Burden of road traffic injuries and related risk factors in low and middle-income Pacific Island countries and territories: a systematic review of the scientific literature (TRIP 5)

BACKGROUND: In Pacific Island countries and territories, the burden of road traffic injuries and their attendant risks are considered significant but are poorly quantified. As with other low and middle-income countries, understanding the epidemiology of road traffic injuries in Pacific countries is critical to informing sustainable research and policy initiatives aimed at reducing this burden. METHODS: We undertook a systematic review and critical appraisal of the relevant epidemiological literature between January 1980 and December 2010, using key search strings for incidence and aetiological studies focusing on RTIs in less resourced Pacific countries. RESULTS: Nineteen studies were identified. The majority were descriptive and were unable to provide population-based estimates of the burden of road crash injury, or reliable information on risk factors using well-designed aetiological research methods. All studies were published more than 10 years ago, and all but three reported on data from Papua New Guinea, thereby limiting the generalisability of findings to the current status in the region. Studies undertaken in Papua New Guinea suggested that RTIs were more frequent among young males, with head injuries the most common cause of death or hospital admission. Two thirds of fatalities occurred at the crash site or soon after admission. Most road crash victims were passengers or pedestrians. Factors postulated to influence the risk of RTIs were travel in open-back utility vehicles, utility vehicle overcrowding, and alcohol. CONCLUSIONS: This review suggests that, despite increasing awareness of the importance of addressing road safety among stakeholders in less resourced Pacific Island countries, road traffic injuries have not been a research priority with little relevant current evidence from the region to inform policy. Robust epidemiological research that can assess the magnitude and key determinants of road traffic injuries in these settings is essential to determine context-specific road safety initiatives that are relevant and affordable. Greater attention to harnessing routinely collected data (e.g., hospital information systems and police crash statistics) to inform policy is also required

The Oryza BAC resource: A genus-wide and genome scale tool for exploring rice genome evolution and leveraging useful genetic diversity from wild relatives

Rice was the first crop to have a high-quality reference genome sequence and is now at the forefront of intense functional and evolutionary research for two reasons-its central role in world food security, and its status as a model system for grasses. A thorough characterization of the rice genome cannot be accomplished without a deep understanding of its evolutionary history. The genus Oryza contains two cultivated and 22 wild rice species that represent 10 distinct genome types embedded within a robust phylogeny spanning a ~15 million year time span. The genus contains an untapped reservoir of agriculturally important traits and a historical record of genomic changes (especially those related to domestication, polyploidy, speciation and adaption).The two main objectives of the 'Oryza Map Alignment Project' (OMAP) were to functionally characterize the rice genome from a comparative standpoint and to provide essential tools to leverage the novel genetic diversity from wild relatives for rice improvement. The objective of this review is to summarize our efforts towards developing the most comprehensive genus-wide set of publicly available BAC resources for the genus Oryza, the first of its kind among plants (and perhaps higher eukaryotes), and their applications

NFIRAOS: TMT's facility adaptive optics system

NFIRAOS, the TMT Observatory's initial facility AO system is a multi-conjugate AO system feeding science light from 0.8 to 2.5 microns wavelength to several near-IR client instruments. NFIRAOS has two deformable mirrors optically conjugated to 0 and 11.2 km, and will correct atmospheric turbulence with 50 per cent sky coverage at the galactic pole. An important requirement is to have very low background: the plan is to cool the optics; and one DM is on a tip/tilt stage to reduce surface count. NFIRAOS' real time control uses multiple sodium laser wavefront sensors and up to three IR natural guide star tip/tilt and/or tip/tilt/focus sensors located within each client instrument. Extremely large telescopes are sensitive to errors due to the variability of the sodium layer. To reduce this sensitivity, NFIRAOS uses innovative algorithms coupled with Truth wavefront sensors to monitor a natural star at low bandwidth. It also includes an IR acquisition camera, and a high speed NGS WFS for operation without lasers. For calibration, NFIRAOS includes simulators of both natural stars at infinity and laser guide stars at varying range distance. Because astrometry is an important science programme for NFIRAOS, there is a precision pinhole mask deployable at the input focal plane. This mask is illuminated by a science wavelength and flat-field calibrator that shines light into NFIRAOS' entrance window. We report on recent effort especially including trade studies to reduce field distortion in the science path and to reduce cost and complexity

Danish Evaluation of Your Heart Forecast (DANY):study protocol for a cluster randomised controlled trial on an interactive risk-communication tool aimed at improving adherence of patients with high blood pressure

BACKGROUND: To improve communication of risk messages, they must be communicated in a way that is understandable and relevant to the patient. Communicating risk of cardiovascular disease is a complex and individualised task, since the risk itself is a combination of multiple personal risk factors. Raised blood pressure is but one of these risk factors. In Denmark, only one-third of hypertensive patients are adequately treated, with regards to national clinical guidelines. One reason for this problem is low treatment adherence; tools with documented effects for increasing adherence of patients are limited. Our objective is to evaluate the effect of a personalised, interactive and dynamic risk-assessment and risk-communication tool: 'Your Heart Forecast' (YHF) on blood pressure control, primary non-compliance, health literacy and patient empowerment.METHODS: Cluster-randomised controlled trial in general practice. Effect measures are adherence, blood pressure, lipid levels and empowerment at inclusion and after 6 and 12 months. To identify other benefits or possible adverse effects of the intervention, qualitative interviews will be conducted with a subgroup of patients.DISCUSSION: The investigators will explore effects of Your Heart Forecast on patients' health literacy, adherence, empowerment and blood pressure control. The DANish evaluation of Your heart forecast (DANY) project will be the first to rigorously evaluate effects of YHF in Denmark and to link adherence of hypertensive patients exposed to YHF with the national databases of prescriptions and health services provided.TRIAL REGISTRATION: Clinicaltrials.gov, NCT04058847. Registered on 16 August 2019.</p

Reconciliation of essential process parameters for an enhanced predictability of Arctic stratospheric ozone loss and its climate interactions : (RECONCILE) ; activities and results

The international research project RECONCILE has addressed central questions regarding polar ozone depletion, with the objective to quantify some of the most relevant yet still uncertain physical and chemical processes and thereby improve prognostic modelling capabilities to realistically predict the response of the ozone layer to climate change. This overview paper outlines the scope and the general approach of RECONCILE, and it provides a summary of observations and modelling in 2010 and 2011 that have generated an in many respects unprecedented dataset to study processes in the Arctic winter stratosphere. Principally, it summarises important outcomes of RECONCILE including (i) better constraints and enhanced consistency on the set of parameters governing catalytic ozone destruction cycles, (ii) a better understanding of the role of cold binary aerosols in heterogeneous chlorine activation, (iii) an improved scheme of polar stratospheric cloud (PSC) processes that includes heterogeneous nucleation of nitric acid trihydrate (NAT) and ice on non-volatile background aerosol leading to better model parameterisations with respect to denitrification, and (iv) long transient simulations with a chemistry-climate model (CCM) updated based on the results of RECONCILE that better reproduce past ozone trends in Antarctica and are deemed to produce more reliable predictions of future ozone trends. The process studies and the global simulations conducted in RECONCILE show that in the Arctic, ozone depletion uncertainties in the chemical and microphysical processes are now clearly smaller than the sensitivity to dynamic variability

Age-stratified comparison of heart age and predicted cardiovascular risk in 370 000 primary care patients

Background: Cardiovascular disease (CVD) preventive medications are recommended for patients at high short-term CVD risk. As most younger people with multiple raised CVD risk factors levels have low short-term risk, they could be falsely reassured to take no action. Heart age-the chronological age of a hypothetical person with the same short-term absolute CVD risk as the patient being assessed, but with an 'ideal' risk profile-is a complementary relative CVD risk metric developed to encourage these younger patients to make long-term lifestyle changes. However, clinicians sometimes use heart age to inform medication decisions. We assessed the appropriateness of this practice by comparing heart age and short-term CVD risk.Methods: New Zealand primary care patients are recruited to the PREDICT cohort when their CVD risk is assessed. PREDICT is an ongoing prospective study in one-third of New Zealand general practices, designed to derive CVD risk prediction algorithms. Five-year CVD risk was calculated for 35-74-year-old PREDICT participants using published equations. Heart age was calculated using non-smoking, systolic blood pressure of 120 mm Hg and total cholesterol/high-density lipoprotein ratio of 3.5, as the 'ideal' risk profile. CVD risk and heart age gaps (difference between chronological age and heart age) were compared.Results: Among 371 676 PREDICT participants, 5-year CVD risk increased with age, approximately doubling every 10 years, whereas heart age gaps decreased with increasing age, approximately halving between 35 and 44-year olds and 65-74-year olds. There were 5-40-year heart age gap differences between groups with similar 5-year CVD risks, but different ages.Conclusion: Short-term CVD risk and heart age are not interchangeable risk metrics. Short-term risk increases with increasing age whereas heart age gaps generally decline, with major differences between younger and older people with similar short-term risk. If heart age is used to inform medication decisions rather than encourage long-term lifestyle changes, older people at high short-term risk could be undertreated and younger people at low short-term risk could be unnecessarily medicated.</p

Risk thresholds for alcohol consumption : combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

Background Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease. Methods We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose-response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12.5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5.6 years [5th-95th percentile 1.04-13.5]) from 71 011 participants from 37 studies. Findings In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5.4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality risk around or below 100 g per week. Alcohol consumption was roughly linearly associated with a higher risk of stroke (HR per 100 g per week higher consumption 1.14, 95% CI, 1.10-1.17), coronary disease excluding myocardial infarction (1.06, 1.00-1.11), heart failure (1.09, 1.03-1.15), fatal hypertensive disease (1.24, 1.15-1.33); and fatal aortic aneurysm (1.15, 1.03-1.28). By contrast, increased alcohol consumption was loglinearly associated with a lower risk of myocardial infarction (HR 0.94, 0.91-0.97). In comparison to those who reported drinking >0-100-200-350 g per week had lower life expectancy at age 40 years of approximately 6 months, 1-2 years, or 4-5 years, respectively. Interpretation In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data support limits for alcohol consumption that are lower than those recommended in most current guidelines. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

Exceptional lability of a genomic complex in rice and its close relatives revealed by interspecific and intraspecific comparison and population analysis

<p>Abstract</p> <p>Background</p> <p>Extensive DNA rearrangement of genic colinearity, as revealed by comparison of orthologous genomic regions, has been shown to be a general concept describing evolutionary dynamics of plant genomes. However, the nature, timing, lineages and adaptation of local genomic rearrangement in closely related species (<it>e.g</it>., within a genus) and haplotype variation of genomic rearrangement within populations have not been well documented.</p> <p>Results</p> <p>We previously identified a hotspot for genic rearrangement and transposon accumulation in the <it>Orp </it>region of Asian rice (<it>Oryza sativa</it>, AA) by comparison with its orthologous region in sorghum. Here, we report the comparative analysis of this region with its orthologous regions in the wild progenitor species (<it>O. nivara</it>, AA) of Asian rice and African rice (<it>O. glaberrima</it>) using the BB genome <it>Oryza </it>species (<it>O. punctata</it>) as an outgroup, and investigation of transposon insertion sites and a segmental inversion event in the AA genomes at the population level. We found that <it>Orp </it>region was primarily and recently expanded in the Asian rice species <it>O. sativa </it>and <it>O. nivara</it>. LTR-retrotransposons shared by the three AA-genomic regions have been fixed in all the 94 varieties that represent different populations of the AA-genome species/subspecies, indicating their adaptive role in genome differentiation. However, LTR-retrotransposons unique to either <it>O. nivara </it>or <it>O. sativa </it>regions exhibited dramatic haplotype variation regarding their presence or absence between or within populations/subpopulations.</p> <p>Conclusions</p> <p>The LTR-retrotransposon insertion hotspot in the <it>Orp </it>region was formed recently, independently and concurrently in different AA-genome species, and that the genic rearrangements detected in different species appear to be differentially triggered by transposable elements. This region is located near the end of the short arm of chromosome 8 and contains a high proportion of LTR-retrotransposons similar to observed in the centromeric region of this same chromosome, and thus may represent a genomic region that has recently switched from euchromatic to heterochromatic states. The haplotype variation of LTR-retrotransposon insertions within this region reveals substantial admixture among various subpopulations as established by molecular markers at the whole genome level, and can be used to develop retrotransposon junction markers for simple and rapid classification of <it>O. sativa </it>germplasm.</p