Factors Associated with Missed Vaccination during Mass Immunization Campaigns

Achieving a high percentage of vaccination coverage with polio vaccine, while necessary, is not sufficient to eliminate or eradicate polio. The existence of pockets of under-vaccinated children has allowed outbreaks of polio in countries that have achieved high levels of vaccination coverage and in countries with no cases for many years. In a literature review, 35 articles were identified that described factors associated with missed vaccination in mass immunization campaigns. An annotated bibliography was developed for each article; these were then coded using the AnSWR program, and codes were organized into three larger thematic categories. These thematic areas were: (a) organization and implementation of mass campaigns; (b) population characteristics; and (c) knowledge and practices of caretakers. If these factors were geographically clustered, it was suspected that these clusters might have higher likelihood of becoming pockets of unvaccinated children. Immunization programme managers can target resources to identify if such clusters exist. If so, they can then ensure supervision of vaccination efforts in those sites and take further action, if indicated, to prevent or mitigate pockets of unvaccinated children

Evaluating the Experience of GAPS—A Methodology for Improving Quality of Mass Immunization Campaigns in Developing Countries

The existence of pockets of under-vaccinated persons has allowed outbreaks of disease in countries that have achieved high levels of vaccination coverage. A field-based methodology—GAPS (Geographic Assessment of Planning and Services)—was developed to predict, in advance of an immunization campaign, the sites of which are most likely to have a pocket of unvaccinated persons and then use this information to improve planning, supervision, and evaluation of the campaign. At this time, there have been two applications of GAPS (Nepal and Ethiopia). The purpose of this paper was to evaluate these two applications of GAPS and make recommendations regarding its future use. Structured, expert interviews were conducted with at least three campaign organizers to evaluate each application of GAPS using purposive sampling. An evaluation of an individual campaign was considered positive when at least two of the three campaign organizers considered GAPS to be useful and worthwhile. The three campaign organizers interviewed following the GAPS application in Ethiopia responded that GAPS was useful and worth the effort. In Nepal, all four campaign organizers responded that GAPS was useful and worth the effort. Some suggestions for improvement were also identified. Although this evaluation was limited in the number of applications evaluated, GAPS appears to have promise as a practical method to help improve the quality of mass immunization campaigns. And even if no pockets of unvaccinated persons are found, the method may serve as a rapid quality-check of administrative estimates of coverage. Further applications in different settings are needed to confirm these findings or under what circumstances GAPS might best be used. GAPS may also be considered for improving other types of health campaigns, such as distribution of insecticide-treated bednets, vitamin A capsules, and deworming medications

The interferon-induced exonuclease ISG20 exerts antiviral activity through upregulation of type I interferon response proteins

The host immune responses to infection lead to the production of type I interferon (IFN), and the upregulation of interferon-stimulated genes (ISGs) reduces virus replication and virus dissemination within a host. Ectopic expression of the interferon-induced 20-kDa exonuclease ISG20 suppressed replication of chikungunya virus and Venezuelan equine encephalitis virus, two mosquito-vectored RNA alphaviruses. Since the replication of alphavirus genomes occurs exclusively in the cytoplasm, the mechanism of nucleus-localized ISG20 inhibition of replication is unclear. In this study, we determined that ISG20 acts as a master regulator of over 100 genes, many of which are ISGs. Specifically, ISG20 upregulated IFIT1 genes and inhibited translation of the alphavirus genome. Furthermore, IFIT1-sensitive alphavirus replication was increased in Isg20−/− mice compared to the replication of wild-type viruses but not in cells ectopically expressing ISG20. We propose that ISG20 acts as an indirect regulator of RNA virus replication in the cytoplasm through the upregulation of many other ISGs.Type I interferon (IFN)-stimulated genes (ISGs) have critical roles in inhibiting virus replication and dissemination. Despite advances in understanding the molecular basis of ISG restriction, the antiviral mechanisms of many remain unclear. The 20-kDa ISG ISG20 is a nuclear 3′–5′ exonuclease with preference for single-stranded RNA (ssRNA) and has been implicated in the IFN-mediated restriction of several RNA viruses. Although the exonuclease activity of ISG20 has been shown to degrade viral RNA in vitro, evidence has yet to be presented that virus inhibition in cells requires this activity. Here, we utilized a combination of an inducible, ectopic expression system and newly generated Isg20−/− mice to investigate mechanisms and consequences of ISG20-mediated restriction. Ectopically expressed ISG20 localized primarily to Cajal bodies in the nucleus and restricted replication of chikungunya and Venezuelan equine encephalitis viruses. Although restriction by ISG20 was associated with inhibition of translation of infecting genomic RNA, degradation of viral RNAs was not observed. Instead, translation inhibition of viral RNA was associated with ISG20-induced upregulation of over 100 other genes, many of which encode known antiviral effectors. ISG20 modulated the production of IFIT1, an ISG that suppresses translation of alphavirus RNAs. Consistent with this observation, the pathogenicity of IFIT1-sensitive alphaviruses was increased in Isg20−/− mice compared to that of wild-type viruses but not in cells ectopically expressing ISG20. Our findings establish an indirect role for ISG20 in the early restriction of RNA virus replication by regulating expression of other ISGs that inhibit translation and possibly other activities in the replication cycle

Loeb Extension and Loeb Equivalence

In Keisler and Sun (2004), the authors raise several open problems on Loeb equivalences between various internal probability spaces. We provide counter-examples for the first two open problems. Moreover, we reduce the third open problem to the following question: Is the internal algebra generated by the union of two Loeb equivalent internal algebras a subset of the Loeb extension of any one of the internal algebra?Comment: 10 page

Accurate preoperative diagnosis of pericardial constriction using cine computed tomography

AbstractObjectives. The purpose of this study was to determine the accuracy of cine computed tomography in the diagnosis of constrictive pericarditis.Background. Constrictive pericarditis is characterized by abnormalities of both cardiac structure and function. Accurate diagnosis requires detection of both a thickened pericardium and abnormal ventricular diastolic filling. At present, no one diagnostic technique has demonstrated sufficient accuracy in this setting. Cine computed tomography is a relatively new cardiac imaging mode with very high time and spatial resolution that has the potential to accurately diagnose constrictive pericarditis.Methods. Twelve consecutive patients were retrospectively identified who had catheterization findings suggestive of constrictive physiology, had undergone a cine computed tomographic examination and had pathologic data that delineated the status of the pericardium. Group 1 (with constrictive pericarditis; n = 5) had surgical confirmation of thickened pericardium and improved clinically after pericardiectomy. Group 2 (no constrictive pericarditis; n = 7) had cardiomyopathy with normal pericardium. Seven normal volunteers (Group 3) were also studied. Cine computed tomograms were obtained for the entire heart (8-mm slices, 17 frames/s, nonionic contrast medium). Pericardial thickness was measured at 10 ° intervals at three ventricular levels in each subject. The rapidity of diastolic filling was assessed by calculating the percent filling fraction in early diastole.Results. Pericardial thickness was 10 ± 2 mm (mean ± SD) in Group 1, 2 ± 1 mm in Group 2 and 1 ± 1 mm in Group 3 (p < 0.05, constrictive pericarditis vs. no constrictive pericarditis). Left ventricular filling fraction was 83 ± 6% in Group 1, 62 ± 9% in Group 2 and 44 ± 5% in Group 3. Right ventricular filling fraction was 93 ± 5% in Group 1, 62 ± 14% in Group 2 and 35 ± 6% in Group 3 (p < 0.05, Group 1 vs. Groups 2 and 3). Both indexes provided a clear-cut distinction between patients with and without constriction.Conclusions. Cine computed tomography simultaneously provides both anatomic and physiologic data that allow accurate preoperative diagnosis of pericardial constriction

Long-Term Follow-Up of Individual Development Accounts: Evidence From the ADD Experiment

Long-Term Follow-Up of Individual Development Accounts: Evidence From the ADD Experimen

Effects of an Individual Development Account Program on Retirement Saving: Follow-Up Evidence From a Randomized Experiment

Using data from a randomized experiment that ran from 1998 to 2003 in Tulsa, Oklahoma, we examine the 10-year follow-up effects on retirement saving of an Individual Development Account (IDA) program. The IDA program included financial education, encouragement to save, and matching funds for several qualified uses of the savings, including contributions to retirement accounts. The results indicate that, as of 2009, 6 years after the program ended, the IDA program had no impact on the propensity to hold a retirement account, the account balance, or the sufficiency of retirement balances to meet retirement expenses

Individual Development Accounts and Post-Secondary Education: Evidence From a Randomized Experiment

This paper presents evidence from a randomized field experiment testing the impact of a 3-year matched savings program on educational outcomes 10 years later. We examine the effect of an Individual Development Account (IDA) program on educational enrollment, degree completion, and increased education level. The IDA program, which ran from 1998 to 2003 in Tulsa, Oklahoma, provided low-income households with financial education and matching funds for qualified savings withdrawals, including a 1:1 match for educational uses. We find a significant impact on education enrollment and positive, but non-significant impacts on degree completion and increase in level of education. We also examine the interaction between gender and treatment assignment and find that the IDA had a strong positive effect on increased educational attainment for males, but not for females

Hydrodynamics of polar liquid crystals

Starting from a microscopic definition of an alignment vector proportional to the polarization, we discuss the hydrodynamics of polar liquid crystals with local $C_{\infty v}$-symmetry. The free energy for polar liquid crystals differs from that of nematic liquid crystals ($D_{\infty h}$) in that it contains terms violating the ${\bf{n}}\to -{\bf{n}}$ symmetry. First we show that these $\mathcal{Z}_2$-odd terms induce a general splay instability of a uniform polarized state in a range of parameters. Next we use the general Poisson-bracket formalism to derive the hydrodynamic equations of the system in the polarized state. The structure of the linear hydrodynamic modes confirms the existence of the splay instability.Comment: 9 pages, corrected typos, added references, revised content, to appear in PR

Communications Biophysics

Contains a summary of research publications and reports on four research projects.National Science Foundation (Grant GP-2495)National Institutes of Health (Grant MH-04737-04)National Aeronautics and Space Administration (Grant NsG-496