Recent changes in candidemia trends in a tertiary hospital (2011–2018)

BackgroundThe epidemiology of candidemia has changed over the last decades and varies widely among geographic areas.AimsWe examined in children (aged 0–14) with candidemia the trends in the incidence rate of this infection, as well as the clinical characteristics of the patients, in order to optimize the prognosis and the control measures of this serious disease.MethodsA retrospective cohort study of candidemia in the period 2011–2018 in the neonatal intensive care unit (NICU), pediatric ICU (PICU) and pediatric wards of a tertiary hospital, was conducted. The clinical course, Candida species isolated, antifungal susceptibility, outcome and incidence rates were analyzed and compared.ResultsWe diagnosed 68 episodes of candidemia in 62 children, 48% occurred in the NICU, 31% in the PICU and 21% in pediatric wards. Candida albicans was the most frequent species isolated in NICU infants (53%), and Candida parapsilosis predominated among PICU patients (59%) and pediatric wards (50%). One third of NICU infants had invasive candidiasis (IC), most of them having extremely low birth weight (ELBW) (35%). All isolates were susceptible to the antifungal administered. Over time, the incidence of candidemia decreased in the PICU (from 2.2 to 0.3 episodes/1000 patient-days, OR = 0.6; 95%CI 0.5–0.8), whereas in the NICU and in the wards remained stable. Mortality occurred mostly in NICU patients (26%), predominated in ELBW infants and did not change over time.ConclusionsThe higher incidence and mortality of candidemia and IC observed in preterm infants requires a continuous evaluation of practices and diagnostic methods which will allow improving the prognosis of this most vulnerable population.     

Patterns and trends in the incidence of paediatric and adult germ cell tumours in Australia, 1982–2011

PurposeGerm cell tumour (GCT) aetiology is uncertain and comprehensive epidemiological studies of GCT incidence are few.MethodsNationwide data on all malignant GCTs notified to Australian population-based cancer registries during 1982–2011 were obtained. Age- and sex-specific, and World age-standardised incidence rates were calculated for paediatric (0–14) and adult (15+) cases using the latest WHO subtype classification scheme. Temporal trends were examined using Joinpoint regression.ResultsThere were 17,279 GCTs (552 paediatric, 16,727 adult). Age-specific incidence in males (all histologies combined) was bimodal, with peaks during infancy for most sites, and second, larger, peaks during young adulthood. Incidence of ovarian tumours peaked at age 15–19. Around half of paediatric tumours were extragonadal, whereas adult tumours were mostly gonadal. Yolk sac tumours and teratomas predominated in infants, whereas germinomas became more frequent towards adulthood. Increasing incidence trends for some adult gonadal tumours have stabilised; the trend for male extragonadal tumours is also declining.ConclusionBroad similarities in the shape of age-specific incidence curves, particularly for gonadal, central nervous system, and mediastinal tumours provide epidemiological support for commonalities in aetiology among clinically disparate GCT subtypes. Differences in peak ages reflect underlying subtype-specific biological differences. Declining incidence trends for some adult gonadal tumours accords with the global transition in GCT incidence, and supports the possibility of a reduction in prevalence of shared aetiological exposures.     

Secular growth trends among children in Beijing (1955–2010)

ObjectivesTo analyze the growth trends of children in Beijing from 1955 to 2010.MethodsData for the period 1955–1975 were derived from published records. Data for the period 1985–2010 were derived from the Chinese National Survey on Students’ Constitution and Health (CNSSCH). Since 1985, the overall sampling and measurement methods have been consistent. The mean, the standard deviation, and the variance (ANOVA) of height, weight, and BMI by age and sex of students aged 7–17 were calculated and analyzed.ResultsBetween 1955 and 2010, the average height and weight of children in Beijing has increased. The average increments per decade for boys and girls were 2.45 cm and 2.03 cm in height and 2.68 kg and 1.68 kg in weight, respectively. The largest height increase per decade occurred between 1975 and 1985: 4.51 cm and 3.23 cm for boys and girls, respectively. The largest height increase for the entire 55-year period under study occurred among boys at age 13 (17.85 cm) and among girls at age 11 (15.90 cm.)ConclusionsDuring the period 1955–2010, growth trends among children in Beijing were positive. The health and nutritional status of these children improved significantly. Since 2007, might be related to government intervention, childhood obesity has been curbed.     

Declining trends in the majority of Greenland’s thick-billed murre (Uria lomvia) colonies 1981–2011

Large population declines were reported for the thick-billed murre (Uria lomvia) in Greenland for the period 1930s–1980s, but no national status has been published for the past 20 years. Meanwhile, the murres have gained more protection and several human-induced mortality factors have been markedly reduced. Here, we give an updated status based on the past 30 years of murre count data. The total Greenland population in 2011 was estimated to 468,300 birds (95 % CI 430,700–505,900) or around 342,000 breeding pairs, distributed within 19 colonies. This represents an overall reduction of 13 % since the mid-/late 1980s. In the same period, five colonies went extinct. Large and apparently stable colonies in Qaanaaq (Northwest Greenland) account for more than half the population (68 %), but most other colonies declined heavily, with up to 6 % p.a. in the most critical areas. So far, nothing indicates that food is a limiting factor in Greenland during the breeding season, although rather few colonies have been studied in details. In contrast, illegal hunting and disturbances during the breeding season are still a problem in Greenland, despite more restrictive hunting regulations, and may explain much of the continued population decline. In addition, recent studies from Svalbard indicate that a large-scale deterioration of the marine environment in the North Atlantic, due to oceanographic changes, may impact recruitment to some of the Greenland colonies. Murre colonies in southern Upernavik, Disko Bay, South Greenland and East Greenland are in urgent need of additional conservation initiatives to avoid further declines and local extinctions.     

Robert (Robin) Hill (1899–1991)

Obituary

Robert (Robin) Hill (1899–1991)     

Towards an indicator of urban centrality? Exploring changes in present and resident population (1991–2011) in Greece

This study compares the spatial distribution of resident and present population at the municipal scale in Greece (1991–2011) with the aim to infer recent trends in urban expansion. The ratio of present to resident population is proposed as a proxy of urban centrality indicating variations in urban hierarchy over time. Results of the analysis outline relevant changes in the spatial distribution of present and resident population along the urban–rural gradient. Apart from the metropolitan areas of Athens and Salonika (which concentrate nearly half of Greek population), the density of present and resident population varied largely across time and space. Urban regions showed higher values in the ratio of resident to present population than rural regions. The indicator proposed in this study contributes to defining more precisely urban and rural areas and may integrate decision support systems for diachronic analysis of urbanization patterns and processes.     

Time trends in minimum mortality temperatures in Castile-La Mancha (Central Spain): 1975–2003

The relationship between air temperature and human mortality is described as non-linear, with mortality tending to rise in response to increasingly hot or cold ambient temperatures from a given minimum mortality or optimal comfort temperature, which varies from some areas to others according to their climatic and socio-demographic characteristics. Changes in these characteristics within any specific region could modify this relationship. This study sought to examine the time trend in the maximum temperature of minimum organic-cause mortality in Castile-La Mancha, from 1975 to 2003. The analysis was performed by using daily series of maximum temperatures and organic-cause mortality rates grouped into three decades (1975–1984, 1985–1994, 1995–2003) to compare confidence intervals (p < 0.05) obtained by estimating the 10-yearly mortality rates corresponding to the maximum temperatures of minimum mortality calculated for each decade. Temporal variations in the effects of cold and heat on mortality were ascertained by means of ARIMA models (Box-Jenkins) and cross-correlation functions (CCF) at seven lags. We observed a significant decrease in comfort temperature (from 34.2°C to 27.8°C) between the first two decades in the Province of Toledo, along with a growing number of significant lags in the summer CFF (1, 3 and 5, respectively). The fall in comfort temperature is attributable to the increase in the effects of heat on mortality, due, in all likelihood, to the percentage increase in the elderly population.     

Socioeconomic inequality and obesity prevalence trends in luxembourg, 1995¿2007

ABSTRACT: BACKGROUND: Overweight and obesity are becoming increasingly critical problems in most developed countries. Approximately 20% of adults in most European countries are obese. This study examines the prevalence of overweight and obesity in Luxembourg and their association with different demographic, socioeconomic (SES), and behavioural factors. METHODS: The data used in this study were taken from 2 surveys on household income and living conditions conducted in 1995 and 2007. The target population was household residents aged 16 years and older, and body mass index (BMI) data were self-reported. Average BMI, overweight, and obesity prevalence rates were calculated according to each demographic (gender, nationality, marital status), SES (educational level, profession, and place of residence), and behavioural (physical activity and diet) factors. A multivariate logistic regression analysis was conducted to measure the relationship between obesity and demographic, SES, and behavioural factors. All analyses were conducted according to gender, and data used were weighted. RESULTS: Between 1995 and 2007, the average BMI remained nearly constant among men and women in the entire study population. Obesity prevalence increased by 24.5% through the study period (14.3% in 1995 to 17.8% in 2007). Obesity prevalence increased by 18.5% for men (15.1% in 1995 to 17.9% in 2007) and by 30% for women (13.6% in 1995 to 17.7% in 2007). Between 1995 and 2007, obesity increased sharply by 48.2% (from 11% to 16.3%) in Portuguese men, 76.7% (from 13.3% to 23.5%) in Portuguese women, 79.7% (from 17.2% to 30.9%) in widowed men, and 84.3% (from 12.1% to 22.3%) in divorced women. Multivariate logistic regression analysis showed that the relationship between the educational level and obesity was not statistically significant for men, but was significant for women. CONCLUSIONS: The prevalence of overweight and obesity is high in Luxembourg and has changed slightly in recent years. SES inequalities in obesity exist and are most compelling among women. The fight against obesity should focus on education, with emphasis on the socially disadvantaged segment of the population.     

Does smoking affect body weight and obesity in China?

An inverse relationship between smoking and body weight has been documented in the medical literature, but the effect of cigarette smoking on obesity remains inconclusive. In addition, the evidence is mixed on whether rising obesity rates are an unintended consequence of successful anti-smoking policies. This study re-examines these relationships using data from China, the largest consumer and manufacturer of tobacco in the world that is also experiencing a steady rise in obesity rates. We focus on the impact of the total number of cigarettes smoked per day on individuals’ body mass index (BMI) and on the likelihood of being overweight and obese. Instrumental variables estimation is used to correct for the endogeneity of cigarette smoking. We find a moderate negative and significant relationship between cigarette smoking and BMI. Smoking is also negatively related to being overweight and obese, but the marginal effects are small and statistically insignificant for being obese. Quantile regression analyses reveal that the association between smoking and BMI is quite weak among subjects whose BMIs are at the high end of the distribution but are considerably stronger among subjects in the healthy weight range. Ordered probit regression analyses also confirm these findings. Our results thus reconcile an inverse average effect of smoking on body weight with the absence of any significant effect on obesity. From a policy perspective these findings suggest that, while smoking cessation may lead to moderate weight gain among subjects of healthy weight, the effects on obese subjects are modest and should not be expected to lead to a large increase in obesity prevalence rates.     

Cancer incidence in the AGRICAN cohort study (2005–2011)

BackgroundNumerous studies have been conducted among farmers, but very few of them have involved large prospective cohorts, and few have included a significant proportion of women and farm workers. Our aim was to compare cancer incidence in the cohort (overall, by sex, and by work on farm, occupational status and pesticide use) within the general population.MethodsMore than 180,000 participants in the AGRICAN cohort were matched to cancer registries to identify cancer cases diagnosed from enrolment (2005–2007) to 31st December 2011. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (95%CIs).ResultsOver the period, 11,067 incident cancer cases were identified (7304 men and 3763 women). Overall cancer incidence did not differ between the cohort and the general population. Moreover, SIRs were significantly higher for prostate cancer (SIR = 1.07, 95%CI 1.03–1.11) and non-Hodgkin lymphoma (SIR = 1.09, 95%CI 1.01–1.18) among men, skin melanoma among women (SIR = 1.23, 95%CI 1.05–1.43) and multiple myeloma (men: SIR = 1.38, 95%CI 1.18–1.62; women: SIR = 1.26, 95%CI 1.02–1.54). In contrast, SIRs were lower for upper aerodigestive tract and respiratory cancers. Increase in risk was greater in male farm workers for prostate and lip cancer, in female farm workers for skin melanoma, and in male farm owners for multiple myeloma. Moreover, incidence of multiple myeloma and skin melanoma was higher among male and female pesticide users respectively.ConclusionWe found a decreased incidence for tobacco-related cancers and an increased incidence of prostate cancers, skin melanoma and multiple myeloma. Specific subgroups had a higher cancer incidence related to occupational status and pesticide use.     

Quantitative trends of zebra mussels in Lake Balaton (Hungary) in 2003–2005 at different water levels

During the extremely dry period between 2000 and 2003, the water level of Lake Balaton decreased by 82 cm and 80% of the stony littoral, an important habitat for the zebra mussel (Dreissena polymorpha), became dry. A recovery period started in 2004 due to intense precipitation, which increased water levels in the lake. Seasonal and spatial variations of the relative abundance, population density, population structure and biomass of the zebra mussel and the relative abundance of the amphipod Chelicorophium curvispinum were monitored in the period of 2003–2005 at four different shoreline sections and in two different portions (on the bottom and near the surface portion of the rip-rap) of Lake Balaton. Along with these studies, a quantitative survey of mussel larvae found in the plankton and of the abundance of mussel feeding diving ducks were made. As a consequence of the water level fall, on the dried part of the stony littoral, numerous zebra mussel druses perished. Following the dry period in early 2004, the relative abundance of the mussel on the bottom stones was smaller than in 2003 and the bottom community was dominated by C. curvispinum. By the end of 2004 and during 2005, the water level returned to normal and the surfaces of the reinundated stones were conducive to the successful colonization of zebra mussels. Hence, they returned as the dominant fauna in 2005. The stones near the surface might provide a new substrate for the recruitment of zebra mussels, probably offering more suitable substrata for the settlement in 2005 than in 2003. Therefore, the new substrata available in 2005 may have encouraged better and more rapid zebra mussel colonization than before. Zebra mussels may be better competitors for new space than C. curvispinum. A minor change of water-level fluctuation in 2005 and the reduction in population size of the mussel feeding waterfowl could have contributed to the intensive spread of zebra mussel by 2005.     

Fission–Fusion Behavior in Yunnan Snub-Nosed Monkeys (Rhinopithecus bieti) in Yunnan, China

Several species of mammals live in relatively large social groups that temporarily fission or subgroup in response to changes in food availability, predation risk, foraging strategies, and mating competition. Although the dynamics of subgrouping are not well understood, evidence of facultative fission–fusion behavior in species that generally exhibit a highly cohesive group structure may help to clarify the set of ecological and social factors that constrain or affect group size in primates. We here examined patterns of subgrouping in Yunnan snub-nosed monkeys (Rhinopithecus bieti) inhabiting the Baimaxueshan National Nature Reserve in Yunnan, China. Rhinopithecus bieti lives in a large multilevel society consisting of 6–41 one-male, multifemale units (OMUs) and one all-male unit (AMU). Over a 5-yr period from 2003 through 2008, we tracked a group of >450 Rhinopithecus bieti. We recorded the location in the group’s home range where fission and fusion events occurred, the size and number of subgroups, days spent in subgroups, and food availability, and monitored predator sightings. The results indicate that the focal group underwent12 group fission events, all of which occurred between mid-June and July, and all in the same area of the group’s range. During these fissioning events, the AMU also showed subgrouping behavior. In all cases, the presence of bamboo shoots, an important seasonal component of the snub-nosed monkey diet, appeared to trigger subgrouping behavior. The subgroups reunited in other parts of their range after a period of 2–11?d. We found no evidence that the presence of predators had a direct affect on subgrouping behavior in Rhinopithecus bieti, as proposed in previous studies.     

Agriculture and palaeoeconomy in prehistoric Xinjiang,China (3000–200 bc)

Vegetation History and Archaeobotany - Many recent studies recognize the crucial role that ancient agropastoralists (pastoralists who also engaged in farming) in Xinjiang played in facilitating...     

Tree-ring-based reconstruction of drought variability (1792–2011) in the middle reaches of the Fen River,North China

We developed a tree-ring chronology based on 52 ring-width series from 25 Pinus tabulaeformis trees at Tianlong Mountain (TLM) using the signal-free method. TLM is located in the middle reaches of the Fen River, North China, and is influenced by the East Asian monsoon system. Tree growth was highly correlated (0.789) with the Palmer Drought Severity Index (PDSI) from May to July and indicated a drought-stress growth pattern. Therefore, we developed a robust May-July PDSI reconstruction for 1792–2011 that explained 62.3% of the instrumental variance for 1951–2005. Severe drought years determined by the reconstruction are consistent with conditions reported in historical documents. The TLM PDSI reconstruction was consistent with other tree-ring-based hydroclimate reconstructions in North China; thus, it may accurately represent dry/wet changes that occur over a large area. Cyclical spectral peaks at 2–8 years in the reconstructed PDSI may indicate ENSO activity, as suggested by the positive correlation with the western Pacific sea-surface temperatures (SSTs) and the negative correlation with the eastern Pacific SSTs on the inter-annual scale.