398 research outputs found
Absolute and relative vaccine effectiveness of primary and booster series of COVID-19 vaccines (mRNA and adenovirus vector) against COVID-19 hospitalizations in the United States, December 2021-April 2022
BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccine effectiveness (VE) studies are increasingly reporting relative VE (rVE) comparing a primary series plus booster doses with a primary series only. Interpretation of rVE differs from traditional studies measuring absolute VE (aVE) of a vaccine regimen against an unvaccinated referent group. We estimated aVE and rVE against COVID-19 hospitalization in primary-series plus first-booster recipients of COVID-19 vaccines.
METHODS: Booster-eligible immunocompetent adults hospitalized at 21 medical centers in the United States during December 25, 2021-April 4, 2022 were included. In a test-negative design, logistic regression with case status as the outcome and completion of primary vaccine series or primary series plus 1 booster dose as the predictors, adjusted for potential confounders, were used to estimate aVE and rVE.
RESULTS: A total of 2060 patients were analyzed, including 1104 COVID-19 cases and 956 controls. Relative VE against COVID-19 hospitalization in boosted mRNA vaccine recipients versus primary series only was 66% (95% confidence interval [CI], 55%-74%); aVE was 81% (95% CI, 75%-86%) for boosted versus 46% (95% CI, 30%-58%) for primary. For boosted Janssen vaccine recipients versus primary series, rVE was 49% (95% CI, -9% to 76%); aVE was 62% (95% CI, 33%-79%) for boosted versus 36% (95% CI, -4% to 60%) for primary.
CONCLUSIONS: Vaccine booster doses increased protection against COVID-19 hospitalization compared with a primary series. Comparing rVE measures across studies can lead to flawed interpretations of the added value of a new vaccination regimen, whereas difference in aVE, when available, may be a more useful metric
Effectiveness of the Ad26.COV2.S (Johnson & Johnson) coronavirus disease 2019 (COVID-19) vaccine for preventing COVID-19 hospitalizations and progression to high disease severity in the United States
Background . Adults in the United States (US) began receiving the adenovirus vector coronavirus disease 2019 (COVID-19) vaccine, Ad26.COV2.S (Johnson & Johnson [Janssen]), in February 2021. We evaluated Ad26.COV2.S vaccine effectiveness (VE) against COVID-19 hospitalization and high disease severity during the first 10 months of its use. Methods . In a multicenter case-control analysis of US adults (≥18 years) hospitalized 11 March to 15 December 2021, we estimated VE against susceptibility to COVID-19 hospitalization (VEs), comparing odds of prior vaccination with a single dose Ad26.COV2.S vaccine between hospitalized cases with COVID-19 and controls without COVID-19. Among hospitalized patients with COVID-19, we estimated VE against disease progression (VEp) to death or invasive mechanical ventilation (IMV), comparing odds of prior vaccination between patients with and without progression. Results . After excluding patients receiving mRNA vaccines, among 3979 COVID-19 case-patients (5% vaccinated with Ad26.COV2.S) and 2229 controls (13% vaccinated with Ad26.COV2.S), VEs of Ad26.COV2.S against COVID-19 hospitalization was 70% (95% confidence interval [CI]: 63-75%) overall, including 55% (29-72%) among immunocompromised patients, and 72% (64-77%) among immunocompetent patients, for whom VEs was similar at 14-90 days (73% [59-82%]), 91-180 days (71% [60-80%]), and 181-274 days (70% [54-81%]) postvaccination. Among hospitalized COVID-19 case-patients, VEp was 46% (18-65%) among immunocompetent patients. Conclusions . The Ad26.COV2.S COVID-19 vaccine reduced the risk of COVID-19 hospitalization by 72% among immunocompetent adults without waning through 6 months postvaccination. After hospitalization for COVID-19, vaccinated immunocompetent patients were less likely to require IMV or die compared to unvaccinated immunocompetent patients
Effectiveness of mRNA vaccines against COVID-19 hospitalization by age and chronic medical conditions burden among immunocompetent US adults, March-August 2021
Vaccine effectiveness (VE) against COVID-19 hospitalization was evaluated among immunocompetent adults (≥18 years) during March-August 2021 using a case-control design. Among 1669 hospitalized COVID-19 cases (11% fully vaccinated) and 1950 RT-PCR-negative controls (54% fully vaccinated), VE was 96% (95% confidence interval [CI], 93%-98%) among patients with no chronic medical conditions and 83% (95% CI, 76%-88%) among patients with ≥ 3 categories of conditions. VE was similar between those aged 18-64 years versus ≥65 years (P \u3e .05). VE against severe COVID-19 was very high among adults without chronic conditions and lessened with increasing comorbidity burden
Community cleavages: gay and bisexual men's perceptions of gay and mainstream community acceptance in the post-AIDS, post-rights era
Changes in gay and bisexual men's connectedness to the gay community are related to the declining public visibility of HIV/AIDS and greater acceptance for homosexuality and bisexuality in mainstream society. Little work, however, has focused on perceived acceptance for subgroups within the gay community or broader society. Using interviews (n = 20) and a survey (n = 202) of gay and bisexual men in a mid-sized Canadian city, we find perceived hierarchies of acceptance for the various subgroups as well as an age effect wherein middle-aged men perceive the least acceptance for all groups. These differences are linked with the uneven impact of social, political, and institutional changes relevant to gay and bisexual men in Canada
Developing a Common Evaluation Tool for Camps
Evaluation has become a standard for youth programming, to provide both evidence for improvement recommendations and an assessment of program outcomes. Having a common evaluation tool across programs (in this case, camps) is beneficial in aggregating measurements and understanding similarities and differences between programs. The purpose of this paper is to describe the process of working with the California 4-H Camping Advisory Committee to develop a common evaluation tool for all California 4-H camps, and to share initial findings from the instrument. We present results from two years of data collection, and the multiple uses of the findings
Enhancing the impact of implementation strategies in healthcare: a research agenda
The field of implementation science was developed to better understand the factors that facilitate or impede implementation and generate evidence for implementation strategies. In this article, we briefly review progress in implementation science, and suggest five priorities for enhancing the impact of implementation strategies. Specifically, we suggest the need to: 1) enhance methods for designing and tailoring implementation strategies; 2) specify and test mechanisms of change; 3) conduct more effectiveness research on discrete, multi-faceted, and tailored implementation strategies; 4) increase economic evaluations of implementation strategies; and 5) improve the tracking and reporting of implementation strategies. We believe that pursuing these priorities will advance implementation science by helping us to understand when, where, why, and how implementation strategies improve implementation effectiveness and subsequent health outcomes
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Multimorphic Materials: Spatially Tailoring Mechanical Properties via Selective Initiation of Interpenetrating Polymer Networks
Access to multimaterial polymers with spatially localized properties and robust interfaces is
anticipated to enable new capabilities in soft robotics, such as smooth actuation for advanced medical
and manufacturing technologies. Here, orthogonal initiation is used to create interpenetrating polymer
networks (IPNs) with spatial control over morphology and mechanical properties. Base catalyzes the
formation of a stiff and strong polyurethane, while blue LEDs initiate the formation of a soft and elastic
polyacrylate. IPN morphology is controlled by when the LED is turned „on‟, with large phase
separation occurring for short time delays (~1-2 minutes) and a mixed morphology for longer time
delays (>5 minutes), which was supported by dynamic mechanical analysis, small angle X-ray
scattering, and atomic force microscopy. Through tailoring morphology, tensile moduli and fracture
toughness can be tuned across ~1-2 orders of magnitude. Moreover, a simple spring model is used to
explain the observed mechanical behavior. Photopatterning produces “multimorphic” materials, where
morphology is spatially localized with fine precision (<100 µm), while maintaining a uniform chemical
composition throughout to mitigate interfacial failure. The fabrication of hinges represents a possible
use-case for multimorphic materials in soft robotics.This work was primarily supported by the National Science Foundation under Grant No. DMR-
2045336 (M.J.A., C. B., and Z.A.P., synthesis and mechanical characterization). Partial support was
provided from the U.S. Department of Energy, Office of Science, Basic Energy Sciences under Award
#DE-SC0022050 (N.P. and X. G., morphology characterization related to scattering and AFM-IR) and
through the Center for Materials for Water and Energy Systems (M-WET), an Energy Frontier
Research Center under Award #DE-SC0019272 (M.J.A. and B.D.F., nanoindentation characterization),
the National Science Foundation under Grant No. CMMI-2038512 (L.M.C., AFM fast force distance
mapping characterization), NSF Graduate Research Fellowship under Grant No. DGE-1610403 (M.J.A.), and the Robert A. Welch Foundation under Grant No. F-2007 (Z.A.P., partial materials and
supplies support). The authors acknowledge the use of shared research facilities supported in part
by the Texas Materials Institute and the Center for Dynamics and Control of Materials (NSF MRSEC)
under Grant No. DMR-1720595.Center for Dynamics and Control of Material
Communications Biophysics
Contains research objectives, summary of research and reports on three research projects.National Institutes of Health (Grant 5 PO1 GM14940-04)National Institutes of Health (Grant 5 TOl GM01555-04)National Aeronautics and Space Administration (Grant NGL 22-009-304
A quantitative synthesis of the medicinal ethnobotany of the Malinké of Mali and the Asháninka of Peru, with a new theoretical framework
<p>Abstract</p> <p>Background</p> <p>Although ethnomedically and taxonomically guided searches for new medicinal plants can improve the percentage of plants found containing active compounds when compared to random sampling, ethnobotany has fulfilled little of its promise in the last few decades to deliver a bounty of new, laboratory-proven medicinal plants and compounds. It is quite difficult to test, isolate, and elucidate the structure and mechanism of compounds from the plethora of new medicinal plant uses described each year with limited laboratory time and resources and the high cost of clinical trials of new drug candidates.</p> <p>Methods</p> <p>A new quantitative theoretical framework of mathematical formulas called "relational efficacy" is proposed that should narrow down this search for new plant-derived medicines based on the hypothesis that closely related plants used to treat closely related diseases in distantly related cultures have a higher probability of being effective because they are more likely to be independent discoveries of similar plant compounds and disease mechanisms. A prerequisite to this hypothesis, the idea that empirical testing in traditional medicine will lead to choosing similar medicinal plants and therefore the medicinal flora of two distant cultures will prove to be more similar than their general flora, is tested using resampling statistics on cross-cultural field data of the plants used by the MalinkĂ© of Mali and the Asháninka of Peru to treat the diseases malaria, African sleeping sickness, Chagas' disease, leishmaniasis, diabetes, eczema, asthma, and uterine fibroids.</p> <p>Results</p> <p>In this case, the similarity of the medicinal floras is found to be significantly greater than the similarity of the general floras, but only when the diseases in question are grouped into the categories of parasitic and autoimmune diseases.</p> <p>Conclusion</p> <p>If the central theoretical framework of this hypothesis is shown to be true, it will allow the synthesis of medicinal plant information from around the world to pinpoint the species with the highest potential efficacy to take into the laboratory and analyze further, ultimately saving much field and laboratory time and resources.</p> <p><b>Spanish abstract</b></p> <p>Las bĂşsquedas que utilizan la etnomedicina y la taxonomĂa para descubrir nuevas plantas medicinales, pueden aumentar la probabilidad de Ă©xito de encontrar compuestos quĂmicos activos en plantas, en comparaciĂłn con las bĂşsquedas aleatorias. A pesar de lo anterior, en las Ăşltimas dĂ©cadas, la etnobotánica no ha cumplido con las expectativas de proveer numerosas plantas medicinales y quĂmicos nuevos una vez examinados en el laboratorio. Cada año se describen una plĂ©tora de plantas medicinales y sus usos, sin embargo las limitaciones de tiempo y recursos en los laboratorios, unidos al alto coste de los ensayos clĂnicos de las drogas potenciales, hacen muy difĂcil probar, aislar, y elucidar la estructura y el mecanismo de los compuestos de estas plantas. Se propone un nuevo marco teĂłrico cuantitativo cuyo fin es focalizar la bĂşsqueda de nueva plantas medicinales. Este marco teĂłrico está basado en la hipĂłtesis que las plantas cercanamente relacionadas, usadas para tratar enfermedades cercanamente relacionadas en culturas distantemente relacionadas, tienen una eficacia potencial más alta, debido a que es más probable que estos hallazgos sean descubrimientos independientes de compuestos quĂmicos similares. Parte de esta hipĂłtesis, que las escogencias racionales se hacen para elegir plantas medicinales similares y que la flora medicinal de dos culturas distantes es más similar que su flora general, se probĂł usando mĂ©todos estadĂsticos de remuestreo con datos de campo de la comunidad MalinkĂ© de MalĂ y de la Asháninka de PerĂş, y las enfermedades de paludismo, enfermedad africana del sueño, enfermedad de Chagas, leishmania, diabetes, eczema, asma, y fibromas uterinos. Se encontrĂł, en este caso, que la similitud de las floras medicinales es significativamente mayor a la similitud de las floras generales, solamente cuando las enfermedades analizadas se agruparon en las categorĂas de enfermedades parasitarias y enfermedades autoinmunes. Si se demostrara que las otras partes de esta hipĂłtesis son ciertas, se podrĂa sintetizar la informaciĂłn sobre plantas medicinales alrededor del mundo, para establecer asĂ las plantas potencialmente más eficaces para llevarlas al laboratorio y analizarlas más profundamente.</p> <p><b>French abstract</b></p> <p>Par rapport aux recherches menĂ©es de façon alĂ©atoire, les recherches effectuĂ©es par des critères ethnobotaniques et taxonomiques ont de meilleures chances Ă dĂ©couvrir de nouvelles plantes mĂ©dicinales Ă produit chimique actifs. Pendant les dernières dĂ©cennies pourtant, l'ethnobotanique a rĂ©alisĂ© peu de ces promesses Ă rĂ©vĂ©ler un grand nombre de plantes mĂ©dicinales et de nouveaux produits chimiques, testĂ©s au laboratoire. Avec les ressources limitĂ©es pour la recherche au laboratoire et le coĂ»t Ă©levĂ© des Ă©preuves cliniques pour trouver de nouveaux candidats aux mĂ©dicaments, il est difficile d'Ă©tudier, d'isoler et d'Ă©lucider la structure et le mĂ©canisme des produits chimiques de chacune des nombreuses plantes mĂ©dicinales (et les utilisations de ces plantes) dĂ©crites chaque annĂ©e. Nous proposons une nouvelle technique thĂ©orique et quantitative pour prĂ©ciser la recherche de nouvelles plantes mĂ©dicinales; elle est basĂ©e sur l'hypothèse que les plantes Ă©troitement apparentĂ©es, employĂ©es pour traiter les maladies Ă©troitement apparentĂ©es dans les cultures très Ă©loignĂ©es les unes des autres, ont une potentialitĂ© d'efficacitĂ© supĂ©rieure parce qu'elles reprĂ©sentent la dĂ©couverte indĂ©pendante des propriĂ©tĂ©s chimiques semblables des plantes. Une partie de cette hypothèse-qui dĂ©montre que la sĂ©lection des plantes mĂ©dicinales semblables est un choix rationnel et qu'il y a davantage de ressemblance dans la flore mĂ©dicinale de deux cultures Ă©loignĂ©es que dans leur flore gĂ©nĂ©rale-est examinĂ©e par un re-Ă©chantillonnage des donnĂ©es de recherches effectuĂ©es parmi les MalinkĂ© au Mali et les Asháninka au PĂ©rou, en particulier sur la malaria, la maladie africaine du sommeil, la maladie de Chagas, la leishmania, le diabète, l'eczĂ©ma, l'asthme et les fibromes utĂ©rins. Dans ces cas prĂ©cis, la similitude de la flore mĂ©dicinale s'avère sensiblement plus grande que la similitude de la flore gĂ©nĂ©rale, mais seulement quand les maladies en question sont regroupĂ©es ensemble comme maladies parasitaires et auto-immunitaires. Si cette hypothèse est prouvĂ©e, elle permettra la synthèse des informations recueillies sur les plantes mĂ©dicinales du monde entier pour en sĂ©lectionner de façon plus prĂ©cise celles qui sont les plus efficaces et qui mĂ©ritent analyse plus approfondie au laboratoire.</p> <p><b>Asháninka abstract</b></p> <p>Aayiantyarori iròpero aavintane, ontzimatye ancovacovatero ayotero ovaqueraripaye incashi iyoyetziri ashaninka, ayotzityaro aajatzi iyotane viracocha paitachari "quimica" ancantero aaca oshintsinka inchashipaye. Atziri yotacotzirori cametsa, ishtoriajacotzirori iyotane ashaninkapaye te iroñà rantero maaroni ocaratzi yamenacotaqueri laboratorioki. Aaviantyarori cametsa, ayotacotero aavintarontsiyetatsiri osamani antzimaventero ishtoriatacotaro, aajatzi osheki opinata ampinaventero aparopaye inchashi, acoviriqui ayotacotero, osaretsikipaye. Tzimatsi ovaquerari quenquishiriantsitatsiri ero opinata osheki ashitoriatacotero aparopaye inchashi, asampiyetatyrey pashinipaye atziri saicatsiri intaina puitarika inchasshi yavintari, ajatzirica oshiyaro ayotzi aaca, quemetachari atziri saikatsiri nampitsiki malinke aajatzi ishiyari ashaninka saicatsiri peruki, tzimatsi inchashi aajatzi yaavintari osheki okamètsatzi aririka anteri mantsiyarentsi icantaitziri ompetarentsi catsirentsi, pochokirentsi, patsarontsi(matatsi) ashipetate maaroni, ampochavathate, ancainikentsite, oncatsithakite tsinani. Aririka añaker aajatzi ahiyaro inchashi yaavintayetari pashinipaye atziri intainasatzi irdotake ahitoriatacoperoteri anĂ ashityard aavintarontsi ovamairiri shithanentsi, onĂ shitaavintarontsi tzicaacoventairi ero antane mantsiyarentsi. Omanperotatyarica iròperotzi avintarontsi, oshitovake laboratorioki aritaque iyoitanaquero maaroni quipatsiki iroperori avintarontsi.</p
Enhancing the Impact of Implementation Strategies in Healthcare: A Research Agenda
The field of implementation science was developed to better understand the factors that facilitate or impede implementation and generate evidence for implementation strategies. In this article, we briefly review progress in implementation science, and suggest five priorities for enhancing the impact of implementation strategies. Specifically, we suggest the need to: (1) enhance methods for designing and tailoring implementation strategies; (2) specify and test mechanisms of change; (3) conduct more effectiveness research on discrete, multi-faceted, and tailored implementation strategies; (4) increase economic evaluations of implementation strategies; and (5) improve the tracking and reporting of implementation strategies. We believe that pursuing these priorities will advance implementation science by helping us to understand when, where, why, and how implementation strategies improve implementation effectiveness and subsequent health outcomes
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