Varying Vaccination Rates Among Patients Seeking Care for Acute Respiratory Illness:A Systematic Review and Meta-analysis

Background: Complications following influenza infection are a major cause of morbidity and mortality, and the Centers for Disease Control Advisory Committee on Immunization Practices recommends universal annual vaccination. However, vaccination rates have remained significantly lower than the Department of Health and Human Services goal. The aim of this work was to assess the vaccination rate among patients who present to health care providers with influenza-like illness and identify groups with lower vaccination rates. Methods: We performed a systematic search of the PubMed and EMBASE databases with a time frame of January 1, 2010, to March 1, 2019 and focused on the vaccination rate among patients seeking care for acute respiratory illness in the United States. A random effects meta-analysis was performed to estimate the pooled seasonal influenza vaccination rate, and we used a time trend analysis to identify differences in annual vaccination over time. Results: The overall pooled influenza vaccination rate was 48.61% (whites: 50.87%; blacks: 36.05%; Hispanics: 41.45%). There was no significant difference among gender groups (men: 46.43%; women: 50.11%). Interestingly, the vaccination rate varied by age group and was significantly higher among adults aged >65 (78.04%) and significantly lower among children 9-17 years old (36.45%). Finally, we found a significant upward time trend in the overall influenza vaccination rate among whites (coef. = .0107; P = .027). Conclusions: In conclusion, because of the significantly lower influenza vaccination rates in black and Hispanic communities, societal initiatives and community outreach programs should focus on these populations and on children and adolescents aged 9-17 years

Impact of selected comorbidities on the presentation and management of aortic stenosis

Background: Contemporary data regarding the impact of comorbidities on the clinical presentation and management of patients with severe aortic stenosis (AS) are scarce. Methods Prospective registry of severe patients with AS across 23 centres in nine European countries. Results Of the 2171 patients, chronic kidney disease (CKD 27.3%), left ventricular ejection fraction (LVEF) = 2 of these). The decision to perform aortic valve replacement (AVR) was taken in a comparable proportion (67%, 72% and 69%, in patients with 0, 1 and >= 2 comorbidities;p=0.186). However, the decision for TAVI was more common with more comorbidities (35.4%, 54.0% and 57.0% for no, 1 and >= 2;p= 2 comorbidities than in those without (8.7%, 10.0% and 15.7%;p= 2 comorbidities (30.8 days) than in those without (35.7 days;p=0.012). Patients with reduced LVEF tended to be offered an AVR more frequently and with a shorter delay while patients with CKD were less frequently treated. Conclusions: Comorbidities in severe patients with AS affect the presentation and management of patients with severe AS. TAVI was offered more often than SAVR and performed within a shorter time period

HUMeral Shaft Fractures: MEasuring Recovery after Operative versus Non-operative Treatment (HUMMER): A multicenter comparative observational study

Background: Fractures of the humeral shaft are associated with a profound temporary (and in the elderly sometimes even permanent) impairment of independence and quality of life. These fractures can be treated operatively or non-operatively, but the optimal tailored treatment is an unresolved problem. As no high-quality comparative randomized or observational studies are available, a recent Cochrane review concluded there is no evidence of sufficient scientific quality available to inform the decision to operate or not. Since randomized controlled trials for this injury have shown feasibility issues, this study is designed to provide the best achievable evidence to answer this unresolved problem. The primary aim of this study is to evaluate functional recovery after operative versus non-operative treatment in adult patients who sustained a humeral shaft fracture. Secondary aims include the effect of treatment on pain, complications, generic health-related quality of life, time to resumption of activities of daily living and work, and cost-effectiveness. The main hypothesis is that operative treatment will result in faster recovery. Methods/design. The design of the study will be a multicenter prospective observational study of 400 patients who have sustained a humeral shaft fracture, AO type 12A or 12B. Treatment decision (i.e., operative or non-operative) will be left to the discretion of the treating surgeon. Critical elements of treatment will be registered and outcome will be monitored at regular intervals over the subsequent 12 months. The primary outcome measure is the Disabilities of the Arm, Shoulder, and Hand score. Secondary outcome measures are the Constant score, pain level at both sides, range of motion of the elbow and shoulder joint at both sides, radiographic healing, rate of complications and (secondary) interventions, health-related quality of life (Short-Form 36 and EuroQol-5D), time to resumption of ADL/work, and cost-effectiveness. Data will be analyzed using univariate and multivariable analyses (including mixed effects regression analysis). The cost-effectiveness analysis will be performed from a societal perspective. Discussion. Successful completion of this trial will provide evidence on the effectiveness of operative versus non-operative treatment of patients with a humeral shaft fracture. Trial registration. The trial is registered at the Netherlands Trial Register (NTR3617)

Influence of Tillage Systems, and Forms and Rates of Nitrogen Fertilizers on CO2 and N2O Fluxes from Winter Wheat Cultivation in Oklahoma

Cultivation of winter wheat under reduced tillage systems is increasing in the U.S. Southern Great Plains. Likewise, there is revived interest for including summer legumes in monocultures of winter wheat as green sources of nitrogen (N). This study investigated the influence of tillage systems (no- and conventional tillage), and source and rates of N fertilizer (0, 45 and 90 kg N ha−1 yr−1 in inorganic N fertilizer, and cowpea as green manure) on emissions of carbon dioxide (CO2) and nitrous oxide (N2O) from winter wheat cultivation. The study was conducted within a long-term field experiment initiated in 2011, at upland and bottomland sites near El Reno, Oklahoma during the 2016–2017 growing season of winter wheat. The experiment was conducted site-wise as split-plots in a completely randomized design, with N treatment as main plots and tillage system as subplots. Thus, there were a total of eight treatment combinations with three replicated plots (4 m × 10 m) in each combination in both sites. Net ecosystem exchange (NEE) of CO2 was measured by a closed chamber connected to an infra-red gas analyzer, and fluxes were partitioned to gross primary production (GPP) and ecosystem respiration (ER). Heterotrophic soil respiration (SR) was measured on bare soil spots. Fluxes of N2O were measured with an opaque closed chamber system with a portable gas analyzer. Dynamics of canopy CO2 fluxes (NEE, GPP and ER) were similar between tillage systems, while canopy CO2 fluxes increased with rate of N fertilization. Canopy CO2 fluxes from cowpea and an unfertilized control were similar, and the lowest, due to poor growth of winter wheat compared to the N fertilized treatments. Fluxes of N2O approximated zero from all treatments throughout the study and no response of N fertilizer or tillage system was seen. In conclusion, the results from this study indicated that canopy fluxes of CO2 from winter wheat are controlled by forms and rates of N fertilizers rather than tillage systems

Impacts of tillage systems, nitrogen fertilizer rates and a legume green manure on light interception and yield of winter wheat

Combining conservation tillage with legumes grown as a green manure is an increasingly popular practice for crop production in the U.S. Southern Great Plains. This study investigated interactions between system of tillage (no-till vs. conventional tillage) and source and amounts of nitrogen (N) fertilization (0, 45 and 90 kg N ha–1 yr–1 in inorganic N fertilizer, and cowpea as a green manure) on radiation use efficiency, and dry matter (DM) yield of winter wheat. The study was conducted at two sites during the 2016–2017 growing season of winter wheat. Fraction of intercepted photosynthetically active radiation (fPAR) was derived by measurements of canopy spectral reflectance taken at 1–2 weeks intervals as ratio vegetation index (RVI). Total cumulative intercepted fPAR (IPAR) during the cropping period was calculated as a product of half global radiation and fPAR. Radiation use efficiency (RUE) was calculated as the ratio of biomass yield and IPAR. At both sites, N treatments had stronger influences on crop growth than tillage systems. The RVI, IPAR and DM yield were generally higher under 90-N treatments followed by 45-N treatment. Responses of cowpea and control treatments were similar and the lowest. Radiation use efficiency was not influenced by tillage systems or N treatments

Soil respiration from winter wheat-based cropping systems in the US Southern Great Plains as influenced by tillage managements

This study compared soil respiration (SR) fluxes from winter wheat-based cropping systems in the US Southern Great Plains (SGP) under reduced and conventional tillage. The study consisted of four sets of paired paddocks assigned to conventional or reduced tillage with a four-year crop rotation applied over time. During the 2016–2017 study year, four sets of paired paddocks were planted to: winter wheat managed for grazing, dual-purpose (grazing and grain production), and grain-only systems of production, and winter canola. Heterotrophic SR fluxes were measured using a plant and root exclusion method on eight permanently deployed PVC cores per paddock. Fluxes from the cores were measured manually using a closed chamber connected to an infrared gas analyser on 12–13 dates during the winter wheat growing season (October through May). There were strong seasonal patterns of SR flux, with lower rates during dry and cold periods, and higher rates during warm and wet periods. Large rainfall induced pulses of SR flux were observed for both tillage systems. There was no consistent large-scale difference in SR flux between tillage treatments applied to paired paddocks. Results from this study indicate SR fluxes from winter wheat-based cropping systems are controlled more by soil environmental conditions than form of tillage

Cross-species amplification and polymorphism of microsatellite loci in Asian bovidae

Microsatellite loci are tandem repeats of short DNA sequences (1-5bp). Polymorphism in these loci results from variation in the number of repeat units. Microsatellites are numerous and dispersed among the chromosomes in all eukaryotic genomes. They are now the markers of choice for genome mapping, pedigree analysis and the study of genetic diversity of livestock. Conservation of flanking sequences of microsatellites allows primer sets to be used across related species. For example, 40 percent of microsatellites isolated in cattle Bos taurus amplify polymorphic loci in goat Capra hircus (Kemp et al 1995, Pepin et al. 1995) and 50 percent of cattle microsatellites amplify polymorphic loci in sheep Ovis aries (Moore et al 1994, Kemp et al 1995). It was Reported in cattle, the isolation and characterisation of 97 microsatellites (Kemp et al. 1995). It is Reported here the cross-species amplification of a subset of 52 loci in two species of Asian bovidae: the swamp and river types of water buffalo Bubalis bubalis and the Bali cattle Bos banteng