Estimating the impact of influenza vaccination and antigenic drift on influenza-related morbidity and mortality in England & Wales using hidden Markov models

Influenza causes substantial morbidity and mortality in some influenza sea- sons, especially among the elderly. Influenza seasons dominated by circula- tion of influenza A/H3N2 virus tend to result in more morbidity and mor- tality than seasons dominated by influenza A/H1N1 or influenza B viruses. Influenza viruses undergo constant mutation, called antigenic drift, which is largely driven by host immunity. It has been shown that antigenic drift in influenza A/H3N2 virus proceeds in a punctuated, as opposed to contin- uous, fashion. A cluster of antigenically similar influenza A/H3N2 viruses appears to remain dominant for between 1 and 8 influenza seasons before being supplanted by a new cluster. Influenza seasons when a new cluster becomes dominant may result in higher morbidity and mortality than other seasons. Influenza vaccine effectiveness varies between influenza seasons be- cause of the different subtypes in circulation and the degree of antigenic match between vaccine and circulating variants. In each influenza season in recent years, over 70% of the population of England & Wales aged > 65 has been vaccinated, though the impact of this high coverage on population level morbidity and mortality is unknown. Multivariate time series models were fitted to reports of laboratory confirmed influenza, sentinel general practi- tioner (GP) consultations for influenza-like-illness, and all deaths registered to underlying pneumonia or influenza in England & Wales from 1975/76 to 2004/05. The models successfully distinguish influenza - attributable GP consultations and deaths from GP consultations and deaths that would be expected in the absence of influenza. This distinction is made jointly by the laboratory reports and the non-laboratory confirmed surveillance data. It is not possible to use the multivariate time series models to quantify the average effect of the appearance of a new cluster of influenza A/H3N2 virus variants, or vaccine impact, on influenza - attributable morbidity or mortality in the data analyzed. Reasons for this are discu

IVOA Recommendation: An IVOA Standard for Unified Content Descriptors Version 1.1

This document describes the current understanding of the IVOA controlled vocabulary for describing astronomical data quantities, called Unified Content Descriptors (UCDs). The present document defines a new standard (named UCD1+) improving the first generation of UCDs (hereafter UCD1). The basic idea is to adopt a new syntax and vocabulary requiring little effort for people to adapt softwares already using UCD1. This document also addresses the questions of maintenance and evolution of the UCD1+. Examples of use cases within the VO, and tools for using UCD1+ are also described

The impact of targeting all elderly persons in England and Wales for yearly influenza vaccination: excess mortality due to pneumonia or influenza and time trend study.

OBJECTIVE: To investigate the impact on mortality due to pneumonia or influenza of the change from risk-based to age group-based targeting of the elderly for yearly influenza vaccination in England and Wales. DESIGN: Excess mortality estimated using time series of deaths registered to pneumonia or influenza, accounting for seasonality, trend and artefacts. Non-excess mortality plotted as proxy for long-term trend in mortality. SETTING: England and Wales. PARTICIPANTS: Persons aged 65-74 and 75+ years whose deaths were registered to underlying pneumonia or influenza between 1975/1976 and 2004/2005. OUTCOME MEASURES: Multiplicative effect on average excess pneumonia and influenza deaths each winter in the 4-6 winters since age group-based targeting of vaccination was introduced (in persons aged 75+ years from 1998/1999; in persons aged 65+ years from 2000/2001), estimated using multivariable regression adjusted for temperature, antigenic drift and vaccine mismatch, and stratified by dominant circulating influenza subtype. Trend in baseline weekly pneumonia and influenza death rates. RESULTS: There is a suggestion of lower average excess mortality in the six winters after age group-based targeting began compared to before, but the CI for the 65-74 years age group includes no difference. Trend in baseline pneumonia and influenza mortality shows an apparent downward turning point around 2000 for the 65-74 years age group and from the mid-1990s in the 75+ years age group. CONCLUSIONS: There is weakly supportive evidence that the marked increases in vaccine coverage accompanying the switch from risk-based to age group-based targeting of the elderly for yearly influenza vaccination in England and Wales were associated with lower levels of pneumonia and influenza mortality in older people in the first 6 years after age group-based targeting began. The possible impact of these policy changes is observed as weak evidence for lower average excess mortality as well as a turning point in baseline mortality coincident with the changes

Lower Bounds to Quality Factor of Small Radiators through Quasistatic Scattering Modes

The problem of finding the optimal current distribution supported by a small radiator yielding the minimum quality ($Q$) factor is a fundamental problem in electromagnetism. $Q$ factor bounds constrain the maximum operational bandwidth of devices including antennas, metamaterials, and open optical resonators. In this manuscript, a representation of the optimal current distribution in terms of quasistatic scattering modes is introduced. Quasi-electrostatic and quasi-magnetostatic modes describe the resonances of small plasmonic and high-permittivity particles, respectively. The introduced representation leads to analytical and closed form expressions of the electric and magnetic polarizability tensors of arbitrarily shaped objects, whose eigenvalues are known to be linked to the minimum $Q$. Hence, the minimum $Q$ and the corresponding optimal current are determined from the sole knowledge of the eigenvalues and the dipole moments associated with the quasistatic modes. It is found that, when the radiator exhibits two orthogonal reflection symmetries, its minimum $Q$ factor can be simply obtained from the $Q$ factors of its quasistatic modes, through a parallel formula. When an electric type radiator supports a spatially uniform quasistatic resonance mode, or when a magnetic type resonator supports a mode of curl type, then these modes are guaranteed to have the minimum $Q$ factor