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James Di Michiel,1 Julie Gawthorne,2 Aruna Shivam,2 Kevin Maruno,2– 4 Sarah Cohn,3,5 Christopher Lemon,3,6 Zhixin Liu,7 Anthony Byrne1,3 1Department of Thoracic Medicine, St Vincent’s Hospital, Sydney, NSW, 2010, Australia; 2Department of Emergency Medicine, St Vincent’s Hospital, Sydney, NSW, 2010, Australia; 3University of New South Wales, St Vincent’s Medical School, Sydney, NSW, 2010, Australia; 4University of Notre Dame, St Vincent’s Medical School, Sydney, NSW, 2010, Australia; 5Department of Psychiatry, Prince of Wales Hospital, Sydney, NSW, 2031, Australia; 6Department of Psychiatry, St Vincent’s Hospital, Sydney, NSW, 2010, Australia; 7Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, 2052, AustraliaCorrespondence: James Di MichielDepartment of Thoracic Medicine, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, NSW, 2010, AustraliaEmail james.dimichiel@health.nsw.gov.auBackground and Objectives: Despite a population of 600,000 people from 900 islands, there is little published data on the prevalence of lung disease in the Solomon Islands. We sought to 1) estimate the prevalence of obstructive lung disease (OLD) in Gizo, Solomon Islands, 2) identify risk factors for respiratory disease in this population and 3) review current management practices for respiratory disease through an audit of local emergency department (ED) presentations.Methods: A two-part mixed methods study was performed between March and May 2019; the first was a population-based, cross-sectional study conducted in Gizo, Solomon Islands, with a random sample undergoing questionnaires and spirometry. The second was an audit of Gizo Hospital ED records to assess presentation numbers, diagnoses and outcomes.Results: A total of 104 patients were randomly selected for spirometry. The mean age was 46.9 years. Current smoking rates were high (24.0% overall, 43.3% age < 40, 16.2% age ≥ 40) as was regular (> 10h/week) exposure to indoor/enclosed wood fire ovens (51.5%). The prevalence of COPD was 3.2% overall. A further 9.7% of participants demonstrated significant bronchodilator responsiveness suggestive of possible asthma. Most patients seen in ED presented with a respiratory condition or fever/viral illness, but spirometry was not available. Only four outpatients were prescribed salbutamol and two patients inhaled corticosteroid.Conclusion: There appears to be a high burden of obstructive lung disease in the Solomon Islands with high smoking rates, indoor smoke exposure and bronchodilator responsiveness. Respiratory symptoms are common amongst hospital ED presentations; however, inhaled asthma treatments are infrequently prescribed to outpatients.Keywords: obstructive lung diseases, COPD, asthma, inhalational exposure, Pacific Islands

Background: Limited evidence has associated lower ventilation rates (VRs) in offices with higher illness-related absence rates. Methods: We studied spaces in office buildings, selected without knowledge of their VRs, in three California climate zones. In each study space, real-time logging sensors measured carbon dioxide and thermal parameters for one year. Web-based surveys every three months collected data on occupants' health outcomes. Using multivariate models, relationships were assessed between CO2 concentrations, or VRs estimated from CO2, and adverse occupant outcomes including respiratory infections and illness absences. For all outcomes, positive associations were hypothesized with higher CO2 levels (and negative associations with higher VRs). Results: Low survey response limited sample size and study power. In the 16 study spaces, CO2 concentrations were uniformly low over the year, and most estimated VRs ranged from twice to nine times the California office minimum VR standard (7L/s or 15 cfm per person). Primary CO2 and VR metrics had no statistically significant relationships with occupant outcomes. Conclusions: Within the observed range of uniformly low CO2 and high VRs (mostly 16-42L/s per person), little variation in contaminant concentrations would be expected, which would explain lack of relationships with occupant outcomes. These high VRs resulted partly from frequently used energy-saving "economizer" cycles in moderate California climates, but VRs at other times also substantially exceeded required VRs. These findings suggest, consistent with theory, that within a higher VR range, increased VRs do not reduce respiratory illness. Further studies are needed to better characterize such relationships.

BACKGROUND: In the INRG dataset, the hypothesis that any segmental chromosomal alteration might be of prognostic impact in neuroblastoma without MYCN amplification (MNA) was tested. METHODS: The presence of any segmental chromosomal alteration (chromosome 1p deletion, 11q deletion and/or chromosome 17q gain) defined a segmental genomic profile. Only tumours with a confirmed unaltered status for all three chromosome arms were considered as having no segmental chromosomal alterations. RESULTS: Among the 8800 patients in the INRG database, a genomic type could be attributed for 505 patients without MNA: 397 cases had a segmental genomic type, whereas 108 cases had an absence of any segmental alteration. A segmental genomic type was more frequent in patients >18 months and in stage 4 disease (P