Seasonality and geographical spread of respiratory syncytial virus epidemics in 15 European countries, 2010 to 2016

Respiratory syncytial virus (RSV) is considered the most common pathogen causing severe lower respiratory tract infections among infants and young children. We describe the seasonality and geographical spread of RSV infection in 15 countries of the European Union and European Economic Area. We performed a retrospective descriptive study of weekly laboratory-confirmed RSV detections between weeks 40/2010 and 20/2016, in patients investigated for influenzalike illness, acute respiratory infection or following the clinician's judgment. Six countries reported 4,230 sentinel RSV laboratory diagnoses from primary care and 14 countries reported 156,188 non-sentinel laboratory diagnoses from primary care or hospitals. The median length of the RSV season based on sentinel and non-sentinel surveillance was 16 (range: 9-24) and 18 (range: 8-24) weeks, respectively. The median peak weeks for sentinel and non-sentinel detections were week 4 (range: 48 to 11) and week 4.5 (range: 49 to 17), respectively. RSV detections peaked later (r = 0.56; p = 0.0360) and seasons lasted longer with increasing latitude (r = 0.57; p = 0.0329). Our data demonstrated regular seasonality with moderate correlation between timing of the epidemic and increasing latitude of the country. This study supports the use of RSV diagnostics within influenza or other surveillance systems to monitor RSV seasonality and geographical spread

Operative versus non-operative management of pediatric medial epicondyle fractures: a systematic review

There is ongoing debate about the management of medial epicondyle fractures in the pediatric population. This systematic review evaluated non-operative versus operative treatment of medial epicondyle fractures in pediatric and adolescent patients over the last six decades. A systematic review of the available literature was performed. Frequency-weighted mean union times were used to compare union rates for closed versus open treatments. Moreover, functional outcomes and range-of-motion variables were correlated with varying treatment modalities. Any complications, including ulnar nerve symptoms, pain, instability, infection, and residual deformity, were cataloged. Fourteen studies, encompassing 498 patients, met the inclusion/exclusion criteria. There were 261 males and 132 female patients; the frequency-weighted average age was 11.93 years. The follow-up range was 6–216 months. Under the cumulative random effects model, the odds of union with operative fixation was 9.33 times the odds of union with non-operative treatment (P < 0.0001). There was no significant difference between operative and non-operative treatments in terms of pain at final follow-up (P = 0.73) or ulnar nerve symptoms (P = 0.412). Operative treatment affords a significantly higher union rate over the non-operative management of medial epicondyle fractures. There was no difference in pain at final follow-up between operative and non-operative treatments. As surgical indications evolve, and the functional demands of pediatric patients increase, surgical fixation should be strongly considered to achieve stable fixation and bony union

Assessing the value of intangible benefits of property level flood risk adaptation (PLFRA) measures

© 2015, Springer Science+Business Media Dordrecht. Studies in the UK and elsewhere have identified that flooding can result in diverse impacts, ranging from significant financial costs (tangible) to social (intangible) impacts on households. At the same time, it is now clear that large-scale flood defence schemes are not the panacea to flood risk, and there is an increasing responsibility on property owners to protect their own properties. Hence, there is an emerging expectation for homeowners to take action in the form of investing in property level flood risk adaptation (PLFRA) measures to protect their properties. However, hitherto the level of uptake of such measures remains very low. The tangible financial benefits of investing in PLFRA measures are generally well understood and have been demonstrated to be cost beneficial for many properties at risk from frequent flooding. Importantly, these estimates tend to take little account of the value of the intangible benefits of PLFRA measures and therefore may be under estimating their full benefits. There remains a need to develop an improved understanding of these intangible benefits, and this research sets out to bridge this knowledge gap. Based on a synthesis of the literature, the contingent valuation method was selected as a means to value intangible impacts of flooding on households. A questionnaire survey of homeowners affected in the 2007 flooding was employed to elicit willingness to pay (WTP) values to avoid the intangible impacts of flooding on their households. The analysis of the questionnaire survey data revealed that the average WTP per household per year to avoid intangible flood impacts was £653. This therefore represents the value of the intangible benefits of investing in PLFRA measures and is significantly higher than previously estimated. This research builds on previous research in suggesting a higher value to the intangible impacts of flooding on households by assessing wider range of intangible impacts and focussing on more experienced individuals. Furthermore, the research indicates that factors which influence the WTP values were principally stress of flood, worrying about loss of house values, worrying about future flooding and age of respondents, with income showing a weak correlation. The establishment of a new value for the intangible impacts of flooding on households in the UK is helpful in the domain of flood risk management when evaluating the total benefits (tangible and intangible) of investing in flood protection measures, thus providing a robust assessment for decision-making on flood adaptation measures at an individual property level

Anti-Cancer Effect of HIV-1 Viral Protein R on Doxorubicin Resistant Neuroblastoma

Several unique biological features of HIV-1 Vpr make it a potentially powerful agent for anti-cancer therapy. First, Vpr inhibits cell proliferation by induction of cell cycle G2 arrest. Second, it induces apoptosis through multiple mechanisms, which could be significant as it may be able to overcome apoptotic resistance exhibited by many cancerous cells, and, finally, Vpr selectively kills fast growing cells in a p53-independent manner. To demonstrate the potential utility of Vpr as an anti-cancer agent, we carried out proof-of-concept studies in vitro and in vivo. Results of our preliminary studies demonstrated that Vpr induces cell cycle G2 arrest and apoptosis in a variety of cancer types. Moreover, the same Vpr effects could also be detected in some cancer cells that are resistant to anti-cancer drugs such as doxorubicin (DOX). To further illustrate the potential value of Vpr in tumor growth inhibition, we adopted a DOX-resistant neuroblastoma model by injecting SK-N-SH cells into C57BL/6N and C57BL/6J-scid/scid mice. We hypothesized that Vpr is able to block cell proliferation and induce apoptosis regardless of the drug resistance status of the tumors. Indeed, production of Vpr via adenoviral delivery to neuroblastoma cells caused G2 arrest and apoptosis in both drug naïve and DOX-resistant cells. In addition, pre-infection or intratumoral injection of vpr-expressing adenoviral particles into neuroblastoma tumors in SCID mice markedly inhibited tumor growth. Therefore, Vpr could possibly be used as a supplemental viral therapeutic agent for selective inhibition of tumor growth in anti-cancer therapy especially when other therapies stop working

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of SARS-CoV-2 genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three available genomic nomenclature systems for SARS-CoV-2 to all sequence data from the WHO European Region available during the COVID-19 pandemic until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation. We provide a comparison of the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2.Peer reviewe

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Hur kan föreningen Kopparberg/Göteborg FC utveckla sin marknadskommunikation mot målgruppen tjejer 8-16 år? : Undersökning av en elitförenings arbete med marknadskommunikation

Syfte och frågeställningar Syftet med studien är att göra en målgruppundersökning samt att utifrån den utveckla föreningens arbete med marknadskommunikation mot den aktuella målgruppen. En förbättrad kommunikation med målgruppen skall förhoppningsvis leda till ökat intresse och större publik på hemmamatcherna.   Följande frågeställningar har behandlats: Hur uppfattar målgruppen Kopparbergs/Göteborg FC (i fortsättningen förkortat KGFC) budskap? Vilken attityd och vilket beteende kännetecknar målgruppen? Hur skapar KGFC ett ökat intresse hos målgruppen? Vilka kanaler skall KGFC främst satsa på? Hur kan KGFC utveckla sin marknadskommunikation mot målgruppen?   Metod Vi har använt oss av en kvalitativ metod med stora kvantitativa inslag. Exempel på kvantitativa inslag är en enkätundersökning på föreningens primära målgrupp (tjejer 8-16 år). Till grund för arbetet ligger enkätundersökningen och en intervju med sportchefen Lars Svensson samt befintlig litteratur inom marknadsföring och kommunikation.   Resultat Som resultat har vi fått fram att KGFCs budskap är otydligt för målgruppen, att KGFCs främsta kanal för att kommunicera är hemsidan samt att målgruppen har begränsad kunskap om föreningen. Resultatet visar även att föreningen måste öka intresset för laget för att locka mer publik till matcherna.    Slutsats Vår slutsats utifrån resultat och litteratur är att KGFC måste arbeta med målgrupp, budskap och framförallt kanal om man vill effektivisera sin kommunikation med målgruppen. Man bör lägga upp en tydlig strategi angående kanalval, budskap och målgrupp istället för att satsa på mindre punktinsatser.