Persistent Barriers to Implementing Efficacious Mosquito Control Activities in the Continental United States: Insights from Vector Control Experts

Many barriers undermine vector surveillance and control efforts in the United States. Experts warn that such barriers, including funding, threaten the capacity of public-health surveillance systems to detect emerging mosquito-borne disease and respond appropriately, timely and effectively. This chapter explores the status, barriers, and corrective strategies to effective mosquito surveillance and control in the US based on experiences and insights of the 35 interviewed representatives of diverse mosquito-control programs selected from 18 U.S. states. Although our interest is in mosquito-borne diseases, we focus on the 2016 Zika outbreak. For the most part, this chapter will outline issues relating to mosquito control and surveillance that have persistent among state, county and municipal programs as a result of insufficient and unreliable funding, inadequate trained personnel, poor facilities, and inadequate political support. At the community level, we will discuss issues that hinder mosquito control efforts including apathy and low public awareness, and provide examples of how mosquito control agencies have adapted to “readily” respond to changing vector-borne disease environments, demands and constrained funding

Dielectric function of InGaAs in the visible

Measurements are reported of the dielectric function of thermodynamically stable In(x)Ga(1-x)As in the composition range 0.3 equal to or less than X = to or less than 0.7. The optically thick samples of InGaAs were made by molecular beam epitaxy (MBE) in the range 0.4 = to or less than X = to or less than 0.7 and by metal-organic chemical vapor deposition (MOCVD) for X = 0.3. The MBE made samples, usually 1 micron thick, were grown on semi-insulating InP and included a strain release structure. The MOCVD sample was grown on GaAs and was 2 microns thick. The dielectric functions were measured by variable angle spectroscopic ellipsometry in the range 1.55 to 4.4 eV. The data was analyzed assuming an optically thick InGaAs material with an oxide layer on top. The thickness of this layer was estimated by comparing the results for the InP lattice matched material, i.e., X = 0.53, with results published in the literature. The top oxide layer mathematically for X = 0.3 and X = 0.53 was removed to get the dielectric function of the bare InGaAs. In addition, the dielectric function of GaAs in vacuum, after a protective arsenic layer was removed. The dielectric functions for X = 0, 0.3, and 0.53 together with the X = 1 result from the literature to evaluate an algorithm for calculating the dielectric function of InGaAs for an arbitrary value of X(0 = to or less than X = to or less than 1) were used. Results of the dielectric function calculated using the algorithm were compared with experimental data

Study of InGaAs based MODFET structures using variable angle spectroscopic ellipsometry

Variable angle spectroscopic ellipsometry was used to estimate the thicknesses of all layers within the optical penetration depth of InGaAs based MODFET structures. Strained and unstrained InGaAs channels were made by MBE on InP substrates and by MOCVD on GaAs substrates. In most cases, ellipsometrically determined thicknesses were within 10 percent of the growth calibration results. The MBE made InGaAs strained layers showed large strain effects, indicating a probable shift in the critical points of their dielectric function toward the InP lattice matched concentration

Spatial distribution and factors associated with modern contraceptive use among women of reproductive age in Nigeria: a multilevel analysis

Background: Evidence suggests that in countries with high fertility and fecundity rates, such as Nigeria, the promotion of modern contraceptive use prevents approximately 32% and 10% of maternal and child mortality, respectively. Therefore, this study aimed to assess the spatial distribution of modern contraceptive use and its predictors among women of reproductive age in Nigeria. Methods: The study employed a cross-sectional analysis of population-based data involving 24,281 women of reproductive age in Nigeria. The study adopted both multilevel and spatial analyses to identify the predictors of modern contraceptive use and its spatial clustering among women in Nigeria. Results: Modern contraceptive use among the study population in Nigeria ranged from 0% to 75%, with regional variations. The spatial analysis showed that areas with a low proportion of modern contraceptive use were Sokoto, Yobe, Borno, Katsina, Zamfara, Kebbi, Niger, Taraba and Delta. Areas with a high proportion of modern contraceptive use were Lagos, Oyo, Osun, Ekiti, Federal capital territory, Plateau, Adamawa, Imo, and Bayelsa. The multilevel analysis revealed that at the individual level, women with secondary/higher education, women from the Yoruba ethnic group, those who had four children and above, and those exposed to mass media had higher odds of using modern contraceptives. On the other hand, women who were 35 years and above, those who were married, and women who were practicing Islam were less likely to use modern contraceptives. At the household/community level, women from the richest households, those residing in communities with medium knowledge of modern contraceptive methods, and women residing in communities with a high literacy level were more likely to use modern contraceptives. Conclusion: There were major variations in the use of modern contraception across various regions in Nigeria. As a result, areas with low contraceptive rates should be given the most deserving attention by promoting contraceptive education and use as well as considering significant factors at the individual and household/community levels

Outcomes with daptomycin in the treatment of Staphylococcus aureus infections with a range of vancomycin MICs

Staphylococcus aureus suggest the use of alternative agents when vancomycin MIC values are ≥2 mg/L. This study examines the outcome of patients treated with daptomycin for S. aureus infections with documented vancomycin MICs. Patients and methods: All patients with skin, bacteraemia and endocarditis infections due to S. aureus with vancomycin MIC values in CORE 2005–08, a retrospective, multicentre, observational registry, were studied. The outcome (cure, improved, failure or non-evaluable) was the investigator assessment at the end of dapto-mycin therapy. Success was defined as cure or improved. Results: Five hundred and forty-seven clinically evaluable patients were identified with discrete vancomycin MIC values [MIC,2 mg/L: 451 (82%); MIC ≥2 mg/L: 96 (18%)]. The vancomycin MIC groups were well matched for patient characteristics, types of infections, first-line daptomycin use (19%) and prior vancomycin use (58%). Clinical success was reported in 94 % of patients. No differences were detected in the daptomycin success rate by the vancomycin MIC group overall or by the infection type. A multivariate logistic regression also failed to identify vancomycin MIC as a predictor of daptomycin failure. Adverse event (AE) rates were not differ-ent when analysed by MIC group; both groups had 17 % of patients with one AE. Conclusions: In this diverse population, daptomycin was associated with similar outcomes for patients, regard-less of whether the vancomycin MIC was categorized as,2 or ≥2 mg/L. Further studies are warranted

Personal preferences for Personalised Trials among patients with chronic diseases: an empirical Bayesian analysis of a conjoint survey.

OBJECTIVE: To describe individual patient preferences for Personalised Trials and to identify factors and conditions associated with patient preferences. DESIGN: Each participant was presented with 18 conjoint questions via an online survey. Each question provided two choices of Personalised Trials that were defined by up to eight attributes, including treatment types, clinician involvement, study logistics and trial burden on a patient. SETTING: Online survey of adults with at least two common chronic conditions in the USA. PARTICIPANTS: A nationally representative sample of 501 individuals were recruited from the Chronic Illness Panel by Harris Poll Online. Participants were recruited from several sources, including emails, social media and telephone recruitment of the target population. MAIN OUTCOME MEASURES: The choice of Personalised Trial design that the participant preferred with each conjoint question. RESULTS: There was large variability in participants\u27 preferences for the design of Personalised Trials. On average, they preferred certain attributes, such as a short time commitment and no cost. Notably, a population-level analysis correctly predicted 62% of the conjoint responses. An empirical Bayesian analysis of the conjoint data, which supported the estimation of individual-level preferences, improved the accuracy to 86%. Based on estimates of individual-level preferences, patients with chronic pain preferred a long study duration (p≤0.001). Asthma patients were less averse to participation burden in terms of data-collection frequency than patients with other conditions (p=0.002). Patients with hypertension were more cost-sensitive (p\u3c0.001). CONCLUSION: These analyses provide a framework for elucidating individual-level preferences when implementing novel patient-centred interventions. The data showed that patient preference in Personalised Trials is highly variable, suggesting that individual differences must be accounted for when marketing Personalised Trials. These results have implications for advancing precise interventions in Personalised Trials by indicating when rigorous scientific principles, such as frequent monitoring, is feasible in a substantial subset of patients

Further Confirmation of Broadly Conserved, Highly Immunogenic Cross-Clade HIV CTL Epitopes for Inclusion in the GAIA HIV Vaccine

Poster Presentation From AIDS Vaccine 2012 Boston, MA, USA. 9-12 September 201

Longitudinal Analysis of Quality of Life, Clinical, Radiographic, Echocardiographic, and Laboratory Variables in Dogs with Preclinical Myxomatous Mitral Valve Disease Receiving Pimobendan or Placebo: The EPIC Study

Background: Changes in clinical variables associated with the administration of pimobendan to dogs with preclinical myxomatous mitral valve disease (MMVD) and cardiomegaly have not been described. Objectives: To investigate the effect of pimobendan on clinical variables and the relationship between a change in heart size and the time to congestive heart failure (CHF) or cardiac-related death (CRD) in dogs with MMVD and cardiomegaly. To determine whether pimobendan-treated dogs differ from dogs receiving placebo at onset of CHF. Animals: Three hundred and fifty-four dogs with MMVD and cardiomegaly. Materials and Methods: Prospective, blinded study with dogs randomized (ratio 1:1) to pimobendan (0.4-0.6 mg/kg/d) or placebo. Clinical, laboratory, and heart-size variables in both groups were measured and compared at different time points (day 35 and onset of CHF) and over the study duration. Relationships between short-term changes in echocardiographic variables and time to CHF or CRD were explored. Results: At day 35, heart size had reduced in the pimobendan group:median change in (Delta) LVIDDN -0.06 (IQR:-0.15 to + 0.02), P < 0.0001, and LA:Ao -0.08 (IQR:-0.23 to + 0.03), P < 0.0001. Reduction in heart size was associated with increased time to CHF or CRD. Hazard ratio for a 0.1 increase in Delta LVIDDN was 1.26, P = 0.0003. Hazard ratio for a 0.1 increase in Delta LA:Ao was 1.14, P = 0.0002. At onset of CHF, groups were similar. Conclusions and Clinical Importance: Pimobendan treatment reduces heart size. Reduced heart size is associated with improved outcome. At the onset of CHF, dogs treated with pimobendan were indistinguishable from those receiving placebo

On two-dimensional surface attractors and repellers on 3-manifolds

We show that if $f: M^3\to M^3$ is an $A$-diffeomorphism with a surface two-dimensional attractor or repeller $\mathcal B$ and $M^2_ \mathcal B$ is a supporting surface for $\mathcal B$, then $\mathcal B = M^2_{\mathcal B}$ and there is $k\geq 1$ such that: 1) $M^2_{\mathcal B}$ is a union $M^2_1\cup...\cup M^2_k$ of disjoint tame surfaces such that every $M^2_i$ is homeomorphic to the 2-torus $T^2$. 2) the restriction of $f^k$ to $M^2_i$ $(i\in\{1,...,k\})$ is conjugate to Anosov automorphism of $T^2$