Suchergebnisse

An ongoing epidemic of chronic kidney disease of uncertain etiology (CKDu) afflicts large parts of Central America and is hypothesized to be linked to heat stress at work. Mortality rates from CKDu appear to have increased dramatically since the 1970s. To explore this relationship, we assessed trends in maximum and minimum temperatures during harvest months between 1973 and 2014 as well as in the number of days during the harvest season for which the maximum temperature surpassed 35 °C. Data were collected at a weather station at a Nicaraguan sugar company where large numbers of workers have been affected by CKDu. Monthly averages of the daily maximum temperatures between 1996 and 2014 were also compared to concurrent weather data from eight Automated Surface Observing System Network weather stations across Nicaragua. Our objectives were to assess changes in temperature across harvest seasons, estimate the number of days that workers were at risk of heat-related illness and compare daily maximum temperatures across various sites in Nicaragua. The monthly average daily maximum temperature during the harvest season increased by 0.7 °C per decade between 1973 and 1990. The number of days per harvest season with a maximum temperature over 35 °C increased by approximately five days per year between 1974 and 1990, from 32 days to 114 days. Between 1991 and 2013, the number of harvest days with a maximum temperature over 35 °C decreased by two days per year, and the monthly average daily maximum temperature decreased by 0.3 °C per decade. Comparisons with weather stations across Nicaragua demonstrate that this company is located in one of the consistently hottest regions of the country. ; MKS and DRB were supported by a grant from the National Institute of Environmental Health Sciences of the National Institutes of Health (NIH/NIEHS), award number R01 ES027584. ZEP was supported by NIH/NIEHS award numbers T32 ES014562 and F31 ES030974. JB gratefully acknowledges funding from the European Union's Horizon 2020 research ...

While Digital contact tracing (DCT) has been argued to be a valuable complement to manual tracing in the containment of COVID-19, no empirical evidence of its effectiveness is available to date. Here, we report the results of a 4-week population-based controlled experiment that took place in La Gomera (Canary Islands, Spain) between June and July 2020, where we assessed the epidemiological impact of the Spanish DCT app Radar Covid. After a substantial communication campaign, we estimate that at least 33% of the population adopted the technology and further showed relatively high adherence and compliance as well as a quick turnaround time. The app detects about 6.3 close-contacts per primary simulated infection, a significant percentage being contacts with strangers, although the spontaneous follow-up rate of these notified cases is low. Overall, these results provide experimental evidence of the potential usefulness of DCT during an epidemic outbreak in a real population. ; This work was funded by the Secretary of State of Digitalisation and Artificial Intelligence, Ministry of Economic Affairs and Digital Transformation, Government of Spain. We thank Government of Spain, Gobierno de Canarias, INDRA, CCN, Fundación ONCE and the EU e-health Network for continuous support. We also thank Elisa Molino, Isabel Zanforlin, Alberto Ricci (Apple) and María Álvarez, Julián Toledo, Marcel Pinto (Google), Jorge García Vidal, Fernando Cucchietti, Josep Martorell and Mateo Valero (BSC). This work was made possible thanks to the incredible collaboration and engagement of the citizens of San Sebastián de la Gomera, Canary Islands (Spain). We also thank the DP3T community for helpful discussions. AA acknowledges financial support from Spanish MINECO (grant PGC2018-094754-B-C21), Generalitat de Catalunya (grant No. 2017SGR-896), and the James S. McDonnell Foundation (grant #220020325). LL acknowledges funding by EPSRC EC Fellowship EP/P01660X/1 and a QMUL COVID-19 Rapid Response Grant. JSM acknowledges funding by a Starting Grant from the European Research Council (grant #759903). ; Peer reviewed