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Improving visual outcomes in patients with rare paediatric eye diseases.

Rare paediatric eye diseases (RPEDs) threaten both vision and life. Recently, rare diseases were recognised as a global public health agenda, with children specified as a priority in the World Health Organization's VISION 2020 against avoidable visual loss. We conducted a review through a query of online databases (PubMed, Embase and Cochrane Library). Articles related to RPEDs were selected based on relevance by 2 authors, with any disagreements adjudicated by the third author. We synthesise the current state of knowledge regarding RPEDs, barriers to their care, and recommendations for the future. RPEDs often result in significant visual loss, profoundly impacting the way children comprehend and participate in the world. These diseases may also reduce life expectancy and even be life-threatening. Barriers to the care of RPEDs include an unclear definition of "rare diseases", missed or delayed diagnosis, inadequate knowledge and expertise in management, and challenging research environments. Our findings provide an update on the diagnosis and management of RPEDs, which is of relevance to ophthalmologists, paediatricians, healthcare policymakers and social workers. We propose supportive policies and adequate resource allocation to these diseases, comprehensive and patient-centred care, alongside improved education and training, enhanced research capabilities and continued collaboration across institutions.

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Carrying capacity and cumulative effects management: A case study using bighorn sheep

AbstractSuccessful cumulative effects management is fundamental for conservation policy and practice. We investigated the application of a carrying capacity (CC) model as a cumulative effects management tool for bighorn sheep (Ovis canadensis canadensis) in British Columbia, Canada, where CC is defined as the natural limit of a sustainable population that is set by the availability of resources in the environment. We estimated winter CC using forage availability across winter ranges, weighted by relative selection by sheep and a safe use factor, and divided by overwinter forage requirements to determine how many sheep the landscape can support. We explored application of our model to decision‐making about new industrial projects or conservation activities in a cumulative effects context. Cumulative effects include both positive and negative contributions to animal populations and we simulated the potential positive outcomes of burning to increase bighorn sheep carrying capacity in our study area. Our results show that carefully planned conservation actions could generate a 5% increase in CC (i.e., from 493 to 519 sheep). Robust tools and scientific techniques that are capable of quantifying multiple impacts and conservation actions and that consider spatial processes over long temporal scales, such as the CC model presented, should be applied to help inform decisions about how to better manage cumulative habitat change and achieve conservation objectives.

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Longitudinal adaptive immune profiling of vaccinated children reveals correlates of protection against symptomatic SARS-CoV-2 infection

Abstract The development of evidence-based COVID-19 vaccination policies for new birth cohorts is hindered by the lack of systematic examination of the protective capacity of elements of adaptive immunity besides neutralising antibodies. To address this knowledge gap, we conducted a longitudinal cohort study of healthy 5- to 12-year-olds vaccinated with BNT162b2. We serially measured binding and neutralising antibody titres, Spike (S)-specific memory B cell (MBC) and S-reactive T cell responses over 1 year; SARS-CoV-2 infections were ascertained using antigen rapid tests, and serological and cellular responses against nucleocapsid. We found that children mounted antibody, MBC and T cell responses after 2 doses, with continual expansion of SARS-CoV-2 variant neutralising capacity up to 1 year in the absence of wild-type infection. A booster (third) dose only improved neutralising antibody titres without impacting MBC and T cell responses. Hybrid immunity was greater in those infected after 2 vaccine doses than those infected before dose 2. Binding IgG titres, MBC and T cell responses were predictive of protection against symptomatic infection prior to attaining hybrid immunity; neutralising antibody titres only correlated with protection after hybrid immunity. The stable MBC and T cell responses over time suggest sustained protection against symptomatic SARS-CoV-2 infection, even when antibody levels wane.

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Review of ethics for occupational hygiene hazard monitoring surveys using sensors

This review is about the ethical use of sensors to monitor occupational exposure to hazards. It considers whether the same or different, ethical measures apply to using sensors, compared to conventional hazard monitoring surveys. To undertake the review, subject experts developed a research question, identified suitable search terms, and set the scope of these searches. Candidate research papers dating from 2000 to mid-2022 that met inclusion criteria were identified and reviewed by each author. Ethical concerns were identified by the authors of studies in which sensors were used to monitor employee health and well-being, but most of the studies that used them to monitor employee exposure to hazards focused on the technical aspects of their deployment. These ethical concerns included questions about employee rights and privacy, the anonymity of the data collected with sensors, and how the security of this data is managed. The review considers ethical standards and codes of practice for occupational hygiene work and the ethical risks when sensors are used to gather data. Sensors may provide insight into occupational exposure to hazards, but their use is not always adequately explained to employees by those managing this monitoring work. The ethical concerns identified were relevant to many areas of industrial hygiene work, but more studies are required that consider the ethical use of sensors in workplaces. Studies that monitored employee health, well-being, and productivity, identified ethical risks in using sensors to monitor these endpoints. An ethical framework and checklist for hygienists are proposed including a set of questions that consider the risks of using sensors to monitor occupational hazards. Industrial hygiene professional bodies provide ethical codes of practice for their members but may also need to consider the implications of using sensors in workplaces. Ethical standards support the collection of industrial hygiene exposure data whilst maintaining the privacy rights of employees.

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