Communication Strategies to Address Vaccine Hesitancy in Healthcare Settings and on Social Media

Abstract Vaccine hesitancy is now recognized as a threat to global health. Its causes are complex, and it is defined by a resistance to or questioning of immunization. It is important to address vaccine hesitancy directly before people who are hesitant become vaccine refusers or anti-vaccine. Fortunately, with evidence-based information delivered with a compassionate communication style many of those who are hesitant to vaccinate can be persuaded to ultimately vaccinate. This paper aims to explain successful communication strategies used to address vaccine hesitancy in healthcare settings and on social media. Vaccine hesitant parents frequently list their child’s healthcare provider as a trusted source of information on vaccine issues. Research has shown that using presumptive language for vaccine introduction, followed by a compassionate and direct response to any concerns is an effective form of communication with vaccine hesitant parents. This paper teaches the C.A.S.E. Model as a way to formulate that communication. Although many people trust their providers, we cannot ignore the influence of the Internet, specifically social media, as a source of vaccine information for patients and parents. Although there is much pro-vaccine messaging on the Internet, the anti-vaccine messaging is frequently simpler, more emotionally appealing, and easily sharable. Since vaccine hesitant people tend to be silent observers of the vaccine debate online, it is important for pro-vaccine sources to communicate effectively in this arena. We describe our experience and lessons learned with this form of communication through the pro-immunization parent advocacy group, Immunize Texas

Rapid Divergence of Predator Functional Traits Affects Prey Composition in Aquatic Communities

AbstractIdentifying traits that underlie variation in individual performance of consumers (i.e., trait utility) can help reveal the ecological causes of population divergence and the subsequent consequences for species interactions and community structure. Here, we document a case of rapid divergence (over the past 100 generations, or ?150 years) in foraging traits and feeding efficiency between a lake and stream population pair of threespine stickleback. Building on predictions from functional trait models of fish feeding, we analyzed foraging experiments with a Bayesian path analysis and elucidated the traits explaining variation in foraging performance and the species composition of ingested prey. Despite extensive previous research on the divergence of foraging traits among populations and ecotypes of stickleback, our results provide novel experimental evidence of trait utility for jaw protrusion, gill raker length, and gill raker spacing when foraging on a natural zooplankton assemblage. Furthermore, we discuss how these traits might contribute to the differential effects of lake and stream stickleback on their prey communities, observed in both laboratory and mesocosm conditions. More generally, our results illustrate how the rapid divergence of functional foraging traits of consumers can impact the biomass, species composition, and trophic structure of prey communities

Effect of Arbuscular Mycorrhizal Fungi, Selenium and Biochar on Photosynthetic Pigments and Antioxidant Enzyme Activity Under Arsenic Stress in Mung Bean (Vigna radiata)

Environmental perturbations alter biochemical compounds in food crops. Arsenic (As), a toxic metalloid, is known to affect the cultivation of food crops in many regions of the world; however, the changes in chlorophyll, catalase (CAT), and proline in response to As stress and the role of stress relief substances remain largely unknown in mung bean (Vigna radiate L.). In this study, biochar (BC), arbuscular mycorrhizal fungi (AMF), and selenium (Se) were applied to soils as stress relief substances (under 30 mg kg-1 As stress), and the effects of BC, AMF, and Se on chlorophyll a, chlorophyll b, total chlorophyll, CAT activity, and proline content were studied in different mung bean genotypes. Under As stress, the chlorophyll a, chlorophyll b, and total chlorophyll contents in BARI mung 3, BARI mung 5, and BARI mung 8 were found statistically similar. Meanwhile, CAT activity increased in comparison to the control due to the application of BC, AMF, and Se in mung bean crops. However, proline was found significantly lower in AMF, BC, and Se-treated mung bean. This indicates that oxidative stress was potentially minimized in As-stressed mung bean crops due to the application of these stress relief substances. Notably, AMF was relatively effective against As stress in comparison to BC and Se. It is concluded that BC, AMF, and Se are all highly effective in enhancing antioxidant defenses as well as the nutritional quality of mung bean crops under As stress

Greenhouse Gas Emissions from Ground Level Area Sources in Dairy and Cattle Feedyard Operations

A protocol that consisted of an isolation flux chamber and a portable gas chromatograph was used to directly quantify greenhouse gas (GHG) emissions at a dairy and a feedyard operation in the Texas Panhandle. Field sampling campaigns were performed 5 consecutive days only during daylight hours from 9:00 am to 7:00 pm each day. The objective of this research was to quantify and compare GHG emission rates (ERs) from ground level area sources (GLAS) at dairy and cattle feedyard operations during the summer. A total of 74 air samples using flux chamber were collected from the barn (manure lane and bedding area), loafing pen, open lot, settling basin, lagoons, and compost pile within the dairy operation. For the cattle feedyard, a total of 87 air samples were collected from four corner pens of a large feedlot, runoff holding pond, and compost pile. Three primary GHGs (methane, carbon dioxide, and nitrous oxide) were measured and quantified from both operations. The aggregate estimated ERs for CH4, CO2, and N2O were 836, 5573, 3.4 g hd−1 d−1 (collectively 27.5 kg carbon dioxide equivalent (CO2e) hd−1 d−1), respectively, at the dairy operation. The aggregate ERs for CH4, CO2, and N2O were 3.8, 1399, 0.68 g hd−1 d−1 (1.7 kg CO2e hd−1 d−1), respectively, from the feedyard. The estimated USEPA GHG ERs were about 13.2 and 1.16 kg CO2e hd−1 d−1, respectively, for dairy and feedyard operations. Aggregate CH4, CO2 and N2O ERs at the dairy facility were about 219, 4 and 5 times higher, respectively, than those at the feedyard. At the dairy, average CH4 ERs estimated from the settling basin, primary and secondary lagoons were significantly higher than those from the other GLAS, contributing about 98% of the aggregate CH4 emission. The runoff holding pond and pen surface of the feedyard contributed about 99% of the aggregate CH4 emission. Average CO2 and N2O ERs estimated from the pen surface area were significantly higher than those estimated from the compost pile and runoff pond. The pen surface alone contributed about 93% and 84% of the aggregate CO2 and N2O emission, respectively. Abatement and management practices that address GHG emissions from these sources will likely be most effective for reducing facility emissions

A detailed clinical and molecular survey of subjects with nonsyndromic USH2A retinopathy reveals an allelic hierarchy of disease-causing variants.

Defects in USH2A cause both isolated retinal disease and Usher syndrome (ie, retinal disease and deafness). To gain insights into isolated/nonsyndromic USH2A retinopathy, we screened USH2A in 186 probands with recessive retinal disease and no hearing complaint in childhood (discovery cohort) and in 84 probands with recessive retinal disease (replication cohort). Detailed phenotyping, including retinal imaging and audiological assessment, was performed in individuals with two likely disease-causing USH2A variants. Further genetic testing, including screening for a deep-intronic disease-causing variant and large deletions/duplications, was performed in those with one likely disease-causing change. Overall, 23 of 186 probands (discovery cohort) were found to harbour two likely disease-causing variants in USH2A. Some of these variants were predominantly associated with nonsyndromic retinal degeneration ('retinal disease-specific'); these included the common c.2276 G>T, p.(Cys759Phe) mutation and five additional variants: c.2802 T>G, p.(Cys934Trp); c.10073 G>A, p.(Cys3358Tyr); c.11156 G>A, p.(Arg3719His); c.12295-3 T>A; and c.12575 G>A, p.(Arg4192His). An allelic hierarchy was observed in the discovery cohort and confirmed in the replication cohort. In nonsyndromic USH2A disease, retinopathy was consistent with retinitis pigmentosa and the audiological phenotype was variable. USH2A retinopathy is a common cause of nonsyndromic recessive retinal degeneration and has a different mutational spectrum to that observed in Usher syndrome. The following model is proposed: the presence of at least one 'retinal disease-specific' USH2A allele in a patient with USH2A-related disease results in the preservation of normal hearing. Careful genotype-phenotype studies such as this will become increasingly important, especially now that high-throughput sequencing is widely used in the clinical setting.European Journal of Human Genetics advance online publication, 4 February 2015; doi:10.1038/ejhg.2014.283

Hybrid Mechanical Systems

We discuss hybrid systems in which a mechanical oscillator is coupled to another (microscopic) quantum system, such as trapped atoms or ions, solid-state spin qubits, or superconducting devices. We summarize and compare different coupling schemes and describe first experimental implementations. Hybrid mechanical systems enable new approaches to quantum control of mechanical objects, precision sensing, and quantum information processing.Comment: To cite this review, please refer to the published book chapter (see Journal-ref and DOI). This v2 corresponds to the published versio

Central venous catheter use in severe malaria: time to reconsider the World Health Organization guidelines?

<p>Abstract</p> <p>Background</p> <p>To optimize the fluid status of adult patients with severe malaria, World Health Organization (WHO) guidelines recommend the insertion of a central venous catheter (CVC) and a target central venous pressure (CVP) of 0-5 cmH₂O. However there are few data from clinical trials to support this recommendation.</p> <p>Methods</p> <p>Twenty-eight adult Indian and Bangladeshi patients admitted to the intensive care unit with severe <it>falciparum </it>malaria were enrolled in the study. All patients had a CVC inserted and had regular CVP measurements recorded. The CVP measurements were compared with markers of disease severity, clinical endpoints and volumetric measures derived from transpulmonary thermodilution.</p> <p>Results</p> <p>There was no correlation between the admission CVP and patient outcome (p = 0.67) or disease severity (p = 0.33). There was no correlation between the baseline CVP and the concomitant extravascular lung water (p = 0.62), global end diastolic volume (p = 0.88) or cardiac index (p = 0.44). There was no correlation between the baseline CVP and the likelihood of a patient being fluid responsive (p = 0.37). On the occasions when the CVP was in the WHO target range patients were usually hypovolaemic and often had pulmonary oedema by volumetric measures. Seven of 28 patients suffered a complication of the CVC insertion, although none were fatal.</p> <p>Conclusion</p> <p>The WHO recommendation for the routine insertion of a CVC, and the maintenance of a CVP of 0-5 cmH₂O in adults with severe malaria, should be reconsidered.</p

BRE modulates granulosa cell death to affect ovarian follicle development and atresia in the mouse

The BRE (brain and reproductive expression) gene, highly expressed in nervous and reproductive system organs, plays an important role in modulating DNA damage repair under stress response and pathological conditions. Folliculogenesis, a process that ovarian follicle develops into maturation, is closely associated with the interaction between somatic granulosa cell and oocyte. However, the regulatory role of BRE in follicular development remains undetermined. In this context, we found that BRE is normally expressed in the oocytes and granulosa cells from the primordial follicle stage. There was a reduction in follicles number of BRE mutant (BRE(−/−)) mice. It was attributed to increase the follicular atresia in ovaries, as a result of retarded follicular development. We established that cell proliferation was inhibited, while apoptosis was markedly increased in the granulosa cells in the absence of BRE. In addition, expressions of γ-H2AX (marker for showing DNA double-strand breaks) and DNA damage-relevant genes are both upregulated in BRE(−/−) mice. In sum, these results suggest that the absence of BRE, deficiency in DNA damage repair, causes increased apoptosis in granulosa cells, which in turn induces follicular atresia in BRE(−/−) mice

Echocardiographic evaluation of mitral geometry in functional mitral regurgitation

<p>Abstract</p> <p>Objectives</p> <p>We sought to evaluate the geometric changes of the mitral leaflets, local and global LV remodeling in patients with left ventricular dysfunction and varying degrees of Functional mitral regurgitation (FMR).</p> <p>Background</p> <p>Functional mitral regurgitation (FMR) occurs as a consequence of systolic left ventricular (LV) dysfunction caused by ischemic or nonischemic cardiomyopathy. Mitral valve repair in ischemic MR is one of the most controversial topic in surgery and proper repairing requires an understanding of its mechanisms, as the exact mechanism of FMR are not well defined.</p> <p>Methods</p> <p>136 consecutive patients mean age of 55 with systolic LV dysfunction and FMR underwent complete echocardiography and after assessing MR severity, LV volumes, Ejection Fraction, LV sphericity index, C-Septal distance, Mitral valve annulus, Interpapillary distance, Tenting distance and Tenting area were obtained.</p> <p>Results</p> <p>There was significant association between MR severity and echocardiogarphic indices (all p values < 0.001). Severe MR occurred more frequently in dilated cardiomyopathy (DCM) patients compared to ischemic patients, (p < 0.001). Based on the model, only Mitral valve tenting distance (TnD) (OR = 22.11, CI 95%: 14.18 – 36.86, p < 0.001) and Interpapillary muscle distance (IPMD), (OR = 6.53, CI 95%: 2.10 – 10.23, p = 0.001) had significant associations with MR severity.</p> <p>Mitral annular dimensions and area, C-septal distance and sphericity index, although greater in patients with severe regurgitation, did not significantly contribute to FMR severity.</p> <p>Conclusion</p> <p>Degree of LV enlargement and dysfunction were not primary determinants of FMR severity, therefore local LV remodeling and mitral valve apparatus deformation are the strongest predictors of functional MR severity.</p

A multifactorial analysis of obesity as CVD risk factor: Use of neural network based methods in a nutrigenetics context

<p>Abstract</p> <p>Background</p> <p>Obesity is a multifactorial trait, which comprises an independent risk factor for cardiovascular disease (CVD). The aim of the current work is to study the complex etiology beneath obesity and identify genetic variations and/or factors related to nutrition that contribute to its variability. To this end, a set of more than 2300 white subjects who participated in a nutrigenetics study was used. For each subject a total of 63 factors describing genetic variants related to CVD (24 in total), gender, and nutrition (38 in total), e.g. average daily intake in calories and cholesterol, were measured. Each subject was categorized according to body mass index (BMI) as normal (BMI ≤ 25) or overweight (BMI > 25). Two artificial neural network (ANN) based methods were designed and used towards the analysis of the available data. These corresponded to i) a multi-layer feed-forward ANN combined with a parameter decreasing method (PDM-ANN), and ii) a multi-layer feed-forward ANN trained by a hybrid method (GA-ANN) which combines genetic algorithms and the popular back-propagation training algorithm.</p> <p>Results</p> <p>PDM-ANN and GA-ANN were comparatively assessed in terms of their ability to identify the most important factors among the initial 63 variables describing genetic variations, nutrition and gender, able to classify a subject into one of the BMI related classes: normal and overweight. The methods were designed and evaluated using appropriate training and testing sets provided by 3-fold Cross Validation (3-CV) resampling. Classification accuracy, sensitivity, specificity and area under receiver operating characteristics curve were utilized to evaluate the resulted predictive ANN models. The most parsimonious set of factors was obtained by the GA-ANN method and included gender, six genetic variations and 18 nutrition-related variables. The corresponding predictive model was characterized by a mean accuracy equal of 61.46% in the 3-CV testing sets.</p> <p>Conclusions</p> <p>The ANN based methods revealed factors that interactively contribute to obesity trait and provided predictive models with a promising generalization ability. In general, results showed that ANNs and their hybrids can provide useful tools for the study of complex traits in the context of nutrigenetics.</p