Variability in the immunogenicity of inactivated seasonal influenza vaccine in children due to age and recent previous influenza vaccination

Poster Session: VaccinesBackground: Annual receipt of trivalent inactivated influenza (TIV) vaccination is recommended for school-age children in some countries. However, there is little data on the variability of the immunogenicity of influenza vaccination in children and how this is affected by their age and recent influenza vaccination history. Materials and Methods: We used data on children in a Hong Kong community-based study who were randomized to receive TIV before the 2009-2010 influenza season. Antibody titers against seasonal and pandemic A(H1N1), seasonal A(H3N2), and two B influenza viruses (B/Brisbane and B/Florida) were measured by hemagglutination inhibition immediately before and 1 month after vaccination (Cowling et al. Clin Infect Dis. 2012). Multivariate regression models were fitted in a Bayesian framework to characterize the distribution of changes in antibody titers following vaccination and update previous findings by considering the correlation between virus strains (Ng et al. Pediatr Infect Dis J. 2013). Results: In 452 subjects, statistically significant rises in the geometric means of all antibody titers were observed, with those against the virus strains included in the TIV rising by geometric means of 7.95 to 13.36; those against pandemic A(H1N1) and B/Florida rose by 1.47 and 4.21, respectively. Geometric standard deviations were between 3.76 and 8.41 around the geometric means, with pandemic A(H1N1) showing the least variability in rises. The most closely correlated titer increases were those for the two influenza B viruses, while increases in pandemic A(H1N1) titers were unrelated to any other titer. Being vaccinated in either of the two previous years significantly reduced the increase in seasonal A(H1N1) and A(H3N2) antibody titers, while among children not vaccinated in the previous 2 years, those aged > 9 years experienced significantly higher increases in the influenza B titers than those aged 6-8 years. Conclusions: Increases in antibody titers following vaccination can vary depending on age and vaccination history. Results from our study suggest that humoral antibody response to TIV may be lower in children receiving repeated vaccination, but receipt of TIV induced seroprotection in most subjects.published_or_final_versio

Age-specific seriousness of avian influenza A(H7N9) in the second-wave epidemic in China

Poster Presentations 2 - Diseases at the Interface of Humans, Wildlife and Other Animals: no. 23.049PURPOSE: In spring 2013, a novel avian influenza A(H7N9) emerged in China causing more than 130 human infections mostly in the eastern provinces. The hospital fatality risk of A(H7N9) were about 35% and caused severe illness especially in older patients. In winter 2013-14, a second wave of A(H7N9) began with higher burden in the southern provinces in China. We estimated the relative risk of serious illness of patients aged 65 or above in the second wave of A(H7N9) epidemic, accounting for potential age-specific differences in poultry exposure …published_or_final_versio

Age-specific seriousness of avian influenza A(H7N9) in the second-wave epidemic in China

Poster Presentations 2 - Diseases at the Interface of Humans, Wildlife and Other Animals: no. 23.049PURPOSE: In spring 2013, a novel avian influenza A(H7N9) emerged in China causing more than 130 human infections mostly in the eastern provinces. The hospital fatality risk of A(H7N9) were about 35% and caused severe illness especially in older patients. In winter 2013-14, a second wave of A(H7N9) began with higher burden in the southern provinces in China. We estimated the relative risk of serious illness of patients aged 65 or above in the second wave of A(H7N9) epidemic, accounting for potential age-specific differences in poultry exposure …published_or_final_versio

Oscillatory, Computational, and Behavioral Evidence for Impaired GABAergic Inhibition in Schizophrenia

The dysconnection hypothesis of schizophrenia (SZ) proposes that psychosis is best understood in terms of aberrant connectivity. Specifically, it suggests that dysconnectivity arises through aberrant synaptic modulation associated with deficits in GABAergic inhibition, excitation-inhibition balance and disturbances of high-frequency oscillations. Using a computational model combined with a graded-difficulty visual orientation discrimination paradigm, we demonstrate that, in SZ, perceptual performance is determined by the balance of excitation-inhibition in superficial cortical layers. Twenty-eight individuals with a DSM-IV diagnosis of SZ, and 30 age- and gender-matched healthy controls participated in a psychophysics orientation discrimination task, a visual grating magnetoencephalography (MEG) recording, and a magnetic resonance spectroscopy (MRS) scan for GABA. Using a neurophysiologically informed model, we quantified group differences in GABA, gamma measures, and the predictive validity of model parameters for orientation discrimination in the SZ group. MEG visual gamma frequency was reduced in SZ, with lower peak frequency associated with more severe negative symptoms. Orientation discrimination performance was impaired in SZ. Dynamic causal modeling of the MEG data showed that local synaptic connections were reduced in SZ and local inhibition correlated negatively with the severity of negative symptoms. The effective connectivity between inhibitory interneurons and superficial pyramidal cells predicted orientation discrimination performance within the SZ group; consistent with graded, behaviorally relevant, disease-related changes in local GABAergic connections. Occipital GABA levels were significantly reduced in SZ but did not predict behavioral performance or oscillatory measures. These findings endorse the importance, and behavioral relevance, of GABAergic synaptic disconnection in schizophrenia that underwrites excitation-inhibition balance

Stakeholder management strategies during construction project work

This paper engages with stakeholder management practices from the building phase of hospital construction projects to analyse the methods employed by contractor and client in a construction project context. A series of vignettes illustrating stakeholder management practices in action are combined with the insights of a Client Relations Manager with direct responsibility for stakeholder management affairs. The paper provides practical guidance for practitioners and explores how stakeholder management issues revolve around the emerging event, with a supporting apparatus to facilitate communication and collaboration being critical to stakeholder interests and concerns being addressed. The insights are valuable for multiple health facility contexts where obtaining and maintaining stakeholder support is important

Assessing sedation need and managing referred dentally anxious patients:is there a role for the Index of Sedation Need?

Aim: To conduct an exploratory investigation of public dental service (PDS) practitioners' planned sedation modality using a structural equation modelling approach, in order to identify the explanatory value of using the Index of Sedation Need (IOSN), or its component parts, to predict sedation modality in patients referred with dental anxiety. Methods: A convenience sample of patients referred to the PDS for dental anxiety management was invited to take part. The IOSN was completed for each patient (patient dental anxiety, medical and behavioural indicators and dental treatment complexity) as well as the American Society of Anesthesiologists Physical Status Classification System and the Case Mix Tool. The practitioners completed details of their planned sedation modality and identified normative dental treatment need. The data were entered onto an SPSS v21 database and subjected to frequency distributions, t-tests, correlation analysis and exploratory partial structural equation modelling (SEM). Results: Ninety-five percent of patients were ranked as MDAS 3 or 4, indicating high dental anxiety; 69% had a medical condition, which might impact on dental treatment and 82% had a dental treatment need, which was classified as intermediate/complex according to the IOSN. Eighty-eight percent of the patients in accordance with the IOSN required sedation: 62% of patients were assessed as requiring intravenous sedation. The IOSN discriminated between patients who were assessed as requiring more complex sedation modalities and had a greater normative treatment need. The SEM showed that the patient dental anxiety (P <0.02) and dental treatment complexity (P <0.02) predicted planned sedation modality. Functional morbidity was less strong, as a predictor, and was significant at the ten percent level. Conclusions: The IOSN is a useful and valid assessment of sedation need and predicted sedation modality for patients referred with high dental anxiety states and secondly, that component parts of the IOSN add explanatory value in practitioners' choice of planned sedation modality

Household Transmission of Rotavirus in a Community with Rotavirus Vaccination in Quininde, Ecuador

Background: We studied the transmission of rotavirus infection in households in peri-urban Ecuador in the vaccination era. Methods: Stool samples were collected from household contacts of child rotavirus cases, diarrhea controls and healthy controls following presentation of the index child to health facilities. Rotavirus infection status of contacts was determined by RT-qPCR. We examined factors associated with transmissibility (index-case characteristics) and susceptibility (householdcontact characteristics). Results: Amongst cases, diarrhea controls and healthy control household contacts, infection attack rates (iAR) were 55%, 8% and 2%, (n = 137, 130, 137) respectively. iARs were higher from index cases with vomiting, and amongst siblings. Disease ARs were higher when the index child was ,18 months and had vomiting, with household contact ,10 years and those sharing a room with the index case being more susceptible. We found no evidence of asymptomatic infections leading to disease transmission. Conclusion: Transmission rates of rotavirus are high in households with an infected child, while background infections are rare. We have identified factors associated with transmission (vomiting/young age of index case) and susceptibility (young age/sharing a room/being a sibling of the index case). Vaccination may lead to indirect benefits by averting episodes or reducing symptoms in vaccinees

Aiming higher to bend the curve of biodiversity loss

The development of the post-2020 strategic plan for the Convention on Biological Diversity provides a vital window of opportunity to set out an ambitious plan of action to restore global biodiversity. The components of such a plan, including its goal, targets and some metrics, already exist and provide a roadmap to 2050

Single-lined Spectroscopic Binary Star Candidates in the RAVE Survey

Repeated spectroscopic observations of stars in the RAdial Velocity Experiment (RAVE) database are used to identify and examine single-lined binary (SB1) candidates. The RAVE latest internal database (VDR3) includes radial velocities, atmospheric parameters, and other parameters for approximately a quarter of a million different stars with slightly less than 300,000 observations. In the sample of ~20,000 stars observed more than once, 1333 stars with variable radial velocities were identified. Most of them are believed to be SB1 candidates. The fraction of SB1 candidates among stars with several observations is between 10% and 15% which is the lower limit for binarity among RAVE stars. Due to the distribution of time spans between the re-observation that is biased toward relatively short timescales (days to weeks), the periods of the identified SB1 candidates are most likely in the same range. Because of the RAVE's narrow magnitude range most of the dwarf candidates belong to the thin Galactic disk while the giants are part of the thick disk with distances extending to up to a few kpc. The comparison of the list of SB1 candidates to the VSX catalog of variable stars yielded several pulsating variables among the giant population with radial velocity variations of up to few tens of km s–1. There are 26 matches between the catalog of spectroscopic binary orbits ($S_{B^9}$) and the whole RAVE sample for which the given periastron time and the time of RAVE observation were close enough to yield a reliable comparison. RAVE measurements of radial velocities of known spectroscopic binaries are consistent with their published radial velocity curves

The Citation Field of Evolutionary Economics

Evolutionary economics has developed into an academic field of its own, institutionalized around, amongst others, the Journal of Evolutionary Economics (JEE). This paper analyzes the way and extent to which evolutionary economics has become an interdisciplinary journal, as its aim was: a journal that is indispensable in the exchange of expert knowledge on topics and using approaches that relate naturally with it. Analyzing citation data for the relevant academic field for the Journal of Evolutionary Economics, we use insights from scientometrics and social network analysis to find that, indeed, the JEE is a central player in this interdisciplinary field aiming mostly at understanding technological and regional dynamics. It does not, however, link firmly with the natural sciences (including biology) nor to management sciences, entrepreneurship, and organization studies. Another journal that could be perceived to have evolutionary acumen, the Journal of Economic Issues, does relate to heterodox economics journals and is relatively more involved in discussing issues of firm and industry organization. The JEE seems most keen to develop theoretical insights