Interim estimates of the effectiveness of influenza vaccination against influenza-associated hospitalization in children in Hong Kong, 2015-16

From 1 September 2015 through 31 January 2016, we enrolled 2068 children 6 months to 17 years of age admitted to hospital with a febrile acute respiratory infection in our test-negative study. Information on receipt of 2015-16 northern hemisphere inactivated influenza vaccination was elicited from parents or legal guardians. Using conditional logistic regression adjusting for age and matching on calendar time, we estimated influenza vaccine effectiveness against hospitalization with influenza A or B to be 79.2% (95% confidence interval: 42.0%-92.4%). Annual influenza vaccination should be more widely used in children in Hong Kong. This article is protected by copyright. All rights reserved.published_or_final_versio

Influenza vaccine effectiveness against influenza A(H3N2) hospitalizations in children in Hong Kong in a prolonged season, 2016/17.

Background: Influenza A(H3N2) viruses circulated for 12 consecutive months in Hong Kong in 2016-2017, peaking in late June and July 2017. The objective of our study was to estimate the effectiveness of influenza vaccination in preventing hospitalizations in children in Hong Kong. Methods: We conducted a test-negative study between September 1 2016 and August 31 2017, enrolling children 6 months to 17 years of age hospitalized for an acute respiratory infection. Influenza was diagnosed by PCR on nasopharyngeal aspirates. Results: We enrolled 5514 children, including 3608 children between 6 months to 2 years, 1600 children 3-5 years, and 1206 children 6-17 years of age. Influenza-associated hospitalizations occurred throughout the study year but time of vaccination of these children was also wide-spread, from September 2016 to May 2017. Influenza vaccine effectiveness (VE) was 39.7% (95% CI: 14.7, 57.3%) against laboratory-confirmed influenza A(H3N2). In analyses stratified by time since vaccination, the VE against influenza A(H3N2) was 52.8% (17.1%, 73.2%) within 3 months of vaccination, and 31.2% (-6.6%, 55.6%) 4-6 months after vaccination. Conclusions: Influenza vaccination was effective in preventing hospitalizations in children in Hong Kong

Application of whole exome sequencing in metachronous lung cancers evaluation

Poster Abstracts: no. 69Conference Theme: Cancer GenomicsMultiplicity and metachronous tumours are recurrent management problems. Morphological resemblance, in-situ carcinoma, cancer driver mutations, etc. have been used to distinguish intrapulmonary metastasis and metachronous primary lung cancers but these criteria are often insufficient. Next generation sequencing promises to advance personalized cancer management but finding a practicable approach remains a problem. We explored the utility of whole exome sequencing for cancer nature determination in a 74 year-old female non-smoker with 2 sequential lung cancers of unknown relation. Initially, she had an EGFR-L858R adenocarcinoma (Tumour-A) treated by excision and adjuvant gefitinib for metastatic pleural tumours. Two years later while ...postprin

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

Subliminally Perceived Odours Modulate Female Intrasexual Competition: An Eye Movement Study

Background: Evidence suggests that subliminal odorants influence human perception and behavior. It has been hypothesized that the human sex-steroid derived compound 4,16-androstadien-3-one (androstadienone) functions as a human chemosignal. The most intensively studied steroid compound, androstadienone is known to be biologically relevant since it seems to convey information about male mate quality to women. It is unclear if the effects of androstadienone are menstrual cycle related. Methodology/Principal Findings: In the first experiment, heterosexual women were exposed to androstadienone or a control compound and asked to view stimuli such as female faces, male faces and familiar objects while their eye movements were recorded. In the second experiment the same women were asked to rate the level of stimuli attractiveness following exposure to the study or control compound. The results indicated that women at high conception risk spent more time viewing the female than the male faces regardless of the compound administered. Women at a low conception risk exhibited a preference for female faces only following exposure to androstadienone. Conclusions/Significance: We contend that a woman’s level of fertility influences her evaluation of potential competitors (e.g., faces of other women) during times critical for reproduction. Subliminally perceived odorants, such as androstadienone, might similarly enhance intrasexual competition strategies in women during fertility phases not critica

FTY720 Suppresses Liver Tumor Metastasis by Reducing the Population of Circulating Endothelial Progenitor Cells

Background: Surgical procedures such as liver resection and liver transplantation are the first-line treatments for hepatocellular carcinoma (HCC) patients. However, the high incidence of tumor recurrence and metastasis after liver surgery remains a major problem. Recent studies have shown that hepatic ischemia-reperfusion (I/R) injury and endothelial progenitor cells (EPCs) contribute to tumor growth and metastasis. We aim to investigate the mechanism of FTY720, which was originally applied as an immunomodulator, on suppression of liver tumor metastasis after liver resection and partial hepatic I/R injury. Methodology/Principal Findings: An orthotopic liver tumor model in Buffalo rat was established using the hepatocellular carcinoma cell line McA-RH7777. Two weeks after orthotopic liver tumor implantation, the rats underwent liver resection for tumor-bearing lobe and partial hepatic I/R injury. FTY720 (2 mg/kg) was administered through the inferior caval vein before and after I/R injury. Blood samples were taken at days 0, 1, 3, 7, 14, 21 and 28 for detection of circulating EPCs (CD133+CD34+). Our results showed that intrahepatic and lung metastases were significantly inhibited together with less tumor angiogenesis by FTY720 treatment. The number of circulating EPCs was also significantly decreased by FTY720 treatment from day 7 to day 28. Hepatic gene expressions of CXCL10, VEGF, CXCR3, CXCR4 induced by hepatic I/R injury were down-regulated in the treatment group. Conclusions/Significance: FTY720 suppressed liver tumor metastasis after liver resection marred by hepatic I/R injury in a rat liver tumor model by attenuating hepatic I/R injury and reducing circulating EPCs. © 2012 Li et al.published_or_final_versio