Leonardnolan5411

Background Substantial limitations have been imposed on passenger air travel to reduce transmission of SARS-CoV-2 between regions and countries. However, as case numbers decrease, air travel will gradually resume. We considered a future scenario in which case numbers are low and air travel returns to normal. Under that scenario, there will be a risk of outbreaks in locations worldwide due to imported cases. We estimated the risk of different locations acting as sources of future COVID-19 outbreaks elsewhere. Methods We use modelled global air travel data and population density estimates from locations worldwide to analyse the risk that 1364 airports are sources of future COVID-19 outbreaks. We use a probabilistic, branching-process based approach that considers the volume of air travelers between airports and the reproduction number at each location, accounting for local population density. see more Results Under the scenario we model, we identify airports in East Asia as having the highest risk of acting as sources of future outbreaks. Moreover, we investigate the locations most likely to cause outbreaks due to air travel in regions that are large and potentially vulnerable to outbreaks India, Brazil and Africa. We find that outbreaks in India and Brazil are most likely to be seeded by individuals travelling from within those regions. We find that this is also true for less vulnerable regions, such as the United States, Europe, and China. However, outbreaks in Africa due to imported cases are instead most likely to be initiated by passengers travelling from outside the continent. Conclusions Variation in flight volumes and destination population densities create a non-uniform distribution of the risk that different airports pose of acting as the source of an outbreak. Accurate quantification of the spatial distribution of outbreak risk can therefore facilitate optimal allocation of resources for effective targeting of public health interventions.Background Tobacco smoking is a leading public health concern and is the most preventable cause of morbidity and mortality worldwide. Sportspeople are no exception and those who smoke are predisposed to the same hazardous health effects as the general public, in addition to the potential effects it may have on their sporting performance. Aims We aimed to ascertain the prevalence of tobacco consumption in a sporting population. We also endeavoured to quantify the use of E-cigarettes and assess exposure to passive smoking. Design Observational study. Methods A web-based e-questionnaire was distributed to participants from various sports across Ireland between November 2017 and January 2018, and data was analysed using SPSS. Results 546 sportspeople completed the survey with more than twice as many male respondents. 16% of participants were current smokers, with males significantly more likely to smoke (p less then 0.001). 26% of Rugby players were current smokers which was significantly higher compared to other sports (p less then 0.01). 10% of all participants were exposed to second-hand smoke for more than 1 hour per day. 2% of all participants were current users of E-cigarettes. Conclusions The prevalence of smoking in our study population was higher than other literature reports. Further studies are essential to evaluate the potential negative effects this may be having on sporting performance, career progression and indeed injury occurrence/rehabilitation. It is imperative to address the matter of smoking in athletes, not only for public health concerns but also considering they are important role models in our society.Background The adjuvanted recombinant zoster vaccine (RZV) is highly immunogenic and efficacious in adults ≥50 years (Y) of age (YOA). We evaluated (1) long-term immunogenicity of an initial 2-dose RZV schedule by following-up adults vaccinated at ≥60 YOA and by modeling, and (2) immunogenicity of 2 additional doses administered 10Y post-initial vaccination. Methods Persistence of humoral and cell-mediated immune (CMI) responses to 2 initial RZV doses was assessed through 10Y post-initial vaccination, and modeled through 20Y using a Piecewise, Power law and Fraser model. Immunogenicity and safety of 2 additional RZV doses were also evaluated (NCT02735915). Results Seventy adults were enrolled. Ten years post-initial vaccination, humoral and CMI responses were ~6-fold and ~3.5-fold above pre-initial vaccination levels, respectively. Predicted immune persistence through 20Y post-initial vaccination was similar across the 3 models. Sixty-two participants (82.6±4.4 YOA) received at least 1 additional RZV dose. Strong anamnestic humoral and CMI responses were elicited by 1 additional dose, without further increases after a second additional dose. Conclusions Immune responses to an initial 2-dose RZV course persisted for many years in older adults. Strong anamnestic immune responses can be induced by additional dosing 10Y after the initial 2-dose course.Background Transmission of M. tuberculosis in healthcare settings is a preventable driver of the global tuberculosis epidemic. We aimed to assess the evidence for infection control interventions, including cough etiquette, engineering and personal respiratory protection measures, to prevent transmission of M. tuberculosis in healthcare settings. Methods Three independent systematic reviews were performed using six databases and clinical trials websites. Randomized trials, cohort studies, before-after studies and case-control studies were included. Searches were performed for controlled studies evaluating respiratory hygiene, engineering and personal respiratory protection measures. Outcome measures included the incidence of tuberculosis infection and disease. Studies involving transmission to either humans or animals were included. Results valuation of respiratory hygiene and cough etiquette interventions identified four human studies, with 22,855 participants, and one guinea pig study. Studies in humans evaluated the effects of multiple concurrent interventions. Patient use of surgical masks reduced infection by 14.8%, and tuberculosis disease was reduced by between 0.5% and 28.9%. Engineering and environmental interventions were evaluated in 10 studies of humans, including 31,776 human participants, and two guinea pig studies. Mechanical ventilation was associated with between 2.9% and 14% less infection. Nine studies of personal respiratory protection were included, including 33,913 participants. Infection was reduced by between 0% and 14.8% in studies where particulate respirators were used. The quality of included studies was assessed as low. Conclusion Respiratory hygiene, engineering and environmental infection controls and personal respiratory protection interventions were associated with reduced transmission of M. tuberculosis and reduced TB disease in healthcare settings.