68 research outputs found

    Generalisability of vaccine effectiveness estimates: an analysis of cases included in a postlicensure evaluation of 13-valent pneumococcal conjugate vaccine in the USA

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    External validity, or generalisability, is the measure of how well results from a study pertain to individuals in the target population. We assessed generalisability, with respect to socioeconomic status, of estimates from a matched case–control study of 13-valent pneumococcal conjugate vaccine effectiveness for the prevention of invasive pneumococcal disease in children in the USA

    La representació de la memòria històrica. Anàlisi dels programes televisius que tracten la Guerra Civil i el franquisme a Catalunya

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    El present treball estudia la representació de la memòria històrica a través del mitjà televisiu a Catalunya. En concret, se centra en la representació dels esdeveniments més traumàtics de la història contemporània d'Espanya, la Guerra Civil i el franquisme. A partir de l'anàlisi de cinc productes recents de característiques diferents s'estableixen els punts en comú i les variants en el discurs sobre la memòria històrica transmès per la televisió.El presente trabajo estudia la representación de la memoria histórica a través del medio televisivo en Cataluña. En concreto, se centra en la representación de los acontecimientos más traumáticos de la historia contemporánea de España, la Guerra Civil y el franquismo. A partir del análisis de cinco productos recientes de características diferentes se establecen los puntos en común y las variantes en el discurso sobre la memoria histórica transmitido por la televisión.This study examines the representation of historical memory on television in Catalonia. In particular, it focuses on the representation of the most traumatic events in the contemporary history of Spain, the Civil War and the Francoist Spain. It is based on the analysis of five recent products with different characteristics, in order to define the points in common and the differences of the discourse on the historical memory broadcasted by television

    Dry deposition and canopy uptake in Mediterranean holm-oak forests estimated with a canopy budget model : a focus on N estimations

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    Bulk/wet and throughfall fluxes of major compounds were measured from June 2011 to June 2013 at four Mediterranean holm-oak (Quercus ilex) forests in the Iberian Peninsula. Regression analysis between net throughfall fluxes and precipitation indicated that the best defined canopy process was leaching for K⁺ and uptake for NH₄⁺ at all sites. A more variable response between sites was found for Na⁺, Ca²⁺, SO₄²⁻ and Cl⁻, which suggests that the interplay of dry deposition, leaching and uptake at the canopy was different depending on site climate and air quality characteristics. A canopy budget model (CBM) was used to try to discriminate between the canopy processes and enable to estimate dry deposition and uptake fluxes at three of the sites that complied with the model specifications. To derive N uptake, an efficiency factor of NH₄⁺ vs. NO₃⁻ uptake (xNH₄) corresponding to moles of NH₄⁺ taken up for each NO₃⁻ mol, has to be determined. Up to now, a value of 6 has been proposed for temperate forests, but we lack information for Mediterranean forests. Experimental determination of N absorption on Quercus ilex seedlings in Spain suggests efficiency factors from 1 to 6. Based on these values, a sensitivity analysis for xNH₄ was performed and the NH₄N and NO₃N modeled dry deposition was compared with dry deposition estimated with independent methods (inferential modeling and washing of branches). At two sites in NE Spain under a milder Mediterranean climate, the best match was obtained for xNH4 = 6, corroborating results from European temperate forests. Based on this value, total DIN deposition was 12-13 kg N ha−1 y−1 at these sites. However, for a site in central Spain under drier conditions, variation of the NH4+ efficiency factor had little effect on DD estimates (which ranged from 2 to 2.6 kg N ha⁻¹ y⁻¹ with varying xNH₄); when added to wet deposition, this produced a total N deposition in the range 2.6-3.4 kg N ha⁻¹ y⁻¹. Dry deposition was the predominant pathway for N, accounting for 60-80% of total deposition, while for base cations wet deposition dominated (55-65%). Nitrogen deposition values at the northwestern sites were close to the empirical critical load proposed for evergreen sclerophyllous Mediterranean forests (15-17 kg N ha⁻¹ y⁻¹). When organic N deposition at these forests is added (3 kg N ha⁻¹ y⁻¹), the total N input to the sites in NE Spain are close to the critical loads for Mediterranean evergreen oak forests

    Bias with respect to socioeconomic status: A closer look at zip code matching in a pneumococcal vaccine effectiveness study

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    In 2010, 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the US for prevention of invasive pneumococcal disease in children. Individual-level socioeconomic status (SES) is a potential confounder of the estimated effectiveness of PCV13 and is often controlled for in observational studies using zip code as a proxy. We assessed the utility of zip code matching for control of SES in a post-licensure evaluation of the effectiveness of PCV13 (calculated as [1-matched odds ratio]*100). We used a directed acyclic graph to identify subsets of confounders and collected SES variables from birth certificates, geocoding, a parent interview, and follow-up with medical providers. Cases tended to be more affluent than eligible controls (for example, 48.3% of cases had private insurance vs. 44.6% of eligible controls), but less affluent than enrolled controls (52.9% of whom had private insurance). Control of confounding subsets, however, did not result in a meaningful change in estimated vaccine effectiveness (original estimate: 85.1%, 95% CI 74.8–91.9%; adjusted estimate: 82.5%, 95% CI 65.6–91.1%). In the context of a post-licensure vaccine effectiveness study, zip code appears to be an adequate, though not perfect, proxy for individual SES

    Applying Big Data to Pediatric Care

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    Pneumococcal genome sequencing tracks a vaccine escape variant formed through a multi-fragment recombination event

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    Streptococcus pneumoniae ('pneumococcus') causes an estimated 14.5 million cases of serious disease and 826,000 deaths annually in children under 5 years of age. The highly effective introduction of the PCV7 pneumococcal vaccine in 2000 in the United States provided an unprecedented opportunity to investigate the response of an important pathogen to widespread, vaccine-induced selective pressure. Here, we use array-based sequencing of 62 isolates from a US national monitoring program to study five independent instances of vaccine escape recombination, showing the simultaneous transfer of multiple and often large (up to at least 44 kb) DNA fragments. We show that one such new strain quickly became established, spreading from east to west across the United States. These observations clarify the roles of recombination and selection in the population genomics of pneumococcus and provide proof of principle of the considerable value of combining genomic and epidemiological information in the surveillance and enhanced understanding of infectious diseases. © 2012 Nature America, Inc. All rights reserved

    Characteristics of surveillance sites included in meta-analysis (<i>n</i> = 21).

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    <p>Australia non-Indigenous does not include data from the State of New South Wales.</p>a<p>Vaccine schedule  =  Primary + booster.</p>b<p>Proportion of children receiving the full infant dose by 12 months. N/P (not provided), meaning that immunization coverage not provided for year 1 and/or last year of surveillance data provided, although all included datasets were from sites that indicated they reached ≥70% coverage in the post-PCV period.</p>c<p>Active (A), proactive effort to identify all cases in an area; passive (P), reporting of cases by clinicians or laboratories without a systematic approach to capture cases not reported.</p>d<p>Number of surveillance years included in the IPD analysis for children <5 y. Number of surveillance years the same for adult age groups unless otherwise indicated.</p>e<p>Not applicable (N/A), age group not included in meningitis analysis. For some sites, some ≥18 y age categories excluded from meningitis analysis (<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001517#pmed-1001517-t001" target="_blank">Table 1</a>; <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001517#pmed.1001517.s013" target="_blank">Table S1</a>).</p>f<p>Site, adult age group (<i>n</i> surveillance years). England and Wales: 18–49 y (4); 50–64 y, and ≥65 y (2). The Netherlands: ≥18 y (2). Norway: ≥18 y (2). USA-Navajo: 50–64 y (4).</p>g<p>Not applicable (NA), age group not included in IPD analysis. France and Ireland only included in the meningitis only analysis.</p><p>ABCs, Active Bacterial Core Surveillance; KPNC, Kaiser Permanente Northern California; NT, Northern Territory; PPV, pneumococcal polysaccharide vaccine.</p
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