Performance of Small Cluster Surveys and the Clustered LQAS Design to estimate Local-level Vaccination Coverage in Mali

<p>Abstract</p> <p>Background</p> <p>Estimation of vaccination coverage at the local level is essential to identify communities that may require additional support. Cluster surveys can be used in resource-poor settings, when population figures are inaccurate. To be feasible, cluster samples need to be small, without losing robustness of results. The clustered LQAS (CLQAS) approach has been proposed as an alternative, as smaller sample sizes are required.</p> <p>Methods</p> <p>We explored (i) the efficiency of cluster surveys of decreasing sample size through bootstrapping analysis and (ii) the performance of CLQAS under three alternative sampling plans to classify local VC, using data from a survey carried out in Mali after mass vaccination against meningococcal meningitis group A.</p> <p>Results</p> <p>VC estimates provided by a 10 × 15 cluster survey design were reasonably robust. We used them to classify health areas in three categories and guide mop-up activities: i) health areas not requiring supplemental activities; ii) health areas requiring additional vaccination; iii) health areas requiring further evaluation. As sample size decreased (from 10 × 15 to 10 × 3), standard error of VC and ICC estimates were increasingly unstable. Results of CLQAS simulations were not accurate for most health areas, with an overall risk of misclassification greater than 0.25 in one health area out of three. It was greater than 0.50 in one health area out of two under two of the three sampling plans.</p> <p>Conclusions</p> <p>Small sample cluster surveys (10 × 15) are acceptably robust for classification of VC at local level. We do not recommend the CLQAS method as currently formulated for evaluating vaccination programmes.</p

Significance Of The Behavior Of Sensitive Stigmas Ii.

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141143/1/ajb205763.pd

Improving Patient Safety by Calculating the QT Correction in Critical Care Patients

Prolonged QTc is recognized as a precursor to Torsades de Points and other lethal ventricular arrhythmias. 52% or patients in critical care units have prolonged QTc and 69% or critical care patients have risks of developing QTc. Many commonly administered medications in the critical care unit are known to prolong QTc yet a microsystem assessment and a gap analysis revealed only 3% of the patients in the surgical ICU had the QTc calculation performed and assessed by the critical care nurse. The global aim is to improve patient safety by incorporating calculating of the QT correction (QTc) into the regularly performed assessments of the patients in the Surgical Intensive Care Unit. Performing this measurement will identify prolonged QTc, a known precursor to Torsades de Pointes and other lethal ventricular arrhythmias. Critical care nurses and the interdisciplinary team will intervene proactively for these critically ill patients. The specific aim is to reach 90% compliance with calculating and documenting the QTc by September 1, 2015. Nursing education through staff huddles, educational fliers, and one on one demonstration was provided throughout July 2015. Through interventions to improve nurses’ awareness of QTc calculation and risks of prolonged QTc intervals, compliance with calculating QTc has improved from 3% to 82%. Surveys were administered pre and post education which showed nurses self-reported comfort level has increased from 75% to 95% with no one reporting least comfort at the end of the intervention

Phenotypic microarrays suggest Escherichia coli ST131 is not a metabolically distinct lineage of extra-intestinal pathogenic E. coli

Extraintestinal pathogenic E. coli (ExPEC) are the major aetiological agent of urinary tract infections (UTIs) in humans. The emergence of the CTX-M producing clone E. coli ST131 represents a major challenge to public health worldwide. A recent study on the metabolic potential of E. coli isolates demonstrated an association between the E. coli ST131 clone and enhanced utilisation of a panel of metabolic substrates. The studies presented here investigated the metabolic potential of ST131 and other major ExPEC ST isolates using 120 API test reagents and found that ST131 isolates demonstrated a lower metabolic activity for 5 of 120 biochemical tests in comparison to non-ST131 ExPEC isolates. Furthermore, comparative phenotypic microarray analysis showed a lack of specific metabolic profile for ST131 isolates countering the suggestion that these bacteria are metabolically fitter and therefore more successful human pathogens

Two Years Later: Journals Are Not Yet Enforcing the ARRIVE Guidelines on Reporting Standards for Pre-Clinical Animal Studies

There is growing concern that poor experimental design and lack of transparent reporting contribute to the frequent failure of pre-clinical animal studies to translate into treatments for human disease. In 2010, the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines were introduced to help improve reporting standards. They were published in PLOS Biology and endorsed by funding agencies and publishers and their journals, including PLOS, Nature research journals, and other top-tier journals. Yet our analysis of papers published in PLOS and Nature journals indicates that there has been very little improvement in reporting standards since then. This suggests that authors, referees, and editors generally are ignoring guidelines, and the editorial endorsement is yet to be effectively implemented

Variations in the phosphorus content of estuarine waters of the Chesapeake Bay near Solomons Island, Maryland

Studies by Cowles and Brambel (1938), Newcombe and Lang (1939), and Newcombe, Horne and Shepherd (1939) have provided information on the quantitative methods for estimating inorganic phosphorus and, also, on the vertical and horizontal distribution of this nutrient substance in the waters of the Chesapeake Bay...

Observations on the alkalinity of estuarine waters of the Chesapeake Bay near Solomons Island, Maryland

Kolthoff (1926) without particular reference to sea water has defined buffer capacity (alkalinity, in the case of added strong base) of a solution quantitatively as the number of equivalents of added strong base or strong acid required to change the pH of one liter of solution one unit. Buch, in 1930, redefined this concept with reference to sea water as the number of moles of carbonic acid which must be added to one liter of the water in order to change its pH by one unit

Behavior Of Plants In Unventilated Chambers

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142325/1/ajb205503.pd

Absence of system xc⁻ on immune cells invading the central nervous system alleviates experimental autoimmune encephalitis

Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease that affects the central nervous system (CNS), leading to neurodegeneration and chronic disability. Accumulating evidence points to a key role for neuroinflammation, oxidative stress, and excitotoxicity in this degenerative process. System x(c)- or the cystine/glutamate antiporter could tie these pathological mechanisms together: its activity is enhanced by reactive oxygen species and inflammatory stimuli, and its enhancement might lead to the release of toxic amounts of glutamate, thereby triggering excitotoxicity and neurodegeneration. Methods: Semi-quantitative Western blotting served to study protein expression of xCT, the specific subunit of system x(c)-, as well as of regulators of xCT transcription, in the normal appearing white matter (NAWM) of MS patients and in the CNS and spleen of mice exposed to experimental autoimmune encephalomyelitis (EAE), an accepted mouse model of MS. We next compared the clinical course of the EAE disease, the extent of demyelination, the infiltration of immune cells and microglial activation in xCT-knockout (xCT(-/-)) mice and irradiated mice reconstituted in xCT(-/-) bone marrow (BM), to their proper wild type (xCT(+/+)) controls. Results: xCT protein expression levels were upregulated in the NAWM of MS patients and in the brain, spinal cord, and spleen of EAE mice. The pathways involved in this upregulation in NAWM of MS patients remain unresolved. Compared to xCT(+/+) mice, xCT(-/-) mice were equally susceptible to EAE, whereas mice transplanted with xCT(-/-) BM, and as such only exhibiting loss of xCT in their immune cells, were less susceptible to EAE. In none of the above-described conditions, demyelination, microglial activation, or infiltration of immune cells were affected. Conclusions: Our findings demonstrate enhancement of xCT protein expression in MS pathology and suggest that system x(c)- on immune cells invading the CNS participates to EAE. Since a total loss of system x(c)- had no net beneficial effects, these results have important implications for targeting system x(c)- for treatment of MS