Recently, a novel coronavirus (2019-nCoV) has emerged from Wuhan, China, causing symptoms in humans similar to those caused by severe acute respiratory syndrome coronavirus (SARS-CoV). Since the SARS-CoV outbreak in 2002, extensive structural analyses have revealed key atomic-level interactions between the SARS-CoV spike protein receptor-binding domain (RBD) and its host receptor angiotensin-converting enzyme 2 (ACE2), which regulate both the cross-species and human-to-human transmissions of SARS-CoV. Here, we analyzed the potential receptor usage by 2019-nCoV, based on the rich knowledge about SARS-CoV and the newly released sequence of 2019-nCoV. First, the sequence of 2019-nCoV RBD, including its receptor-binding motif (RBM) that directly contacts ACE2, is similar to that of SARS-CoV, strongly suggesting that 2019-nCoV uses ACE2 as its receptor. Second, several critical residues in 2019-nCoV RBM (particularly Gln493) provide favorable interactions with human ACE2, consistent with 2019-nCoV's capacity for human cell infection. Third, several other critical residues in 2019-nCoV RBM (particularly Asn501) are compatible with, but not ideal for, binding human ACE2, suggesting that 2019-nCoV has acquired some capacity for human-to-human transmission. Last, while phylogenetic analysis indicates a bat origin of 2019-nCoV, 2019-nCoV also potentially recognizes ACE2 from a diversity of animal species (except mice and rats), implicating these animal species as possible intermediate hosts or animal models for 2019-nCoV infections. These analyses provide insights into the receptor usage, cell entry, host cell infectivity and animal origin of 2019-nCoV and may help epidemic surveillance and preventive measures against 2019-nCoV.IMPORTANCE The recent emergence of Wuhan coronavirus (2019-nCoV) puts the world on alert. 2019-nCoV is reminiscent of the SARS-CoV outbreak in 2002 to 2003. Our decade-long structural studies on the receptor recognition by SARS-CoV have identified key interactions between SARS-CoV spike protein and its host receptor angiotensin-converting enzyme 2 (ACE2), which regulate both the cross-species and human-to-human transmissions of SARS-CoV. One of the goals of SARS-CoV research was to build an atomic-level iterative framework of virus-receptor interactions to facilitate epidemic surveillance, predict species-specific receptor usage, and identify potential animal hosts and animal models of viruses. Based on the sequence of 2019-nCoV spike protein, we apply this predictive framework to provide novel insights into the receptor usage and likely host range of 2019-nCoV. This study provides a robust test of this reiterative framework, providing the basic, translational, and public health research communities with predictive insights that may help study and battle this novel 2019-nCoV.

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Receptor Recognition by the Novel Coronavirus from Wuhan: an Analysis Based on Decade-Long Structural Studies of SARS Coronavirus.

Summary Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer's disease and other dementias (46·0 [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services. Funding Bill & Melinda Gates Foundation.

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Global, regional, and national burden of neurological disorders, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis.

https://www.cdc.gov/coronavirus/mers/downloads/Isolation2007.pdf

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings.

Importance Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. Objective To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. Evidence Review The general methodology of the Global Burden of Disease (GBD) 2013 study was used. Cancer registries were the source for cancer incidence data as well as mortality incidence (MI) ratios. Sources for cause of death data include vital registration system data, verbal autopsy studies, and other sources. The MI ratios were used to transform incidence data to mortality estimates and cause of death estimates to incidence estimates. Cancer prevalence was estimated using MI ratios as surrogates for survival data; YLDs were calculated by multiplying prevalence estimates with disability weights, which were derived from population-based surveys; YLLs were computed by multiplying the number of estimated cancer deaths at each age with a reference life expectancy; and DALYs were calculated as the sum of YLDs and YLLs. Findings In 2013 there were 14.9 million incident cancer cases, 8.2 million deaths, and 196.3 million DALYs. Prostate cancer was the leading cause for cancer incidence (1.4 million) for men and breast cancer for women (1.8 million). Tracheal, bronchus, and lung (TBL) cancer was the leading cause for cancer death in men and women, with 1.6 million deaths. For men, TBL cancer was the leading cause of DALYs (24.9 million). For women, breast cancer was the leading cause of DALYs (13.1 million). Age-standardized incidence rates (ASIRs) per 100 000 and age-standardized death rates (ASDRs) per 100 000 for both sexes in 2013 were higher in developing vs developed countries for stomach cancer (ASIR, 17 vs 14; ASDR, 15 vs 11), liver cancer (ASIR, 15 vs 7; ASDR, 16 vs 7), esophageal cancer (ASIR, 9 vs 4; ASDR, 9 vs 4), cervical cancer (ASIR, 8 vs 5; ASDR, 4 vs 2), lip and oral cavity cancer (ASIR, 7 vs 6; ASDR, 2 vs 2), and nasopharyngeal cancer (ASIR, 1.5 vs 0.4; ASDR, 1.2 vs 0.3). Between 1990 and 2013, ASIRs for all cancers combined (except nonmelanoma skin cancer and Kaposi sarcoma) increased by more than 10% in 113 countries and decreased by more than 10% in 12 of 188 countries. Conclusions and Relevance Cancer poses a major threat to public health worldwide, and incidence rates have increased in most countries since 1990. The trend is a particular threat to developing nations with health systems that are ill-equipped to deal with complex and expensive cancer treatments. The annual update on the Global Burden of Cancer will provide all stakeholders with timely estimates to guide policy efforts in cancer prevention, screening, treatment, and palliation.

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The Global Burden of Cancer 2013

No studies have specifically reported the association of lung adenocarcinoma with environmental tobacco smoke (ETS) exposure among nonsmoking males. The objective of this study was to examine the exposure-response relation between ETS exposure and lung cancer among nonsmoking males. In particular, the association with adenocarcinoma of the lung was studied. This is a population-based, case-referent study in Hong Kong during 2004-2006. A total of 132 Chinese male nonsmokers with newly diagnosed primary lung cancer and 536 nonsmoking community referents were interviewed about ETS exposures from the household and/or workplace, including ever ETS exposure, sources of exposure, number of smoking cohabitants/coworkers, and smoker-years. Univariate logistic regression analyses showed a weak association between all lung cancers and ever ETS exposure from the household and/or workplace (odds ratio (OR) = 1.11, 95% confidence interval (CI): 0.74, 1.67), but an increased risk was restricted to adenocarcinoma (OR = 1.68, 95% CI: 1.00, 2.38). After adjustment for family cancer history and other confounders, excess risk (OR = 1.62, 95% CI: 0.91, 2.88) still persisted for adenocarcinoma, although it was no longer statistically significant. Exposure-response relations for adenocarcinoma were found with increasing levels of all ETS indices when exposures from the household and workplaces were combined. The consistent exposure-response relations between ETS exposures and adenocarcinoma suggested a probable causal link, which would have to be confirmed by future larger studies.

Environmental Tobacco Smoke and Lung Cancer Among Chinese Nonsmoking Males: Might Adenocarcinoma Be the Culprit?

Inhaled asbestos fibers may contribute to three-fourths of malignant mesotheliomas diagnosed in men and almost 40% of cases diagnosed in women. Bans on the manufacture and sale of amphibole asbestos fibers are expected to reduce the incidence of mesothelioma, but the long latency period from initial exposure to clinical disease means that people exposed before bans were enacted will continue to develop asbestos-related mesotheliomas as they age. Tse et al. (p. 382) used historical data on asbestos consumption and mesothelioma diagnoses to predict future mesothelioma trends in Hong Kong. Asbestos use peaked during a construction boom in the early 1960s and subsequently declined by > 90% following a ban on the sale and import of crocidolite and amosite asbestos in 1996, whereas mesothelioma diagnoses in men increased from a single case in 1972–1976 to 63 cases in 2002–2006 (corresponding to crude incidence rates of 0.09 and 3.86 cases/million men, respectively). Assuming an average latency of 42 years, the authors predict that incidence rates will peak in 2009 and that diagnoses will peak in 2014. However, they caution that ongoing use of chrysotile asbestos and the release of asbestos fibers from older buildings during demolition or renovation may slow the projected decline. [corrected]

/pdf/are-current-or-future-mesothelioma-epidemics-in-hong-kong-58eux3clt7.pdf

Are current or future mesothelioma epidemics in Hong Kong the tragic legacy of uncontrolled use of asbestos in the past

Background
Although severe impairment of pulmonary function is believed to occur commonly in complicated pneumoconiosis, the relationships of simple coal workers' pneumoconiosis (CWP) to pulmonary function and respiratory symptoms have remained under debate. The study aims to investigate if simple pneumoconiosis is associated with significant impairment of pulmonary function and increased risk of respiratory symptoms.

Methods
Spirometry and diffusing capacity were performed in 205 miners with simple CWP and 289 without X ray evidence of pneumoconiosis, who were selected from a large underground coal mine in China. A questionnaire on occupational history and respiratory symptoms including breathlessness, chronic cough, and phlegm was administered. The presence or absence of emphysema on their X-ray films was also evaluated. Logistic regression and multiple linear regression analysis were applied to estimate the independent effect of CWP on respiratory symptoms and parameters of pulmonary function.

Results
On the average, the miners with CWP had lower values of pulmonary function and higher prevalences of respiratory symptoms, and emphysema than did those without. The simple CWP was associated with increased risk of the respiratory symptoms after adjusting for age, smoking, and years underground. Regression analysis showed that the CWP had significantly independent effects on parameters of pulmonary function. Even when the effects of emphysema, respiratory symptoms indicating chronic bronchitis were taken into consideration, the significant relationship between CWP and decrements in FVC and diffusing capacity remained.

Conclusion
The findings of this study are consistent with simple CWP being a contributor to significant decrements in pulmonary function, and to increased risk of respiratory symptoms. Am. J. Ind. Med. 35:124–131, 1999. © 1999 Wiley-Liss, Inc.

Respiratory symptoms and pulmonary function in coal miners: looking into the effects of simple pneumoconiosis.

The study was conducted to estimate the effects of age, year of diagnosis (period) and year of birth (cohort) on the time trend of female lung cancer incidence between 1976 and 2000 in Hong Kong. Data were obtained from a population-based cancer registry and the Census and Statistics Department. Using the Hong Kong general population of 1990 as the reference, age-adjusted incidence rates were computed by using direct standardization. We also analyzed secular trends in 2 consecutive periods, 1976-1990 and 1991-2000, using a Poisson regression model to estimate the annual percentage change in incidence rate. Age, period and cohort effects were assessed employing the method proposed by Clayton and Schifflers with 3 Poisson regression models fitted separately for age alone, age and period, and age and cohort. The age-adjusted incidence rate increased steadily up to 1990, when a peak of 40.1 per 100,000 was reached. Thereafter, a downward trend was observed. The overall annual increase was 4.2% during the period 1976-1990 with the fastest increase observed in women aged 80-84 years. An overall decrease of 2.3% was seen in the period 1991-2000, with the greatest reduction occurring in the 35-39 age group. After the adjustment for age, significant period and cohort effects on the time trend of incidence were observed. The age-cohort model provided a better description of the data than the age-period model. The risk of successive 5-year birth cohorts increased from 1896 to 1925 and then decreased. The time trend of lung cancer incidence of Hong Kong female in 1976-2000 had a marked birth cohort effect. Our results imply that major sources of exposure, which carry an increased risk of lung cancer for Hong Kong women, have been becoming less common in recent decades. Domestic air pollution, poor nutrition and tobacco smoking might have played important roles in the change of risks in successive generations and provide guidance for future interventions.

Time trends of female lung cancer in hong kong: age, period and birth cohort analysis

Background

Accelerated silicosis has become uncommon in developed countries, whereas serious health threat still exists in small-scale mining in developing countries. This study was to investigate the prevalence and risk factors of accelerated silicosis among Chinese gold miners.



Methods

A cross-sectional medical examination was conducted among 574 Chinese gold miners. All participants were male rock-drillers. The concentrations of total dust and quartz content were obtained from the government documentations. Descriptive data analyses were performed.



Results

The prevalence of accelerated silicosis was 29.1% (95% CI: 24.8–33.4%, 167 cases) after an average of 5.6 years of dust exposure, and a history of tuberculosis seemed to increase the risk. The concentration of respirable silica dust was estimated to be 89.5 mg/m3 (ranged: 70.2–108.8) in the underground goldmine, far exceeding the permissible exposure limits.



Conclusions

This study illustrates a serious health threat to small-scale goldmine in China and indicates an urgent need for environmental control and disease prevention. Am. J. Ind. Med. 50:876–880, 2007. © 2007 Wiley-Liss, Inc.

Ignatius Tak-sun Yu

Papers

Environmental Tobacco Smoke and Lung Cancer Among Chinese Nonsmoking Males: Might Adenocarcinoma Be the Culprit?

Are current or future mesothelioma epidemics in Hong Kong the tragic legacy of uncontrolled use of asbestos in the past

Respiratory symptoms and pulmonary function in coal miners: looking into the effects of simple pneumoconiosis.

Time trends of female lung cancer in hong kong: age, period and birth cohort analysis

High prevalence of accelerated silicosis among gold miners in Jiangxi, China.