Age as a Determinant for Dissemination of Seasonal and Pandemic Influenza: An Open Cohort Study of Influenza Outbreaks in ?sterg?tland County,Sweden

An understanding of the occurrence and comparative timing of influenza infections in different age groups is important for developing community response and disease control measures. This study uses data from a Scandinavian county (population 427.000) to investigate whether age was a determinant for being diagnosed with influenza 2005–2010 and to examine if age was associated with case timing during outbreaks. Aggregated demographic data were collected from Statistics Sweden, while influenza case data were collected from a county-wide electronic health record system. A logistic regression analysis was used to explore whether case risk was associated with age and outbreak. An analysis of variance was used to explore whether day for diagnosis was also associated to age and outbreak. The clinical case data were validated against case data from microbiological laboratories during one control year. The proportion of cases from the age groups 10–19 (p<0.001) and 20–29 years old (p<0.01) were found to be larger during the A pH1N1 outbreak in 2009 than during the seasonal outbreaks. An interaction between age and outbreak was observed (p<0.001) indicating a difference in age effects between circulating virus types; this interaction persisted for seasonal outbreaks only (p<0.001). The outbreaks also differed regarding when the age groups received their diagnosis (p<0.001). A post-hoc analysis showed a tendency for the young age groups, in particular the group 10–19 year olds, led outbreaks with influenza type A H1 circulating, while A H3N2 outbreaks displayed little variations in timing. The validation analysis showed a strong correlation (r = 0.625;p<0.001) between the recorded numbers of clinically and microbiologically defined influenza cases. Our findings demonstrate the complexity of age effects underlying the emergence of local influenza outbreaks. Disentangling these effects on the causal pathways will require an integrated information infrastructure for data collection and repeated studies of well-defined communities.     

A Middle Llandovery shelly fauna from Motala in Östergötland,south central Sweden. 1.Trilobita

A temporary exposure of Middle Llandovery (Aeronian) shales in the Swedish town of Motala has yielded a rich collection of shelly fauna and graptolites. The shelly fauna is restricted to a thin mudstone band in a graptolitic shale sequence, and is within theconvolutus Biozone. This mudstone band may be correlated with a similar mudstone in the Kolka core from northwestern Latvia. The faunas, including the trilobites, from the two occurrences represent the same species. In the collection from Motala, nine species of trilobites are present, of whichAcernaspis dispersa sp. nov. is new. The material represents the first trilobite fauna described from the Middle Llandovery of Sweden.     

Thermal bioclimatic conditions and patterns of behaviour in an urban park in Göteborg,Sweden

People in urban areas frequently use parks for recreation and outdoor activities. Owing to the complexity of the outdoor environment, there have only been a few attempts to understand the effect of the thermal environment on people's use of outdoor spaces. This paper therefore seeks to determine the relationship between the thermal environment, park use and behavioural patterns in an urban area of Sweden. The methods used include structured interviews, unobtrusive observations of the naturally occurring behaviour and simultaneous measurements of thermal comfort variables, i.e., air temperature, air humidity, wind speed and global radiation. The thermal environment is investigated through the mean radiant temperature (T_mrt) and the predicted mean vote (PMV) index. The outcome is compared to the subjective behaviour and thermal sensation of the interviewees. It is found that the thermal environment, access and design are important factors in the use of the park. In order to continue to use the park when the thermal conditions become too cold or too hot for comfort, people improve their comfort conditions by modifying their clothing and by choosing the most supportive thermal opportunities available within the place. The study also shows that psychological aspects such as time of exposure, expectations, experience and perceived control may influence the subjective assessment. Comparison between the thermal sensation of the interviewees and the thermal sensation assessed by the PMV index indicates that steady-state models such as the PMV index may not be appropriate for the assessment of short-term outdoor thermal comfort, mainly because they are unable to analyse transient exposure.     

Characterization of H9 subtype influenza viruses from the ducks of southern China: a candidate for the next influenza pandemic in humans?

A current view of the emergence of pandemic influenza viruses envisages a gene flow from the aquatic avian reservoir to humans via reassortment in pigs, the hypothetical "mixing vessel." Understanding arising from recent H5N1 influenza outbreaks in Hong Kong since 1997 and the isolation of avian H9N2 virus from humans raises alternative options for the emergence of a new pandemic virus. Here we report that H9N2 influenza viruses established in terrestrial poultry in southern China are transmitted back to domestic ducks, in which the viruses generate multiple reassortants. These novel H9N2 viruses are double or even triple reassortants that have amino acid signatures in their hemagglutinin, indicating their potential to directly infect humans. Some of them contain gene segments that are closely related to those of A/Hong Kong/156/97 (H5N1/97, H5N1) or A/Quail/Hong Kong/G1/97 (G1-like, H9N2). More importantly, some of their internal genes are closely related to those of novel H5N1 viruses isolated during the outbreak in Hong Kong in 2001. This study reveals a two-way transmission of influenza virus between terrestrial and aquatic birds that facilitates the generation of novel reassortant H9N2 influenza viruses. Such reassortants may directly or indirectly play a role in the emergence of the next pandemic virus.     

Temporal changes and fluxes of sulphur and calcium in wet and dry deposition, internal circulation as well as in run-off and soil in a forest at Gårdsjön, Sweden

Sulphur dioxide in air as well as dry deposition of sulphur dioxide to a forest has decreased by a factor of 20 during the last two decades. It was earlier found that the internal circulation of calcium in Norway spruce follows the dry deposition of sulphur dioxide. The sulphur and calcium fluxes from 1992 were calculated from wet deposition, throughfall and a surrogate surface. Earlier fluxes from 1981 to 1991 were calculated using assumptions of the dry deposition of non-marine sulphate and calcium. The new estimates confirm the earlier studies that the internal circulation of calcium in a coniferous forest is directly related to the dry deposition of sulphur dioxide to the canopies and that the internal circulation of calcium decreases at the same rate as the deposition of sulphur decreased during the last two decades. The deposition fluxes were also compared to run-off and uptake of calcium in the forest as well as on modelled weathering rates from severely acidified forested catchments near the coast and inland and the soil pool. A reconstruction of changes in the soil pool of calcium over the last 100 years indicate that the soil pool has decreased by ca. 70% in catchments with complete harvest of the forest and ca. 40% if branches and needles are left on the ground. In a natural forest without acid deposition the soil pool of calcium would have increased by 6%. Estimates for the 21st century show that harvesting of stems+branches and needles may almost empty the soil pool of calcium in the next 100 years. Increased nitrogen deposition has increased forest growth, which indirectly increased uptake of calcium by the trees and indirectly caused a further decrease of the soil pool of calcium.     

Pseudorascora parva (Teleostei, Cyprinidae), an invasive species, a new vector for the maintenance and dissemination of anguillicolosis in France?]

Pseudorasbora parva (Pisces, Cyprinidae) is an invasive species from eastern Asia. Known in France since 1983, it has only been observed since 1993 in the Rh?ne delta where large populations occur. 203 specimens of that fish species have been examined for L3-larvae of Anguillicola crassus. 35% of the fish were found to be infected.     

Relationships between urban open spaces and humans’ health benefits from an ecological perspective: a study in an urban campus

The rapid increase in urban population worldwide is one among the important global environmental issues. The urban ecological system is made up of human society and environments. We cannot exclude humans from the urban ecosystem since humans are an integral component of landscape ecology. Bridging humans and landscape ecology is important to sustainable landscape planning and management from a holistic point of view. Humans’ responses to landscape structure are crucial to understand the relationships between humans and nature. In current study, we conducted a field experiment in an urban campus to investigate the relationships between urban open spaces and humans’ health benefits. The landscape structure of urban open spaces were derived from land cover maps. The results show that people’s psycho-physiological responses are correlated with selected landscape metrics of different land cover types. Overall, dense trees and large artificial structures likely have negative effects on humans, while large continuous grassland patches or water patches enhance humans’ positive responses. The findings give some insights into the design and management of urban open spaces that are favorable for ecosystems and the health of urban population. The methodology taken to investigate the relationships between landscape structure and human health in this study may be of value to future efforts in establishing healthy and sustainable urban environments.     

LCA as an element in environmental management systems—comparison of conditions in selected organisations in Poland, Sweden and Germany

Purpose

In this two-part paper (Background and Initial Assumptions (part 1) and Results of Survey Research (part 2)), we present surveys whose main objective is to determine whether, and to what extent, the life cycle assessment (LCA) technique is used for the identification and assessment of environmental aspects in environmental management systems (EMS) and whether there are any differences in this respect between the companies and countries analysed.

Methods

The survey research was carried out using the computer assisted self-administered interviewing method among selected Polish, German and Swedish organisations which implement EMS in accordance with the requirements of ISO 14001 and/or the EMAS regulation.

Results

The organisations investigated, regardless of their country, are dominated by qualitative and semi-quantitative techniques of assessment and identification of environmental aspects. LCA was used sporadically, although some differences can be observed between the countries analysed.

Conclusions

The environmental managers accustomed to traditional qualitative and semi-quantitative solutions have not been given preparation to enable them to understand and adopt different approaches such as LCA. On the other hand, representatives of the organisations investigated declared that they were ready to accept an even longer timescale for the identification and assessment processes relating to environmental aspects, which represents a potential opportunity for LCA. The more precise understanding and definition of environmental problems that are precisely defined in LCA would represent a novelty for environmental managers. In practice, environmental problems are defined in a general sense and rather ambiguously, as this level of detail is sufficient in the context of qualitative and semi-quantitative techniques commonly used for the identification and assessment of environmental aspects.     

Building a dual identity as an immigrant in the UK: Eritreans’ search for freedom and a sense of balance

This study explored the experiences of newly arrived and settled Eritrean immigrants currently in the UK. Semi-structured interviews were carried out with ten newly arrived (<one year) and ten settled (>seven years) participants, recruited through an Eritrean café and using snowball sampling. Thematic analysis identified three themes: (1) Wanting freedom, expectations of the UK and the desire for safety, (2) Integration and becoming part of the British community, (3) Personal development, which involved growth and aspirations. Transcending these themes was the notion of balance, and the co-existence of past and present. It is argued that Eritreans in the UK wish to become part of British community whilst at the same time remembering and celebrating their Eritrean culture. This is explained within the context of a dual identity and it is argued that rather than being a hindrance, a dual rather than single identity facilitates the process of integration.     

Extracellular matrix as a contextual determinant of transforming growth factor-β signaling in epithelial-mesenchymal transition and in cancer

Extracellular matrix (ECM) provides both structural support and contextual information to cells within tissues and organs. The combination of biochemical and biomechanical signals from the ECM modulates responses to extracellular signals toward differentiation, proliferation, or apoptosis; alterations in the ECM are necessary for development and remodeling processes, but aberrations in the composition and organization of ECM are associated with disease pathology and can predispose to development of cancer. The primary cell surface sensors of the ECM are the integrins, which provide the physical connection between the ECM and the cytoskeleton and also convey biochemical information about the composition of the ECM. Transforming growth factor-β (TGF-β) is an extracellular signaling molecule that is a powerful controller of a variety of cellular functions, and that has been found to induce very different outcomes according to cell type and cellular context. It is becoming clear that ECM-mediated signaling through integrins is reciprocally influenced by TGF-β: integrin expression, activation, and responses are affected by cellular exposure to TGF-β, and TGF-β activation and cellular responses are in turn controlled by signaling from the ECM through integrins. Epithelial-mesenchymal transition (EMT), a physiological process that is activated by TGF-β in normal development and in cancer, is also affected by the composition and structure of the ECM. Here, we will outline how signaling from the ECM controls the contextual response to TGF-β, and how this response is selectively modulated during disease, with an emphasis on recent findings, current challenges, and future opportunities.     

Stability and resilience of the intestinal microbiota in children in daycare – a 12 month cohort study

Background

We performed a 12-month cohort study of the stability and resilience of the intestinal microbiota of healthy children in daycare in Denmark in relation to diarrheal events and exposure to known risk factors for gastrointestinal health such as travelling and antibiotic use. In addition, we analyzed how gut microbiota recover from such exposures.

Results

We monitored 32 children in daycare aged 1–6?years. Fecal samples were submitted every second month during a one-year observational period. Information regarding exposures and diarrheal episodes was obtained through questionnaires. Bacterial communities were identified using 16S rRNA gene sequencing. The core microbiota (mean abundance >?95%) dominated the intestinal microbiota, and none of the tested exposures (diarrheal events, travel, antibiotic use) were associated with decreases in the relative abundance of the core microbiota. Samples exhibited lower intra-individual variation than inter-individual variation. Half of all the variation between samples was explained by which child a sample originated from. Age explained 7.6–9.6% of the variation, while traveling, diarrheal events, and antibiotic use explained minor parts of the beta diversity. We found an age-dependent increase of alpha diversity in children aged 1–3?years, and while diarrheal events caused a decrease in alpha diversity, a recovery time of 40–45?days was observed.Among children having had a diarrheal event, we observed a 10x higher relative abundance of Prevotella. After travelling, a higher abundance of two Bacteroides species and 40% less Lachnospiraceae were seen. Antibiotic use did not correlate with changes in the abundance of any bacteria.

Conclusion

We present data showing that Danish children in daycare have stable intestinal microbiota, resilient to the exposures investigated. An early age-dependent increase in the diversity was demonstrated. Diarrheal episodes decreased alpha diversity with an estimated recovery time of 40–45?days.

     

Trace element imbalances in patients undergoing chronic hemodialysis therapy – Report of an observational study in a cohort of Portuguese patients

IntroductionPatients with end-stage renal disease undergoing hemodialysis therapy are at risk of developing deficiencies of essential trace elements and/or overload of toxic trace elements, both of which may significantly affect their clinical status of. Those imbalances may result from the disease itself but also from the quality of the therapeutic process, namely the hemodialysis process, which has greatly evolved in the last decades. Thus, old observations that have been assumed as very well-proven have been recently questioned. In this case-control study we evaluate the current trace elements status in a group of Portuguese patients under hemodialysis therapy.Material and methodsSerum samples from patients (n = 93), collected for the routine periodic control of Al levels, were analyzed for a wide panel of trace elements (Li, Al, Mn, Co, Ni, Cu, Zn, Se, Rb, Sr, Mo, Cd, Ba, Pb) using inductively coupled plasma mass spectrometry technique (hemodialysis patients’ group). For comparison purposes, samples of individuals with no evidence of renal disease according to standard laboratory analytical criteria (n = 50) were also analyzed (control group).ResultsThe results showed significant differences between the two groups, with higher values in hemodialysis patients group for Al (14.6 vs. 9.5 μg/L), Co, Ni, Sr, Mo (4.5 vs. 1.4 μg/L), Cd (0.058 vs. 0.025 μg/L) and Pb (0.55 vs. 0.30 μg/L); and lower values in hemodialysis patients group for Li (4.0 vs. 75.8 μg/L), Mn, Cu (943.5 vs. 1038.5 μg/L), Zn (943.5 vs. 1038.5 μg/L), Se (71.5 vs. 103.8 μg/L), Rb (202.4 vs. 300.3 μg/L) and Ba (0.65 vs. 8.7 μg/L).ConclusionThis study confirms that hemodialysis patients tend to present significant trace elements imbalances, which may be related to the higher morbidity and mortality observed in this specific patients’ group.     

Male–male competition for large nests as a determinant of male mating success in a Japanese stream goby, Rhinogobius sp. DA

Males of the stream goby Rhinogobius sp. DA (dark type) court females in deep pools and care for the eggs under stones in shallow riffles. We studied male–male competition for access to females and nest sites to understand how male size influences the mating success of this species. In field observations, larger males won in fighting with other males. However, large males did not tend to monopolize courtship opportunities, and the frequency of successful courtships, after which males led the females to the nests, was not related to male body size. The fact that courted females always escaped from the fighting sites once males began fighting likely explains why male size was not positively related to courtship success. Large males occupied large nest stones, and the number of eggs received in the nest was correlated positively with nest size. In aquarium experiments with two tiles of different sizes provided as nesting materials, males always chose the larger nest and, when two males were introduced simultaneously, the larger one occupied the larger nest. These results suggested that male mating success of this goby is determined by male–male competition for large nests rather than for access to females. Received: June 9, 2000 / Revised: September 2, 2000 / Accepted: October 4, 2000     

A clash of traditions: the history of comparative and experimental embryology in Sweden as exemplified by the research of Gösta Jägersten and Sven Hörstadius

Until the 1940s research traditions were often imported from Germany to Sweden, and young scientists went to German universities to learn new techniques and get in touch with the latest ideas. In developmental biology, the comparative, phylogenetic embryology advocated most forcefully by Ernst Haeckel co-existed with the “Entwickelungsmechanik” tradition developed by Wilhelm His, Wilheln Roux and others partly as a reaction to Haeckel’s ideas. I use the zoology department at Uppsala University as a microcosmos to reflect the tensions between these traditions: Gösta Jägersten (1903–1993) and Sven Hörstadius (1898–1996) are used as exemples. Jägersten was a marine biologist who worked on the morphology and evolution of invertebrates, especiallly their larval forms. He developed a comprehensive theory describing the evolution of the life cycle in early metazoans. Recapitulation was an important ingredient, and Jägersten explicitly based his reasoning on Ernst Haeckel’s “biogenetic law”. Jägersten developed Haeckel’s “Gastraea” theory into another hypothetical animal—Bilaterogastraea—that came into being when the holopelagic Blastaea settled on the ground as an adult and kept a pelagic, planktonic larval form. This was the birth of the pelago-benthic life cycle, which plays such an important role in Jägersten’s speculations on the deep phylogeny of metazoans. Sven Hörstadius was a leading experimental embryologist in the mid-twentieth century. His most important work was on the determination and differentiation of the sea urchin embryo. Early work inspired by his teacher John Runnström’s double gradient theory showed that gradients of animalness (ectodermal determination) and vegetalness (endodermal determination) existed in the 16- and 32- cell embryos. Hörstadius became famous for his elegant extirpation and transplantation experiments using glass needles, and for his microsugical skills. He also made important contributions to the study of cranial neural crest development in the Mexican axolotl, in collaboration with his student Sven Sellman. Hörstadius was the great experimentalist, but did not develop speculative hypotheses the way Jägersten did. The very different styles of scientific research might have played a role also in the development of the personal difficulties that existed for a long time between the two professors.     

Design, synthesis, and evaluation of an α-tocopherol analogue as a mitochondrial antioxidant

An efficient synthesis has provided access to a novel α-tocopherol analogue (2), as well as its trifluoroacetate salt and acetate ester. An annulation reaction was used to establish the pyridinol core structure and a Stille coupling reaction was employed for conjugation with the tocopherol side chain. This analogue was shown to suppress the levels of reactive oxygen species in cultured cells, and to quench peroxidation of mitochondrial membranes.     

The HIV-poverty thesis re-examined: poverty, wealth or inequality as a social determinant of HIV infection in sub-Saharan Africa?

Although health is generally believed to improve with higher wealth, research on HIV in sub-Saharan Africa has shown otherwise. Whereas researchers and advocates have frequently advanced poverty as a social determinant that can help to explain sub-Saharan Africa's disproportionate burden of HIV infection, recent evidence from population surveys suggests that HIV infection is higher among wealthier individuals. Furthermore, wealthier countries in Africa have experienced the fastest growing epidemics. Some researchers have theorized that inequality in wealth may be more important than absolute wealth in explaining why some countries have higher rates of infection and rapidly increasing epidemics. Studies taking a longitudinal approach have further suggested a dynamic process whereby wealth initially increases risk for HIV acquisition and later becomes protective. Prior studies, conducted exclusively at either the individual or the country level, have neither attempted to disentangle the effects of absolute and relative wealth on HIV infection nor to look simultaneously at different levels of analysis within countries at different stages in their epidemics. The current study used micro-, meso- and macro-level data from Demographic and Health Surveys (DHS) across 170 regions within sixteen countries in sub-Saharan Africa to test the hypothesis that socioeconomic inequality, adjusted for absolute wealth, is associated with greater risk of HIV infection. These analyses reveal that inequality trumps wealth: living in a region with greater inequality in wealth was significantly associated with increased individual risk of HIV infection, net of absolute wealth. The findings also reveal a paradox that supports a dynamic interpretation of epidemic trends: in wealthier regions/countries, individuals with less wealth were more likely to be infected with HIV, whereas in poorer regions/countries, individuals with more wealth were more likely to be infected with HIV. These findings add additional nuance to existing literature on the relationship between HIV and socioeconomic status.     

Supreme™ laryngeal mask airway use in general Anesthesia for category 2 and 3 Cesarean delivery: a prospective cohort study

Background

The Supreme? laryngeal mask airway (SLMA) is a single-use LMA with double lumen design that allows separation of the respiratory and the alimentary tract, hence potentially reducing the gastric volume and risk of aspiration. The purpose of this prospective cohort study is to evaluate the the role of the SLMA as an airway technique for women undergoing category 2 and 3 Cesarean delivery under general anesthesia.

Methods

We recruited 584 parturients who underwent category 2 or 3 Cesarean delivery under general anesthesia, in which 193 parturients underwent category 2 and 391 parturients underwent category 3 Cesarean delivery. The primary outcome was insertion success rate at 1st attempt in SLMA insertion. The secondary outcomes included anaesthetic, obstetric outcomes and maternal side effects associated with airway device.

Results

The 1st attempt insertion success rate was 98.3%, while the overall insertion success rate was 100%. The mean (Standard deviation) time to effective ventilation was 15.6 (4.4) seconds. Orogastric tube insertion was successful at the 1st attempt in all parturients. There was no clinical evidence of aspiration or regurgitation. No episodes of hypoxemia, laryngospasm or bronchospasm were observed intra-operatively. The incidence of complications was low and with good maternal satisfaction reported.

Conclusions

The SLMA could be an alternative effective airway in category 2 and 3 parturients emergency Cesarean Delivery under general anesthesia in a carefully-selected obstetric population.

Trial registration

Clinical Trials Registration: Clinicaltrials.gov Registration NCT02026882. Registered on December 31, 2013.