The Practical Science of Society

https://commons.und.edu/und-books/1107/thumbnail.jp

Irreversible Kidney Damage due to Multicentric Castleman's Disease

Castleman's Disease (CD) is a rare lymphoproliferative disorder accompanied by marked systemic inflammatory response. Morphological diagnosis of CD requires biopsy of the whole of the involved lymph node tissue. Three histologic variants have already been described in CD morphology (hyaline vascular, plasma-cell, and mixed). In this study, we report a case of a multicentric Castleman's disease of the plasma cell variant type with negative Herpes Virus 8. The clinical presentation of this patient was of systemic amyloidosis as a result of both a delayed diagnosis and medical management. Previously described cases of CD with secondary amyloidosis have been of the localized type. Regardless, long-standing clinical remission of CD by cytotoxic drugs and anti-CD20 antibody therapy was achieved, but the nephrotic syndrome remained irreversible

Stop Release in Polish English — Implications for Prosodic Constituency

Although there is little consensus on the relevance of non-contrastive allophonic processes in L2 speech acquisition, EFL pronunciation textbooks cover the suppression of stop release in coda position. The tendency for held stops in English is in stark opposition to a number of other languages, including Polish, in which plosive release is obligatory. This paper presents phonetic data on the acquisition of English unreleased stops by Polish learners. Results show that in addition to showing a tendency for the target language pattern of unreleased plosives, advanced learners may acquire more native-like VC formant transitions. From the functional perspective, languages with unreleased stops may be expected to have robust formant patterns on the final portion of the preceding vowel, which allow listeners to identify the final consonant when it lacks an audible release burst (see e.g. Wright 2004). From the perspective of syllabic positions, it may be said that ‘coda’ stops are obligatorily released in Polish, yet may be unreleased in English. Thus, the traditional term ‘coda’ is insufficient to describe the prosodic properties of post-vocalic stops in Polish and English. These differences may be captured in the Onset Prominence framework (Schwartz 2013). In languages with unreleased stops, the mechanism of submersion places post-vocalic stops at the bottom of the representational hierarchy where they may be subject to weakening. Submersion produces larger prosodic constituents and thus has phonological consequences beyond ‘coda’ behavior

National immunization program decision making using the CAPACITI decision-support tool: user feedback from Indonesia and Ethiopia

To ensure that limited domestic resources are invested in the most effective interventions, immunization programs in low- and middle-income countries (LMICs) must prioritize a growing number of new vaccines while considering opportunities to optimize the vaccine portfolio, as well as other components of the health system. There is a strong impetus for immunization decision-making to engage and coordinate various stakeholders across the health system in prioritization. To address this, national immunization program decision-makers in LMICs collaborated with WHO to structure deliberation among stakeholders and document an evidence-based, context-specific, and transparent process for prioritization or selection among multiple vaccination products, services, or strategies. The output of this effort is the Country-led Assessment for Prioritization on Immunization (CAPACITI) decision-support tool, which supports using multiple criteria and stakeholder perspectives to evaluate trade-offs affecting health interventions, taking into account variable data quality. Here, we describe the user feedback from Indonesia and Ethiopia, two initial countries that piloted the CAPACITI decision-support tool, highlighting enabling and constraining factors. Potential immunization program benefits and lessons learned are also summarized for consideration in other settings

Controlled temperature chain for vaccination in low- and middle-income countries: a realist evidence synthesis

Objective To evaluate the evidence describing how the controlled temperature chain approach for vaccination could lead to improved equitable immunization coverage in low-and middle-income countries. Methods We created a theory of change construct from the Controlled temperature chain: strategic roadmap for priority vaccines 2017–2020, containing four domains: (i) uptake and demand for the approach; (ii) compliance and safe use of the approach; (iii) programmatic efficiency gains from the approach; and (iv) improved equitable immunization coverage. To verify and improve the theory of change, we applied a realist review method to analyse published descriptions of controlled temperature chain or closely related experiences. Findings We evaluated 34 articles, describing 22 unique controlled temperature chain or closely related experiences across four World Health Organization regions. We identified a strong demand for this approach among service delivery providers; however, generating an equal level of demand among policy-makers requires greater evidence on economic benefits and on vaccination coverage gains, and use case definitions. Consistent evidence supported safety of the approach when integrated into special vaccination programmes. Feasible training and supervision supported providers in complying with protocols. Time-savings were the main evidence for efficiency gains, while cost-saving data were minimal. Improved equitable coverage was reported where vaccine storage beyond the cold chain enabled access to hard-to-reach populations. No evidence indicated an inferior vaccine effectiveness nor increased adverse event rates for vaccines delivered under the approach. Conclusion Synthesized evidence broadly supported the initial theory of change. Addressing evidence gaps on economic benefits and coverage gains may increase future uptake

A Geostatistical Data Fusion Technique for Merging Remote Sensing and Ground-Based Observations of Aerosol Optical Thickness

Particles in the atmosphere reflect incoming sunlight, tending to cool the Earth below. Some particles, such as soot, also absorb sunlight, which tens to warm the ambient atmosphere. Aerosol optical depth (AOD) is a measure of the amount of particulate matter in the atmosphere, and is a key input to computer models that simulate and predict Earth's changing climate. The global AOD products from the Multi-angle Imaging SpectroRadiometer (MISR) and the MODerate resolution Imaging Spectroradiometer (MODIS), both of which fly on the NASA Earth Observing System's Terra satellite, provide complementary views of the particles in the atmosphere. Whereas MODIS offers global coverage about four times as frequent as MISR, the multi-angle data makes it possible to separate the surface and atmospheric contributions to the observed top-of-atmosphere radiances, and also to more effectively discriminate particle type. Surface-based AERONET sun photometers retrieve AOD with smaller uncertainties than the satellite instruments, but only at a few fixed locations. So there are clear reasons to combine these data sets in a way that takes advantage of their respective strengths. This paper represents an effort at combining MISR, MODIS and AERONET AOD products over the continental US, using a common spatial statistical technique called kriging. The technique uses the correlation between the satellite data and the "ground-truth" sun photometer observations to assign uncertainty to the satellite data on a region-by-region basis. The larger fraction of the sun photometer variance that is duplicated by the satellite data, the higher the confidence assigned to the satellite data in that region. In the Western and Central US, MISR AOD correlation with AERONET are significantly higher than those with MODIS, likely due to bright surfaces in these regions, which pose greater challenges for the single-view MODIS retrievals. In the east, MODIS correlations are higher, due to more frequent sampling of the varying AOD. These results demonstrate how the MISR and MODIS aerosol products are complementary. The underlying technique also provides one method for combining these products in such a way that takes advantage of the strengths of each, in the places and times when they are maximal, and in addition, yields an estimate of the associated uncertainties in space and time

Physicians' human papillomavirus vaccine recommendations in the context of permissive guidelines for male patients: a national study

BACKGROUND: Little is known about physicians' human papillomavirus (HPV) vaccine recommendations for males while the Advisory Committee on Immunization Practices' (ACIP) permissive guidelines for male vaccination were in effect. The purpose of this study was to examine and explore factors associated with U.S. physicians' HPV vaccine recommendations to early (ages 11-12), middle (13-17), and late adolescent/young adult (18-26) males. METHODS: Nationally representative samples of family physicians and pediatricians were selected in 2011 (n = 1,219). Physicians reported the frequency with which they recommended HPV vaccine to male patients ["always" (>75% of the time) vs. other] for each age group. Statistically significant predictors of vaccine recommendation were identified using multivariable logistic regression. RESULTS: The prevalence of physicians reporting they "always" recommended HPV vaccination for males was 10.8% for ages 11 to 12, 12.9% for ages 13 to 17, and 13.2% for ages 18 to 26. Pediatrician specialty and self-reported early adoption of new vaccines were significantly associated with recommendation for all patient age groups. In addition, physician race and patient payment method were associated with physician recommendations to patients ages 11 to 12, and patient race was associated with recommendations to ages 13 to 17 and 18 to 26. CONCLUSIONS: Less than 15% of physicians surveyed reported "always" recommending HPV vaccine to male patients following national guidelines for permissive vaccination. Vaccine financing may have affected physicians' vaccine recommendations. IMPACT: If these recommendation practices continue following the ACIP's routine recommendation for males in October 2011, then interventions designed to increase recommendations should target family physicians and possibly use early adopters to encourage support of HPV vaccination guidelines

Evaluation of the ESGE recommendations for COVID-19 pre-endoscopy risk-stratification in a high-volume center in Germany

Background and study aims The European Society of Gastrointestinal Endoscopy (ESGE) has defined COVID-19 infection prevention and control strategies within the endoscopy unit. These include pre-endoscopic questionnaire-based risk-stratification as well as pre-procedure viral testing. Real-life data on the effectiveness of these measures are presented here. Patients and methods Data from the outpatient endoscopic unit of the University Hospital Augsburg between July 1, 2020 and December 31, 2020 including the second pandemic wave were reviewed retrospectively. All patients were assessed with a pre-endoscopic risk-stratification questionnaire as well as viral testing using an antigen point-of-care test (Ag-POCT) in conjunction with a standard polymerase chain reaction (PCR) test. Highly elective procedures were postponed. The theoretically expected number of SARS-CoV-2-positive patients was simulated and compared with the actual number. In addition, endoscopy staff was evaluated with a rapid antibody test to determine the number of infections among the personnel. Results In total, 1029 procedures, 591 questionnaires, 591 Ag-POCTs, and 529 standard PCR tests were performed in 591 patients. 247 procedures in 142 patients were postponed. One Ag-POCT was positive but with a negative PCR test, while one PCR test was positive but with a negative Ag-POCT. This was lower than the theoretically expected number of COVID-19-positive patients (n = 15). One of 43 employees (2.3 %) in the outpatient endoscopy unit was seropositive. Conclusions Pre-endoscopic risk management including questionnaire-based risk stratification and viral testing seems to be an effective tool in combination with personal protective equipment for SARS-CoV-2 infection prevention and control within the endoscopy unit even in a high-prevalence setting

External injuries, trauma and avoidable deaths in Agincourt, South Africa : a retrospective observational and qualitative study

Acknowledgments We thank Chodziwadziwa Kabudula (MRC/Wits Rural Public Health and Health Transitions Research Unit—School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg/Acornhoek, South Africa) for his assistance with assembling the Agincourt HDSS data set for our use. The research presented in this paper was in part funded by the Health Systems Research Initiative from the Department for International Development (DFID)/ Medical Research Council (MRC)/Wellcome Trust/Economic and Social Research Council (ESRC) (MR/P014844/1).Peer reviewedPublisher PD