Comparative Effectiveness of High-Dose Versus Standard-Dose Influenza Vaccine Among Patients Receiving Maintenance Hemodialysis

Rationale & Objective: Studies of patients on maintenance dialysis therapy suggest that standard-dose influenza vaccine (SDV) may not prevent influenza-related outcomes. Little is known about the comparative effectiveness of SDV versus high-dose influenza vaccine (HDV) in this population. Study Design: Cohort study using data from the US Renal Data System. Setting & Participants: 507,552 adults undergoing in-center maintenance hemodialysis between the 2010 to 2011 and 2014 to 2015 influenza seasons. Exposures: SDV and HDV. Outcomes: All-cause mortality, hospitalization due to influenza or pneumonia, and influenza-like illness during the influenza season. Analytic Approach: Patients were eligible for inclusion in multiple yearly cohorts; thus, our unit of analysis was the influenza patient-season. To examine the relationship between vaccine dose and effectiveness outcomes, we estimated risk differences and risk ratios using propensity score weighting of Kaplan-Meier functions, accounting for a wide range of patient- and facility-level characteristics. For nonmortality outcomes, we used competing-risk methods to account for the high mortality rate in the dialysis population. Results: Within 225,215 influenza patient-seasons among adults 65 years and older, 97.4% received SDV and 2.6% received HDV. We observed similar risk estimates for HDV and SDV recipients for mortality (risk difference, −0.08%; 95% CI, −0.85% to 0.80%), hospitalization due to influenza or pneumonia (risk difference, 0.15%; 95% CI, −0.69% to 0.93%), and influenza-like illness (risk difference, 0.00%; 95% CI, −1.50% to 1.08%). Our findings were similar among adults younger than 65 years, as well as within other subgroups defined by influenza season, age group, dialysis vintage, month of influenza vaccination, and vaccine valence. Limitations: Residual confounding and outcome misclassification. Conclusions: The HDV does not appear to provide additional protection beyond the SDV against all-cause mortality or influenza-related outcomes for adults undergoing hemodialysis. The additional cost and side effects associated with HDV should be considered when offering this vaccine. Future studies of HDV and other influenza vaccine strategies are warranted

Bouncing back from failure: Entrepreneurial resilience and the internationalization of subsequent ventures created by serial entrepreneurs

This paper examines the impact over international propensity of past negative entrepreneurial experience for those who re-enter into entrepreneurial activity; referred to as resilient serial entrepreneurs. We first hypothesize on the effects over entrepreneurial re-entry that such negative past experience may have and highlight the link between the past entrepreneurial experience of resilient entrepreneurs and their subsequent propensity towards international markets. Building on insights from the generative experiential learning process of entrepreneurial activity and from cognition theories, we propose that resilient entrepreneurs who re-enter business despite having faced negative entrepreneurial experiences in the past benefit from enriched cognitive schemas leading them to greater export propensity. The proposed hypotheses are tested on a unique sample drawn from a Spanish adult population survey. Results from the sequential deductive triangulation analysis (QUAN -> qual) reveal that practical experience is an essential prerequisite for entrepreneurial learning, and that the resilience of those with negative entrepreneurial experience induces the generative entrepreneurial learning especially suitable for subsequent internationally oriented ventures.Peer ReviewedPreprin

Discrete cilia modelling with singularity distributions

We discuss in detail techniques for modelling flows due to finite and infinite arrays of beating cilia. An efficient technique, based on concepts from previous ‘singularity models’ is described, that is accurate in both near and far-fields. Cilia are modelled as curved slender ellipsoidal bodies by distributing Stokeslet and potential source dipole singularities along their centrelines, leading to an integral equation that can be solved using a simple and efficient discretisation. The computed velocity on the cilium surface is found to compare favourably with the boundary condition. We then present results for two topics of current interest in biology. 1) We present the first theoretical results showing the mechanism by which rotating embryonic nodal cilia produce a leftward flow by a ‘posterior tilt,’ and track particle motion in an array of three simulated nodal cilia. We find that, contrary to recent suggestions, there is no continuous layer of negative fluid transport close to the ciliated boundary. The mean leftward particle transport is found to be just over 1 μm/s, within experimentally measured ranges. We also discuss the accuracy of models that represent the action of cilia by steady rotlet arrays, in particular, confirming the importance of image systems in the boundary in establishing the far-field fluid transport. Future modelling may lead to understanding of the mechanisms by which morphogen gradients or mechanosensing cilia convert a directional flow to asymmetric gene expression. 2) We develop a more complex and detailed model of flow patterns in the periciliary layer of the airway surface liquid. Our results confirm that shear flow of the mucous layer drives a significant volume of periciliary liquid in the direction of mucus transport even during the recovery stroke of the cilia. Finally, we discuss the advantages and disadvantages of the singularity technique and outline future theoretical and experimental developments required to apply this technique to various other biological problems, particularly in the reproductive system

Consensus statement on future directions for the behavioral and social sciences in oral health

The behavioral and social sciences are central to understanding and addressing oral and craniofacial health, diseases, and conditions. With both basic and applied approaches, behavioral and social sciences are relevant to every discipline in dentistry and all dental, oral, and craniofacial sciences, as well as oral health promotion programs and health care delivery. Key to understanding multilevel, interacting influences on oral health behavior and outcomes, the behavioral and social sciences focus on individuals, families, groups, cultures, systems, societies, regions, and nations. Uniquely positioned to highlight the importance of racial, cultural, and other equity in oral health, the behavioral and social sciences necessitate a focus on both individuals and groups, societal reactions to them related to power, and environmental and other contextual factors. Presented here is a consensus statement that was produced through an iterative feedback process. The statement reflects the current state of knowledge in the behavioral and social oral health sciences and identifies future directions for the field, focusing on 4 key areas: behavioral and social theories and mechanisms related to oral health, use of multiple and novel methodologies in social and behavioral research and practice related to oral health, development and testing of behavioral and social interventions to promote oral health, and dissemination and implementation research for oral health. This statement was endorsed by over 400 individuals and groups from around the world and representing numerous disciplines in oral health and the behavioral and social sciences. Having reached consensus, action is needed to advance and further integrate and translate behavioral and social sciences into oral health research, oral health promotion and health care, and the training of those working to ensure oral health for all

Historical trends in iodine and selenium in soil and herbage at the Park Grass experiment, Rothamsted Research, UK

Long term trends in iodine and selenium retention in soil, and uptake by herbage, were investigated in archived samples from the Park Grass Experiment, initiated in 1856 at Rothamsted, UK. Soil (0-23 cm) and herbage samples from plots receiving various mineral fertilisers and organic manures, with and without lime, were analysed for Se and iodine (I) to assess the effect of soil amendment, annual rainfall, crop yield and changes in soil chemistry from 1876 to 2008. Comparing soil from limed and un-limed control (unfertilized) plots, TMAH-extractable Se and I concentrations both diverged, with time, with greater retention in un-limed plots; differences in concentration amounted to 92 and 1660 µg kg-1 for Se and I respectively after 105 yr. These differences were broadly consistent with estimated additions from rainfall and dry deposition. Offtake of both elements in herbage was negligible compared to soil concentrations and annual inputs (<0.003% of total soil I and <0.006% of total soil Se). A positive correlation was observed between I and Se concentrations in herbage, suggesting some common factors controlling bioavailability. A growth-dilution effect for I and Se was suggested by the positive correlation between growing season rainfall (GSR) and herbage yield together with soil-to-plant transfer factors decreasing with yield. Phosphate and sulphate fertilizers reduced I and Se herbage concentrations, both through ion competition and increased herbage yield. Results suggest that in intensive agriculture with soil pH control, the I requirement of grazing animals is not likely to be met by herbage alone

Measurement of the B0-anti-B0-Oscillation Frequency with Inclusive Dilepton Events

The $B^0$-$\bar B^0$ oscillation frequency has been measured with a sample of 23 million \B\bar B pairs collected with the BABAR detector at the PEP-II asymmetric B Factory at SLAC. In this sample, we select events in which both B mesons decay semileptonically and use the charge of the leptons to identify the flavor of each B meson. A simultaneous fit to the decay time difference distributions for opposite- and same-sign dilepton events gives $\Delta m_d = 0.493 \pm 0.012{(stat)}\pm 0.009{(syst)}$ ps$^{-1}$.Comment: 7 pages, 1 figure, submitted to Physical Review Letter

CANDELS : constraining the AGN-merger connection with host morphologies at z ~ 2

Using Hubble Space Telescope/WFC3 imaging taken as part of the Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey, we examine the role that major galaxy mergers play in triggering active galactic nucleus (AGN) activity at z ~ 2. Our sample consists of 72 moderate-luminosity (L X ~ 1042-44 erg s-1) AGNs at 1.5 < z < 2.5 that are selected using the 4 Ms Chandra observations in the Chandra Deep Field South, the deepest X-ray observations to date. Employing visual classifications, we have analyzed the rest-frame optical morphologies of the AGN host galaxies and compared them to a mass-matched control sample of 216 non-active galaxies at the same redshift. We find that most of the AGNs reside in disk galaxies (51.4+5.8 - 5.9%), while a smaller percentage are found in spheroids (27.8+5.8 - 4.6%). Roughly 16.7+5.3 - 3.5% of the AGN hosts have highly disturbed morphologies and appear to be involved in a major merger or interaction, while most of the hosts (55.6+5.6 - 5.9%) appear relatively relaxed and undisturbed. These fractions are statistically consistent with the fraction of control galaxies that show similar morphological disturbances. These results suggest that the hosts of moderate-luminosity AGNs are no more likely to be involved in an ongoing merger or interaction relative to non-active galaxies of similar mass at z ~ 2. The high disk fraction observed among the AGN hosts also appears to be at odds with predictions that merger-driven accretion should be the dominant AGN fueling mode at z ~ 2, even at moderate X-ray luminosities. Although we cannot rule out that minor mergers are responsible for triggering these systems, the presence of a large population of relatively undisturbed disk-like hosts suggests that the stochastic accretion of gas plays a greater role in fueling AGN activity at z ~ 2 than previously thought

The PHENIX Experiment at RHIC

The physics emphases of the PHENIX collaboration and the design and current status of the PHENIX detector are discussed. The plan of the collaboration for making the most effective use of the available luminosity in the first years of RHIC operation is also presented.Comment: 5 pages, 1 figure. Further details of the PHENIX physics program available at http://www.rhic.bnl.gov/phenix