Background. Pneumococcal serotypes 1, 3, 5, 7F, and 19A were the most implicated in community-acquired pneumonia (CAP) after implementation of 7-valent pneumococcal conjugate vaccine (PCV7). In ...France, the switch from PCV7 to 13-valent pneumococcal conjugate vaccine (PCV13) occurred in June 2010. An active surveillance network was set up to analyze the impact of PCV13 on CAP. Methods. An observational prospective study performed in 8 pediatric emergency departments from June 2009 to May 2012 included all children between 1 month and 15 years of age with chest radiography–confirmed pneumonia. Three 1-year periods were defined: pre-PCV13, transitional, and post-PCV13. Results. During the 3-year study period, among the 953 274 pediatric emergency visits, 5645 children with CAP were included. CAP with pleural effusion and documented pneumococcal CAP were diagnosed in 365 and 136 patients, respectively. Despite an increase (4.5%) in number of pediatric emergency visits, cases of CAP decreased by 16% (2060 to 1725) between pre- and post-PCV13 periods. The decrease reached 32% in infants in the same periods (757 to 516; P < .001). Between pre- and post-PCV13 periods, the proportion of CAP patients with a C-reactive protein level >120 mg/dL decreased from 41.3% to 29.7% (P < .001), the number of pleural effusion cases decreased by 53% (167 to 79; P < .001) and the number of pneumococcal CAP cases decreased by 63% (64 to 24; P = .002). The number of additional PCV13 serotypes identified decreased by 74% (27 to 7). Conclusions. Our data suggest a strong impact of PCV13 on CAP, pleural effusion, and documented pneumococcal pneumonia, particularly cases due to PCV13 serotypes.
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Aims
Functional mitral regurgitation (FMR) contributes to morbidity and mortality in heart failure (HF) patients. The aim of this study was to determine whether percutaneous mitral annuloplasty could ...safely and effectively reduce FMR and yield durable long‐term clinical benefit.
Methods and results
The impact of mitral annuloplasty (Carillon Mitral Contour System) was evaluated in HF patients with at least moderate FMR. Patients in whom the device was placed then acutely recaptured for clinical reasons served as a comparator group. Quantitative measures of FMR, left ventricular (LV) dimensions, New York Heart Association (NYHA) class, 6 min walk distance (6MWD), and quality of life were assessed in both groups up to 12 months. Safety and key functional data were assessed in the implanted cohort up to 24 months. Thirty‐six patients received a permanent implant; 17 had the device recaptured. The 30‐day major adverse event rate was 1.9%. In contrast to the comparison group, the implanted cohort demonstrated significant reductions in FMR as represented by regurgitant volume baseline 34.5 ±11.5 mL to 17.4 ±12.4 mL at 12 months (P < 0.001). There was a corresponding reduction in LV diastolic volume baseline 208.5 ±62.0 mL to 178.9 ±48.0 mL at 12 months (P =0.015) and systolic volume baseline 151.8 ±57.1 mL to 120.7 ±43.2 mL at 12 months (P =0.015), compared with progressive LV dilation in the comparator. The 6MWD markedly improved for the implanted patients by 102.5 ±164 m at 12 months (P =0.014) and 131.9 ±80 m at 24 months (P < 0.001).
Conclusion
Percutaneous reduction of FMR using a coronary sinus approach is associated with reverse LV remodelling. Significant clinical improvements persisted up to 24 months.
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BFBNIB, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
Global aerosol climatology from the MODIS satellite sensors Remer, Lorraine A.; Kleidman, Richard G.; Levy, Robert C. ...
Journal of Geophysical Research - Atmospheres,
27 July 2008, Volume:
113, Issue:
D14
Journal Article, Conference Proceeding
Peer reviewed
Open access
The recently released Collection 5 Moderate Resolution Imaging Spectroradiometer (MODIS) aerosol products provide a consistent record of the Earth's aerosol system. Comparing with ground‐based ...AERONET observations of aerosol optical depth (AOD) we find that Collection 5 MODIS aerosol products estimate AOD to within expected accuracy more than 60% of the time over ocean and more than 72% of the time over land. This is similar to previous results for ocean and better than the previous results for land. However, the new collection introduces a 0.015 offset between the Terra and Aqua global mean AOD over ocean, where none existed previously. Aqua conforms to previous values and expectations while Terra is higher than what had been expected. The cause of the offset is unknown, but changes to calibration are a possible explanation. Even though Terra's higher ocean AOD is unexpected and unexplained, we present climatological analyses of data from both sensors. We find that the multiannual global mean AOD at 550 nm over oceans is 0.13 for Aqua and 0.14 for Terra, and over land it is 0.19 in both Aqua and Terra. AOD in situations with 80% cloud fraction are twice the global mean values, although such situations occur only 2% of the time over ocean and less than 1% of the time over land. Aerosol particle size associated with these very cloudy situations does not show a drastic change over ocean, but does over land. Regionally, aerosol amounts vary from polluted areas such as east Asia and India, to the cleanest regions such as Australia and the northern continents. As AOD increases over maritime background conditions, fine mode aerosol dominates over dust over all oceans, except over the tropical Atlantic downwind of the Sahara and during some months over the Arabian Sea.
Patients with psychiatric illness feel the brunt of the intersection of many of our society's and our health care system's disparities, and the vulnerability of this population during the Covid‐19 ...pandemic cannot be overstated. Patients with psychiatric illness often suffer from the stigma of mental illness and receive poor medical care. Many patients with severe and persistent mental illness face additional barriers, including poverty, marginal housing, and food insecurity. Patients who require psychiatric hospitalization now face the risk of transmission of Covid‐19 due to the inherent difficulties of social distancing within a psychiatric hospital. Patients whose freedom and self‐determination have been temporarily overruled as they receive involuntary psychiatric treatment deserve a setting that maintains their health and safety. While tele‐mental health has been rapidly expanded to provide new ways to access psychiatric treatment, some patients may have limitations in technological literacy or access to devices. The social isolation, economic fallout, and potential traumatization related to the current pandemic will disproportionately affect this vulnerable population, and society's duties to them must be considered.
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BFBNIB, DOBA, FZAB, GIS, IJS, INZLJ, IZUM, KILJ, NLZOH, NMLJ, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ, ZRSKP
We have studied the possibility of using multiwalled carbon nanotube (MWCNT) films as strain sensors. The MWCNT films were prepared by a solution/filtration method and were bonded directly onto ...specimens by a nonconductive adhesive. For comparison, conventional foil strain gages were also bonded to the structure on the opposite side. The specimens then underwent a uniaxial tensile load-unload cycle to evaluate them as strain sensors. To ensure good electrical contact between carbon nanotube film and the wires, a thin layer of copper was thermally deposited on both ends of the film as electrodes, and the wires were connected to the electrodes by silver ink. Wheatstone bridges were used to convert the resistance changes of the MWCNTs to voltage output. Results indicated that the output voltages were proportional to the strain readings from the stain indicator. The effect of temperature on the resistance was measured and the MWCNT film resistance was found to be independent of temperature over the range 273-363 K. The optimal film dimension for strain sensing was evaluated as well. Dynamic tests suggest that the MWCNTs were able to extract the structural signature. Our results indicate that MWCNT film is potentially useful for structural health monitoring and vibration control applications.
Phakopsora pachyrhizi was discovered on soybeans in Uganda in 1996. This was the initial confirmation of the pathogen on soybeans in Africa, although there had been earlier unsubstantiated listings ...on other legumes. Thereafter, it was wind-dispersed southward to Rwanda, Zimbabwe, and Zambia in February 1998, where it severely damaged commercial plantings. It also devastated small-scale fields in eastern Nigeria at about this time. Rust continued its southward movement to southern Mozambique in early 2000, and into eastern South Africa in March 2001. By early 2003, substantial losses were being reported from western Cameroon. Scientists in Zimbabwe and South Africa have coordinated their research to combat the pathogen and have developed a strategy based on the effective, economical use of fungicides and the development of resistant germ plasm. The chemical and spraying recommendations resulting from field studies are discussed in relation to their practicalities, and a preliminary analysis of the meteorological data recorded will show the fundamental factors that influence the development of an epidemic.
We present submillimeter spectra of the (proto-)super star cluster (SSC) candidates in the starbursting center of the nearby galaxy NGC 253 identified by Leroy et al. The 2.5 pc resolution of our ...Atacama Large Millimeter/submillimeter Array cycle 3 observations approaches the size of the SSCs and allows for the study of physical and chemical properties of the molecular gas in these sources. In the 14 SSC sources and in the frequency ranges 342.0-345.8 GHz and 353.9-357.7 GHz, we detect 55 lines belonging to 19 different chemical species. The SSCs differ significantly in chemical complexity, with the richest clusters showing 19 species and the least complex showing four species. We detect HCN isotopologues and isomers (H13CN, HC15N, H15NC), abundant HC3N, SO and S18O, SO2, and H2CS. The gas ratios CO/HCN, CO/HCO+ are low, ∼1-10, implying high dense gas fractions in the SSCs. Line ratio analyses suggests chemistry consistent with photon-dominated regions and mechanical heating. None of the SSCs near the galaxy center show line ratios that imply an X-ray-dominated region, suggesting that heating by any (still unknown) active galactic nucleus does not play a major role. The gas temperatures are high in most sources, with an average rotational temperature of ∼130 K in SO2. The widespread existence of vibrationally excited HCN and HC3N transitions implies strong infrared radiation fields, potentially trapped by a greenhouse effect due to high continuum opacities.
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