In this randomized trial in subjects between 15 and 65 years old, a new acellular pertussis vaccine was safe and had an efficacy of 92 percent against documented, symptomatic
Bordetella pertussis
...infections. Among controls, the incidence of pertussis was 370 per 100,000 person-years. Vaccination of adults and adolescents could prevent pertussis and reduce the transmission of
B. pertussis
to young children.
In subjects between 15 and 65 years old, a new acellular pertussis vaccine was safe and had an efficacy of 92 percent against documented, symptomatic
Bordetella pertussis
infections.
Bordetella pertussis
infects the human respiratory tract and in nonimmune persons causes whooping cough, a severe illness associated with prolonged cough.
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,
2
The severity of illness varies with age, immune status (prior immunization or infection), and probably such factors as the extent of exposure and the virulence of the organism. Disease risk and severity are greatest in unimmunized infants.
3
–
5
During the past 50 years, routine pediatric pertussis immunization has dramatically decreased the pediatric disease burden.
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,
2
In the United States, the annual incidence of pertussis fell from 157 per 100,000 persons in the prevaccine era to less than 1 . . .
Accurate pavement crack detection has long been a challenging task, causing significant difficulties to the pavement management sectors in the managerial decision making. The high complexity of the ...crack’s characteristics and the less effective of the crack analytical tools are the two crucial aspects to be accounted for. Recently, three-dimensional (3D) technology based high precision crack detection methodologies has undergone extensive developments. Nevertheless, none of those methods has taken into the errors caused by the data collection systems into consideration, resulting in a less satisfying performance. Hence, the primary objective of this research is to outline the Primary Surface Profile (PSP) optimized dual-phase computing 3D crack detection methodology. Two years ago, variations caused by the automatic 3D data collection systems were observed, so researchers proposed PSP based data filtering algorithm. Therefore, this research is the upgrade solution of the previous innovation regarding the unbiased 3D pavement crack detection. Firstly, the dual-phase computing approach is proposed in dealing with the non-variance 3D data. Then, the self-adaptive 3D PSP generation method is introduced. Finally, PSP is embedded in the dual-phase computing method for performance optimization. For performance assessment, both precisions and recalls of the proposed approach are compared with conventional method for transverse, longitudinal, and map crack detections. Even crack detection precisions are found for both methods, which are all higher than 0.9. However, the recalls of the proposed method (transverse cracks:0.973, longitudinal cracks:0.981, map cracks:0.940) are significantly outperforming non-optimized dual-phase computing method (transverse cracks: 0.682, longitudinal cracks: 0.789, map cracks:0.811).
•Addressed the vehicle violation induced problem in the automatic three-dimensional (3D) pavement crack detection systems.•Proposed innovative primary surface profile (PSP)-based solution to the observed problem.•Developed integrated 3D based PSP optimized dual-phase crack detection methodology with high accuracy and robustness.
Objective: We aimed to compare the visually dependent neuropsychological functioning among adults with Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) ADHD who recalled symptom ...onset by and after age 7 and non-ADHD controls. Method: We divided the participants, aged 17 to 40 years, into three groups—(a) ADHD, onset <7 years (early-onset, n = 142); (b) ADHD, onset between 7 and <12 years (late-onset, n = 41); (c) non-ADHD controls (n = 148)—and compared their neuropsychological functioning, measured by the Cambridge Neuropsychological Testing Automated Battery. Results: Both ADHD groups had deficits in attention and signal detectability, spatial working memory, and short-term spatial memory, but only the early-onset group showed deficits in alertness, set-shifting, and planning after controlling for age, sex, and psychiatric comorbidities. There was no statistical difference between the two ADHD groups in neuropsychological functioning. Conclusion: DSM-5 criteria for diagnosing adult ADHD are not too lax regarding neuropsychological functioning.
•In 2013, there was an increase in the availability of illicitly-manufactured fentanyl in the US.•Non-Hispanic Black (vs. white) Americans had a greater increase in overdose rate.•Urban non-Hispanic ...Black Americans had the greatest increases in overdose rate.•Older urban non-Hispanic Black men had the greatest increase in fentanyl-induced overdose.•Urban non-Hispanic Black Americans need of harm reduction and drug treatment services.
With the emergence of illicit fentanyl, fentanyl-involved overdose rates increased from 2013 to 2017 in the United States (US). We describe US trends in opioid-related overdose mortality rates by race, age, urbanicity, and opioid type before and after the emergence of fentanyl.
Using the Centers for Disease Control and Prevention’s WONDER database, we estimated crude and age-standardized opioid-related overdose mortality rates at the intersections of race (non-Hispanic NH Black and white), age (<55 and ≥55 years), sex (male and female) and urbanicity (urban and rural residence) from 2005 to 2017. We compare relative changes in mortality from 2013 to 17, and describe changes in the contributions of fentanyl, heroin, and other opioids to opioid-related overdose mortality.
From 2013 to 2017, the overall opioid overdose mortality rate was consistently higher in NH white Americans, however, the rate increase was greater among NH Black (174 %) compared to NH white (85 %) Americans. The steepest increases occurred in the overdose rates between 2013 and 2017 among younger (aged <55 years) urban NH Black Americans (178 % increase). Among older (≥55 years) adults, only urban NH Black Americans had an increase in overdose-related mortality rate (87 % increase). Urban NH Black Americans also experienced the greatest increase in the percent of fentanyl-involved deaths (65 % in younger, 61 % in older).
In the era of increased availability of illicitly manufactured fentanyl (2013–2017), there has been a disproportionate increase in opioid-related overdose deaths among urban NH Black Americans. Interventions for urban NH Black Americans are urgently needed to halt the increase in overdose deaths.
Although children generally regard adults as more knowledgeable than their peers, an informant's past accuracy trumps age when in conflict. In a recent study, however, Korean 5‐year‐olds were more ...likely to trust a less accurate adult informant over a more accurate peer informant when learning new information. To examine whether such a pattern was attributable to the cultural influence of shaping early respect for the elderly among Korean children, a pattern of selective label endorsement was examined among Canadian 5‐year‐olds, who were raised under different cultural values, relatively putting less emphasis on social relationships than individual expressions (Experiment 1). We also investigated Korean 6–7‐year‐olds’ selective endorsement pattern when the informant's past accuracy conflicted with the informant's age to examine how cultural influences shift as children develop (Experiment 2). When the adult was 25% accurate in labeling familiar objects, relative to the 75% accurate child informant, Canadian 5‐year‐olds tended to endorse the label offered by the child, demonstrating a prioritization of the epistemic cue over the social cue. By comparison, Korean 6–7‐year‐olds were equally likely to choose between two informants, showing difficulty disregarding inaccurate adults, even when they always mislabeled familiar objects. These results offer insight into cultural influences on the development of selective word learning and suggest the relative weighing of social and epistemic cues evolves with development.
Colorado potato beetle (CPB) is a leading pest of solanaceous plants. Despite the economic importance of this pest, surprisingly few studies have been carried out to characterize its molecular ...interaction with the potato plant. In particular, little is known about the effect of CPB elicitors on gene expression associated with the plant's defense response. In order to discover putative CPB elicitor-responsive genes, the TIGR 11,421 EST Solanaceae microarray was used to identify genes that are differentially expressed in response to the addition of CPB regurgitant to wounded potato leaves. By applying a cutoff corresponding to an adjusted P-value of <0.01 and a fold change of >1.5 or <0.67, we found that 73 of these genes are induced by regurgitant treatment of wounded leaves when compared to wounding alone, whereas 54 genes are repressed by this treatment. This gene set likely includes regurgitant-responsive genes as well as wounding-responsive genes whose expression patterns are further enhanced by the presence of regurgitant. Real-time polymerase chain reaction was used to validate differential expression by regurgitant treatment for five of these genes. In general, genes that encoded proteins involved in secondary metabolism and stress were induced by regurgitant; genes associated with photosynthesis were repressed. One induced gene that encodes aromatic amino acid decarboxylase is responsible for synthesis of the precursor of 2-phenylethanol. This is significant because 2-phenylethanol is recognized by the CPB predator Perillus bioculatis. In addition, three of the 16 type 1 and type 2 proteinase inhibitor clones present on the potato microarray were repressed by application of CPB regurgitant to wounded leaves. Given that proteinase inhibitors are known to interfere with digestion of proteins in the insect midgut, repression of these proteinase inhibitors by CPB may inhibit this component of the plant's defense arsenal. These data suggest that beyond the wound response, CPB elicitors play a role in mediating the plant/insect interaction.
Breast cancer screening recommendations are based on risk factors. For average-risk women, screening mammography and/or digital breast tomosynthesis is recommended beginning at age 40. Ultrasound ...(US) may be useful as an adjunct to mammography for incremental cancer detection in women with dense breasts, but the balance between increased cancer detection and the increased risk of a false-positive examination should be considered in the decision. For intermediate-risk women, US or MRI may be indicated as an adjunct to mammography depending upon specific risk factors. For women at high risk due to prior mantle radiation between the ages of 10 to 30, mammography is recommended starting 8 years after radiation therapy but not before age 25. For women with a genetic predisposition, annual screening mammography is recommended beginning 10 years earlier than the affected relative at the time of diagnosis but not before age 30. Annual screening MRI is recommended in high-risk women as an adjunct to mammography. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
•People who use multiple drugs have more overdoses than those who only use heroin.•Those with polysubstance use receive less overdose training and naloxone.•Homelessness was the strongest correlate ...of polysubstance use profile in our study.
Opioid-related overdose rates continue to climb. However, little research has examined the reach of overdose education and naloxone trainings among people who inject drugs (PWID). Understanding gaps in coverage is essential to improving the public health response to the ongoing crisis.
We surveyed 298 PWID in Baltimore City, MD. We conducted a latent class analysis of drug use indicators and tested for differences by class in past month overdose, having received overdose training, and currently having naloxone.
Three classes emerged: cocaine/heroin injection (40.2%), heroin only injection (32.2%), and multi-drug/multi-route use (27.6%). The prevalence of past month overdose differed marginally by class (p = 0.06), with the multi-drug/multi-route use class having the highest prevalence (22.5%) and the heroin only class having the lowest (4.6%). The prevalence of previous overdose training differed significantly by class (p = 0.02), with the heroin/cocaine class (76.5%) having more training than the other two classes. Training was least common amongst the multi-drug/multi-route class (60.3%), though not statistically different from the heroin only class (63.0%). Classes did not differ significantly in current naloxone possession, although the multi-drug/multi-route class exhibited the lowest prevalence of naloxone possession (37.2%).
People who inject multiple substances are at high risk for overdose and are also the least likely to receive overdose trainings. The current service landscape does not adequately reach individuals with high levels of structural vulnerability and high levels of drug use and homelessness. Actively including this subgroup into harm reduction efforts are essential for preventing overdose fatalities.
The Hedgehog (Hh) cascade is central to development, tissue homeostasis and cancer. A pivotal step in Hh signal transduction is the activation of glioma-associated (GLI) transcription factors by the ...atypical G protein-coupled receptor (GPCR) SMOOTHENED (SMO). How SMO activates GLI remains unclear. Here we show that SMO uses a decoy substrate sequence to physically block the active site of the cAMP-dependent protein kinase (PKA) catalytic subunit (PKA-C) and extinguish its enzymatic activity. As a result, GLI is released from phosphorylation-induced inhibition. Using a combination of in vitro, cellular and organismal models, we demonstrate that interfering with SMO-PKA pseudosubstrate interactions prevents Hh signal transduction. The mechanism uncovered echoes one used by the Wnt cascade, revealing an unexpected similarity in how these two essential developmental and cancer pathways signal intracellularly. More broadly, our findings define a mode of GPCR-PKA communication that may be harnessed by a range of membrane receptors and kinases.
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