Allogeneic hematopoietic cell transplantation(allo-HCT) remains a cornerstone therapy for severe hematologic malignancies, offering a potential cure when conventional therapies are ineffective. However, not all patien...Allogeneic hematopoietic cell transplantation(allo-HCT) remains a cornerstone therapy for severe hematologic malignancies, offering a potential cure when conventional therapies are ineffective. However, not all patients are suitable recipients of allo-HCT, particularly the elderly patients and those with high comorbidity burdens.Furthermore, patients who develop relapse or graft failure after initial transplantation encounter additional challenges when evaluated for a second transplant.展开更多
Brazilian public managers have been structuring and updating policies to support workers’employment and income strategies.However,when the vulnerable individual has social,emotional,or technical limitations,success i...Brazilian public managers have been structuring and updating policies to support workers’employment and income strategies.However,when the vulnerable individual has social,emotional,or technical limitations,success in this operation becomes uncertain.This research aim was to propose a methodology to identify profiles in vulnerable populations,viewing to promote the efficient elaboration of employment and income strategies.The unit of analysis was vulnerable population of waste pickers,in a large city from South Brazil,in the scope of a municipal program named"All of us are Porto Alegre".A literature review allowed the identification of tools from marketing,economy and design adequate to profile analysis.A workshop with social educators responsible for giving support to the individuals.Insights from workshop and the literature allowed the proposition of a methodology including cluster analysis and the creative tool named personas.The methodological approach suggests it is adequate in confirming the differences in profiles.The theoretical contribution lies in the use of quantitative-creativity tools to support policymaking.The practical contribution is to provide consistent information for governmental decision-making at the labor access market.展开更多
Background:Since the introduction of direct-acting antivirals,thousands of chronic hepatitis C patients have been successfully treated.However,vulnerable populations have a higher prevalence of hepatitis C virus(HCV)i...Background:Since the introduction of direct-acting antivirals,thousands of chronic hepatitis C patients have been successfully treated.However,vulnerable populations have a higher prevalence of hepatitis C virus(HCV)infection and face barriers that impede their access to antivirals.We carried out an HCV microelimination program focused on vulnerable population groups in Malaga.Methods:People in drug addiction treatment centers and homeless shelters in Malaga who participated in the program between October 2020 and October 2021 were included.After providing participants with educational information on HCV,a dry drop test(DDT)was used to collect blood for subsequent screening for HCV infection.The participants who were diagnosed with HCV infection were scheduled for comprehensive healthcare assessments,including blood tests,ultrasonography,elastography,and the prescription of antivirals,all conducted in a single hospital visit.Sustained viral response(SVR)was analysed 12weeks after end of treatment.Results:Of the 417 persons invited to participate,271(65%)agreed to participate in the program.These participants were screened for HCV infection and 28 of them were diagnosed with HCV infection(10%).These hepatitis C-infected patients had a mean age of 53±9years;86%were males and 93%were or had been drug users.Among 23 patients with HCV infection,HCV genotype 1a predominated(74%).Medical exams showed that 19%(4/21)had advanced fibrosis(F3-4),and 5%(1/21)had portal hypertension.Finally,23 infected patients received treatment with glecaprevir/pibrentasvir or sofosbuvir/velpatasvir and SVR was confirmed in 22 patients(96%).Conclusions:Drug users and homeless people have a higher prevalence of HCV infection than the general population.The microelimination program with educational activity and screening tools achieved a high participation rate,easy healthcare access,and a high rate of SVR despite the SARS-CoV-2 pandemic.展开更多
Social vulnerability experienced by collectors of recyclable materials has a strong influence on their understanding and confrontations health. This research aimed to explore the relationship between oral health and p...Social vulnerability experienced by collectors of recyclable materials has a strong influence on their understanding and confrontations health. This research aimed to explore the relationship between oral health and perception of subjects in a context of social disadvantage, in order to support concrete alternatives for action on (oral) health conference. This was a qualitative study carried out with representatives of an autonomous community of Brazilian collectors of recyclable materials. Data were collected through interviews and focus group treated with the technique of qualitative analysis. Respondents showed perceptions of etiology and care practices on oral health promoted beliefs and values collectively instituted in a social risk territory. Also, they associate the quality of their oral health and their difficulty of public access to the context of social vulnerability. This study suggests the adoption of protective, educational and interceptive in oral health practice in order to improve and enable the oral health status of this population.展开更多
Air pollution has emerged as one of the most pressing public health challenges of the twenty-first century.According to the World Health Organization(WHO),more than 7 million premature deaths occur annually as a direc...Air pollution has emerged as one of the most pressing public health challenges of the twenty-first century.According to the World Health Organization(WHO),more than 7 million premature deaths occur annually as a direct consequence of exposure to polluted air,which is estimated to affect over 90%of the global population.Air pollution manifests in two principal forms:outdoor pollution,largely driven by industrial emissions,transportation,and energy production,and indoor pollution,often linked to inadequate ventilation,heating systems,and household fuel use.Both forms contribute significantly to a wide range of health outcomes,including chronic respiratory illnesses,cardiovascular complications,strokes,and various types of cancer.Vulnerable groups—such as children,the elderly,and individuals with pre-existing medical conditions—are disproportionately at risk.Efforts to mitigate the harmful effects of air pollution include stricter emission regulations,adoption of clean and renewable technologies,expansion of sustainable public transportation networks,and public education campaigns aimed at raising awareness of health risks and preventive strategies.Uzbekistan is not exempt from these challenges.In particular,the Navoi region,recognized as one of the country’s most industrialized areas,faces heightened exposure to harmful substances released into the atmosphere.A comparative analysis of air quality indicators in Navoi’s urban centers before and after the COVID-19 pandemic revealed a significant post-pandemic rise in pollution levels,linked to economic recovery,industrial activity,and transport flows.These findings provide valuable insights for policymakers and local authorities in developing targeted environmental and public health interventions.展开更多
Objectives To explore the relationship between acceptance of illness and quality of life(QOL),and factors associated with acceptance of illness among men who have sex with men(MSM)living with human immunodeficiency vi...Objectives To explore the relationship between acceptance of illness and quality of life(QOL),and factors associated with acceptance of illness among men who have sex with men(MSM)living with human immunodeficiency virus(HIV).Methods Three hundred and one MSM were recruited from an HIV clinic between August and December 2018.The battery of measurements consisted of the Acceptance of Illness Scale,World Health Organization Quality of Life Questionnaire for HIV brief version,HIV Cognitive Appraisal Scale and a self-designed questionnaire used to collect general information.Pearson correlation test was used to examine the relationship between acceptance of illness and QOL.Univariate and multivariate ordinal logistic regression analyses were used to examine whether the general data(demographic and HIV-related clinical data)and HIV cognitive appraisal were associated with acceptance of illness levels.Results Descriptive analysis showed the acceptance level among MSM living with HIV was moderate(Mean=26.29,SD=5.28).Those with a better acceptance of illness had a better QOL(r=0.69,P<0.01).In the multivariate ordinal logistic regression model,education level,threat appraisals(OR:1.09;95%CI[1.06–1.13]),and controllability appraisals(OR:0.82;95%CI[0.71–0.94])were significantly associated with acceptance of illness.Conclusions Results showed acceptance level was moderate and had a positive correlation with QOL.High level of education,low threat appraisals and high controllability appraisals were related to high illness acceptance.This finding highlights the importance of focusing on HIV-infected MSM with low education and on their perceptions of threat and controllability about HIV-related issues when designing interventions to promote illness acceptance in this vulnerable population.展开更多
Nitrous oxide is one of the most commonly used inhalational anesthetic agents used in practice.It is a cost-effective,pleasant,safe,and versatile anesthetic agent with many desirable properties like good quality analg...Nitrous oxide is one of the most commonly used inhalational anesthetic agents used in practice.It is a cost-effective,pleasant,safe,and versatile anesthetic agent with many desirable properties like good quality analgesia,decreased awareness,accelerated induction and recovery from anesthesia,and reduced utilization of other expensive inhalational agents with potential cost savings.The use of nitrous oxide has been questioned by a lot of studies and case reports perceiving its adverse systemic,hematological,immune,and neurologic adverse effects.However,the literature in the recent past has tried to resolve the controversies related to its use.The concerns over an increase in cardiovascular complications and mortality following nitrous oxide use have been negated by recent data.However,its use in certain vulnerable populations like children with cobalamin and folate deficiency or defects in their metabolic pathways remains a cause of concern for its toxic effects.In this narrative review,we aim to discuss the pharmacological properties of nitrous oxide,the potential advantages and drawbacks of the use of nitrous oxide in children,address the neurodevelopmental and other systemic effects,and throw light on the evidence regarding the safety of nitrous oxide use and its current role in pediatric procedural sedation and anesthesia practice.The literature related to its use in the pediatric population for painful procedures and surgeries has been summarized.展开更多
The goal of the paper is to conduct an exploratory review and analyses of the dynamics of the pandemic focusing on two themes:pandemic morbidity and vulnerable populations.Method:Review of literature,anecdotal evidenc...The goal of the paper is to conduct an exploratory review and analyses of the dynamics of the pandemic focusing on two themes:pandemic morbidity and vulnerable populations.Method:Review of literature,anecdotal evidence,and reports on the morbidity of COVID-19;including scope of its devastating effects in selected countries.Findings:The devastating effects of the coronavirus are felt across different vulnerable populations.These include the elderly,front line workers,marginalized communities,visible minorities,and more.Inadequate and sometimes conflicting remarks by“experts”have only contributed in exacerbating the confusion in the general population.However,compassion and empathy from different communities have had positive effects on mitigating some of the health outcomes like mental health and other health-related effects of the pandemic.Institutional support needs to be strengthened,especially with regard to individual risks and supply chain coordination:personal protection equipment(PPE),masks,swabs,reagents,etc.The challenge in Africa is especially daunting,because of limited and inadequate financial resources and infrastructure,as confirmed by the health budget allocations as a percentage of their respective GDP(gross domestic product).Discussion:The effects of the COVID-19 are producing unprecedented and catastrophic outcomes in many countries.These have been exacerbated by the level of unpreparedness and inadequate degrees of prevention and intervention strategies.With a few exceptions,the common and current intervention approach is driven by many unknowns including compilation of relevant reliable and compelling data sets.Vulnerable communities continue to suffer most:a situation that is highlighted in this essay as one attempt to remind institutions of their duty to provide appropriate support,including compassion and empathy to these populations.The repercussions of no or inadequate action are numerous,significant,and mind-boggling with unpredictable future outcomes and possible dire consequences.The continuous carnage caused by COVID-19 is a wake-up call reminding all stakeholders(public and private institutions)that once again the inequality infiltrating vulnerable populations needs to be effectively addressed with emphasis on affordability,improved quality of life,and an inclusive long-term strategic plan.Ubiquitous and inadequate supply chain coordination mechanisms have been a major deterrent towards mitigating the effects of this coronavirus pandemic.展开更多
Human mpox(formerly known as monkeypox)historically received little attention until its emergence beyond African countries in 2022.As of September 30,2024,a total of 109,699 laboratory-confirmed mpox cases have been r...Human mpox(formerly known as monkeypox)historically received little attention until its emergence beyond African countries in 2022.As of September 30,2024,a total of 109,699 laboratory-confirmed mpox cases have been reported to the World Health Organization(WHO).[1]It has been more than one year since the WHO announced on May 11,2023 that the mpox epidemic did not constitute a public health emergency of international concern(PHEIC).However,on August 14,2024,the WHO declared that the upsurge of mpox in the Democratic Republic of the Congo(DRC)and an increasing number of countries in Africa constituted a PHEIC once again.Although the WHO has proposed the“Strategic Framework for Enhancing Prevention and Control of Mpox 2024–2027”,controlling and eliminating the mpox from 2024 to 2025,as planned,appears to be a significant challenge.[2]Additionally,various vulnerable populations(such as children,pregnant women,and immunosuppressed individuals),adverse outcomes(such as myocarditis),and hospital management strategies for mpox complicate prevention and control efforts.[3–5]To effectively prevent and control mpox in the public,it is critical to understand the epidemic trends,the threat posed by Clade Ib,and the necessary control measures.展开更多
Increases in ambient temperatures and the frequency of extreme heat events constitute important burdens on global public health.However,evidence on their effects on public health is limited and inconclusive in China.I...Increases in ambient temperatures and the frequency of extreme heat events constitute important burdens on global public health.However,evidence on their effects on public health is limited and inconclusive in China.In this study,data on daily deaths recorded in 33 Chinese cities from 2007 to 2013 was used to evaluate the effect of heat on mortality in China.In addition to the definition of a heatwave established by the China Meteorological Administration,we combined four city-specific relative thresholds(90th,92.5th,95th,and 97.5th percentiles)of the daily mean temperature during the study period and three durations of≽2,≽3,and≽4 days,from which 13 heatwave definitions were developed.Then,we estimated the main and added effects of heat at the city level using a quasi-Poisson generalized additive model combined with a distributed lag nonlinear model.Next,the estimates for the effects were pooled at the national level using a multivariable meta-analysis.Subgroup analysis was performed according to sex,age,educational attainment,and spatially stratified heterogeneity.The results showed that the mortality risk increased from 22.3%to 37.1%due to the effects of the different heatwave definitions.The added effects were much lower,with the highest increase of 3.9%(95%CI:1.7%–6.1%)in mortality risk.Females,the elderly,populations with low educational levels,and populations living inland in China were found to be the most vulnerable to the detrimental effects of heat.These findings have important implications for the improvement of early warning systems for heatwaves.展开更多
Somatosensory comfort is mainly determined by the Temperature and Humidity Index(THI)with Wind Efficiency Index(WEI),but this conventional usage of these indicators does not capture the age-related differentials.Here ...Somatosensory comfort is mainly determined by the Temperature and Humidity Index(THI)with Wind Efficiency Index(WEI),but this conventional usage of these indicators does not capture the age-related differentials.Here we resolved this gap with a modification of the climatic comfort definition and method in a national standard,denoted as the Relative Climate Sensitive Index(RCSI),which incorporated the age-related vulnerability scores determined through online questionnaires with a scoring method,for each of the age-related and adaptive climatic comfort responses to changes in residence with Beijing-Tianjin-Hebei(BTH)region as an example.First,the result showed that the human comfort of living environment decreased with age in the BTH region,implicating age obviously impacted comfort,and weak adaptability made the elderly the relatively most high-risk group-their suitable region was less than a quarter of the whole study region.Second the adverse effects of persistent hot weather on comfort,indicating global warming as the leading driver of dwindling comfort over recent years.As the warming was more significant in the southeastern part,all these forces combined had there a hotspot,appealing for extra attention.Last this improved evaluation accorded with actual situation to captured high-risk groups with their distributions.展开更多
基金supported by National Natural Science Foundation of China (No. 82370215).
文摘Allogeneic hematopoietic cell transplantation(allo-HCT) remains a cornerstone therapy for severe hematologic malignancies, offering a potential cure when conventional therapies are ineffective. However, not all patients are suitable recipients of allo-HCT, particularly the elderly patients and those with high comorbidity burdens.Furthermore, patients who develop relapse or graft failure after initial transplantation encounter additional challenges when evaluated for a second transplant.
文摘Brazilian public managers have been structuring and updating policies to support workers’employment and income strategies.However,when the vulnerable individual has social,emotional,or technical limitations,success in this operation becomes uncertain.This research aim was to propose a methodology to identify profiles in vulnerable populations,viewing to promote the efficient elaboration of employment and income strategies.The unit of analysis was vulnerable population of waste pickers,in a large city from South Brazil,in the scope of a municipal program named"All of us are Porto Alegre".A literature review allowed the identification of tools from marketing,economy and design adequate to profile analysis.A workshop with social educators responsible for giving support to the individuals.Insights from workshop and the literature allowed the proposition of a methodology including cluster analysis and the creative tool named personas.The methodological approach suggests it is adequate in confirming the differences in profiles.The theoretical contribution lies in the use of quantitative-creativity tools to support policymaking.The practical contribution is to provide consistent information for governmental decision-making at the labor access market.
基金supported by a grant from GILEAD for hepatitis C microelimination programs and the Instituto de Salud Carlos III[Río Hortega CM21/00074 to J.M.P.B.].
文摘Background:Since the introduction of direct-acting antivirals,thousands of chronic hepatitis C patients have been successfully treated.However,vulnerable populations have a higher prevalence of hepatitis C virus(HCV)infection and face barriers that impede their access to antivirals.We carried out an HCV microelimination program focused on vulnerable population groups in Malaga.Methods:People in drug addiction treatment centers and homeless shelters in Malaga who participated in the program between October 2020 and October 2021 were included.After providing participants with educational information on HCV,a dry drop test(DDT)was used to collect blood for subsequent screening for HCV infection.The participants who were diagnosed with HCV infection were scheduled for comprehensive healthcare assessments,including blood tests,ultrasonography,elastography,and the prescription of antivirals,all conducted in a single hospital visit.Sustained viral response(SVR)was analysed 12weeks after end of treatment.Results:Of the 417 persons invited to participate,271(65%)agreed to participate in the program.These participants were screened for HCV infection and 28 of them were diagnosed with HCV infection(10%).These hepatitis C-infected patients had a mean age of 53±9years;86%were males and 93%were or had been drug users.Among 23 patients with HCV infection,HCV genotype 1a predominated(74%).Medical exams showed that 19%(4/21)had advanced fibrosis(F3-4),and 5%(1/21)had portal hypertension.Finally,23 infected patients received treatment with glecaprevir/pibrentasvir or sofosbuvir/velpatasvir and SVR was confirmed in 22 patients(96%).Conclusions:Drug users and homeless people have a higher prevalence of HCV infection than the general population.The microelimination program with educational activity and screening tools achieved a high participation rate,easy healthcare access,and a high rate of SVR despite the SARS-CoV-2 pandemic.
文摘Social vulnerability experienced by collectors of recyclable materials has a strong influence on their understanding and confrontations health. This research aimed to explore the relationship between oral health and perception of subjects in a context of social disadvantage, in order to support concrete alternatives for action on (oral) health conference. This was a qualitative study carried out with representatives of an autonomous community of Brazilian collectors of recyclable materials. Data were collected through interviews and focus group treated with the technique of qualitative analysis. Respondents showed perceptions of etiology and care practices on oral health promoted beliefs and values collectively instituted in a social risk territory. Also, they associate the quality of their oral health and their difficulty of public access to the context of social vulnerability. This study suggests the adoption of protective, educational and interceptive in oral health practice in order to improve and enable the oral health status of this population.
文摘Air pollution has emerged as one of the most pressing public health challenges of the twenty-first century.According to the World Health Organization(WHO),more than 7 million premature deaths occur annually as a direct consequence of exposure to polluted air,which is estimated to affect over 90%of the global population.Air pollution manifests in two principal forms:outdoor pollution,largely driven by industrial emissions,transportation,and energy production,and indoor pollution,often linked to inadequate ventilation,heating systems,and household fuel use.Both forms contribute significantly to a wide range of health outcomes,including chronic respiratory illnesses,cardiovascular complications,strokes,and various types of cancer.Vulnerable groups—such as children,the elderly,and individuals with pre-existing medical conditions—are disproportionately at risk.Efforts to mitigate the harmful effects of air pollution include stricter emission regulations,adoption of clean and renewable technologies,expansion of sustainable public transportation networks,and public education campaigns aimed at raising awareness of health risks and preventive strategies.Uzbekistan is not exempt from these challenges.In particular,the Navoi region,recognized as one of the country’s most industrialized areas,faces heightened exposure to harmful substances released into the atmosphere.A comparative analysis of air quality indicators in Navoi’s urban centers before and after the COVID-19 pandemic revealed a significant post-pandemic rise in pollution levels,linked to economic recovery,industrial activity,and transport flows.These findings provide valuable insights for policymakers and local authorities in developing targeted environmental and public health interventions.
文摘Objectives To explore the relationship between acceptance of illness and quality of life(QOL),and factors associated with acceptance of illness among men who have sex with men(MSM)living with human immunodeficiency virus(HIV).Methods Three hundred and one MSM were recruited from an HIV clinic between August and December 2018.The battery of measurements consisted of the Acceptance of Illness Scale,World Health Organization Quality of Life Questionnaire for HIV brief version,HIV Cognitive Appraisal Scale and a self-designed questionnaire used to collect general information.Pearson correlation test was used to examine the relationship between acceptance of illness and QOL.Univariate and multivariate ordinal logistic regression analyses were used to examine whether the general data(demographic and HIV-related clinical data)and HIV cognitive appraisal were associated with acceptance of illness levels.Results Descriptive analysis showed the acceptance level among MSM living with HIV was moderate(Mean=26.29,SD=5.28).Those with a better acceptance of illness had a better QOL(r=0.69,P<0.01).In the multivariate ordinal logistic regression model,education level,threat appraisals(OR:1.09;95%CI[1.06–1.13]),and controllability appraisals(OR:0.82;95%CI[0.71–0.94])were significantly associated with acceptance of illness.Conclusions Results showed acceptance level was moderate and had a positive correlation with QOL.High level of education,low threat appraisals and high controllability appraisals were related to high illness acceptance.This finding highlights the importance of focusing on HIV-infected MSM with low education and on their perceptions of threat and controllability about HIV-related issues when designing interventions to promote illness acceptance in this vulnerable population.
文摘Nitrous oxide is one of the most commonly used inhalational anesthetic agents used in practice.It is a cost-effective,pleasant,safe,and versatile anesthetic agent with many desirable properties like good quality analgesia,decreased awareness,accelerated induction and recovery from anesthesia,and reduced utilization of other expensive inhalational agents with potential cost savings.The use of nitrous oxide has been questioned by a lot of studies and case reports perceiving its adverse systemic,hematological,immune,and neurologic adverse effects.However,the literature in the recent past has tried to resolve the controversies related to its use.The concerns over an increase in cardiovascular complications and mortality following nitrous oxide use have been negated by recent data.However,its use in certain vulnerable populations like children with cobalamin and folate deficiency or defects in their metabolic pathways remains a cause of concern for its toxic effects.In this narrative review,we aim to discuss the pharmacological properties of nitrous oxide,the potential advantages and drawbacks of the use of nitrous oxide in children,address the neurodevelopmental and other systemic effects,and throw light on the evidence regarding the safety of nitrous oxide use and its current role in pediatric procedural sedation and anesthesia practice.The literature related to its use in the pediatric population for painful procedures and surgeries has been summarized.
文摘The goal of the paper is to conduct an exploratory review and analyses of the dynamics of the pandemic focusing on two themes:pandemic morbidity and vulnerable populations.Method:Review of literature,anecdotal evidence,and reports on the morbidity of COVID-19;including scope of its devastating effects in selected countries.Findings:The devastating effects of the coronavirus are felt across different vulnerable populations.These include the elderly,front line workers,marginalized communities,visible minorities,and more.Inadequate and sometimes conflicting remarks by“experts”have only contributed in exacerbating the confusion in the general population.However,compassion and empathy from different communities have had positive effects on mitigating some of the health outcomes like mental health and other health-related effects of the pandemic.Institutional support needs to be strengthened,especially with regard to individual risks and supply chain coordination:personal protection equipment(PPE),masks,swabs,reagents,etc.The challenge in Africa is especially daunting,because of limited and inadequate financial resources and infrastructure,as confirmed by the health budget allocations as a percentage of their respective GDP(gross domestic product).Discussion:The effects of the COVID-19 are producing unprecedented and catastrophic outcomes in many countries.These have been exacerbated by the level of unpreparedness and inadequate degrees of prevention and intervention strategies.With a few exceptions,the common and current intervention approach is driven by many unknowns including compilation of relevant reliable and compelling data sets.Vulnerable communities continue to suffer most:a situation that is highlighted in this essay as one attempt to remind institutions of their duty to provide appropriate support,including compassion and empathy to these populations.The repercussions of no or inadequate action are numerous,significant,and mind-boggling with unpredictable future outcomes and possible dire consequences.The continuous carnage caused by COVID-19 is a wake-up call reminding all stakeholders(public and private institutions)that once again the inequality infiltrating vulnerable populations needs to be effectively addressed with emphasis on affordability,improved quality of life,and an inclusive long-term strategic plan.Ubiquitous and inadequate supply chain coordination mechanisms have been a major deterrent towards mitigating the effects of this coronavirus pandemic.
基金supported by a grant from the National Natural Science Foundation of China(No.72122001).
文摘Human mpox(formerly known as monkeypox)historically received little attention until its emergence beyond African countries in 2022.As of September 30,2024,a total of 109,699 laboratory-confirmed mpox cases have been reported to the World Health Organization(WHO).[1]It has been more than one year since the WHO announced on May 11,2023 that the mpox epidemic did not constitute a public health emergency of international concern(PHEIC).However,on August 14,2024,the WHO declared that the upsurge of mpox in the Democratic Republic of the Congo(DRC)and an increasing number of countries in Africa constituted a PHEIC once again.Although the WHO has proposed the“Strategic Framework for Enhancing Prevention and Control of Mpox 2024–2027”,controlling and eliminating the mpox from 2024 to 2025,as planned,appears to be a significant challenge.[2]Additionally,various vulnerable populations(such as children,pregnant women,and immunosuppressed individuals),adverse outcomes(such as myocarditis),and hospital management strategies for mpox complicate prevention and control efforts.[3–5]To effectively prevent and control mpox in the public,it is critical to understand the epidemic trends,the threat posed by Clade Ib,and the necessary control measures.
基金the Wellcome Trust(No.209387/Z/17/Z)Funding was also provided by the Cultivation Fund of Beijing Center for Disease Prevention and Control,the Beijing Research Center for Preventive Medicine(No.2020-BJYJ-10)+1 种基金the National Natural Science Foundation of China(No.82003552)the Guangdong Basic and Applied Basic Research Foundation(No.2020A1515011161)。
文摘Increases in ambient temperatures and the frequency of extreme heat events constitute important burdens on global public health.However,evidence on their effects on public health is limited and inconclusive in China.In this study,data on daily deaths recorded in 33 Chinese cities from 2007 to 2013 was used to evaluate the effect of heat on mortality in China.In addition to the definition of a heatwave established by the China Meteorological Administration,we combined four city-specific relative thresholds(90th,92.5th,95th,and 97.5th percentiles)of the daily mean temperature during the study period and three durations of≽2,≽3,and≽4 days,from which 13 heatwave definitions were developed.Then,we estimated the main and added effects of heat at the city level using a quasi-Poisson generalized additive model combined with a distributed lag nonlinear model.Next,the estimates for the effects were pooled at the national level using a multivariable meta-analysis.Subgroup analysis was performed according to sex,age,educational attainment,and spatially stratified heterogeneity.The results showed that the mortality risk increased from 22.3%to 37.1%due to the effects of the different heatwave definitions.The added effects were much lower,with the highest increase of 3.9%(95%CI:1.7%–6.1%)in mortality risk.Females,the elderly,populations with low educational levels,and populations living inland in China were found to be the most vulnerable to the detrimental effects of heat.These findings have important implications for the improvement of early warning systems for heatwaves.
基金This work was funded by the National Key R&D program of China[No.2018YFA0606303].
文摘Somatosensory comfort is mainly determined by the Temperature and Humidity Index(THI)with Wind Efficiency Index(WEI),but this conventional usage of these indicators does not capture the age-related differentials.Here we resolved this gap with a modification of the climatic comfort definition and method in a national standard,denoted as the Relative Climate Sensitive Index(RCSI),which incorporated the age-related vulnerability scores determined through online questionnaires with a scoring method,for each of the age-related and adaptive climatic comfort responses to changes in residence with Beijing-Tianjin-Hebei(BTH)region as an example.First,the result showed that the human comfort of living environment decreased with age in the BTH region,implicating age obviously impacted comfort,and weak adaptability made the elderly the relatively most high-risk group-their suitable region was less than a quarter of the whole study region.Second the adverse effects of persistent hot weather on comfort,indicating global warming as the leading driver of dwindling comfort over recent years.As the warming was more significant in the southeastern part,all these forces combined had there a hotspot,appealing for extra attention.Last this improved evaluation accorded with actual situation to captured high-risk groups with their distributions.
