ALMA observations of the narrow HR 4796A debris ring

The young A0V star HR 4796A is host to a bright and narrow ring of dust, thought to originate in collisions between planetesimals within a belt analogous to the Solar system’s Edgeworth–Kuiper belt. Here we present high spatial resolution 880 μm continuum images from the Atacama Large Millimeter Array. The 80 au radius dust ring is resolved radially with a characteristic width of 10 au, consistent with the narrow profile seen in scattered light. Our modelling consistently finds that the disc is also vertically resolved with a similar extent. However, this extent is less than the beam size, and a disc that is dynamically very cold (i.e. vertically thin) provides a better theoretical explanation for the narrow scattered light profile, so we remain cautious about this conclusion. We do not detect 12CO J=3–2 emission, concluding that unless the disc is dynamically cold the CO+CO2 ice content of the planetesimals is of order a few per cent or less. We consider the range of semi-major axes and masses of an interior planet supposed to cause the ring’s eccentricity, finding that such a planet should be more massive than Neptune and orbit beyond 40 au. Independent of our ALMA observations, we note a conflict between mid-IR pericentre-glow and scattered light imaging interpretations, concluding that models where the spatial dust density and grain size vary around the ring should be explored

Key Stakeholder Perspectives on Challenges and Opportunities for Rural HPV Vaccination in North and South Carolina

The objective of this study was to identify factors at the individual, provider, and systems levels that serve as challenges or opportunities for increasing adolescent vaccination—including Human Papillomavirus (HPV) vaccination—in rural communities in the southern United States (US). As part of a broader study to increase HPV vaccine uptake in the southern US, we conducted in-depth interviews with vaccination stakeholders representing public health and education agencies in North Carolina (NC) and South Carolina (SC). Fourteen key stakeholders were recruited using purposive sampling to obtain insights into challenges and solutions to rural-urban disparities in HPV vaccination coverage. Stakeholders were also queried about their experiences and attitudes toward school-based vaccination promotion programs and campaigns. We used a rapid qualitative approach to analyze the data. Stakeholders identified factors at the individual, provider, and systems levels that serve as challenges to vaccination in rural communities. Similar to previous studies, stakeholders mentioned challenges with healthcare access and vaccine-related misconceptions that pose barriers to HPV vaccination for rural residents. Systems-level challenges identified included limited access to high-speed internet in rural areas that may impact providers’ ability to interface with state-level digital systems such as the vaccination registry. Stakeholders identified a number of opportunities to increase HPV vaccination coverage, including through school-based health promotion programs. Stakeholders strongly supported school-based programs and approaches to strengthen confidence and demand for HPV vaccination and to help address persistent social determinants and system level factors that pose challenges to HPV vaccination coverage in many rural areas

Association of Caregiver Attitudes With Adolescent HPV Vaccination in 13 Southern US States

Background and objectives: HPV vaccination coverage is lower than that of other adolescent vaccines in the southern US. This study sought to characterize caregiver attitudes associated with adolescent HPV vaccination in the southern US and to inform interventions to promote HPV vaccination. Methods: From December 2019 – January 2020, caregivers of adolescents (ages 9–17 years) living in thir- teen southern US states were recruited from a nationally-representative online survey panel. Caregivers (N = 1,105) completed a cross-sectional survey that assessed general adolescent vaccine attitudes as well as those associated with the HPV vaccine and HPV vaccination decision-making. The primary study out- come was adolescents’ receipt of at least one dose of the HPV vaccine. Results: Caregivers with vaccinated adolescents had greater positive attitudes towards adolescent vacci- nes compared to caregivers of unvaccinated adolescents. Top three areas of concern among caregivers were related to vaccine ingredients, perceptions that adolescents receive too many vaccines, and worry about vaccine side effects. In multivariable regression models, positive attitudes towards the HPV vaccine and HPV vaccination decision-making strongly associated with HPV vaccination in addition to general adolescent vaccination attitudes. Caregivers’ reported discomfort with discussing the topic of sex was predictive of lower vaccination uptake for older adolescents. Conclusions: Public health messaging in the southern US should be tailored to reduce concerns about vac- cine safety and to communicate the importance of timely HPV vaccination. Campaigns that deliver infor- mation specific to the HPV vaccine and to support vaccination decision-making may be more effective than those delivering only general adolescent vaccination information at promoting on-time HPV vaccinatio

Examining Associations Between Knowledge and Vaccine Uptake Using the Human Papillomavirus Knowledge Questionnaire (HPV-KQ)

Objectives: Understanding the relationship between human papillomavirus (HPV) knowledge and vaccination behavior is important to inform public health interventions, yet few validated HPV knowledge scales exist. This study describes development of the Human Papillomavirus Knowledge Questionnaire (HPV-KQ) and its validation with parents residing in the southern United States (US). Methods: Drawing on previously published measures, we developed the 13-item HPV-KQ and administered the scale via Web-based survey to parents (N=1105) of adolescents ages 9 to 17 years. Dimensionality, internal consistency, model fit, and predictive validity were assessed. Results: The scale was bidimensional. One factor captured general HPV knowledge, and the second factor captured perceptions of gender differences in HPV infection and vaccine recommendations. The 13-item scale and 2-factor solution displayed strong internal consistency and good model fit. Parents of vaccinated adolescents scored higher on the 13-item HPV-KQ (Mean = 8.56) than parents of unvaccinated adolescents (Mean = 6.43) (p \u3c .001). In regression models, controlling for key covariates, parents\u27 performance on the HPV-KQ predicted adolescent HPV vaccination (p \u3c .001). Conclusions: Evaluation indicates the HPV-KQ is a reliable and valid tool for measuring knowledge of HPV and the HPV vaccine among parents residing in the southern US. We recommend further efforts to validate the scale with other populations

Molecular characterization of a Chinese variant of the Flury-LEP strain

The entire genome of rabies virus vaccine strain Flury-LEP-C, a Chinese variant of the rabies virus vaccine strain Flury-LEP, was sequenced. The overall length of the genome of Flury-LEP-C strain was 11 924 nucleotides (nt), comprising a leader sequence of 58 nt, nucleoprotein (N) gene of 1353 nt, phosphoprotein (P) gene of 894 nt, matrix protein (M) gene of 609 nt, glycoprotein (G) gene of 1575 nt, RNA-dependent RNA polymerase (RdRp, L) gene of 6384 nt, and a trailer region of 70 nt. There was TGAAAAAAA (TGA7) consensus sequence in the end of each gene in Flury-LEP-C genome, except G gene which had a GAGAAAAAAA sequence in the end of the non-coding G-L region. There were AACAYYYCT consensus start signal close to the TGA7. Flury-LEP-C has 310 nucleotides more than HEP-Flury in G-L intergenic region. The analysis showed that the residue at 333 of the mature G protein was Arg, which was reported to be related to pathogenicity. Compared with FluryLEP, there were 19 different amino acids (AAs) in five proteins of Flury-LEP-C, including 15 AAs which were identical with corresponding residues of Hep-Flury, and 4 AAs which were neither identical with the residues of FluryLEP nor with the residues of Hep-Flury. The results showed the topology of the phylogenetic trees generated by two protein sequences were similar. It was demonstrated that HN10, BD06, FJ009, FJ008, D02, D01, F04, F02 have a close relationship to CTN-1 and CTN181, and MRV was closely related to Flury-LEP, HEP-Flury and Flury-LEP-C

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Exogenous Factors in Itch Response1

Itch is a common sensation and a component of numerous disease states. Itch can be classified according to its origin and may be modulated by both endogenous and exogenous factors. The purpose of this chapter is to classify the common causes of exogenous itch in humans. These factors were classified into mechanical, chemical, and environmental components. A better understanding of the various mechanisms of pruritus is critical to effective research into the treatment of itch

Classification of Exogenous Factors Contributing to the Itch Response

Itch is a common sensation and a component of numerous disease states. Itch can be classified according to its origin and may be modulated by both endogenous and exogenous factors. Recent research has led to a better understanding of the mechanisms of itch, but there are still many areas to be explored. The purpose of this article is to classify the common causes of exogenous itch in humans. To facilitate this, a Medline literature review was conducted using the MeSH search term ‘pruritus’ along with relevant associated subheadings to identify articles dealing with exogenous factors related to itch. Factors relevant to exogenous itch were classified into mechanical, chemical, and environmental components. A better understanding of the various mechanisms of pruritus is critical to effective research into the treatment of itch

Abstract Number ‐ 231: Role of Anticoagulation in Recurrent Basilar Artery Thrombosis Secondary to Dolichoectasia, a Case Report

Introduction Basilar artery thrombosis accounts for a small part of ischemic strokes but contributes to one‐fifth of the posterior circulation strokes. Recurrent basilar artery thrombosis secondary to dolichoectasia is caused by abnormal flow in the dilated artery and can result in cerebral ischemia. We present a similar case of recurrent thrombosis with a missed dose of anticoagulation and dehydration on two separate occasions. Methods An 81‐year‐old man with a past medical history of ulcerative colitis with colostomy, provoked deep venous thrombosis presented as a transfer from an outside hospital with acute onset of dysarthria, nausea/vomiting, unsteadiness, and left hemiparesis. CT angiogram of head and neck revealed right vertebral thrombosis extending into the basilar artery with dolichoectasia involving distal right vertebral artery and basilar artery. He was started on heparin infusion with improvement in symptoms and a return to baseline. He was later transitioned to apixaban and discharged home. On a follow‐up office visit two months later, his repeat CT angiogram revealed resolution of the thrombus. He was advised to continue the medication due to the risk of recurrent occlusion secondary to vessel anomaly. After four months, the patient returned to the emergency department with acute onset dizziness, imbalance, nausea, and vomiting. CT angiogram of the head and neck was performed which revealed non‐occlusive thrombosis in the basilar artery. On evaluation by neurology, he admits to three missed doses of apixaban. Clinical and laboratory data were concerning for volume depletion. On further questioning about his symptoms, he mentions decreased oral intake on the day of colostomy change. He was advised to continue apixaban and stay hydrated. Results After fifteen months of the first presentation, the patient is symptom‐free but was continued on anticoagulation with apixaban to prevent recurrent events. Conclusions The role of short‐term and long‐term anticoagulation in basilar artery occlusion is less studied. No prospective trials were done so far to suggest that antithrombotic therapy lowers the risk of recurrent ischemic events and/or anticoagulation is superior to antiplatelets. Dolichoectasia by itself can increase the risk of recurrent thrombosis and dehydration likely facilitated the thrombosis in our patient during the event of missed anticoagulation