the clinical severity of SARS-CoV-2.     

Data on known anti-virals in combating CoVid-19

Design and development of effective anti-virals in combating CoVid-19 is a great challenge worldwide. Known drugs such as chloroquine, lopinavir, favipiravir and remdesivir are used in the management of CoVid - 19. It is known that Ivermectin and remdesivir both are effective against filoviruses, paramyxo viruses. Available data also shows that ivermectin and remedesivir repress the replication of SARS-CoV-2. Thus, we document the potential use of ivermectin and remdesivir in the management of CoVid -19.     

Mass gathering events and the spread of infectious diseases: Evidence from the early growth phase of COVID-19

This paper studies the impact on reported coronavirus 2019 (COVID-19) cases and deaths in Spain resulting from large mass gatherings that occurred from March 6 to March 8, 2020. To study these outcomes, the geographic differences in the planned pre-pandemic major events that took place on these dates were exploited, which is a quasi-random source of variation for identification purposes. We collected daily and detailed information about the number of attendees at football (soccer) and basketball matches in addition to individuals participating in the Women’s Day marches across Spain, which we merged with daily data on reported COVID-19 cases and deaths at the provincial level. Our results reveal evidence of non-negligible COVID-19 cases related to the differences in the percentage of attendees at these major events from March 6 to March 8. In a typical province, approximately 31% of the average daily reported COVID-19 cases per 100,000 inhabitants between mid-March and early April 2020 can be explained by the participation rate in those major events. A back-of-the-envelope calculation suggests that this implies almost five million euros (169,000 euros/day) of additional economic cost in the health system of a typical province with one million inhabitants in the period under consideration. Several mechanisms behind the spread of COVID-19 are also examined.