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Four different study designs to evaluate vaccine safety were equally validated with contrasting limitations
OBJECTIVE:
We conducted a simulation study to empirically compare four study designs [cohort, case-control, risk-interval, self-controlled case series (SCCS)] used to assess vaccine safety. STUDY DESIGN AND METHODS:
Using Vaccine Safety Datalink data (a Centers for Disease Control and Prevention-funded project), we simulated 250 case sets of an acute illness within a cohort of vaccinated and unvaccinated children. We constructed the other three study designs from the cohort at three different incident rate ratios (IRRs, 2.00, 3.00, and 4.00), 15 levels of decreasing disease incidence, and two confounding levels (20%, 40%) for both fixed and seasonal confounding. Each of the design-specific study samples was analyzed with a regression model. The design-specific beta; estimates were compared. RESULTS:
The beta; estimates of the case-control, risk-interval, and SCCS designs were within 5% of the true risk parameters or cohort estimates. However, the case-control\u27s estimates were less precise, less powerful, and biased by fixed confounding. The estimates of SCCS and risk-interval designs were biased by unadjusted seasonal confounding. CONCLUSIONS:
All the methods were valid designs, with contrasting strengths and weaknesses. In particular, the SCCS method proved to be an efficient and valid alternative to the cohort method
Formation of Super-Earths
Super-Earths are the most abundant planets known to date and are
characterized by having sizes between that of Earth and Neptune, typical
orbital periods of less than 100 days and gaseous envelopes that are often
massive enough to significantly contribute to the planet's overall radius.
Furthermore, super-Earths regularly appear in tightly-packed multiple-planet
systems, but resonant configurations in such systems are rare. This chapters
summarizes current super-Earth formation theories. It starts from the formation
of rocky cores and subsequent accretion of gaseous envelopes. We follow the
thermal evolution of newly formed super-Earths and discuss their atmospheric
mass loss due to disk dispersal, photoevaporation, core-cooling and collisions.
We conclude with a comparison of observations and theoretical predictions,
highlighting that even super-Earths that appear as barren rocky cores today
likely formed with primordial hydrogen and helium envelopes and discuss some
paths forward for the future.Comment: Invited review accepted for publication in the 'Handbook of
Exoplanets,' Planet Formation section, Springer Reference Works, Juan Antonio
Belmonte and Hans Deeg, Ed
Variation in hepatitis B immunization coverage rates associated with provider practices after the temporary suspension of the birth dose
BACKGROUND: In 1999, the American Academy of Pediatrics and U.S. Public Health Service recommended suspending the birth dose of hepatitis B vaccine due to concerns about potential mercury exposure. A previous report found that overall national hepatitis B vaccination coverage rates decreased in association with the suspension. It is unknown whether this underimmunization occurred uniformly or was associated with how providers changed their practices for the timing of hepatitis B vaccine doses. We evaluate the impact of the birth dose suspension on underimmunization for the hepatitis B vaccine series among 24-month-olds in five large provider groups and describe provider practices potentially associated with underimmunization following the suspension. METHODS: Retrospective cohort study of children enrolled in five large provider groups in the United States (A-E). Logistic regression was used to evaluate the association between the birth dose suspension and a child's probability of being underimmunized at 24 months for the hepatitis B vaccine series. RESULTS: Prior to July 1999, the percent of children who received a hepatitis B vaccination at birth varied widely (3% to 90%) across the five provider groups. After the national recommendation to suspend the hepatitis B birth dose, the percent of children who received a hepatitis B vaccination at birth decreased in all provider groups, and this trend persisted after the policy was reversed. The most substantial decreases were observed in the two provider groups that shifted the first hepatitis B dose from birth to 5–6 months of age. Accounting for temporal trend, children in these two provider groups were significantly more likely to be underimmunized for the hepatitis B series at 24 months of age if they were in the birth dose suspension cohort compared with baseline (Group D OR 2.7, 95% CI 1.7 – 4.4; Group E OR 3.1, 95% CI 2.3 – 4.2). This represented 6% more children in Group D and 9% more children in Group E who were underimmunized in the suspension cohort compared with baseline. Children in the reversal cohort in these groups remained significantly more likely to be underimmunized compared with baseline. In contrast, in a third provider group where the typical timing of the third dose was unchanged and in two other provider groups whose hepatitis B vaccination schedules were unaffected by the birth dose suspension, hepatitis B vaccination coverage either was maintained or improved. CONCLUSION: When the hepatitis B birth dose was suspended, provider groups that moved the first dose of vaccination to 5–6 months of age or later had decreases in hepatitis B vaccine coverage at 24 months. These findings suggest that as vaccine policy changes occur, providers could attempt to minimize underimmunization by adopting vaccination schedules that minimize delays in the recommended timing of vaccine doses
Impact of the introduction of pneumococcal conjugate vaccine on immunization coverage among infants
Background
The introduction of pneumococcal conjugate vaccine (PCV) to the U.S. recommended childhood immunization schedule in the year 2000 added three injections to the number of vaccinations a child is expected to receive during the first year of life. Surveys have suggested that the addition of PCV has led some immunization providers to move other routine childhood vaccinations to later ages, which could increase the possibility of missing these vaccines. The purpose of this study was to evaluate whether introduction of PCV affected immunization coverage for recommended childhood vaccinations among 13-month olds in four large provider groups. Methods
In this retrospective cohort study, we analyzed computerized data on vaccinations for 33,319 children in four large provider groups before and after the introduction of PCV. The primary outcome was whether the child was up to date for all non-PCV recommended vaccinations at 13 months of age. Logistic regression was used to evaluate the association between PCV introduction and the primary outcome. The secondary outcome was the number of days spent underimmunized by 13 months. The association between PCV introduction and the secondary outcome was evaluated using a two-part modelling approach using logistic and negative binomial regression. Results
Overall, 93% of children were up-to-date at 13 months, and 70% received all non-PCV vaccinations without any delay. Among the entire study population, immunization coverage was maintained or slightly increased from the pre-PCV to post-PCV periods. After multivariate adjustment, children born after PCV entered routine use were less likely to be up-to-date at 13 months in one provider group (Group C: OR = 0.5; 95% CI: 0.3 – 0.8) and were less likely to have received all vaccine doses without any delay in two Groups (Group B: OR = 0.4, 95% CI: 0.3 – 0.6; Group C: OR = 0.5, 95% CI: 0.4 – 0.7). This represented 3% fewer children in Group C who were up-to-date and 14% (Group C) to 16% (Group B) fewer children who spent no time underimmunized at 13 months after PCV entered routine use compared to the pre-PCV baseline. Some disruptions in immunization delivery were also observed concurrent with temporary recommendations to suspend the birth dose of hepatitis B vaccine, preceding the introduction of PCV. Conclusion
These findings suggest that the introduction of PCV did not harm overall immunization coverage rates in populations with good access to primary care. However, we did observe some disruptions in the timely delivery of other vaccines coincident with the introduction of PCV and the suspension of the birth dose of hepatitis B vaccine. This study highlights the need for continued vigilance in coming years as the U.S. introduces new childhood vaccines and policies that may change the timing of existing vaccines
Deep-Sea Origin and In-Situ Diversification of Chrysogorgiid Octocorals
The diversity, ubiquity and prevalence in deep waters of the octocoral family Chrysogorgiidae Verrill, 1883 make it noteworthy as a model system to study radiation and diversification in the deep sea. Here we provide the first comprehensive phylogenetic analysis of the Chrysogorgiidae, and compare phylogeny and depth distribution. Phylogenetic relationships among 10 of 14 currently-described Chrysogorgiidae genera were inferred based on mitochondrial (mtMutS, cox1) and nuclear (18S) markers. Bathymetric distribution was estimated from multiple sources, including museum records, a literature review, and our own sampling records (985 stations, 2345 specimens). Genetic analyses suggest that the Chrysogorgiidae as currently described is a polyphyletic family. Shallow-water genera, and two of eight deep-water genera, appear more closely related to other octocoral families than to the remainder of the monophyletic, deep-water chrysogorgiid genera. Monophyletic chrysogorgiids are composed of strictly (Iridogorgia Verrill, 1883, Metallogorgia Versluys, 1902, Radicipes Stearns, 1883, Pseudochrysogorgia Pante & France, 2010) and predominantly (Chrysogorgia Duchassaing & Michelotti, 1864) deep-sea genera that diversified in situ. This group is sister to gold corals (Primnoidae Milne Edwards, 1857) and deep-sea bamboo corals (Keratoisidinae Gray, 1870), whose diversity also peaks in the deep sea. Nine species of Chrysogorgia that were described from depths shallower than 200 m, and mtMutS haplotypes sequenced from specimens sampled as shallow as 101 m, suggest a shallow-water emergence of some Chrysogorgia species
Spatial variations in ambient ultrafine particle concentrations and the risk of incident prostate cancer: A case-control study
Background Diesel exhaust contains large numbers of ultrafine particles (UFPs, <0.1 µm) and is a recognized human carcinogen. However, epidemiological studies have yet to evaluate the relationship between UFPs and cancer incidence. Methods We conducted a case-control study of UFPs and incident prostate cancer in Montreal, Canada. Cases were identified from all main Francophone hospitals in the Montreal area between 2005 and 2009. Population controls were identified from provincial electoral lists of French Montreal residents and frequency-matched to cases using 5-year age gr
Molecular and Atomic Excitation Stratification in the Outflow of the Planetary Nebula M27
High resolution spectroscopy with FUSE and STIS of atomic and molecular
velocity stratification in the nebular outflow of M27 challenge models for the
abundance kinematics in planetary nebulae. The simple picture of a very high
speed (~ 1000 km/s), high ionization, radiation driven stellar wind surrounded
by a slower (~ 10 km/s) mostly molecular outflow, with low ionization and
neutral atomic species residing at the wind interaction interface, is not
supported... We find ...there is a fast (33 -- 65 km/s) low ionization zone,
surrounding a slower (<~ 33 km/s) high ionization zone and, at the transition
velocity (33 km/s), vibrationally excited H_2 is intermixed with a
predominately neutral atomic medium... Far-UV continuum fluorescence of H_2 is
not detected, but Lyman alpha (Lya) fluorescence is present. The diffuse
nebular medium is inhospitable to molecules and dust. Maintaining the modest
equilibrium abundance of H_2 (N(H_2)/N(HI) << 1) in the diffuse nebular medium
requires a source of H_2, mostly likely the clumpy nebular medium. The stellar
SED shows no signs of reddening (E(B-V) < 0.01), but paradoxically measurements
of Ha/Hb ... indicate E(B-V) ~ 0.1. ...the apparent enhancement of Ha/Hb in the
absence of dust may result from a two step process of H_2 ionization by Lyman
continuum (Lyc) photons followed by dissociative recombination (H_2 + gamma ->
H_2^+ + e -> H(1s) + H (nl)), which ultimately produces fluorescence of Ha and
Lya. In the optically thin limit at the inferred radius of the velocity
transition we find dissociation of H_2 by stellar Lyc photons is an order of
magnitude more efficient than spontaneous dissociation by far-UV photons. We
suggest that the importance of this H_2 destruction process in HII regions has
been overlooked.Comment: In emulateapj 2 column, 28 pages total, 18 figures. Accepted for
publication in the Astrophysical Journal on 5 January 2007. Abstract abridge
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