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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
While sick building syndrome (SBS) encompasses a multitude of non-specific symptoms, building-related illness (BRI) comprises specific, diagnosable symptoms caused by certain agents (chemicals, bacteria, fungi, etc.). These can typically be identified, measured, and quantified. There are usually 4 causal agents in BRI; 1.) Immunologic, 2.) Infectious, 3.) toxic, and 4.) irritant. For instance, Legionnaire's disease, usually caused by "Legionella pneumophila", involves a specific organism which could be ascertained through clinical findings as the source of contamination within a building. SBS does not have any known cure; alleviation consists of removing the affected person from the building associated with non-specific symptoms. BRI, on the other hand, utilizes treatment appropriate for the contaminant identified within the building (e.g., antibiotics for Legionnaire's disease). In most cases, simply improving the indoor air quality (IAQ) of a particular building will attenuate, or even eliminate, the acute symptoms of SBS, while removal of the source contaminant would prove more effective for a specific illness, as in the case of BRI. Building-Related Illness is vital to the overall understanding of Sick Building Syndrome because BRI illustrates a causal path to infection, theoretically. Office BRI may more likely than not be explained by three events: “Wide range in the threshold of response in any population (susceptibility), a spectrum of response to any given agent, or variability in exposure within large office buildings." Isolating any one of the three aspects of office BRI can be a great challenge, which is why those who find themselves with BRI should take three steps, history, examinations, and interventions. History describes the action of continually monitoring and recording the health of workers experiencing BRI, as well as obtaining records of previous building alterations or related activity. Examinations go hand in hand with monitoring employee health. This step is done by physically examining the entire workspace and evaluating possible threats to health status among employees. Interventions follow accordingly based off the results of the Examination and History report.
Some studies have shown a small difference between genders, with women having slightly higher reports of SBS symptoms compared to men. However, many other studies have shown an even higher difference in the report of sick building syndrome symptoms in women compared to men. It is not entirely clear, however, if this is due to biological, social, or occupational factors.
A 2001 study published in the Journal Indoor Air 2001 gathered 1464 office-working participants to increase the scientific understanding of gender differences under the Sick Building Syndrome phenomenon. Using questionnaires, ergonomic investigations, building evaluations, as well as physical, biological, and chemical variables, the investigators obtained results that compare with past studies of SBS and gender. The study team found that across most test variables, prevalence rates were different in most areas, but there was also a deep stratification of working conditions between genders as well. For example, men’s workplace tend to be significantly larger and have all around better job characteristics. Secondly, there was a noticeable difference in reporting rates, finding that women have higher rates of reporting roughly 20% higher than men. This information was similar to that found in previous studies, indicating a potential difference in willingness to report.
There might be a gender difference in reporting rates of sick building syndrome because women tend to report more symptoms than men do. Along with this, some studies have found that women have a more responsive immune system and are more prone to mucosal dryness and facial erythema. Also, women are alleged by some to be more exposed to indoor environmental factors because they have a greater tendency to have clerical jobs, wherein they are exposed to unique office equipment and materials (example: blueprint machines), whereas men often have jobs based outside of offices.
A fiber cannot be identified or ruled out as asbestos, either using the naked eye or by simply looking at a fiber under a regular microscope. The most common methods of identifying asbestos fibers are by using polarized light microscopy (PLM) or transmission electron microscopy (TEM). PLM is less expensive, but TEM is more precise and can be used at lower concentrations of asbestos.
If asbestos abatement is performed, completion of the abatement is verified using visual confirmation and may also involve air sampling. Air samples are typically analyzed using phase contrast microscopy (PCM). PCM involves counting fibers on a filter using a microscope. Airborne occupational exposure limits for asbestos are based on using the PCM method.
The American Conference of Governmental Industrial Hygienists has a recommended Threshold Limit Value (TLV) for asbestos of 0.1 fibers/mL over an 8-hour shift. OSHA in the United States and occupational health and safety regulatory jurisdictions in Canada use 0.1 fibers/mL over an 8-hour shift as their exposure limits.
Most pesticide-related illnesses have signs and symptoms that are similar to common medical conditions, so a complete and detailed environmental and occupational history is essential for correctly diagnosing a pesticide poisoning. A few additional screening questions about the patient's work and home environment, in addition to a typical health questionnaire, can indicate whether there was a potential pesticide poisoning.
If one is regularly using carbamate and organophosphate pesticides, it is important to obtain a baseline cholinesterase test. Cholinesterase is an important enzyme of the nervous system, and these chemical groups kill pests and potentially injure or kill humans by inhibiting cholinesterase. If one has had a baseline test and later suspects a poisoning, one can identify the extent of the problem by comparison of the current cholinesterase level with the baseline level.
Accidental poisonings can be avoided by proper labeling and storage of containers. When handling or applying pesticides, exposure can be significantly reduced by protecting certain parts of the body where the skin shows increased absorption, such as the scrotal region, underarms, face, scalp, and hands. Safety protocols to reduce exposure include the use of personal protective equipment, washing hands and exposed skin during as well as after work, changing clothes between work shifts, and having first aid trainings and protocols in place for workers.
Personal protective equipment for preventing pesticide exposure includes the use of a respirator, goggles, and protective clothing, which have all have been shown to reduce risk of developing pesticide-induced diseases when handling pesticides. A study found the risk of acute pesticide poisoning was reduced by 55% in farmers who adopted extra personal protective measures and were educated about both protective equiment and pesticide exposure risk. Exposure can be significantly reduced when handling or applying pesticides by protecting certain parts of the body where the skin shows increased absorption, such as the scrotal region, underarms, face, scalp, and hands. Using chemical-resistant gloves has been shown to reduce contamination by 33–86%.
Diseases commonly associated with asbestos include:
- Asbestosis: Progressive fibrosis of the lungs of varying severity, progressing to bilateral fibrosis, honeycombing of the lungs on radiological view with symptoms including rales and wheezing. Individuals who have been exposed to asbestos via home, environment, work should notify their doctors about exposure history.
- Asbestos warts: caused when the sharp fibers lodge in the skin and are overgrown causing benign callus-like growths.
- Pleural plaques: discrete fibrous or partially calcified thickened area which can be seen on X-rays of individuals exposed to asbestos. Although pleural plaques are themselves asymptomatic, in some patients this develops into pleural thickening.
- Diffuse pleural thickening: similar to above and can sometimes be associated with asbestosis. Usually no symptoms shown but if exposure is extensive, it can cause lung impairment.
- Pneumothorax: Some reports have also linked the condition of pneumothorax to asbestos related diseases.
It is important to consult a doctor, particularly if the following symptoms develop: shortness of breath, wheezing or hoarseness, persistent cough that worsens over time, blood in fluid coughed up, pain or tightening in chest, difficulty swallowing, swelling of neck or face, decreased appetite, weight loss, fatigue or anemia.
The United States Environmental Protection Agency (EPA) does not generally recommend sampling unless an occupant of the space has symptoms. Sampling should be performed by a trained professional with specific experience in mold-sampling protocols, sampling methods and the interpretation of findings. It should be done only to make a particular determination, such as airborne spore concentration or identifying a particular species. Before sampling, a subsequent course of action should be determined.
In the U.S., sampling and analysis should follow the recommendations of the Occupational Safety and Health Administration (OSHA), National Institute for Occupational Safety and Health (NIOSH), the EPA and the American Industrial Hygiene Association (AIHA).
Types of samples include air, surface, bulk, and swab. Air is the most common form of sampling to assess mold levels. Indoor and outdoor air are sampled, and their mold-spore levels compared. Air sampling often identifies hidden mold. Surface sampling measures the number of mold spores deposited on indoor surfaces, collected on tape or in dust. Bulk removal of material from the contaminated area is used to identify and quantify the mold in the sample. With swab, a cotton swab is rubbed across the area being sampled, often a measured area, and subsequently sent to the mold testing laboratory. Final results indicate mold levels and species located in suspect area.
Multiple types of sampling are recommended by the AIHA, since each has limitations; for example, air samples will not identify a hidden mold source and a tape sample cannot determine the level of contamination in the air.
The first step in assessment is to non-intrusively determine if mold is present by visually examining the premises; visible mold helps determine the level of remediation necessary. If mold is actively growing and visibly confirmed, sampling for its specific species is unnecessary.
Intrusive observation is sometimes needed to assess the mold level. This includes moving furniture, lifting (or removing) carpets, checking behind wallpaper or paneling, checking ventilation ductwork and exposing wall cavities. Detailed visual inspection and the recognition of moldy odors should be used to find problems. Efforts should focus on areas where there are signs of liquid moisture or water vapor (humidity), or where moisture problems are suspected.
Recommended strategies to prevent mold include: avoiding mold-contamination; utilization of environmental controls; the use of personal protective equipment (PPE) including skin and eye protection and respiratory protection; and environmental controls such as ventilation and suppression of dust. When mold cannot be prevented, the CDC recommends clean-up protocol including first taking emergency action to stop water intrusion. Second, they recommend determining the extent of water damage and mold contamination. And third, they recommend planning remediation activities such as establishing containment and protection for workers and occupants; eliminating water or moisture sources if possible; decontaminating or removing damaged materials and drying any wet materials; evaluating whether the space has been successfully remediated; and reassembling the space to control sources of moisture.
Mold health issues are potentially harmful effects of molds.
Molds (US usage; British English "moulds") are ubiquitous in the biosphere, and mold spores are a common component of household and workplace dust. The United States Centers for Disease Control and Prevention reported in its June 2006 report, 'Mold Prevention Strategies and Possible Health Effects in the Aftermath of Hurricanes and Major Floods,' that "excessive exposure to mold-contaminated materials can cause adverse health effects in susceptible persons regardless of the type of mold or the extent of contamination." When mold spores are present in abnormally high quantities, they can present especially hazardous health risks to humans after prolonged exposure, including allergic reactions or poisoning by mycotoxins, or causing fungal infection (mycosis).
Several studies have shown that obese men tend to have a lower sperm count, fewer rapidly mobile sperm and fewer progressively motile sperm compared to normal-weight men.
A lack of exercise is a cause of obesity. A study showed that children only got 30 minutes of exercise instead of the hour that is required. Proper skeletal development, muscle building, heart and circulation are among the benefits of exercising during childhood.
X-ray and neuroimaging studies may be helpful in confirming a diagnosis of Coffin–Lowry syndrome. Decreased ribosomal S6 kinase activity in cultured fibroblast or transformed lymphoblast cells from a male indicates Coffin–Lowry syndrome. Studies of enzyme activity can not be used to diagnose an affected female.
Molecular genetic testing on a blood specimen or cells from a cheek swab is available to identify mutations in the RSK2 gene. This testing can be used to confirm but not rule out the diagnosis of Coffin–Lowry syndrome because not all affected individuals have a detectable mutation.
People of any age may suffer from Legionnaires' disease, but the illness most often affects middle-aged and older persons, particularly those who smoke cigarettes or have chronic lung disease. Immunocompromised people are also at higher risk. Pontiac fever most commonly occurs in persons who are otherwise healthy.
The most useful diagnostic tests detect the bacteria in coughed up mucus, find "Legionella" antigens in urine samples, or allow comparison of "Legionella" antibody levels in two blood samples taken 3 to 6 weeks apart. A urine antigen test is simple, quick, and very reliable, but it will only detect "Legionella pneumophila" serogroup 1, which accounts for 70 percent of disease caused by "L. pneumophila", which means use of the urine antigen test alone may miss as many as 30% of cases. This test was developed by Richard Kohler in 1982. When dealing with "Legionella pneumophila" serogroup 1, the urine antigen test is useful for early detection of Legionnaire's disease and initiation of treatment, and has been helpful in early detection of outbreaks. However, it will not identify the specific subtypes, so it cannot be used to match the person with the environmental source of infection. The "Legionella" bacteria can be cultured from sputum or other respiratory samples. "Legionella" stains poorly with Gram stain, stains positive with silver, and is cultured on charcoal yeast extract with iron and cysteine (CYE agar).
A significant under-reporting problem occurs with legionellosis. Even in countries with effective health services and readily available diagnostic testing, about 90 percent of cases of Legionnaires' disease are missed. This is partly due to Legionnaires' disease being a relatively rare form of pneumonia, which many clinicians may not have encountered before and thus may misdiagnose. A further issue is that people with legionellosis can present with a wide range of symptoms, some of which (such as diarrhea) may distract clinicians from making a correct diagnosis.
It is done through isolation of a bacteria from chickens suspected to have history of coryza and clinical finds from infected chickens also is used in the disease diagnosis. Polymerase chain reaction is a reliable means of diagnosis of the disease
Weather pains or weather-related pain, is a phenomenon that occurs when people with conditions such as arthritis claim to feel pain, particularly with changes in barometric pressure, humidity or other weather phenomena. Scientific evidence, however, does not support a connection between weather and arthritic pain and concludes that it is largely or entirely due to perceptual errors such as confirmation bias.
Although the risk of Legionnaires' disease being spread by large-scale water systems cannot be eliminated, it can be greatly reduced by writing and enforcing a highly detailed, systematic water safety plan appropriate for the specific type of facility involved (office building, hospital, hotel, spa, cruise ship, etc.) Some of the elements that such a plan may include are the following:
- Keeping water temperature either above or below the range in which the "Legionella" bacterium thrives.
- Preventing stagnation, for example by removing from a network of pipes any sections that have no outlet (dead ends). Where stagnation is unavoidable, for example when a wing of a hotel is closed for the off-season, systems must be thoroughly disinfected just prior to resuming normal operation.
- Preventing the buildup of biofilm, for example by not using (or by replacing) construction materials that encourage its development, and by reducing the quantity of nutrients for bacterial growth that enter the system.
- Periodic disinfection of the system, by high heat or a chemical biocide, and the use of chlorination where appropriate.
- System design (or renovation) that reduces the production of aerosols and reduces human exposure to them, for example by directing them well away from building air intakes.
An effective water safety plan will also cover such matters as training, record-keeping, communication among staff, contingency plans and management responsibilities. The format and content of the plan may be prescribed by public health laws or regulations. There is tentative evidence for the treatment of the water with copper-silver ionization or ultraviolet light.
Morgellons (/mɔː(ɹ)ˈdʒɛlənz/) is the informal name of a self-diagnosed skin condition in which individuals have sores that they believe contain some kind of fibers. Morgellons is poorly understood but the general medical consensus is that it is a form of delusional parasitosis; the sores are the result of compulsive scratching, and the fibers, when analysed, turn out to originate from textiles.
The name was coined in 2002 by Mary Leitao, a mother who rejected the medical diagnosis of her son's delusional parasitosis. She revived it from a letter written by a physician in the mid-17th century. Leitao and others involved in her Morgellons Research Foundation successfully lobbied members of the U.S. Congress and the U.S. Centers for Disease Control and Prevention (CDC) to investigate the condition in 2006. CDC researchers issued the results of their multi-year study in January 2012, indicating that there were no disease organisms present in people with Morgellons and that the fibers found were likely cotton, and concluded that the condition was "similar to more commonly recognized conditions such as delusional infestation".
François Madec, a French author, has written many recommendations on how reduce PMWS symptoms. They are mostly measures for disinfection, management, and hygiene, referred to as the "20 Madec Points" [Madec & Waddilove, 2002].
These measures have recently been expanded upon by Dr. David Barcellos, a professor at the Veterinary College in the Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil. He presented these points at "1st Universidade Federal do Rio Grande do Sul Symposium about swine management, reproduction, and hygiene".
He divided his points by pig growth stage, and they can be loosely summarized as:
- keep the gutters clean
- increase feeder space
- use pens or small cages with solid dividers
- avoid mixing pigs from different origins
- improve the quality of air
- decrease maximum capacity, giving each pig more room
- separate sick animals as soon as possible, and treat them in a hospital pen. If they do not respond to antibiotics in three days, they should be culled
- control access of people and other animals
- reduce invironmental stress factors such as gases and air currents
- use immunizations and preventive medications for secondary agents commonly associated with PMWS
Alimentary Toxic Aleukia was first characterized in the early 19th century after affecting a large population in the Orenburg district of the former U.S.S.R. during World War II. The sick people had eaten overwintered grain colonized with Fusarium sporotrichioides and Fusarium poae
Morgellons is poorly understood but the general medical consensus is that it is a form of delusional parasitosis in which individuals have some form of actual skin condition that they believe contains some kind of fibers.
Several trials investigated a possible therapy for ESS. However, they yielded inconsistent and partly contradictory results. This may be caused by the fact that the investigated populations were too heterogeneous in the lack of a consistent definition of "non-thyroid illness syndrome".
Modern theories regard the TACITUS syndrome as an adaptive and therefore possibly beneficial response of thyroid homeostasis. Their proponents are therefore reserved with respect to substitutive treatment.
Diagnosis typically is based on physical signs, X-rays, and improvement after treatment.
Prevention is through use of Stock coryza-free birds. In other areas culling of the whole flock is a good means of the disease control. Bacterin also is used at a dose of two to reduce brutality of the disease. Precise exposure has also has been used but it should be done with care. Vaccination of the chicks is done in areas with high disease occurrence. Treatment is done by using antibiotics such as erythromycin, Dihydrostreptomycin, Streptomycin sulphonamides, tylosin and Flouroquinolones .
The "British Medical Journal" reported in a study that looked at mortality statistics in the United States over a
25-year period. They found that on the fourth day of the month, Asian people were thirteen percent more likely to die of heart failure. In California, Asians were twenty-seven percent more likely to die of a heart attack on that day. The purpose of the study was to see if psychological stress caused by belief in this superstition could indeed trigger deadly heart attacks and other fatal incidents.