Coadministration of Anti-Viral Monoclonal Antibodies With Routine Pediatric Vaccines and Implications for Nirsevimab Use: A White Paper

Routine childhood vaccinations are key for the protection of children from a variety of serious and potentially fatal diseases. Current pediatric vaccine schedules mainly cover active vaccines. Active vaccination in infants is a highly effective approach against several infectious diseases; however, thus far, for some important viral pathogens, including respiratory syncytial virus (RSV), vaccine development and license by healthcare authorities have not been accomplished. Nirsevimab is a human-derived, highly potent monoclonal antibody (mAb) with an extended half-life for RSV prophylaxis in all infants. In this manuscript, we consider the potential implications for the introduction of an anti-viral mAb, such as nirsevimab, into the routine pediatric vaccine schedule, as well as considerations for coadministration. Specifically, we present evidence on the general mechanism of action of anti-viral mAbs and experience with palivizumab, the only approved mAb for the prevention of RSV infection in preterm infants, infants with chronic lung disease of prematurity and certain infants with hemodynamically significant heart disease. Palivizumab has been used for over two decades in infants who also receive routine vaccinations without any alerts concerning the safety and efficacy of coadministration. Immunization guidelines (Advisory Committee on Immunization Practices, Joint Committee on Vaccination and Immunization, National Advisory Committee on Immunization, Centers for Disease Control and Prevention, American Academy of Pediatrics, The Association of the Scientific Medical Societies in Germany) support coadministration of palivizumab with routine pediatric vaccines, noting that immunobiologics, such as palivizumab, do not interfere with the immune response to licensed live or inactivated active vaccines. Based on the mechanism of action of the new generation of anti-viral mAbs, such as nirsevimab, which is highly specific targeting viral antigenic sites, it is unlikely that it could interfere with the immune response to other vaccines. Taken together, we anticipate that nirsevimab could be concomitantly administered to infants with routine pediatric vaccines during the same clinic visit

A QCD Sum Rule Approach to the s→dγs\to d\gamma Contribution to the Ω−→Ξ−γ\Omega^-\to \Xi^-\gamma Radiative Decay

QCD sum rules are used to calculate the contribution of short-distance single-quark transition $s\rightarrow d \gamma$, to the amplitudes of the hyperon radiative decay, $\Omega^-\rightarrow \Xi^-\gamma$. We re-evaluate the Wilson coefficient of the effective operator responsible for this transition. We obtain a branching ratio which is comparable to the unitarity limit.Comment: 15 pages, Revtex, 13 figures available as a uuencoded, gz-compressed ps fil

Long Distance Contribution to s→dγs \to d\gamma and Implications for Ω−→Ξ−γ,Bs→Bd∗γ\Omega^-\to \Xi ^-\gamma, B_s \to B_d^*\gamma and b→sγb \to s\gamma

We estimate the long distance (LD) contribution to the magnetic part of the $s \to d\gamma$ transition using the Vector Meson Dominance approximation $(V=\rho,\omega,\psi_i)$. We find that this contribution may be significantly larger than the short distance (SD) contribution to $s \to d\gamma$ and could possibly saturate the present experimental upper bound on the $\Omega^-\to \Xi^-\gamma$ decay rate, $\Gamma^{\rm MAX}_{\Omega^-\to \Xi^-\gamma} \simeq 3.7\times10^{-9}$eV. For the decay $B_s \to B^*_d\gamma$, which is driven by $s \to d\gamma$ as well, we obtain an upper bound on the branching ratio $BR(B_s \to B_d^*\gamma)<3\times10^{-8}$ from $\Gamma^{\rm MAX}_{\Omega^-\to \Xi^-\gamma}$. Barring the possibility that the Quantum Chromodynamics coefficient $a_2(m_s)$ be much smaller than 1, $\Gamma^{\rm MAX}_{\Omega^-\to \Xi^-\gamma}$ also implies the approximate relation $\frac{2}{3} \sum_i \frac{g^2_{\psi_i}(0)}{m^2_{\psi_i}} \simeq \frac{1}{2} \frac{g^2_\rho(0)}{m^2_\rho} + \frac{1}{6}\frac{g^2_\omega(0)}{m^2_\omega}$. This relation agrees quantitatively with a recent independent estimate of the l.h.s. by Deshpande et al., confirming that the LD contributions to $b \to s\gamma$ are small. We find that these amount to an increase of $(4\pm2)\%$ in the magnitude of the $b \to s \gamma$ transition amplitude, relative to the SD contribution alone.Comment: 16 pages, LaTeX fil

Suicide cases in developed and emerging countries: an analysis using wavelets.

Objetivo: Verificar se existe relação de similaridade entre o número de suicídio em países desenvolvidos e emergentes usando a técnica de ondaletas. Métodos: Os dados anuais foram obtidos a partir do relatório da Organização Mundial da Saúde (OMS), no período de 1986 a 2015. Para análise, foi empregada a transformada discreta não decimada de ondaleta (NDWT), a função ondaleta aplicada foi a Daubechies com cinco níveis de decomposição. Com relação ao agrupamento, utilizou-se a energia (variância) para analisar os clusters e, para a visualização do processo de clusterização, trabalhamos com o dendograma, no qual se empregou a distância de Mahalanobis. A quantidade de grupos foi definida por meio da função NbCluster. Resultados: A partir da análise de cluster, verificou-se a formação de quatros grupos. No qual, Japão e Estados Unidos e Brasil localizam-se em grupos distintos e isolados. E os demais países (Áustria, Bélgica, Chile, Israel, México, Itália e Holanda) em um único grupo. Conclusão: Utilizando esse método, foi possível verificar com mais detalhes quais países apresentaram comportamentos semelhantes, mesmo apresentando características bem distintas entre si, tanto socioeconômica, geográfica e climática

An MPEG-7 scheme for semantic content modelling and filtering of digital video

Abstract Part 5 of the MPEG-7 standard specifies Multimedia Description Schemes (MDS); that is, the format multimedia content models should conform to in order to ensure interoperability across multiple platforms and applications. However, the standard does not specify how the content or the associated model may be filtered. This paper proposes an MPEG-7 scheme which can be deployed for digital video content modelling and filtering. The proposed scheme, COSMOS-7, produces rich and multi-faceted semantic content models and supports a content-based filtering approach that only analyses content relating directly to the preferred content requirements of the user. We present details of the scheme, front-end systems used for content modelling and filtering and experiences with a number of users

Resonant and nonresonant contributions to the weak D→Vl+l−D\to Vl^+l^- decays

The Cabibbo suppressed decays $D\to Vl^+l^-$ (V is light vector meson) present in principle the opportunity to observe the short distance FCNC transition $c\to ul^+l^-$, which is sensitive to physics beyond the Standard Model. We analyze these as well as the Cabibbo allowed $D \to V l^+ l^-$ decays within the Standard Model, where in addition to the short distance dynamics also the long distance dynamics is present. The long distance contribution is induced by the effective nonleptonic weak Lagrangian accompanied by the emission of a virtual photon, which occurs resonantly via conversion from a vector meson $\rho^0, \omega$ or $\phi$ or nonresonantly as direct emission from a $D$ meson. We calculate the branching ratios for all $D\to Vl^+l^-$ decays using the model, which combines heavy quark symmetry and chiral perturbation theory. The short distance contribution due to $c\to ul^+l^-$ transition, which is present only in the Cabibbo suppressed decays, is found to be three orders of magnitude smaller than the long distance contribution. The branching ratios well above $10^{-7}$ for Cabibbo suppressed decays could signal new physics. The most frequent decays are the Cabibbo allowed decays, which are expected at the rates, that are not much lower than the present experimental upper limit: $D_s^+\to \rho^+\mu^+\mu^-$ is expected at the branching ratio of approximately $3\cdot 10^{-5}$, while $D^0\to\bar K^{*0}\mu^+\mu^-$ is expected at $1.7\cdot 10^{-6}$.Comment: 21 pages, latex, 6 figures; minor corrections in purpose of clear presentation Published in Phys. Rev. D 58 09403

Hyperon weak radiative decays in chiral perturbation theory

We investigate the leading-order amplitudes for weak radiative decays of hyperons in chiral perturbation theory. We consistently include contributions from the next-to-leading order weak-interaction Lagrangian. It is shown that due to these terms Hara's theorem is violated. The data for the decays of charged hyperons can be easily accounted for. However, at this order in the chiral expansion, the four amplitudes for the decays of neutral hyperons satisfy relations which are in disagreement with the data. The asymmetry parameters for all the decays can not be accounted for without higher-order terms. We shortly comment on the effect of the 27-plet part of the weak interaction.Comment: 8 pages of REVTeX and using macro-package "feynman.tex" (available at http://xxx.lanl.gov/ftp/hep-ph/papers/macros) for the 2 figure

IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) Consensus Conference Statement on One-Anastomosis Gastric Bypass (OAGB-MGB): Results of a Modified Delphi Study

Background: One-anastomosis gastric bypass (OAGB-MGB) is currently the third performed primary bariatric surgical procedure worldwide. However, the procedure is hampered by numerous controversies and there is considerable variability in surgical technique, patient selection, and pre- and postoperative care among the surgeons performing this procedure. This paper reports the results of a modified Delphi consensus study organized by the International Federation for Surgery of Obesity and Metabolic Disorders (IFSO). Methods: Fifty-two internationally recognized bariatric experts from 28 countries convened for voting on 90 consensus statements over two rounds to identify those on which consensus could be reached. Inter-voter agreement of ≥ 70% was considered consensus, with voting participation ≥ 80% considered a robust vote. Results: At least 70% consensus was achieved for 65 of the 90 questions (72.2% of the items), 61 during the first round of voting and an additional four in the second round. Where consensus was reached on a binary agree/disagree or yes/no item, there was agreement with the statement presented in 53 of 56 instances (94.6%). Where consensus was reached on a statement where options favorable versus unfavorable to OAGB-MGB were provided, including statements in which OAGB-MGB was compared to another procedure, the response option favorable to OAGB-MGB was selected in 13 of 23 instances (56.5%). Conclusion: Although there is general agreement that the OAGB-MGB is an effective and usually safe option for the management of patients with obesity or severe obesity, numerous areas of non-consensus remain in its use. Further empirical data are needed

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

Immunization during pregnancy has been recommended in an increasing number of countries. The aim of this strategy is to protect pregnant women and infants from severe infectious disease, morbidity and mortality and is currently limited to tetanus, inactivated influenza, and pertussis-containing vaccines. There have been recent advancements in the development of vaccines designed primarily for use in pregnant women (respiratory syncytial virus and group B Streptococcus vaccines). Although there is increasing evidence to support vaccination in pregnancy, important gaps in knowledge still exist and need to be addressed by future studies. This collaborative consensus paper provides a review of the current literature on immunization during pregnancy and highlights the gaps in knowledge and a consensus of priorities for future research initiatives, in order to optimize protection for both the mother and the infant

Vitamin D Binding Protein Genotype and Osteoporosis

Osteoporosis is a bone disease leading to an increased fracture risk. It is considered a complex multifactorial genetic disorder with interaction of environmental and genetic factors. As a candidate gene for osteoporosis, we studied vitamin D binding protein (DBP, or group-specific component, Gc), which binds to and transports vitamin D to target tissues to maintain calcium homeostasis through the vitamin D endocrine system. DBP can also be converted to DBP-macrophage activating factor (DBP-MAF), which mediates bone resorption by directly activating osteoclasts. We summarized the genetic linkage structure of the DBP gene. We genotyped two single-nucleotide polymorphisms (SNPs, rs7041 = Glu416Asp and rs4588 = Thr420Lys) in 6,181 elderly Caucasians and investigated interactions of the DBP genotype with vitamin D receptor (VDR) genotype and dietary calcium intake in relation to fracture risk. Haplotypes of the DBP SNPs correspond to protein variations referred to as Gc1s (haplotype 1), Gc2 (haplotype 2), and Gc1f (haplotype3). In a subgroup of 1,312 subjects, DBP genotype was found to be associated with increased and decreased serum 25-(OH)D3 for haplotype 1 (P = 3 × 10−4) and haplotype 2 (P = 3 × 10−6), respectively. Similar associations were observed for 1,25-(OH)2D3. The DBP genotype was not significantly associated with fracture risk in the entire study population. Yet, we observed interaction between DBP and VDR haplotypes in determining fracture risk. In the DBP haplotype 1-carrier group, subjects of homozygous VDR block 5-haplotype 1 had 33% increased fracture risk compared to noncarriers (P = 0.005). In a subgroup with dietary calcium intake <1.09 g/day, the hazard ratio (95% confidence interval) for fracture risk of DBP hap1-homozygote versus noncarrier was 1.47 (1.06–2.05). All associations were independent of age and gender. Our study demonstrated that the genetic effect of the DBP gene on fracture risk appears only in combination with other genetic and environmental risk factors for bone metabolism