Epidemiological and economic impact of pandemic influenza in Chicago: Priorities for vaccine interventions.

The study objective is to estimate the epidemiological and economic impact of vaccine interventions during influenza pandemics in Chicago, and assist in vaccine intervention priorities. Scenarios of delay in vaccine introduction with limited vaccine efficacy and limited supplies are not unlikely in future influenza pandemics, as in the 2009 H1N1 influenza pandemic. We simulated influenza pandemics in Chicago using agent-based transmission dynamic modeling. Population was distributed among high-risk and non-high risk among 0-19, 20-64 and 65+ years subpopulations. Different attack rate scenarios for catastrophic (30.15%), strong (21.96%), and moderate (11.73%) influenza pandemics were compared against vaccine intervention scenarios, at 40% coverage, 40% efficacy, and unit cost of $28.62. Sensitivity analysis for vaccine compliance, vaccine efficacy and vaccine start date was also conducted. Vaccine prioritization criteria include risk of death, total deaths, net benefits, and return on investment. The risk of death is the highest among the high-risk 65+ years subpopulation in the catastrophic influenza pandemic, and highest among the high-risk 0-19 years subpopulation in the strong and moderate influenza pandemics. The proportion of total deaths and net benefits are the highest among the high-risk 20-64 years subpopulation in the catastrophic, strong and moderate influenza pandemics. The return on investment is the highest in the high-risk 0-19 years subpopulation in the catastrophic, strong and moderate influenza pandemics. Based on risk of death and return on investment, high-risk groups of the three age group subpopulations can be prioritized for vaccination, and the vaccine interventions are cost saving for all age and risk groups. The attack rates among the children are higher than among the adults and seniors in the catastrophic, strong, and moderate influenza pandemic scenarios, due to their larger social contact network and homophilous interactions in school. Based on return on investment and higher attack rates among children, we recommend prioritizing children (0-19 years) and seniors (65+ years) after high-risk groups for influenza vaccination during times of limited vaccine supplies. Based on risk of death, we recommend prioritizing seniors (65+ years) after high-risk groups for influenza vaccination during times of limited vaccine supplies

The X-ray Size-Temperature Relation for Intermediate Redshift Galaxy Clusters

We present the first measurements of the X-ray size-temperature (ST) relation in intermediate redshift (z~0.30) galaxy clusters. We interpret the local ST relation (z~0.06) in terms of underlying scaling relations in the cluster dark matter properties, and then we use standard models for the redshift evolution of those dark matter properties to show that the ST relation does not evolve with redshift. We then use ROSAT HRI observations of 11 clusters to examine the intermediate redshift ST relation; for currently favored cosmological parameters, the intermediate redshift ST relation is consistent with that of local clusters. Finally, we use the ST relation and our evolution model to measure angular diameter distances; with these 11 distances we evaluate constraints on Omega_M and Omega_L which are consistent with those derived from studies of Type Ia supernovae. The data rule out a model with Omega_M=1 and Omega_L=0 with 2.5 sigma confidence. When limited to models where Omega_M+Omega_L=1, these data are inconsistent with Omega_M=1 with 3 sigma confidence.Comment: ApJ: submitted April 7, accepted June 28, to appear Dec 1 (vol 544

Magnetic domain-wall velocity enhancement induced by a transverse magnetic field

Spin dynamics of field-driven domain walls (DWs) guided by Permalloy nanowires are studied by high-speed magneto-optic polarimetry and numerical simulations. DW velocities and spin configurations are determined as functions of longitudinal drive field, transverse bias field, and nanowire width. Nanowires having cross-sectional dimensions large enough to support vortex wall structures exhibit regions of drive-field strength (at zero bias field) that have enhanced DW velocity resulting from coupled vortex structures that suppress oscillatory motion. Factor of ten enhancements of the DW velocity are observed above the critical longitudinal drive-field (that marks the onset of oscillatory DW motion) when a transverse bias field is applied. Nanowires having smaller cross-sectional dimensions that support transverse wall structures also exhibit a region of higher mobility above the critical field, and similar transverse-field induced velocity enhancement but with a smaller enhancement factor. The bias-field enhancement of DW velocity is explained by numerical simulations of the spin distribution and dynamics within the propagating DW that reveal dynamic stabilization of coupled vortex structures and suppression of oscillatory motion in the nanowire conduit resulting in uniform DW motion at high speed.Comment: 8 pages, 5 figure

Understanding climate data through commentary metadata: the CHARMe project

We describe the CHARMe project, which aims to link climate datasets with publications, user feedback and other items of "commentary metadata". The system will help users learn from previous community experience and select datasets that best suit their needs, as well as providing direct traceability between conclusions and the data that supported them. The project applies the principles of Linked Data and adopts the Open Annotation standard to record and publish commentary information. CHARMe contributes to the emerging landscape of "climate services", which will provide climate data and information to influence policy and decision-making. Although the project focuses on climate science, the technologies and concepts are very general and could be applied to other fields

Substrate stabilisation and small structures in coral restoration: State of knowledge, and considerations for management and implementation.

Coral reef ecosystems are under increasing pressure from local and regional stressors and a changing climate. Current management focuses on reducing stressors to allow for natural recovery, but in many areas where coral reefs are damaged, natural recovery can be restricted, delayed or interrupted because of unstable, unconsolidated coral fragments, or rubble. Rubble fields are a natural component of coral reefs, but repeated or high-magnitude disturbances can prevent natural cementation and consolidation processes, so that coral recruits fail to survive. A suite of interventions have been used to target this issue globally, such as using mesh to stabilise rubble, removing the rubble to reveal hard substrate and deploying rocks or other hard substrates over the rubble to facilitate recruit survival. Small, modular structures can be used at multiple scales, with or without attached coral fragments, to create structural complexity and settlement surfaces. However, these can introduce foreign materials to the reef, and a limited understanding of natural recovery processes exists for the potential of this type of active intervention to successfully restore local coral reef structure. This review synthesises available knowledge about the ecological role of coral rubble, natural coral recolonisation and recovery rates and the potential benefits and risks associated with active interventions in this rapidly evolving field. Fundamental knowledge gaps include baseline levels of rubble, the structural complexity of reef habitats in space and time, natural rubble consolidation processes and the risks associated with each intervention method. Any restoration intervention needs to be underpinned by risk assessment, and the decision to repair rubble fields must arise from an understanding of when and where unconsolidated substrate and lack of structure impair natural reef recovery and ecological function. Monitoring is necessary to ascertain the success or failure of the intervention and impacts of potential risks, but there is a strong need to specify desired outcomes, the spatial and temporal context and indicators to be measured. With a focus on the Great Barrier Reef, we synthesise the techniques, successes and failures associated with rubble stabilisation and the use of small structures, review monitoring methods and indicators, and provide recommendations to ensure that we learn from past projects

Dexamethasone to prevent everolimus-induced stomatitis (Alliance MIST trial: A221701)

mTOR inhibitors such as everolimus may cause oral stomatitis, often a dose-limiting toxicity. Prior clinical research has suggested that a dexamethasone mouth rinse might help prevent and/or treat this. Alliance A221701 was a randomized phase III trial of patients initiating 10 mg daily oral everolimus that compared dexamethasone mouthwash taken preventively (initial dexamethasone group) versus therapeutically (initial placebo group) to assess two coprimary endpoints: the incidence of mTOR inhibitor-associated stomatitis (mIAS), and the area under the curve (AUC) of mIAS-associated pain over an 8-week treatment period. A Fisher\u27s exact test was used to compare the incidences while a Wilcoxon rank-sum test was used to compare the AUCs. In addition, we performed an exploratory analysis of the association of everolimus trough concentrations and toxicity using a Mann-Whitney U test. Due to slow accrual, this study closed after 39 patients were randomized (19 to upfront placebo and 20 to upfront dexamethasone). There were no significant differences between groups seen in either of the coprimary endpoints; furthermore, we found no association between whole blood everolimus trough concentrations and toxicity. Although limited by poor enrollment, the results of this study do not suggest that prophylactic dexamethasone mouthwash is superior to therapeutic dexamethasone mouthwash (initiated at the first sign of mouth pain) for reducing the incidence or severity of mIAS from everolimus

Vitamin D and the risk of dementia and Alzheimer disease

OBJECTIVE: To determine whether low vitamin D concentrations are associated with an increased risk of incident all-cause dementia and Alzheimer disease. METHODS: One thousand six hundred fifty-eight elderly ambulatory adults free from dementia, cardiovascular disease, and stroke who participated in the US population-based Cardiovascular Health Study between 1992-1993 and 1999 were included. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were determined by liquid chromatography-tandem mass spectrometry from blood samples collected in 1992-1993. Incident all-cause dementia and Alzheimer disease status were assessed during follow-up using National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria. RESULTS: During a mean follow-up of 5.6 years, 171 participants developed all-cause dementia, including 102 cases of Alzheimer disease. Using Cox proportional hazards models, the multivariate adjusted hazard ratios (95% confidence interval [CI]) for incident all-cause dementia in participants who were severely 25(OH)D deficient (<25 nmol/L) and deficient (≥25 to <50 nmol/L) were 2.25 (95% CI: 1.23-4.13) and 1.53 (95% CI: 1.06-2.21) compared to participants with sufficient concentrations (≥50 nmol/L). The multivariate adjusted hazard ratios for incident Alzheimer disease in participants who were severely 25(OH)D deficient and deficient compared to participants with sufficient concentrations were 2.22 (95% CI: 1.02-4.83) and 1.69 (95% CI: 1.06-2.69). In multivariate adjusted penalized smoothing spline plots, the risk of all-cause dementia and Alzheimer disease markedly increased below a threshold of 50 nmol/L. CONCLUSION: Our results confirm that vitamin D deficiency is associated with a substantially increased risk of all-cause dementia and Alzheimer disease. This adds to the ongoing debate about the role of vitamin D in nonskeletal conditions.National Heart, Lung, and Blood InstituteNational Institute of Neurological Disorders and StrokeNational Institute on AgingAlzheimer's AssociationMary Kinross Charitable TrustJames Tudor FoundationHalpin TrustAge Related Diseases and Health TrustNorman Family Charitable TrustUK National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsul

O2‐03‐02: Vitamin D and the risk of developing neuroimaging abnormalities

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152624/1/alzjjalz201507143.pd

How Baryonic Processes affect Strong Lensing properties of Simulated Galaxy Clusters

The observed abundance of giant arcs produced by galaxy cluster lenses and the measured Einstein radii have presented a source of tension for LCDM. Previous cosmological tests for high-redshift clusters (z>0.5) have suffered from small number statistics in the simulated sample and the implementation of baryonic physics is likely to affect the outcome. We analyse zoomed-in simulations of a fairly large sample of cluster-sized objects, with Mvir > 3x10^14 Msun/h, identified at z=0.25 and z=0.5, for a concordance LCDM cosmology. We start with dark matter only simulations, and then add gas hydrodynamics, with different treatments of baryonic processes: non-radiative cooling, radiative cooling with star formation and galactic winds powered by supernova explosions, and finally including the effect of AGN feedback. We find that the addition of gas in non-radiative simulations does not change the strong lensing predictions significantly, but gas cooling and star formation together significantly increase the number of expected giant arcs and the Einstein radii, particularly for lower redshift clusters and lower source redshifts. Further inclusion of AGN feedback reduces the predicted strong lensing efficiencies such that the lensing probability distributions becomes closer to those obtained for simulations including only dark matter. Our results indicate that the inclusion of baryonic physics in simulations will not solve the arc-statistics problem at low redshifts, when the physical processes included provide a realistic description of cooling in the central regions of galaxy clusters. [Abridged]Comment: 19 pages, 18 figures, 1 table, Accepted for publication in MNRA