255 research outputs found
Differences in health symptoms among residents living near illegal dump sites in Los Laureles Canyon, Tijuana, Mexico: a cross sectional survey.
Living near landfills is a known health hazard prompting recognition of environmental injustice. The study aim was to compare self-reported symptoms of ill health among residents of four neighborhoods, living in haphazardly constructed settlements surrounded by illegal dumpsites in Tijuana, Mexico. One adult from each of 388 households located in Los Laureles Canyon were interviewed about demographics, health status, and symptoms. Distance from each residence to both the nearest dumpsite and the canyon bottom was assessed. The neighborhoods were selected from locations within the canyon, and varied with respect to proximity to dump sites. Residents of San Bernardo reported significantly higher frequencies of ill-health symptoms than the other neighborhoods, including extreme fatigue (OR 3.01 (95% CI 1.6-5.5)), skin problems/irritations (OR 2.73 (95% CI 1.3-5.9)), stomach discomfort (OR 2.47 (1.3-4.8)), eye irritation/tears (OR 2.02 (1.2-3.6)), and confusion/difficulty concentrating (OR 2.39 (1.2-4.8)). Proximity to dumpsites did not explain these results, that varied only slightly when adjusted for distance to nearest dumpsite or distance to the canyon bottom. Because San Bernardo has no paved roads, we hypothesize that dust and the toxicants it carries is a possible explanation for this difference. Studies are needed to further document this association and sources of toxicants
Whom and Where Are We Not Vaccinating? Coverage after the Introduction of a New Conjugate Vaccine against Group A Meningococcus in Niger in 2010
MenAfriVac is a new conjugate vaccine against Neisseria meningitidis serogroup A developed for the African “meningitis belt”. In Niger, the first two phases of the MenAfriVac introduction campaign were conducted targeting 3,135,942 individuals aged 1 to 29 years in the regions of Tillabéri, Niamey, and Dosso, in September and December 2010. We evaluated the campaign and determined which sub-populations or areas had low levels of vaccination coverage in the regions of Tillabéri and Niamey. After Phase I, conducted in the Filingué district, we estimated coverage using a 30×15 cluster-sampling survey and nested lot quality assurance (LQA) analysis in the clustered samples to identify which subpopulations (defined by age 1–14/15–29 and sex) had unacceptable vaccination coverage (<70%). After Phase II, we used Clustered Lot Quality Assurance Sampling (CLQAS) to assess if any of eight districts in Niamey and Tillabéri had unacceptable vaccination coverage (<75%) and estimated overall coverage. Estimated vaccination coverage was 77.4% (95%CI: 84.6–70.2) as documented by vaccination cards and 85.5% (95% CI: 79.7–91.2) considering verbal history of vaccination for Phase I; 81.5% (95%CI: 86.1–77.0) by card and 93.4% (95% CI: 91.0–95.9) by verbal history for Phase II. Based on vaccination cards, in Filingué, we identified both the male and female adult (age 15–29) subpopulations as not reaching 70% coverage; and we identified three (one in Tillabéri and two in Niamey) out of eight districts as not reaching 75% coverage confirmed by card. Combined use of LQA and cluster sampling was useful to estimate vaccination coverage and to identify pockets with unacceptable levels of coverage (adult population and three districts). Although overall vaccination coverage was satisfactory, we recommend continuing vaccination in the areas or sub-populations with low coverage and reinforcing the social mobilization of the adult population
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
Intervene before leaving: clustered lot quality assurance sampling to monitor vaccination coverage at health district level before the end of a yellow fever and measles vaccination campaign in Sierra Leone in 2009
From antiferromagnetic insulator to correlated metal in pressurized and doped LaMnPO
Widespread adoption of superconducting technologies requires the discovery of
new materials with enhanced properties, especially higher superconducting
transition temperatures T. The unexpected discovery of high T
superconductivity in cuprates and in materials as diverse as heavy fermions,
organic conductors, and endohedrally-doped fullerenes suggests that the highest
Ts occur when pressure or doping transform the localized and
moment-bearing electrons in antiferromagnetic insulators into itinerant and
weakly magnetic metals. The absence of this delocalization transition in
Fe-based superconductors may limit their Ts, but even larger Ts may
be possible in their isostructural Mn analogs, which are antiferromagnetic
insulators like the cuprates. It is generally believed that prohibitively large
pressures would be required to suppress the strong Hund's rule coupling in
these Mn-based compounds, collapsing the insulating gap and enabling
superconductivity. Indeed, no Mn-based compounds are known to be
superconductors. The electronic structure calculations and x-ray diffraction
measurements presented here challenge these long held beliefs, finding that
only modest pressures are required to transform LaMnPO, isostructural to
superconducting host LaFeAsO, from an insulating tetragonal structure with a
large Mn moment to a gapless orthorhombic structure with a small Mn moment.
Proximity to this electronic delocalization transition in LaMnPO results in a
highly interacting metallic state, the familiar breeding ground of
superconductivity.Comment: 5 pages, 5 figure
Chitosan-Graft-Branched Polyethylenimine Copolymers: Influence of Degree of Grafting on Transfection Behavior
BACKGROUND: Successful non-viral gene delivery currently requires compromises to achieve useful transfection levels while minimizing toxicity. Despite high molecular weight (MW) branched polyethylenimine (bPEI) is considered the gold standard polymeric transfectant, it suffers from high cytotoxicity. Inversely, its low MW counterpart is less toxic and effective in transfection. Moreover, chitosan is a highly biocompatible and biodegradable polymer but characterized by very low transfection efficiency. In this scenario, a straightforward approach widely exploited to develop effective transfectants relies on the synthesis of chitosan-graft-low MW bPEIs (Chi-g-bPEI(x)) but, despite the vast amount of work that has been done in developing promising polymeric assemblies, the possible influence of the degree of grafting on the overall behavior of copolymers for gene delivery has been largely overlooked. METHODOLOGY/PRINCIPAL FINDINGS: With the aim of providing a comprehensive evaluation of the pivotal role of the degree of grafting in modulating the overall transfection effectiveness of copolymeric vectors, we have synthesized seven Chi-g-bPEI(x) derivatives with a variable amount of bPEI grafts (minimum: 0.6%; maximum: 8.8%). Along the Chi-g-bPEI(x) series, the higher the degree of grafting, the greater the ζ-potential and the cytotoxicity of the resulting polyplexes. Most important, in all cell lines tested the intermediate degree of grafting of 2.7% conferred low cytotoxicity and higher transfection efficiency compared to other Chi-g-bPEI(x) copolymers. We emphasize that, in transfection experiments carried out in primary articular chondrocytes, Chi-g-bPEI(2.7%) was as effective as and less cytotoxic than the gold standard 25 kDa bPEI. CONCLUSIONS/SIGNIFICANCE: This work underlines for the first time the pivotal role of the degree of grafting in modulating the overall transfection effectiveness of Chi-g-bPEI(x) copolymers. Crucially, we have demonstrated that, along the copolymer series, the fine tuning of the degree of grafting directly affected the overall charge of polyplexes and, altogether, had a direct effect on cytotoxicity
Eff ectiveness of one dose of oral cholera vaccine in response to an outbreak: a case-cohort study
Background Oral cholera vaccines represent a new eff ective tool to fi ght cholera and are licensed as two-dose regimens
with 2–4 weeks between doses. Evidence from previous studies suggests that a single dose of oral cholera vaccine
might provide substantial direct protection against cholera. During a cholera outbreak in May, 2015, in Juba, South
Sudan, the Ministry of Health, Médecins Sans Frontières, and partners engaged in the fi rst fi eld deployment of a
single dose of oral cholera vaccine to enhance the outbreak response. We did a vaccine eff ectiveness study in
conjunction with this large public health intervention.
Methods We did a case-cohort study, combining information on the vaccination status and disease outcomes from a
random cohort recruited from throughout the city of Juba with that from all the cases detected. Eligible cases were
those aged 1 year or older on the fi rst day of the vaccination campaign who sought care for diarrhoea at all three
cholera treatment centres and seven rehydration posts throughout Juba. Confi rmed cases were suspected cases who
tested positive to PCR for Vibrio cholerae O1. We estimated the short-term protection (direct and indirect) conferred by
one dose of cholera vaccine (Shanchol, Shantha Biotechnics, Hyderabad, India).
Findings Between Aug 9, 2015, and Sept 29, 2015, we enrolled 87 individuals with suspected cholera, and an 898-person
cohort from throughout Juba. Of the 87 individuals with suspected cholera, 34 were classifi ed as cholera positive,
52 as cholera negative, and one had indeterminate results. Of the 858 cohort members who completed a follow-up
visit, none developed clinical cholera during follow-up. The unadjusted single-dose vaccine eff ectiveness was 80·2%
(95% CI 61·5–100·0) and after adjusting for potential confounders was 87·3% (70·2–100·0).
Interpretation One dose of Shanchol was eff ective in preventing medically attended cholera in this study. These
results support the use of a single-dose strategy in outbreaks in similar epidemiological settings
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