Rubella is generally a mild childhood disease, but infection during early pregnancy may cause spontaneous abortion or congenital rubella syndrome (CRS), which may entail a variety of birth defects. ...Since vaccination at levels short of those necessary to achieve eradication may increase the average age of infection, and thus potentially the CRS burden, introduction of the vaccine has been limited to contexts where coverage is high. Recent work suggests that spatial heterogeneity in coverage should also be a focus of concern. Here, we use a detailed dataset from South Africa to explore the implications of heterogeneous vaccination for the burden of CRS, introducing realistic vaccination scenarios based on reported levels of measles vaccine coverage. Our results highlight the potential impact of country-wide reductions of incidence of rubella on the local CRS burdens in districts with small population sizes. However, simulations indicate that if rubella vaccination is introduced with coverage reflecting current estimates for measles coverage in South Africa, the burden of CRS is likely to be reduced overall over a 30 year time horizon by a factor of 3, despite the fact that this coverage is lower than the traditional 80 per cent rule of thumb for vaccine introduction, probably owing to a combination of relatively low birth and transmission rates. We conclude by discussing the likely impact of private-sector vaccination.
BACKGROUND
It is unknown how pooled platelets (PPs) compare to random apheresis platelets (RAPs) when HLA‐selected platelets (PLTs) are unavailable for HLA‐sensitized patients. The aim of this study ...was to compare patient responses to RAPs, HLA‐selected PLTs, and PPs in HLA‐sensitized patients.
STUDY DESIGN AND METHODS
This is a single‐institution retrospective study of patients from January 2014 to April 2017 with a class I calculated panel‐reactive antibody of 60% or more. Response to transfusion was determined by a corrected count increment (CCI) up to 1 hour after completion of transfusion. A CCI of 5 or more was considered successful.
RESULTS
Seventy‐seven units of RAPs, 412 units of HLA‐selected PLT, and 388 units PPs were transfused. Mean CCIs when transfusing RAPs, HLA‐selected PLTs, and PPs were 2.82, 11.44, and 4.77, respectively (p < 0.0001). Posttest comparison between RAPs and PPs revealed no significant difference in mean CCI while there was a significant difference between HLA‐selected PLTs versus RAPs and HLA‐selected PLTs versus PPs. The success rates of RAPs, HLA‐selected PLTs, and PPs were 31%, 80%, and 35% respectively. There was no significant association of type of PLT and success rate when comparing RAPs versus PPs (p = 0.51) while there was a significant association between success rate and type of PLT transfusion when comparing HLA‐selected PLTs with RAPs and PPs.
CONCLUSION
HLA‐selected PLTs resulted in higher mean CCIs and more successful transfusions. There was no significant difference in mean CCI or success rate when transfusing RAPs versus PPs to HLA‐sensitized patients. Future studies should assess clinical outcomes in HLA‐sensitized patients receiving each type of PLT product.
Energy partition in two solar flare/CME events Emslie, A. G.; Kucharek, H.; Dennis, B. R. ...
Journal of Geophysical Research - Space Physics,
October 2004, Letnik:
109, Številka:
A10
Journal Article
Recenzirano
Odprti dostop
Using coordinated observations from instruments on the Advanced Composition Explorer (ACE), the Solar and Heliospheric Observatory (SOHO), and the Ramaty High Energy Solar Spectroscopic Imager ...(RHESSI), we have evaluated the energetics of two well‐observed flare/CME events on 21 April 2002 and 23 July 2002. For each event, we have estimated the energy contents (and the likely uncertainties) of (1) the coronal mass ejection, (2) the thermal plasma at the Sun, (3) the hard X‐ray producing accelerated electrons, (4) the gamma‐ray producing ions, and (5) the solar energetic particles. The results are assimilated and discussed relative to the probable amount of nonpotential magnetic energy available in a large active region.
Animal communities are essential drivers of energy and elemental flow in ecosystems. However, few studies have investigated the functional role of animals as sources of dissolved organic matter (DOM) ...and the subsequent utilization of that DOM by the microbial community.
In a small forested headwater stream, we tested the effects of taxonomy, feeding traits, and body size on the quality and quantity of dissolved organic carbon (DOC) and dissolved organic nitrogen (DON) excreted by aquatic insects. In addition, we conducted steady‐state solute additions to estimate instream demand for labile C and compared it to the C excreted by invertebrates.
Individual excretion rates and excretion composition varied with body size, taxonomy and feeding guild. The estimated average community excretion rate was 1.31 μg DOC· per mg insect dry weight (DW)−1 hr−1 and 0.33 μg DON·mg DW−1 hr‐1, and individuals excreted DON at nearly twice the rate of NH4+.
This DOM was 2–5 times more bioavailable to microbial heterotrophs than ambient stream water DOM.
We estimated that the insect community, conservatively, excreted 1.62 mg of bioavailable DOC·m−2 hr−1 and through steady‐state additions measured an ambient labile C demand as 3.97 ± 0.67 mg C m−2 hr−1. This suggests that insect‐mediated transformation and excretion of labile DOC could satisfy a significant fraction (40 ± 7%) of labile C demand in this small stream.
Collectively, our results suggest that animal excretion plays an essential functional role in transforming organic matter into microbially bioavailable forms and may satisfy a variable but significant portion of microbial demand for labile C and N.
A plain language summary is available for this article.
Plain Language Summary
Rubella virus infection typically presents as a mild illness in children; however, infection during pregnancy may cause the birth of an infant with congenital rubella syndrome (CRS). As of February ...2017, India began introducing rubella-containing vaccine (RCV) into the public-sector childhood vaccination programme. Low-level RCV coverage among children over several years can result in an increase in CRS incidence by increasing the average age of infection without sufficiently reducing rubella incidence. We evaluated the impact of RCV introduction on CRS incidence across India's heterogeneous demographic and epidemiological contexts. We used a deterministic age-structured model that reflects Indian states’ rural and urban area-specific demography and vaccination coverage levels to simulate rubella dynamics and estimate CRS incidence with and without RCV introduction to the public sector. Our analysis suggests that current low-level private-sector vaccination has already slightly increased the burden of CRS in India. We additionally found that the effect of public-sector RCV introduction depends on the basic reproductive number, R0, of rubella. If R0 is five, a value empirically estimated from an array of settings, CRS incidence post-RCV introduction will likely decrease. However, if R0 is seven or nine, some states may experience short-term or annual increases in CRS, even if a long-term total reduction in cases (30 years) is expected. Investment in population-based serological surveys and India's fever/rash surveillance system will be key to monitoring the success of the vaccination programme.
Obesity and metabolic dysfunction have been shown to be associated with overproduction of reactive oxygen species (ROS) in the gastrointestinal (GI) tract, which contributes to dysbiosis or ...imbalances in the gut microbiota. Recently, the reversal of dysbiosis has been observed as a result of dietary supplementation with antioxidative compounds including polyphenols. Likewise, dietary polyphenols have been associated with scavenging of GI ROS, leading to the hypothesis that radical scavenging in the GI tract is a potential mechanism for the reversal of dysbiosis. The objective of this study was to investigate the relationship between GI ROS, dietary antioxidants and beneficial gut bacterium
. The results of this study demonstrated
to be a discriminant microorganism between lean (
= 7) and obese (
= 7) mice. The relative abundance of
was also found to have a significant negative correlation with extracellular ROS in the GI tract as measured using fluorescent probe hydroindocyanine green. The ability of the dietary antioxidants ascorbic acid, β-carotene and grape polyphenols to scavenge GI ROS was evaluated in tandem with their ability to support
bloom in lean mice (
= 20). While the relationship between GI ROS and relative abundance of
was conserved in lean mice, only grape polyphenols stimulated the bloom of
. Analysis of fecal antioxidant capacity and differences in the bioavailability of the antioxidants of interest suggested that the poor bioavailability of grape polyphenols contributes to their superior radical scavenging activity and support of
in comparison to the other compounds tested. These findings demonstrate the utility of the GI redox environment as a modifiable therapeutic target in the treatment of chronic inflammatory diseases like metabolic syndrome.
Recent outbreaks of enterovirus D68 (EV-D68) infections, and their causal linkage with acute flaccid myelitis (AFM), continue to pose a serious public health concern. During 2020 and 2021, the ...dynamics of EV-D68 and other pathogens have been significantly perturbed by non-pharmaceutical interventions against COVID-19; this perturbation presents a powerful natural experiment for exploring the dynamics of these endemic infections. In this study, we analyzed publicly available data on EV-D68 infections, originally collected through the New Vaccine Surveillance Network, to predict their short- and long-term dynamics following the COVID-19 interventions. Although long-term predictions are sensitive to our assumptions about underlying dynamics and changes in contact rates during the NPI periods, the likelihood of a large outbreak in 2023 appears to be low. Comprehensive surveillance data are needed to accurately characterize future dynamics of EV-D68. The limited incidence of AFM cases in 2022, despite large EV-D68 outbreaks, poses further questions for the timing of the next AFM outbreaks.
•EV-D68 dynamics in the US can be explained using a simple SIR model.•Two different assumptions are consistent with the observed dynamics.•Different assumptions predict different long-term dynamics.•Our model consistently predicts a limited EV-D68 circulations for 2023.