Since The Start Of The Vaccines For Children Program, Uptake Has Increased, And Most Disparities Have Decreased

The Vaccines for Children program is a US government intervention aimed at increasing vaccination uptake by removing financial barriers that may prevent US children from accessing vaccinations. This study examined the impact that this intervention had on race and ethnicity–related and income-related disparities for diphtheria-tetanus-acellular pertussis, measles-mumps-rubella, and polio vaccinations, using data from the National Immunization Survey, 1995–2013. Vaccination rates increased across all races, ethnicities, and income groups following the introduction of the Vaccines for Children program. Disparities among race and ethnic groups narrowed considerably over time since the introduction of the vaccine program, although income-related disparities changed at different rates within racial and ethnic groups and in some cases increased. Government interventions aimed solely at reducing certain financial barriers to vaccination may fail to address other important aspects of cost or perceived benefits that influence vaccination uptake, especially among poorer children

Influence of water intercalation and hydration on chemical decomposition and ion transport in methylammonium lead halide perovskites

The use of methylammonium (MA) lead halide perovskites \ce{CH3NH3PbX3} (X=I, Br, Cl) in perovskite solar cells (PSCs) has made great progress in performance efficiency during recent years. However, the rapid decomposition of \ce{MAPbI3} in humid environments hinders outdoor application of PSCs, and thus, a comprehensive understanding of the degradation mechanism is required. To do this, we investigate the effect of water intercalation and hydration of the decomposition and ion migration of \ce{CH3NH3PbX3} using first-principles calculations. We find that water interacts with \ce{PbX6} and MA through hydrogen bonding, and the former interaction enhances gradually, while the latter hardly changes when going from X=I to Br and to Cl. Thermodynamic calculations indicate that water exothermically intercalates into the perovskite, while the water intercalated and monohydrated compounds are stable with respect to decomposition. More importantly, the water intercalation greatly reduces the activation energies for vacancy-mediated ion migration, which become higher going from X=I to Br and to Cl. Our work indicates that hydration of halide perovskites must be avoided to prevent the degradation of PSCs upon moisture exposure

Probing midplane CO abundance and gas temperature with DCO+ in the protoplanetary disk around HD 169142

Context. Physical and chemical processes in protoplanetary disks affect the disk structure and the midplane environment within which planets form. The simple deuterated molecular cation DCO+ has been proposed to act as a tracer of the disk midplane conditions. Aims. This work aims to understand which midplane conditions are probed by the DCO+ emission in the disk around the Herbig Ae star HD 169142. We explore the sensitivity of the DCO+ formation pathways to gas temperature and CO abundance. Methods. The DCO+ J = 3−2 transition was observed with Atacama Large Millimeter/submillimeter Array at a spatial resolution of ~0.3′′ (35 AU at 117 pc). We modeled the DCO+ emission in HD 169142 with a physical disk structure adapted from the literature, and employed a simple deuterium chemical network to investigate the formation of DCO+ through the cold deuterium fractionation pathway via H2D+. Parameterized models are used to modify the gas temperature and CO abundance structure of the disk midplane to test their effect on DCO+ production. Contributions from the warm deuterium fractionation pathway via CH2D+ are approximated using a constant abundance in the intermediate disk layers. Results. The DCO+ line is detected in the HD 169142 disk with a total integrated line flux of 730 ± 73 mJy km s−1. The radial intensity profile reveals a warm, inner component of the DCO+ emission at radii ≲30 AU and a broad, ring-like structure from ~50–230 AU with a peak at 100 AU just beyond the edge of the millimeter grain distribution. Parameterized models show that alterations to the midplane gas temperature and CO abundance are both needed to recover the observed DCO+ radial intensity profile. The alterations are relative to the fiducial physical structure of the literature model constrained by dust and CO observations. The best-fit model contains a shadowed, cold midplane in the region z∕r 120 AU. The warm deuterium fractionation pathway is implemented as a constant DCO+ abundance of 2.0 × 10−12 between 30–70 K and contributes >85% to the DCO+ emission at r < 83 AU in the best-fit model. Conclusions. The DCO+ emission probes a reservoir of cold material in the HD 169142 outer disk that is not probed by the millimeter continuum, the spectral energy distribution, nor the emission from the 12 CO, 13 CO, or C18O J = 2−1 lines. The DCO+ emission is a sensitive probe of gas temperature and CO abundance near the disk midplane and provides information about the outer disk beyond the millimeter continuum distribution that is largely absent in abundant gaseous tracers such as CO isotopologues

Which circulating antioxidant vitamins are confounded by socioeconomic deprivation? The MIDSPAN family study

&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Antioxidant vitamins are often described as having “independent” associations with risk of cancer, cardiovascular disease (CVD) and mortality. We aimed to compare to what extent a range of antioxidant vitamins and carotenoids are associated with adulthood and childhood markers of socioeconomic deprivation and to adverse lifestyle factors.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods and Findings:&lt;/b&gt; Socioeconomic and lifestyle measures were available in 1040 men and 1298 women from the MIDSPAN Family Study (30–59 years at baseline) together with circulating levels of vitamins A, C, E, and carotenoids (α-carotene, β-carotene, lutein and lycopene). Markers of socioeconomic deprivation in adulthood were consistently as strongly associated with lower vitamin C and carotenoid levels as markers of adverse lifestyle; the inverse association with overcrowding was particularly consistent (vitamin C and carotenoids range from 19.1% [95% CI 30.3–6.0] to 38.8% [49.9–25.3] lower among those in overcrowded residencies). These associations were consistent after adjusting for month, classical CVD risk factors, body mass index, physical activity, vitamin supplements, dietary fat and fibre intake. Similar, but weaker, associations were seen for childhood markers of deprivation. The association of vitamin A or E were strikingly different; several adult adverse lifestyle factors associated with higher levels of vitamin A and E, including high alcohol intake for vitamin A (9.5% [5.7–13.5]) and waist hip ratio for vitamin E (9.5% [4.8–14.4]), with the latter associations partially explained by classical risk factors, particularly cholesterol levels.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Plasma vitamin C and carotenoids have strong inverse associations with adulthood markers of social deprivation, whereas vitamin A and E appear positively related to specific adverse lifestyle factors. These findings should help researchers better contextualize blood antioxidant vitamin levels by illustrating the potential limitations associated with making causal inferences without consideration of social deprivation.&lt;/p&gt

Psychological impact, support and information needs for women with an abnormal Pap smear: comparative results of a questionnaire in three European countries

<p>Abstract</p> <p>Background</p> <p>Extensive information on cervical cancer is currently available. Its effectiveness in reducing anxiety in women receiving abnormal Pap tests is not clear. We investigated current practices of communicating abnormal Pap results to evaluate women's reactions and determine the sources of information they use subsequently.</p> <p>Methods</p> <p>A self-administered questionnaire-based study was performed in 1475 women in France, Spain and Portugal who had received an abnormal Pap smear result in the 12 months prior to completing the questionnaire. Questions covered methods of communication of the result, emotional reactions, support received (from the physician and entourage), and information sources, using pre-specified check box options and rating scales. Data were analyzed by country.</p> <p>Results</p> <p>Pap test results were mostly communicated by phone to Spanish women (76%), while physician letters were common in France (59%) and Portugal (36%). Frequent reactions were anxiety, panic and stress, which were less common in Spanish women than their French and Portuguese counterparts. After discussing with their physician, half of the participants were worried, despite rating highly the psychological support received. Over 90% of women in each country discussed their results with family or friends. Partners provided a high level of support. Overall, the abnormal diagnosis and consequences had a low to medium impact on daily, professional and family life and their relationships with their partner. Impact was higher in Spanish women than the French or Portuguese. Information on the diagnosis and its treatment was rated average, and nearly 80% of participants wanted more information, notably French women. Preferred sources were the physician and the Internet.</p> <p>Conclusions</p> <p>Women expressed a strong wish for more information about cervical cancer and other HPV-related diseases, and that their physician play a major role in its provision and in support. There was a heavy reliance on the close entourage and the Internet for information, highlighting the need for dissemination of accurate material. Differences between countries suggest information management strategies may need to be tailored to different geographical regions.</p

vCJD risk in the Republic of Ireland

BACKGROUND: The Republic of Ireland has the second highest incidence of BSE worldwide. Only a single case of vCJD has been identified to date. METHODS: We estimate the total future number of clinical cases of vCJD using an established mathematical model, and based on infectivity of bovine tissue calculated from UK data and on the relative exposure to BSE contaminated meat. RESULTS: We estimate 1 future clinical case (95% CI 0 – 15) of vCJD in the Republic of Ireland. Irish exposure is from BSE infected indigenous beef products and from imported UK beef products. Additionally, 2.5% of the Irish population was exposed to UK beef through residing in the UK during the 'at-risk' period. The relative proportion of risk attributable to each of these three exposures individually is 2:2:1 respectively. CONCLUSIONS: The low numbers of future vCJD cases estimated in this study is reassuring for the Irish population and for other countries with a similar level of BSE exposure

Erythroderma: A clinical study of 97 cases

BACKGROUND: Erythroderma is a rare skin disorder that may be caused by a variety of underlying dermatoses, infections, systemic diseases and drugs. METHODS: We reviewed the clinical, laboratory and biopsy material of 97 patients diagnosed with erythroderma who were treated in our department over a 6-year period (1996 through 2002). RESULTS: The male-female ratio was 1.85:1. The mean age at diagnosis was 46.2 years. The most common causative factors were dermatoses (59.7%), followed by drug reactions (21.6%), malignancies (11.3%) and idiopathic causes (7.2%). Carbamazepine was the most common drug (57.1%). The best clinicopathologic correlation was found in cutaneous T-cell lymphoma and pityriasis rubra pilaris related erythroderma. Apart from scaling and erythema that were present in all patients, pruritus was the most common finding (97.5%), followed by fever (33.6%), lymphadenopathy (21.3%), edema (14.4%) and hyperkeratosis (7.2%). CONCLUSION: This study outlines that underlying etiologic factors of erythroderma may show geographic variations. Our series had a high percentage of erythroderma secondary to preexisting dermatoses and a low percentage of idiopathic cases. There was no HIV-infected patient among our series based on multiple serum antibody tests. The clinical features of erythroderma were identical, irrespective of the etiology. The onset of the disease was usually insidious except in drug-induced erythroderma, where it was acute. The group associated with the best prognosis was that related to drugs

Continuum sources from the THOR survey between 1 and 2 GHz

We carried out a large program with the Karl G. Jansky Very Large Array (VLA): "THOR: The HI, OH, Recombination line survey of the Milky Way". We observed a significant portion of the Galactic plane in the first quadrant of the Milky Way in the 21cm HI line, 4 OH transitions, 19 radio recombination lines, and continuum from 1 to 2 GHz. In this paper we present a catalog of the continuum sources in the first half of the survey (l=14.0-37.9deg and l=47.1-51.2deg, |b|<1.1deg) at a spatial resolution of 10-25", with a spatially varying noise level of ~0.3-1 mJy/beam. The catalog contains ~4400 sources. Around 1200 of these are spatially resolved, and ~1000 are possible artifacts, given their low signal-to-noise ratios. Since the spatial distribution of the unresolved objects is evenly distributed and not confined to the Galactic plane, most of them are extragalactic. Thanks to the broad bandwidth of the observations from 1 to 2 GHz, we are able to determine a reliable spectral index for ~1800 sources. The spectral index distribution reveals a double-peaked profile with maxima at spectral indices of alpha = -1 and alpha = 0 , corresponding to steep declining and flat spectra, respectively. This allows us to distinguish between thermal and non-thermal emission, which can be used to determine the nature of each source. We examine the spectral index of ~300 known HII regions, for which we find thermal emission with spectral indices around alpha = 0. In contrast, supernova remnants (SNR) show non-thermal emission with alpha = -0.5 and extragalactic objects generally have a steeper spectral index of alpha = -1. Using the spectral index information of the THOR survey, we investigate potential SNR candidates. We classify the radiation of four SNR candidates as non-thermal, and for the first time, we provide strong evidence for the SNR origin of these candidates