SARS in Three Categories of Hospital Workers, Hong Kong
Hong Kong, nosocomial infection, Hospital infection, Chinese, SARS, Incidence study
We analyzed attack rates for severe acute respiratory syndrome (SARS) in three categories of hospital workers (nurses, nonmedical support staff, and other technical or medical staff) in all public hospitals in Hong Kong that had admitted SARS patients. Of 16 such hospitals, 14 had cases. The overall attack rate was 1.20%. Nonmedical support staff had the highest attack rate (2.73%). The odds ratios of group nonmedical support staff versus those of nurses and of nonmedical support staff versus other technical or medical staff were 2.30 (p < 0.001) and 9.78 (p < 0.001), respectively. The number of affected staff and attack rates were significantly correlated with the number of SARS patients admitted (r = 0.914 and 0.686, respectively). Affected patients were concentrated in three hospitals and in the earlier phase of the epidemic. Cleaning and clerical staff on hospital wards were at a much higher risk.
Joseph T. F. Lau, Carmen Fong, P. C. Leung, Xilin Yang, H.Y. Tsui, Eliza Wong, Louis Chan
Centers for Disease Control and Prevention
Infectious and parasitic diseases, Medicine
SARS Transmission, Risk Factors, and Prevention in Hong Kong
SARS, source, Transmission, Hong Kong, Chinese
We analyzed information obtained from 1,192 patients with probable severe acute respiratory syndrome (SARS) reported in Hong Kong. Among them, 26.6% were hospital workers, 16.1% were household members of SARS patients and had probable secondary infections, 14.3% were Amoy Garden residents, 4.9% were inpatients, and 20.1% were contacts of SARS patients who were not family members. The remaining 347 case-patients (29.1%) did not have “known” sources of infection. Excluding those
Joseph T. F. Lau, Hi Yi Tsui, Mason Lau, Xilin Yang
SARS Transmission among Hospital Workers in Hong Kong
SARS, hospital worker, nosocomial infections, breakthrough transmission, Hong Kong, research
Despite infection control measures, breakthrough transmission of severe acute respiratory syndrome (SARS) occurred for many hospital workers in Hong Kong. We conducted a case-control study of 72 hospital workers with SARS and 144 matched controls. Inconsistent use of goggles, gowns, gloves, and caps was associated with a higher risk for SARS infection (unadjusted odds ratio 2.42 to 20.54, p < 0.05). The likelihood of SARS infection was strongly associated with the amount of personal protection equipment perceived to be inadequate, having
Joseph T. F. Lau, Kitty S. Fung, Tze-wai Wong, Jean H. Kim, Eric Wong, Sydney Chung, Deborah Ho, Louis Y. Chan, S.F. Lui, Augustine Cheng
Probable Secondary Infections in Households of SARS Patients in Hong Kong
SARS, secondary infections, Epidemiology, Hong Kong
Although severe acute respiratory syndrome (SARS) is highly infectious in clinical settings, SARS has not been well examined in household settings. The household and household member attack rates were calculated for 1,214 SARS case-patients and their household members, stratified by two phases of the epidemic. A case-control analysis identified risk factors for secondary infection. Secondary infection occurred in 14.9% (22.1% versus 11% in earlier and later phases) of all households and 8% (11.7% versus 5.9% in the earlier and later phases) of all household members. Healthcare workers’ households were less likely to be affected. Risk factors from the multivariate analysis included at-home duration before hospitalization, hospital visitation to the SARS patient (and mask use during the visit), and frequency of close contact. SARS transmission at the household level was not negligible in Hong Kong. Transmission rates may be greatly reduced with precautionary measures taken by household members of SARS patients.
Joseph T. F. Lau, Mason Lau, Jean H. Kim, Eric Wong, Hi Yi Tsui, Thomas Tsang, Tze-wai Wong
Keywords: Hong Kong, SARS, community responses, perceptions, Mental health, Chinese
To understand different aspects of community responses related to severe acute respiratory syndrome (SARS), 2 population-based, random telephone surveys were conducted in June 2003 and January 2004 in Hong Kong. More than 70% of respondents would avoid visiting hospitals or mainland China to avoid contracting SARS. Most respondents believed that SARS could be transmitted through droplets, fomites, sewage, and animals. More than 90% believed that public health measures were efficacious means of prevention; 40.4% believed that SARS would resurge in Hong Kong; and ≈70% would then wear masks in public places. High percentages of respondents felt helpless, horrified, and apprehensive because of SARS. Approximately 16% showed signs of posttraumatic symptoms, and ≈40% perceived increased stress in family or work settings. The general public in Hong Kong has been very vigilant about SARS but needs to be more psychologically prepared to face a resurgence of the epidemic.
Joseph T. F. Lau, Xilin Yang, Ellie Pang, H.Y. Tsui, Eric Wong, Yun Kwok Wing
Mutations in the SARS-CoV-2 spike protein modulate the virus affinity to the human ACE2 receptor, an in silico analysis.
covid-19, Spike, SARS-CoV-2, variants, B.1.1.7
The increasing number of SARS-CoV-2 variants associated with highly transmissible phenotypes is a health-public concern in the current pandemic scenario. Herein, we developed a comprehensive in silico analysis of the changes occurring upon mutations in the viral spike. We focused on mutants located in the receptor-binding domain of the viral spike protein and analyzed whether these mutants modulate the interaction with the human host receptor angiotensin-converting enzyme II (ACE2). Thirty-two highly prevalent mutants were retrieved from the GISAID database, and their structural models were built using the SWISS-Model server. The stabilization effect for each mutation was assessed by the DUET and DeepDGG software. By applying molecular docking using both Z-Dock and Haddock software we found that multiple mutations, including A475V, V455E, V445L, and V445I, resulted in the higher binding free energy as compared to the wild type (WT) spike protein, thus had a destabilizing effect on the binding to ACE2. On the other hand, several mutants, including the most prevalent N501Y and B.1.1.7 variants, as well as the K444R, L455F, Q493R, and Y505W variants exhibited lower binding free energy as compared to the WT spike. These mutants showed an increased number of electrostatic interactions with ACE2 than the WT spike protein, and they changed the interaction pattern of the neighboring residues. Together, the results presented in this study contribute to a better understanding of the changes in the interaction between SARS-CoV-2 and the human host ACE2 receptor associated with point mutations in the viral spike protein.
Joseph Thomas Ortega, Flor Helene Pujol, Beata Jastrzebska, Hector R Rangel
overdose, respiratory depression, potassium channels, Carotid body, Respiratory stimulant
The interest in substances that stimulate respiration has waxed and waned throughout the years, intensifying following the introduction of a new class of drugs that causes respiratory depression, and diminishing when antidotes or better drug alternatives are found. Examples include the opioids--deaths increasing during overprescribing, diminishing with wider availability of the opioid receptor antagonist naloxone, increasing again during COVID-19; the barbiturates--until largely supplanted by the benzodiazepines; propofol; and other central nervous system depressants. Unfortunately, two new troubling phenomena force a reconsideration of the status-quo: (1) overdoses due to highly potent opioids such as fentanyl, and even more-potent licit and illicit fentanyl analogs, and (2) overdose due to polysubstance use (the combination of an opioid plus one or more non-opioid drug, such as a benzodiazepine, sedating antidepressant, skeletal muscle relaxant, or various other agents). Since these now represent the majority of cases, new solutions are again needed. An interest in respiratory stimulants has been revived. This interest can be informed by a short review of the history of this interesting class of medications. We present a short history of the trajectory of advances toward more selective and safer respiratory stimulants.
Joseph V Pergolizzi, John F Peppin, Jeffrey Fudin, Tricia A Meyer, Robert B Raffa
The fiscal value of human lives lost from coronavirus disease (COVID-19) in China
Coronavirus disease, Fiscal value of human lives, Non-health gross domestic product
Abstract Objective According to the WHO coronavirus disease (COVID-19) situation report 35, as of 24th February 2020, there was a total of 77,262 confirmed COVID-19 cases in China. That included 2595 deaths. The specific objective of this study was to estimate the fiscal value of human lives lost due to COVID-19 in China as of 24th February 2020. Results The deaths from COVID-19 had a discounted (at 3%) total fiscal value of Int$ 924,346,795 in China. Out of which, 63.2% was borne by people aged 25–49 years, 27.8% by people aged 50–64 years, and 9.0% by people aged 65 years and above. The average fiscal value per death was Int$ 356,203. Re-estimation of the economic model alternately with 5% and 10 discount rates led to a reduction in the expected total fiscal value by 21.3% and 50.4%, respectively. Furthermore, the re-estimation of the economic model using the world’s highest average life expectancy of 87.1 years (which is that of Japanese females), instead of the national life expectancy of 76.4 years, increased the total fiscal value by Int$ 229,456,430 (24.8%).
Joses M. Kirigia, Rosenabi Deborah Karimi Muthuri
Biology (General), Science (General), Medicine
Entre deux mers, d’un savoir à l’autre, Francisco de Quevedo (1580-1645) : aspects de l’imaginaire espagnol au temps des Habsbourg
altérité, Education, esclavage, Habsbourg, Histoire vs. légende noire, Savoirs
De 1580 à 1652, le Roi des Espagnes, de la Méditerranée à l’Océan et au-delà, règne sur le territoire le plus étendu de son histoire. Ses royaumes, réunis sous la seule autorité du roi de Castille, semblent avoir retrouvé l’extension de la Province conquise par Rome, augmentée des terres nouvellement découvertes. Sa puissance, à la fois admirée et détestée, va donner naissance en Europe, et en premier lieu aux Pays-Bas, à ce qu’il convient d’appeler la légende noire. Francisco de Quevedo (1580-1645), écrivain de génie, s’emploie dès 1609 à défendre l’Espagne contre cette légende : grâce à sa prodigieuse érudition et à son savoir de philosophe, d’historien, de philologue, il entend prouver la supériorité de sa patrie sur les autres, pour la splendeur de son passé, les richesses de sa terre, la valeur de ses enfants, la prééminence de ses écrivains, la suprématie de sa langue. De ses démonstrations se dégage, fondée sur les savoirs qu’il partage avec les élites de son temps, la perception qu’il a de l’Espagne et des Espagnols, de lui-même par conséquent, ainsi que celle qu’il a de l’autre, Allemand ou Flamand, mais aussi Indien, Africain, ou Juif.
French literature - Italian literature - Spanish literature - Portuguese literature, Literature (General)
Ramon Margalef, de lo posible y lo razonable
Filosofía natural, Ramon Margalef, antiespecismo, ecología, Ética ecológica
El científico que se presenta aquí ha realizado contribuciones muy significativas al desarrollo de la teoría ecológica a nivel internacional. Pero su pensamiento descansa, por un lado, sobre un evidente cañamazo filosófico y, por otro, se extiende hasta alcanzar campos como la política y la ética. Se tratará, pues, de señalar tanto su itinerario al través de la filosofía natural, como de la medida en que su legado afecta a cuestiones ambientales muy discutidas en distintos ámbitos. Para la conclusión, se confrontan sus propuestas con algunas corrientes ‘intervencionistas’ que despuntan en el actual paraguas de la ética ecológica.
History of scholarship and learning. The humanities, Philosophy (General)