Impact Of Health Care Access On Delayed Or Missed Adolescent Vaccinations For Tdap, Meningococcal, And Hpv Vaccines Among U.s. Adolescents, Nis-Teen 2018

Background: Adolescent vaccination coverage varies considerably between Tdap, meningococcal, and HPV vaccines. While evidence suggests that health care access affects vaccination coverage, evidence does not explain whether access drives delayed or no vaccination. This study evaluates whether measures of health care access are associated with delayed vaccination or not being vaccinated by age 17 years for Tdap, meningococcal, and HPV vaccines when controlling for sociodemographic factors as proxies for vaccine hesitancy. The secondary objective assesses whether health care access measures had consistent associations across the different vaccines. Methods: Using current ACIP recommendations, ‘on-time’, ‘delayed’, and ‘missed’ status by age 17 were defined for Tdap, meningococcal, and HPV vaccinations. Vaccination coverage disparities among 17-year-olds by access and sociodemographic variables were assessed using data from NIS-Teen 2018. Associations between measures of health access and delayed or missed vaccination by age 17 were evaluated using multivariable logistic regression analysis. Results: For adolescents age 17 years, missing the 11–12 years well-child check-up was the strongest predictor for delayed or missed vaccination for Tdap, ≥1 dose MenACWY, and HPV. Other measures of health care access, such as continuity of insurance and number of health provider visits in the past 12 months, were not significantly associated with delayed or missed vaccination for any of the vaccines. Conclusions: For the small proportion of the adolescent population that does not have an 11–12-year-old check-up, the detrimental effect on vaccination follows them through adolescence with a higher likelihood of no recommended vaccinations by age 17. The findings support a need to improve efforts for catch-up vaccination throughout adolescence

Gut Microbiome Dysbiosis in Antibiotic-Treated COVID-19 Patients is Associated with Microbial Translocation and Bacteremia

Although microbial populations in the gut microbiome are associated with COVID-19 severity, a causal impact on patient health has not been established. Here we provide evidence that gut microbiome dysbiosis is associated with translocation of bacteria into the blood during COVID-19, causing life-threatening secondary infections. We first demonstrate SARS-CoV-2 infection induces gut microbiome dysbiosis in mice, which correlated with alterations to Paneth cells and goblet cells, and markers of barrier permeability. Samples collected from 96 COVID-19 patients at two different clinical sites also revealed substantial gut microbiome dysbiosis, including blooms of opportunistic pathogenic bacterial genera known to include antimicrobial-resistant species. Analysis of blood culture results testing for secondary microbial bloodstream infections with paired microbiome data indicates that bacteria may translocate from the gut into the systemic circulation of COVID-19 patients. These results are consistent with a direct role for gut microbiome dysbiosis in enabling dangerous secondary infections during COVID-19

Repair of noise-induced damage to stereocilia F-actin cores is facilitated by XIRP2 and its novel mechanosensor domain

Prolonged exposure to loud noise has been shown to affect inner ear sensory hair cells in a variety of deleterious manners, including damaging the stereocilia core. The damaged sites can be visualized as ‘gaps’ in phalloidin staining of F-actin, and the enrichment of monomeric actin at these sites, along with an actin nucleator and crosslinker, suggests that localized remodeling occurs to repair the broken filaments. Herein, we show that gaps in mouse auditory hair cells are largely repaired within 1 week of traumatic noise exposure through the incorporation of newly synthesized actin. We provide evidence that Xin actin binding repeat containing 2 (XIRP2) is required for the repair process and facilitates the enrichment of monomeric γ-actin at gaps. Recruitment of XIRP2 to stereocilia gaps and stress fiber strain sites in fibroblasts is force-dependent, mediated by a novel mechanosensor domain located in the C-terminus of XIRP2. Our study describes a novel process by which hair cells can recover from sublethal hair bundle damage and which may contribute to recovery from temporary hearing threshold shifts and the prevention of age-related hearing loss

Future Opportunities in Accelerator-based Neutrino Physics

International audienceThis document summarizes the conclusions of the Neutrino Town Meeting held at CERN in October 2018 to review the neutrino field at large with the aim of defining a strategy for accelerator-based neutrino physics in Europe. The importance of the field across its many complementary components is stressed. Recommendations are presented regarding the accelerator based neutrino physics, pertinent to the European Strategy for Particle Physics. We address in particular i) the role of CERN and its neutrino platform, ii) the importance of ancillary neutrino cross-section experiments, and iii) the capability of fixed target experiments as well as present and future high energy colliders to search for the possible manifestations of neutrino mass generation mechanisms