A trial with a 7-valent pneumococcal-conjugate vaccine in children with recurrent acute otitis media showed a shift in pneumococcal colonisation towards non-vaccine serotypes and an increase in ...Staphylococcus aureus-related acute otitis media after vaccination. We investigated prevalence and determinants of nasopharyngeal carriage of Streptococcus pneumoniae and S aureus in 3198 healthy children aged 1–19 years. Nasopharyngeal carriage of S pneumoniae was detected in 598 (19%) children, and was affected by age (peak incidence at 3 years) and day-care attendance (odds ratio OR 2·14, 95% CI 1·44–3·18). S aureus carriage was affected by age (peak incidence at 10 years) and male sex (OR 1·46, 1·25–1·70). Serotyping showed 42% vaccine type pneumococci. We noted a negative correlation for co-colonisation of S aureus and vaccine-type pneumococci (OR 0·68, 0·48–0·94), but not for S aureus and non-vaccine serotypes. These findings suggest a natural competition between colonisation with vaccine-type pneumococci and S aureus, which might explain the increase in S aureus-related otitis media after vaccination.
Although intensity has been reported as a reliable acoustical correlate of stress, it is generally considered a weak cue in the perception of linguistic stress. In natural speech stressed syllables ...are produced with more vocal effort. It is known that, if a speaker produces more vocal effort, higher frequencies increase more than lower frequencies. In this study, the effects of lexical stress on intensity are examined in the abstraction from the confounding accent variation. A production study was carried out in which ten speakers produced Dutch lexical and reiterant disyllabic minimal stress pairs spoken with and without an accent in a fixed carrier sentence. Duration, overall intensity, formant frequencies, and spectral levels in four contiguous frequency bands were measured. Results revealed that intensity differences as a function of stress are mainly located above 0.5 kHz, i.e., a change in spectral balance emphasizing higher frequencies for stressed vowels. Furthermore, we showed that the intensity differences in the higher regions are caused by an increase in physiological effort rather than by shifting formant frequencies due to stress. The potential of each acoustic correlate of stress to differentiate between initial- and final-stressed words was examined by linear discriminant analysis. Duration proved the most reliable correlate of stress. Overall intensity and vowel quality are the poorest cues. Spectral balance, however, turned out to be a reliable cue, close in strength to duration.
To assess the risk of hysterectomy after nonresectoscopic endometrial ablation in patients with heavy menstrual bleeding.
The EMBASE, MEDLINE, ClinicalTrials.gov and Cochrane databases were searched ...for eligible articles from inception until June 13, 2022. We used combinations of search terms for endometrial ablation and hysterectomy.
Articles included in the review described the incidence of hysterectomy at a specific point in time after ablation with a minimum follow-up duration of 12 months.
The literature search yielded a total of 3,022 hits. A total of 53 studies met our inclusion and exclusion criteria, including six retrospective studies, 24 randomized controlled trials, and 23 prospective studies. A total of 48,071 patients underwent endometrial ablation between 1992 and 2017. Follow-up duration varied between 12 and 120 months. Analyses per follow-up moment showed 4.3% hysterectomy rate at 12 months of follow-up (n=29 studies), 11.1% at 18 months (n=1 study), 8.0% at 24 months (n=11 studies), 10.2% at 36 months (n=12 studies), 7.6% at 48 months (n=2 studies), and 12.4% at 60 months (n=6 studies). Two studies reported a mean hysterectomy rate at 10 years after ablation of 21.3%. Minimal clinically relevant differences in hysterectomy rates were observed among the different study designs. Furthermore, we found no significant differences in hysterectomy rate among the different nonresectoscopic endometrial ablation devices.
The risk of hysterectomy after endometrial ablation seems to increase from 4.3% after 1 year to 12.4% after 5 years. Clinicians can use the results of this review to counsel patients about the 12% risk of hysterectomy 5 years after endometrial ablation.
PROSPERO, CRD42020156281.
In this study, the claim that intensity, as an acoustic operationalization of loudness, is a weak cue in the perception of linguistic stress is reconsidered. This claim is based on perception ...experiments in which loudness was varied in a naive way: All parts of the spectrum were amplified uniformly, i.e., loudness was implemented as intensity or gain. In an earlier study it was found that if a speaker produces stressed syllables in natural speech, higher frequencies increase more than lower frequencies. Varying loudness in this way would therefore be more realistic, and should bring its true cue value to the surface. Results of a perception experiment bear out that realistic intensity level manipulations (i.e., concentrated in the higher frequency bands) provide stronger stress cues than uniformly distributed intensity differences, and are close in strength to duration differences.
We investigated the prevalence and determinants of nasopharyngeal carriage of Neisseria meningitidis in 3200 healthy children aged 1-19 years. The incidence of meningococcal carriage was, on average, ...1.5%. Peak incidences were seen at age 1 year and after age 15 years. The independent determinants of meningococcal carriage included age, regular visits to youth clubs (odds ratio OR, 2.2) and discotheques (OR, 4.3), and pneumococcal carriage (OR, 4.1).
Tumor cells frequently escape from CD8+ T cell recognition by abrogating MHC-I antigen presentation. Deficiency in processing components, like the transporter associated with antigen processing ...(TAP), results in strongly decreased surface display of peptide/MHC-I complexes. We previously identified a class of hidden self-antigens known as T cell epitopes associated with impaired peptide processing (TEIPP), which emerge on tumor cells with such processing defects. In the present study, we analyzed thymus selection and peripheral behavior of T cells with specificity for the prototypic TEIPP antigen, the "self" TRH4 peptide/Db complex. TEIPP T cells were efficiently selected in the thymus, egressed with a naive phenotype, and could be exploited for immunotherapy against immune-escaped, TAP-deficient tumor cells expressing low levels of MHC-I (MHC-Ilo). In contrast, overt thymus deletion and functionally impaired TEIPP T cells were observed in mice deficient for TAP1 due to TEIPP antigen presentation on all body cells in these mice. Our results strongly support the concept that TEIPPs derive from ubiquitous, nonmutated self-antigens and constitute a class of immunogenic neoantigens that are unmasked during tumor immune evasion. These data suggest that TEIPP-specific CD8+ T cells are promising candidates in the treatment of tumors that have escaped from conventional immunotherapies.
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