RESUMEN
Aquatic ecosystem conservation is imperative to reaching global biodiversity and sustainability targets. However, the ecological status of waters has been continuously eroded through mismanagement in the face of existing and emerging anthropogenic stressors, such as pollutants. There has been an emerging trend towards the use of dyes to manage algae and plants as well as to alter aesthetics within various aquatic environments. This artificial colouring has potential ecological implications through reductions in light levels and disruptions to thermoclines (i.e., temperature regime changes with depth). Abiotic regime shifts could in turn drive ecological cascades by depowering primary production, hampering top-down trophic interactions, and affecting evolved animal behaviours. Despite commercial dyes being marketed as acutely non-toxic, very little is known about the chronic effects of these dyes across ecological scales and contexts. We thus call for greater research efforts to understand the ecological consequences of dye usage in aquatic environments, as well as the socio-cultural drivers for its application. This emerging research area could harness approaches such as biological assays, community module experiments, remote sensing, culturomics, and social surveys to elucidate dye effects, trends, and perspectives under a pollution framework. A greater understanding of the potential effects of dye in aquatic ecosystems under relevant contexts would help to inform management decisions and regulation options, while helping to mediate ecocentric and anthropocentric perspectives.
RESUMEN
PURPOSE: To compare the incidence and nature of secondary infections (SI) between critically ill patients with viral pneumonia due to COVID-19 and seasonal influenza and explore the association between SI and clinical outcomes. METHODS: We conducted a historical cohort study of patients admitted to the intensive care unit (ICU) at two tertiary care centers during the first wave of the COVID-19 pandemic and patients admitted with influenza during the 2018-2019 season. The primary outcome was the rate of SI. Secondary outcomes included rates of ICU and in-hospital mortality, organ-support-dependent disease, and length of ICU and hospital stay. RESULTS: Secondary infections developed in 55% of 95 COVID-19 patients and 51% of 47 influenza patients (unadjusted odds ratio [OR], 1.16; 95% confidence interval [CI], 0.57 to 2.33). After adjusting for baseline differences between cohorts, there were no significant differences between the COVID-19 cohort and the influenza cohort (adjusted OR, 1.00; 95% CI, 0.41 to 2.44). COVID-19 patients with SI had longer ICU and hospital stays and duration of mechanical ventilation. The SI incidence was higher in COVID-19 patients treated with steroids than in those not treated with steroids (15/20, 75% vs 37/75, 49%). CONCLUSION: Secondary infections were common among critically ill patients with viral pneumonia including COVID-19. We found no difference in the incidence of SI between COVID-19 and influenza in our cohort study, but SI in patients with COVID-19 were associated with worse clinical outcomes and increased healthcare resource use. The small cohort size precludes any causal inferences but may provide a basis for future research.
RéSUMé: OBJECTIF: Comparer l'incidence et la nature des infections secondaires entre les patients gravement malades atteints de pneumonie virale due à la COVID-19 et ceux atteints de la grippe saisonnière et explorer l'association entre les infections secondaires et les issues cliniques. MéTHODE: Nous avons réalisé une étude de cohorte historique de patients admis à l'unité de soins intensifs (USI) dans deux centres de soins tertiaires pendant la première vague de la pandémie de COVID-19 et de patients admis pour la grippe au cours de la saison 2018-2019. Le critère d'évaluation principal était le taux d'infections secondaires. Les critères d'évaluation secondaires comprenaient les taux de mortalité à l'USI et à l'hôpital, les maladies nécessitant un support d'organes et la durée du séjour à l'USI et à l'hôpital. RéSULTATS: Des infections secondaires se sont développées chez 55 % des 95 patients atteints de COVID-19 et 51 % des 47 patients grippaux (rapport des cotes [RC] non ajusté, 1,16; intervalle de confiance [IC] à 95 %, 0,57 à 2,33). Après ajustement pour tenir compte des différences initiales entre les cohortes, aucune différence significative n'a été observée entre la cohorte de COVID-19 et la cohorte de grippe (RC ajusté, 1,00; IC 95 %, 0,41 à 2,44). Les patients atteints de COVID-19 atteints d'infections secondaires ont séjourné plus longtemps aux soins intensifs et à l'hôpital et la durée de la ventilation mécanique était plus longue pour ces patients. L'incidence d'infections secondaires était plus élevée chez les patients atteints de COVID-19 traités par stéroïdes que chez ceux non traités par stéroïdes (15/20, 75 % vs 37/75, 49 %). CONCLUSION: Les infections secondaires étaient fréquentes chez les patients gravement malades atteints de pneumonie virale, y compris de COVID-19. Nous n'avons observé aucune différence dans l'incidence d'infections secondaires entre les patients atteints de COVID-19 et ceux atteints de grippe dans notre étude de cohorte, mais les infections secondaires chez les patients atteints de COVID-19 étaient associées à de moins bonnes issues cliniques et à une utilisation accrue des ressources de soins de santé. La petite taille de la cohorte exclut toute inférence causale, mais peut fournir une base pour les recherches futures.
Asunto(s)
COVID-19 , Coinfección , Gripe Humana , Neumonía Viral , Humanos , COVID-19/complicaciones , COVID-19/epidemiología , Estudios de Cohortes , SARS-CoV-2 , Enfermedad Crítica , Gripe Humana/complicaciones , Gripe Humana/epidemiología , Pandemias , Coinfección/epidemiología , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Unidades de Cuidados Intensivos , Estudios RetrospectivosRESUMEN
Contributors and editors were asked to respond to a series of questions concerning male sex work in order to stimulate an informal "conversation." Some of the topics explored include: why people seek the services of prostitutes; is the term "sex work" favorable to "prostitution": is it right to pay for sex; and is exploitation a necessary part of the sex worker/client interchange'? Contributors' responses were compiled and listed in the order they were received. Common elements of their responses are summarized and the advantages of this informal approach are articulated.