Abstract
Background
School-located influenza vaccination programme (SIVP) can effectively promote childhood seasonal influenza vaccination (SIV). However, the longitudinal effects of continuation and ...discontinuation of the SIVP on parents’ vaccine hesitancy remained unknown.
Methods
A two-wave longitudinal study recruited adult parents who had at least one child attending a kindergarten or primary school using random-digital-dialled telephone interviews. Generalized estimating equation and structural equation modelling were used to examine the impact of changes in schools’ SIVP participation status on parents’ vaccine-related attitudes, and childhood SIV acceptance over 2 years in Hong Kong.
Results
Children’s SIV uptake varied by the schools’ SIVP participation status. The highest SIV uptake was found in schools that consistently participated in SIVP (Consistent participation group) (2018/2019: 85.0%; 2019/2020: 83.0%) but lowest in the Consistent non-Participation group (2018/2019: 45.0%; 2019/2020: 39.0%). SIV uptake increased in the Late Initiation group but declined in the Discontinuation group. An increasing trend of parental vaccine-hesitant attitudes was observed in the Consistent non-Participation group.
Conclusions
Initiation and continuation of the SIVP can reduce parental vaccine hesitancy to achieve a high childhood SIV uptake. Conversely, discontinuation of the SIVP or persistent resistance to the implementation of SIVP can increase parental vaccine hesitancy and reduce childhood SIV uptake.
Abstract Background/Purpose Whether laparoscopic surgery is superior to open surgery in the repair of congenital duodenal obstruction remains controversial. The objective of this study is to ...systematically review the literatures which compare the outcomes of these two operative approaches. Methods A systematic review of the studies comparing these two surgical approaches since 2000 was carried out. Results Four retrospective cohort studies compromising 180 patients were eligible for analysis. Duodenal atresia was the most common diagnosis (62.3%). Overall, there were no statistically significant differences in terms of operative duration (SMD: 0.75, 95% CI: 0.46–1.04), ventilator dependence (SMD: 0.04, 95% CI: − 0.22 – 0.29), time to initial enteral feeding (SMD: 0.12, 95% CI: − 0.14 – 0.38), time to full enteral feeding (SMD: 0.18, 95% CI: − 0.15 – 0.50) and hospital stay (SMD-0.03, 95% CI: − 0.29 – 0.22). The overall incidences of anastomotic complications in laparoscopic vs open groups were 4.4% vs 1.8%. Two cases of missed distal pathology were reported in the laparoscopic group. Conclusions Laparoscopic surgery is feasible in the repair of CDO. Study with larger sample size is needed for further analysis to examine whether open or laparoscopic approach is superior. Meanwhile, it is still safe to practice laparoscopic repair of CDO in skilled surgeons with attention to the possibility of distal pathology.
Abstract
Background: Extranodal natural killer/T-cell lymphoma (NKTCL) is an aggressive malignancy that has been linked to infection with Epstein-Barr virus (EBV). However, the humoral immune ...response to EBV in relation to NKTCL has not been well studied.
Methods: We examined plasma samples from 51 NKTCL cases and 154 controls from Hong Kong and Taiwan from the multi-center hospital-based AsiaLymph case-control study using a protein microarray that measured IgG and IgA antibodies against 202 sequences across the entire EBV proteome. Internal validation was performed by using four ELISA assays targeting IgG and IgA antibodies against viral capsid antigen (VCA) and nuclear antigen 1 (EBNA1), antibodies that have previously been linked to other EBV-associated cancers and reported in NKTCL cases. Differences in the mean standardized signal intensity (SSI) for IgG and IgA antibodies against each of the array sequences between NKTCL and controls were compared using unpaired t tests. Odds ratios (ORs) and 95% CIs for the association between each three-level categorical anti-EBV antibody variable (i.e., tertiles) and NKTCL status were calculated using logistic regression models adjusted for sex, age and study area.
Results: We analyzed 157 IgG antibodies and 127 IgA antibodies that fulfilled quality control requirements. NKTCL disease associations were disproportionately observed for IgG rather than IgA markers. Nine anti-EBV IgG responses were elevated in NKTCL cases compared with controls with odds ratios highest vs. lowest tertile > 6.0 (Bonferroni-corrected p-values<0.05). Among these nine responses, three (all mapping to EBNA3A) are novel and have not been found to be strongly associated with other EBV-associated tumors of B-cell or epithelial origin while six mapped to proteins (BALF2, BMRF1, BZLF1, BVRF2, and BPLF1) that have been reported previously to be associated with other EBV-associated cancers. IgG antibodies against EBNA1, which have consistently been associated with other EBV-associated tumors in different populations, were not elevated in NKTCL cases. Results from ELISA assays confirmed our array-based findings.
Conclusions: Our data suggest that the anti-EBV humoral response profiles are altered in NKTCL, but that alterations observed differ from those for other EBV-associated tumors of B-cell or epithelial origin. Our findings provide clues for future NKTCL pathogenesis research.
Citation Format: Zhiwei Liu, Yomani Sarathkumara, John K. Chan, Yok-Lam Kwong, Tai Hing Lam, Dennis Kai Ming Ip, Brian Chiu, Jun Xu, Yu-Chieh Su, Carla Proietti, Kelly J. Yu, Raymond Liang, Wei Hu, Bu-Tian Ji, Anna E. Coghill, Ruth M. Pfeiffer, Allan Hildesheim, Nathaniel Rothman, Denise Doolan, Qing Lan. Characterization of the humoral immune response to the EBV proteome in extranodal natural killer T-cell lymphoma abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 833.
BACKGROUND:Infections occurring among vaccinated persons (vaccine failures) are known to occur in vaccines with imperfect efficacy. Failures among vaccinated children who were infected with ...vaccine-matched influenza B virus strain have not been adequately characterized.
METHODS:Taking advantage of a randomized controlled trial of trivalent seasonal influenza vaccine (TIV), the viral shedding and clinical symptoms associated with reverse transcriptase polymerase chain reaction-confirmed influenza B infection and serum hemaggluttination inhibiting antibody response to vaccine were compared between children 6 and 17 years receiving TIV and placebo.
RESULTS:Vaccine failures were observed to show lower antibody response to TIV compared with other vaccine recipients. We did not find any evidence that vaccination reduced the severity or duration of clinical symptoms of reverse transcriptase polymerase chain reaction-confirmed vaccine-matched influenza B infections. Vaccination was not observed to alter viral load or shedding duration.
CONCLUSIONS:TIV was not observed to ameliorate clinical symptoms or viral shedding among vaccine failures compared with infected placebo recipients. Lower antibody response might have explained vaccine failure and also lack of effect in reducing clinical symptoms and viral shedding upon infection. Our results are based on a randomized controlled trial of split virus inactivated vaccine and may not be applicable to other vaccine types. Further studies in vaccine failure among children will be important in future vaccine development.
In community-based epidemiological studies, job- and industry-specific 'modules' are often used to systematically obtain details about the subject's work tasks. The module assignment is often made by ...the interviewer, who may have insufficient occupational hygiene knowledge to assign the correct module. We evaluated, in the context of a case-control study of lymphoid neoplasms in Asia ('AsiaLymph'), the performance of an algorithm that provided automatic, real-time module assignment during a computer-assisted personal interview.
AsiaLymph's occupational component began with a lifetime occupational history questionnaire with free-text responses and three solvent exposure screening questions. To assign each job to one of 23 study-specific modules, an algorithm automatically searched the free-text responses to the questions 'job title' and 'product made or services provided by employer' using a list of module-specific keywords, comprising over 5800 keywords in English, Traditional and Simplified Chinese. Hierarchical decision rules were used when the keyword match triggered multiple modules. If no keyword match was identified, a generic solvent module was assigned if the subject responded 'yes' to any of the three solvent screening questions. If these question responses were all 'no', a work location module was assigned, which redirected the subject to the farming, teaching, health professional, solvent, or industry solvent modules or ended the questions for that job, depending on the location response. We conducted a reliability assessment that compared the algorithm-assigned modules to consensus module assignments made by two industrial hygienists for a subset of 1251 (of 11409) jobs selected using a stratified random selection procedure using module-specific strata. Discordant assignments between the algorithm and consensus assignments (483 jobs) were qualitatively reviewed by the hygienists to evaluate the potential information lost from missed questions with using the algorithm-assigned module (none, low, medium, high).
The most frequently assigned modules were the work location (33%), solvent (20%), farming and food industry (19%), and dry cleaning and textile industry (6.4%) modules. In the reliability subset, the algorithm assignment had an exact match to the expert consensus-assigned module for 722 (57.7%) of the 1251 jobs. Overall, adjusted for the proportion of jobs in each stratum, we estimated that 86% of the algorithm-assigned modules would result in no information loss, 2% would have low information loss, and 12% would have medium to high information loss. Medium to high information loss occurred for <10% of the jobs assigned the generic solvent module and for 21, 32, and 31% of the jobs assigned the work location module with location responses of 'someplace else', 'factory', and 'don't know', respectively. Other work location responses had ≤8% with medium to high information loss because of redirections to other modules. Medium to high information loss occurred more frequently when a job description matched with multiple keywords pointing to different modules (29-69%, depending on the triggered assignment rule).
These evaluations demonstrated that automatically assigned modules can reliably reproduce an expert's module assignment without the direct involvement of an industrial hygienist or interviewer. The feasibility of adapting this framework to other studies will be language- and exposure-specific.
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