Thirty years of vaccination in Vietnam: Impact and cost-effectiveness of the national Expanded Programme on Immunization.

INTRODUCTION: Countries like Vietnam transitioning to middle-income status increasingly bear the cost of both existing and new vaccines. However, the impact and cost-effectiveness of the Expanded Programme on Immunization (EPI) as a whole has never been assessed on a country level. METHODS: Data on vaccine-preventable disease incidence and mortality from Vietnam's national surveillance was analysed to estimate the likely impact that vaccination in 1980-2010 may have had. Adjustment for under-reporting was made by examining trends in reported mumps incidence and in case-fatality risks for each disease. The same data were separately analysed using the Lives Saved Tool (LiST) to give an alternative estimate of impact. The financial cost of EPI in 1996-2010 was also estimated from the perspective of service provider. RESULTS: National surveillance data suggests that up to 5.7 million diseases cases and 26,000 deaths may have been prevented by EPI. Analysis using LiST suggests that even more deaths (370,000) may have been prevented by measles and pertussis vaccination alone. The cost-effectiveness of EPI is estimated to be around $1000-$27,000 per death prevented. CONCLUSION: Two separate approaches to assessing EPI impact in Vietnam give different quantitative results but a common conclusion: that EPI has made a substantial impact on mortality and represents good value for money

Diphtheria in Metro Manila, the Philippines 2006–2017: A Clinical, Molecular, and Spatial Characterization

BACKGROUND: Diphtheria is a vaccine-preventable disease that persists as a global health problem. An understanding of the pattern of disease is lacking in low- and middle-income countries such as the Philippines. METHODS: We conducted a retrospective review of the clinical, microbiological, and epidemiological features of patients admitted with a clinical diagnosis of diphtheria to an infectious disease referral hospital in Metro Manila, the Philippines, between 2006 and 2017. Cases were mapped and the distribution was compared with population density. Corynebacterium diphtheriae isolates from between 2015 and 2017 were examined by multilocus sequence typing (MLST). RESULTS: We studied 267 patients (range:12-54 cases/year) admitted between 2006 and 2017. The case fatality rate (CFR) was 43.8% (95% confidence interval, 37.8-50.0%). A higher number of cases and CFR was observed among children <10 years. Mortality was associated with a delayed admission to hospital and a lack of diphtheria antitoxin. Between 2015 and 2017 there were 42 laboratory-confirmed cases. We identified 6 multilocus sequence types (STs). ST-302 was the most common (17/34, 48.6%), followed by ST67 (7/34, 20%) and ST458 (5/34, 14%). Case mapping showed a wide distribution of diphtheria patients in Metro Manila. Higher case numbers were found in densely populated areas but with no apparent clustering of ST types. CONCLUSIONS: Our analysis indicates that diphtheria remains endemic in Metro Manila and that the infection is frequently fatal in young children. Improved vaccine coverage and a sustainable supply of diphtheria antitoxin should be prioritized

Pollination mutualism between Alocasia macrorrhizos (Araceae) and two taxonomically undescribed Colocasiomyia species (Diptera: Drosophilidae) in Sabah, Borneo

Two taxonomically undescribed Colocasiomyia species were discovered from inflorescences of Alocasia macrorrhizos in Kota Kinabalu City, Sabah, Borneo, Malaysia. The aims of this study were to investigate the reproductive ecology of the flies and the plant, ascertain the importance of the flies as pollinators and examine the intimate association between flowering events and life history of the flies. We conducted sampling, observations and field pollination experiments. The flies were attracted by the odour of female-phase inflorescences in the early morning on the first day of anthesis. They fed, mated and oviposited in the inflorescences for one day. On the second day, the flies, covered with pollen grains, left the male-phase inflorescences for the next female-phase inflorescences. The immatures of both fly species hatched, developed and pupated within the infructescences without damaging the fruits and developed adults emerged when the mature infructescences dehisced. The flowering events and fly behaviours were well synchronized. In the field pollination experiments, the inflorescences bagged with a fine mesh (insect exclusion) produced almost no fruits, whereas those bagged with a coarse mesh (bee exclusion) produced as many fruits as the open-pollinated controls. These results indicate that the flies are the most efficient and specialised pollinators for their host, A. macrorrhizos. These flies, in return, depend on A. macrorrhizos for food and habitat through most of their life cycle. This study provides a deeper insight into the less recognised, highly intimate pollination mutualism between Araceae plants and Colocasiomyia flies

Is the past farther than the future? A registered replication and test of the time-expansion hypothesis based on the filling rate of duration

People feel some events to be psychologically closer, while others to be farther away. Caruso et al. (2013) reported the Temporal Doppler Effect (TDE), in which people feel that the past is farther than the future, despite an equivalent objective temporal distance. They hypothesized that movement based on the spatio-temporal metaphor implies an asymmetry in psychological distance in time and explained the TDE from this perspective. In the current study, we made a high-power (N = 2244 in total), direct replication of the study by Caruso et al. as a registered report, and examined whether temporal expansion depending on the degree of fulfillment in durations found in time perception studies is related to the TDE. We predicted that the past would be felt farther than the future because past experiences form definite and numerous memory traces, and the filling rate of duration of the past should be higher than that of the future. The results showed that psychological distance was significantly closer in the past than in the future in both Studies 1 and 2. Moreover, the filling rate of duration was significantly higher in the past than in the future, as predicted, but was negligible (Study 1) or negatively (Study 2) correlated with psychological distance. Overall, our results did not replicate the previous findings but were reversed, and the filling rate of duration failed to explain psychological distance. Based on these findings, we discuss what needs to be clarified in future TDE studies

Ultrafast beam pattern modulation by superposition of chirped optical vortex pulses

As an extension of pulse shaping techniques using the space-time coupling of ultrashort pulses or chirped pulses, we demonstrated the ultrafast beam pattern modulation by the superposition of chirped optical vortex pulses with orthogonal spatial modes. The stable and robust modulations with a modulation frequency of sub-THz were carried out by using the precise phase control technique of the constituent pulses in both the spatial and time/frequency domains. The performed modulations were ultrafast ring-shaped optical lattice modulation with 2, 4 and 6 petals, and beam pattern modulations in the radial direction. The simple linear fringe modulation was also demonstrated with chirped spatially Gaussian pulses. While the input pulse energy of the pulses to be modulated was 360 mu J, the output pulse energy of the modulated pulses was 115 mu J with the conversion efficiency of similar to 32%. Demonstrating the superposition of orthogonal spatial modes in several ways, this ultrafast beam pattern modulation technique with high intensity can be applicable to the spatially coherent excitation of quasi-particles or collective excitation of charge and spin with dynamic degrees of freedom. Furthermore, we analyzed the Poynting vector and OAM of the composed chirped OV pulses. Although the ring-shaped optical lattice composed of OV pulse with topological charges of +/- l is rotated in a sub-THz frequency, the net orbital angular momentum (OAM) averaged over one optical period is found to be negligible. Hence, it is necessary to require careful attention to the application of the OAM transfer interaction with matter by employing such rotating ring-shaped optical lattices

Effects of Epigenetic Modification of PGC-1α by a Chemical Chaperon on Mitochondria Biogenesis and Visual Function in Retinitis Pigmentosa

Retinitis pigmentosa (RP) is a hereditary blinding disease characterized by gradual photoreceptor death, which lacks a definitive treatment. Here, we demonstrated the effect of 4-phenylbutyric acid (PBA), a chemical chaperon that can suppress endoplasmic reticulum (ER) stress, in P23H mutant rhodopsin knock-in RP models. In the RP models, constant PBA treatment led to the retention of a greater number of photoreceptors, preserving the inner segment (IS), a mitochondrial- and ER-rich part of the photoreceptors. Electroretinography showed that PBA treatment preserved photoreceptor function. At the early point, ER-associated degradation markers, xbp1s, vcp, and derl1, mitochondrial kinetic-related markers, fis1, lc3, and mfn1 and mfn2, as well as key mitochondrial regulators, pgc-1α and tfam, were upregulated in the retina of the models treated with PBA. In vitro analyses showed that PBA upregulated pgc-1α and tfam transcription, leading to an increase in the mitochondrial membrane potential, cytochrome c oxidase activity, and ATP levels. Histone acetylation of the PGC-1α promoter was increased by PBA, indicating that PBA affected the mitochondrial condition through epigenetic changes. Our findings constituted proof of concept for the treatment of ER stress-related RP using PBA and revealed PBA’s neuroprotective effects, paving the way for its future clinical application