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  • 1
    Publication Date: 2018-03-09
    Description: Background Socioeconomic status (SES) has long been conjectured to be associated with the incidence and progression of chronic kidney disease (CKD), but few studies have examined this quantitatively. This meta-analysis aims to fill this gap. Methods A systematic literature review was performed using Medline and EMBASE to identify observational studies on associations between SES and incidence and progression of CKD, published between 1974 and March 2017. Individual results were meta-analysed using a random effects model, in line with Meta-analysis of Observational Studies in Epidemiology guidelines. Results In total, 43 articles met our inclusion criteria. CKD prevalence was associated with several indicators of SES, particularly lower income (OR 1.34, 95% CI (1.18 to 1.53), P〈0.001; I 2 =73.0%, P=0.05); lower education (OR 1.21, 95% CI (1.11 to 1.32), P〈0.001; I 2 =45.20%, P=0.034); and lower combined SES (OR 2.18, 95% CI (1.64 to 2.89), P〈0.001; I 2 =0.0%, P=0.326). Lower levels of income, occupation and combined SES were also significantly associated with progression to end-stage renal disease (risk ratio (RR) 1.24, 95% CI (1.12 to 1.37), P〈0.001; I 2 =66.6%, P=0.006; RR 1.05, 95% CI (1.01 to 1.09), P=0.012; I 2 =0.0%, P=0.796; and RR 1.39, 95% CI (1.09 to 1.79), P=0.009; I 2 =74.2%, P=0.009). Subgroup analyses generally confirmed these results, except in a few cases, such as an inverse association related to particular socioeconomic backgrounds and where results were adjusted by more disease-related risk factors. Conclusion Lower income was most closely associated with prevalence and progression of CKD, and lower education was significantly associated with its prevalence. Evidence for other indicators was inconclusive.
    Keywords: Editor's choice
    Print ISSN: 0143-005X
    Electronic ISSN: 1470-2738
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 2
    Publication Date: 2018-02-14
    Description: Exchange of gene segments through reassortment is a major feature of influenza A virus evolution and frequently contributes to the emergence of novel epidemic, pandemic, and zoonotic strains. It has long been evident that viral diversification through reassortment is constrained by genetic incompatibility between divergent parental viruses. In contrast, the role of virus-extrinsic factors in determining the likelihood of reassortment has remained unclear. To evaluate the impact of such factors in the absence of confounding effects of segment mismatch, we previously reported an approach in which reassortment between wild-type (wt) and genetically tagged variant (var) viruses of the same strain is measured. Here, using wt/var systems in the A/Netherlands/602/2009 (pH1N1) and A/Panama/2007/99 (H3N2) strain backgrounds, we tested whether inoculation of parental viruses into distinct sites within the respiratory tract limits their reassortment. Using a ferret ( Mustella putorius furo ) model, either matched parental viruses were coinoculated intranasally or one virus was instilled intranasally whereas the second was instilled intratracheally. Dual intranasal inoculation resulted in robust reassortment for wt/var viruses of both strain backgrounds. In contrast, when infections were initiated simultaneously at distinct sites, strong compartmentalization of viral replication was observed and minimal reassortment was detected. The observed lack of viral spread between upper and lower respiratory tract tissues may be attributable to localized exclusion of superinfection within the host, mediated by innate immune responses. Our findings indicate that dual infections in nature are more likely to result in reassortment if viruses are seeded into similar anatomical locations and have matched tissue tropisms. IMPORTANCE Genetic exchange between influenza A viruses (IAVs) through reassortment can facilitate the emergence of antigenically drifted seasonal strains and plays a prominent role in the development of pandemics. Typical human influenza infections are concentrated in the upper respiratory tract; however, lower respiratory tract (LRT) infection is an important feature of severe cases, which are more common in the very young, the elderly, and individuals with underlying conditions. In addition to host factors, viral characteristics and mode of transmission can also increase the likelihood of LRT infection: certain zoonotic IAVs are thought to favor the LRT, and transmission via small droplets allows direct seeding into lower respiratory tract tissues. To gauge the likelihood of reassortment in coinfected hosts, we assessed the extent to which initiation of infection at distinct respiratory tract sites impacts reassortment frequency. Our results reveal that spatially distinct inoculations result in anatomical compartmentalization of infection, which in turn strongly limits reassortment.
    Print ISSN: 0022-538X
    Electronic ISSN: 1098-5514
    Topics: Medicine
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  • 3
    Publication Date: 2016-03-18
    Description: Knowledge of the contribution that individual countries have made to global radiative forcing is important to the implementation of the agreement on "common but differentiated responsibilities" reached by the United Nations Framework Convention on Climate Change. Over the past three decades, China has experienced rapid economic development, accompanied by increased emission of greenhouse gases, ozone precursors and aerosols, but the magnitude of the associated radiative forcing has remained unclear. Here we use a global coupled biogeochemistry-climate model and a chemistry and transport model to quantify China's present-day contribution to global radiative forcing due to well-mixed greenhouse gases, short-lived atmospheric climate forcers and land-use-induced regional surface albedo changes. We find that China contributes 10% +/- 4% of the current global radiative forcing. China's relative contribution to the positive (warming) component of global radiative forcing, mainly induced by well-mixed greenhouse gases and black carbon aerosols, is 12% +/- 2%. Its relative contribution to the negative (cooling) component is 15% +/- 6%, dominated by the effect of sulfate and nitrate aerosols. China's strongest contributions are 0.16 +/- 0.02 watts per square metre for CO2 from fossil fuel burning, 0.13 +/- 0.05 watts per square metre for CH4, -0.11 +/- 0.05 watts per square metre for sulfate aerosols, and 0.09 +/- 0.06 watts per square metre for black carbon aerosols. China's eventual goal of improving air quality will result in changes in radiative forcing in the coming years: a reduction of sulfur dioxide emissions would drive a faster future warming, unless offset by larger reductions of radiative forcing from well-mixed greenhouse gases and black carbon.〈br /〉〈span class="detail_caption"〉Notes: 〈/span〉Li, Bengang -- Gasser, Thomas -- Ciais, Philippe -- Piao, Shilong -- Tao, Shu -- Balkanski, Yves -- Hauglustaine, Didier -- Boisier, Juan-Pablo -- Chen, Zhuo -- Huang, Mengtian -- Li, Laurent Zhaoxin -- Li, Yue -- Liu, Hongyan -- Liu, Junfeng -- Peng, Shushi -- Shen, Zehao -- Sun, Zhenzhong -- Wang, Rong -- Wang, Tao -- Yin, Guodong -- Yin, Yi -- Zeng, Hui -- Zeng, Zhenzhong -- Zhou, Feng -- England -- Nature. 2016 Mar 17;531(7594):357-61. doi: 10.1038/nature17165.〈br /〉〈span class="detail_caption"〉Author address: 〈/span〉Sino-French Institute for Earth System Science, Laboratory for Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China. ; Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, 210023, China. ; Laboratoire des Sciences du Climat et de l'Environnement, CEA-CNRS-UVSQ, 91191 Gif-sur-Yvette, France. ; Centre International de Recherche en Environnement et Developpement, CNRS-PontsParisTech-EHESS-AgroParisTech-CIRAD, 94736 Nogent-sur-Marne, France. ; Key Laboratory of Alpine Ecology and Biodiversity, Institute of Tibetan Plateau Research, Center for Excellence in Tibetan Earth Science, Chinese Academy of Sciences, Beijing 100085, China. ; Laboratoire de Meteorologie Dynamique, CNRS, Universite Pierre et Marie Curie-Paris 6, 75252 Paris, France.〈br /〉〈span class="detail_caption"〉Record origin:〈/span〉 〈a href="" target="_blank"〉PubMed〈/a〉
    Keywords: Aerosols/analysis/chemistry ; Air Pollution/*analysis ; Atmosphere/*chemistry ; Carbon Dioxide/analysis ; China ; Fossil Fuels ; *Greenhouse Effect ; Methane/analysis ; Soot/analysis ; Sulfates/analysis ; Sulfur Dioxide/analysis ; Uncertainty
    Print ISSN: 0028-0836
    Electronic ISSN: 1476-4687
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
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