Estimated impact of maternal vaccination on global paediatric influenza-related in-hospital mortality: A retrospective case series

BACKGROUND: Influenza virus infection is an important cause of under-five mortality. Maternal vaccination protects children younger than 3 months of age from influenza infection. However, it is unknown to what extent paediatric influenza-related mortality may be prevented by a maternal vaccine since global age-stratified mortality data are lacking. METHODS: We invited clinicians and researchers to share clinical and demographic characteristics from children younger than 5 years who died with laboratory-confirmed influenza infection between January 1, 1995 and March 31, 2020. We evaluated the potential impact of maternal vaccination by estimating the number of children younger than 3 months with in-hospital influenza-related death using published global mortality estimates. FINDINGS: We included 314 children from 31 countries. Comorbidities were present in 166 (53%) children and 41 (13%) children were born prematurely. Median age at death was 8·6 (IQR 4·5-16·6), 11·5 (IQR 4·3-24·0), and 15·5 (IQR 7·4-27·0) months for children from low- and lower-middle-income countries (LMICs), upper-middle-income countries (UMICs), and high-income countries (HICs), respectively. The proportion of children younger than 3 months at time of death was 17% in LMICs, 12% in UMICs, and 7% in HICs. We estimated that 3339 annual influenza-related in-hospital deaths occur in the first 3 months of life globally. INTERPRETATION: In our study, less than 20% of children is younger than 3 months at time of influenza-related death. Although maternal influenza vaccination may impact maternal and infant influenza disease burden, additional immunisation strategies are needed to prevent global influenza-related childhood mortality. The missing data, global coverage, and data quality in this study should be taken into consideration for further interpretation of the results. FUNDING: Bill & Melinda Gates Foundation

Comparison of Predictors and Mortality Between Bloodstream Infections Caused by ESBL-Producing Escherichia coli and ESBL-Producing Klebsiella pneumoniae.

Comparison of the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum \u3b2-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP

Effect of surface roughness of biomaterials on Staphylococcus epidermidis adhesion

Background: Implant-related infections are caused by adhesion of bacteria to the surface of biomaterials. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis (ATCC35984) to adhere to the surface of solid biomaterials at different levels of roughness below 30 nm Ra and investigated the minimum level of roughness required to promote bacterial adhesion on five kinds of biomaterials: oxidized zirconium-niobium alloy (Oxinium), cobalt-chromium-molybdenum alloy (Co-Cr-Mo), titanium alloy (Ti-6Al-4 V), commercially pure titanium (Cp-Ti) and stainless steel (SUS316L), samples of which were categorized into a fine group and a coarse group according to surface roughness. The test specimens were physically analyzed and the viable bacterial density of the adhered bacteria was quantitatively determined (n = 20).Results: The amount of bacteria that adhered to the biomaterials in the coarse group was higher than those in the fine group. Oxinium, Ti-6Al-4 V and SUS316L in particular demonstrated statistically significant differences between the two groups (P < 0.05). Of the materials, the Co-Cr-Mo specimens exhibited significantly lower amounts of adhered bacteria than the Ti-6Al-4 V, Cp-Ti and SUS316L specimens in the fine group. Similarly, the Co-Cr-Mo specimens in the coarse group exhibited significantly lower values than the other four materials.Conclusions: These results suggest that minimum level of roughness affecting initial bacterial adherence activity differs according to the type of biomaterial used, and that even a surface roughness of below 30 nm Ra in Oxinium, Ti-6Al-4 V and SUS316L can promote bacterial adhesion. Relative hydrophobic Co-Cr-Mo surfaces were less susceptible to bacterial adherence

Early Staphylococcal Biofilm Formation on Solid Orthopaedic Implant Materials: In Vitro Study

Biofilms forming on the surface of biomaterials can cause intractable implant-related infections. Bacterial adherence and early biofilm formation are influenced by the type of biomaterial used and the physical characteristics of implant surface. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis, the main pathogen in implant-related infections, to form biofilms on the surface of the solid orthopaedic biomaterials, oxidized zirconium-niobium alloy, cobalt-chromium-molybdenum alloy (Co-Cr-Mo), titanium alloy (Ti-6Al-4V), commercially pure titanium (cp-Ti) and stainless steel. A bacterial suspension of Staphylococcus epidermidis strain RP62A (ATCC35984) was added to the surface of specimens and incubated. The stained biofilms were imaged with a digital optical microscope and the biofilm coverage rate (BCR) was calculated. The total amount of biofilm was determined with the crystal violet assay and the number of viable cells in the biofilm was counted using the plate count method. The BCR of all the biomaterials rose in proportion to culture duration. After culturing for 2-4 hours, the BCR was similar for all materials. However, after culturing for 6 hours, the BCR for Co-Cr-Mo alloy was significantly lower than for Ti-6Al-4V, cp-Ti and stainless steel (P0.05). These results suggest that surface properties, such as hydrophobicity or the low surface free energy of Co-Cr-Mo, may have some influence in inhibiting or delaying the two-dimensional expansion of biofilm on surfaces with a similar degree of smoothness

Diary of an internship with the Federal Probation and Parole Office, Tucson District of Arizona

Please contact [email protected] if you wish to view this title.Diary in lieu of thesis (M.P.A. - Public Administration) --University of Arizona. / "Names of defendants have been changed in local cases..."restricted item; create redacted version if end-user wants to view item (there is a note that "names of defendants have been changed in local cases" but it is unclear if that applies to the names of defendant's friends, birthdates, addresses, social security numbers, military IDs, and names of victims. Kimberl

Risk Factors of Diarrheal Disease Among Children in the East African Countries of Burundi, Rwanda and Tanzania

Diarrheal diseases are a leading cause of childhood morbidity and mortality globally and in East Africa. Determining diarrheal disease risk factors and their strength of association to diarrheal disease in this region is necessary to identify and prioritize future research questions and interventions. Demographic and Health Surveys (DHS) Program Data on child health in Burundi, Rwanda, and Tanzania from 2010 were used and simple and multiple logistic regressions were completed to determine factors that predicted diarrheal disease. Diarrhea that occurred in the two weeks prior to data collection was reported for 24.80% of Burundian, 13.1% of Rwandan, and 13.91% of Tanzanian children under five. In Burundian children, increased risk of diarrhea was associated with unimproved sanitation, young mothers, and the mother’s education level (secondary school or less). In Rwandan children, increased risk of diarrhea was associated with more than 30-minute travel time to water source, rainy season, young mothers, mother’s lack of education, and low wealth index. In Tanzanian children, increased risk of diarrhea was associated with rainy season and young mothers. The impact of improved water source and sanitation facility on diarrheal disease is not consistent across the literature or results of this study. Future research should include information on hygiene practices, type of water storage container and types of household water treatment. Further, pathogen specific research, such as molecular fingerprinting, would assist to link the source to the disease. These additions would provide a more comprehensive understanding of risk factors for and sources of diarrheal disease globally and in East Africa

Biosand Water Filter Evaluation: Pilot Study of Field Use Indicators

Diarrheal diseases are a global public health burden, killing 1.8 million people annually. Diarrhea disproportionately affects children and those in poverty. Most diarrheal cases can be prevented through safe drinking water, basic hygiene and/or sanitation measures, with drinking water interventions having the most impact on reducing diarrheal disease. A meta-evaluation was completed of studies evaluating a specific household water treatment method, the biosand water filter. Results from the meta-evaluation illustrate that biosand water filters improve drinking water quality and reduce diarrheal disease. However, there is no generally agreed upon field method for determining biosand water filter effectiveness that is useable in low-resource communities. A pilot study was conducted of potential field use indicators, including the Colilert coliform Presence/ Absence test, hydrogen sulfide, alkalinity, hardness, pH, and fluorescently-labeled latex microspheres. The study included both laboratory and field testing. The Colilert Presence/ Absence test had the highest correlation to the United States Environmental Protection Agency standard method (IDEXX Quanti-trays), but more data is needed before making a recommendation. This study adds to understanding about evaluation of biosand water filters and provides preliminary data to address the need for a field use indicator for biosand water filters

Review of Biosand Water Filters

Diarrhoeal diseases are a global public health burden, killing 1.8 million people annually. Diarrhoea disproportionately affects children and those in poverty. Most diarrhoeal cases can be prevented through safe drinking water and basic hygiene and sanitation measures, with drinking water interventions having the most impact on reducing diarrhoeal disease. A metaevaluation of studies assessing a specific household water treatment method, the biosand water filter, was completed. Results from the meta-evaluation illustrated that biosand water filters improve drinking water quality and reduce diarrhoeal disease. However, short follow-up times and inconsistent measures are a concern. Furthermore, there is no generally accepted field method for determining biosand water filter effectiveness that is useable in low-resource communities. This study adds to understanding of biosand water filters