Background. Little is known about the epidemiology of invasive pneumococcal disease (IPD) after the introduction of 7-valent pneumococcal conjugate vaccine (PCV7) in Spain and other European ...countries. Methods. We performed a 10-year prospective study including all children with culture-proven IPD admitted to Sant Joan de Deu Hospital, a children's center in the southern area of Barcelona, Catalonia, Spain. PCV7 was introduced in June 2001, and the current estimate of PCV7 coverage is 45%–50%. Results. Comparing the prevaccine period (1997–2001) with the vaccine period (2002–2006), among children aged <2 years, the rate of IPD increased from 32.4 episodes per 100,000 population to 51.3 episodes per 100,000 population (an increase of 58%; 95% confidence interval, 2%–145%), and among children aged 2–4 years, the rate increased from 11.3 episodes per 100,000 population to 26.5 episodes per 100,000 population (an increase of 135%; 95% confidence interval, 31%–320%). At clinical presentation, the rate of pneumonia and/or empyema among children aged <5 years increased from 3.6 episodes per 100,000 population to 15.1 episodes per 100,000 population (an increase of 320%; 95% confidence interval, 98%–790%). These increased rates of IPD were caused by non-PCV7 serotypes, which represented 38% and 72% of infecting serotypes in the prevaccine and vaccine periods, respectively (P<.001). Penicillin resistance decreased from 48% in the prevaccine period to 27% in the vaccine period (P=.005). In the vaccine period, there was an emergence of previously established virulent clones of non-PCV7 serotypes 1 and 5. There was also an increase in the prevalence of serotypes 19A and 6A expressed with different clonal types, including Spain23F-1 and Spain6B-2. Conclusions. Since the introduction of PCV7 for children, there has been an emergence of IPD caused by virulent clones of non-PCV7 serotypes that has been associated with significant clinical changes and a decrease in antibiotic resistance.
Significant advances in our understanding of the in vivo functions of human cells and tissues and the human immune system have resulted from the development of 'humanized' mouse strains that are ...based on severely immunodeficient mice with mutations in the interleukin-2 receptor common γ-chain locus. These mouse strains support the engraftment of a functional human immune system and permit detailed analyses of human immune biology, development and functions. In this Review, we discuss recent advances in the development and utilization of humanized mice, the lessons learnt, the remaining challenges and the promise of using humanized mice for the in vivo study of human immunology.
•The self-healing concept in polymers is presented and its state-of-the-art discussed.•Concepts to implement intrinsic healing in polymers are introduced.•The effect of polymer architecture on the ...intrinsic self-healing character of polymers is discussed.
Intrinsic and extrinsic self-healing strategies can be employed to mitigate the effects of local damage in order to (partially) restore a lost property or functionality and to avoid premature catastrophic failure of the whole system.
It is well known that polymer architecture has a crucial influence on mechanical, physical and thermal properties. However, the effect of polymer architecture on the healing capabilities of self-healing polymers has not yet been studied in detail. This paper addresses the effect of polymer architecture on the intrinsic healing character of polymeric materials using different reversible chemistries and aims at highlighting the need for more studies on this particular topic.
Abstract Objective To estimate the prevalence and comorbidity of the most common mental disorders in primary care practice in Spain, using the Primary Care Evaluation of Mental Disorders (PRIME-MD) ...questionnaire. Design A systematic sample of 7936 adult primary care patients was recruited by 1925 general practitioners in a large cross-sectional national epidemiological study. The PRIME-MD was used to diagnose psychiatric disorders. Setting 1356 primary care units proportionally distributed throughout the country. Results 53.6% of the sample presented one or more psychiatric disorder. The most prevalent were affective (35.8%), anxiety (25.6%), and somatoform (28.8%) disorders. 30.3% of the patients had more than one current mental disorder. 11.5% presented comorbidity between affective, anxiety, and somatoform disorders. Conclusions The study provides further evidence of the high prevalence and high comorbidity of mental disorders in primary care. Given the large overlap between affective, anxiety and somatoform disorders, future diagnostic classifications should reconsider the current separation between these entities.
Despite years of fully suppressive antiretroviral therapy (ART), HIV persists in its hosts and is never eradicated. One major barrier to eradication is that the virus infects multiple cell types that ...may individually contribute to HIV persistence. Tissue macrophages are critical contributors to HIV pathogenesis; however, their specific role in HIV persistence during long-term suppressive ART has not been established. Using humanized myeloid-only mice (MoM), we demonstrate that HIV infection of tissue macrophages is rapidly suppressed by ART, as reflected by a rapid drop in plasma viral load and a dramatic decrease in the levels of cell-associated viral RNA and DNA. No viral rebound was observed in the plasma of 67% of the ART-treated animals at 7 weeks after ART interruption, and no replication-competent virus was rescued from the tissue macrophages obtained from these animals. In contrast, in a subset of animals (∼33%), a delayed viral rebound was observed that is consistent with the establishment of persistent infection in tissue macrophages. These observations represent the first direct evidence, to our knowledge, of HIV persistence in tissue macrophages in vivo.
The influence of the compositional parameters Na2O/Al2O3 = 0.60–1.08, SiO2/Al2O3 = 2.42–3.17 and of 20–60% limestone on the compressive strength, gel composition and structure of alkali-activated ...metakaolin-limestone cements was studied. The reference formulation of SiO2/Al2O3 = 3.17, Na2O/Al2O3 = 1.08 and 20%limestone, formed sodium aluminosilicate hydrate (N-A-S-H) intermixed with a Ca-containing N-A-S-H (N-(C)-A-S-H), both with 3D-network structure. A reduced SiO2/Al2O3 = 2.42 resulted in the formation of Zeolites and calcium-aluminosilicate-hydrate (C-A-S-H) as secondary phases that reduced the strength. A lower Na2O/Al2O3 = 0.60 reduced the reactivity of metakaolin and the Al uptake in the gels, forming silica gel and reduced the strength of mortars. Increasing the limestone load to 60% increased the Ca2+ uptake in N-(C)-A-S-H via ion exchange Na+↔Ca2+ as charge balancers, without modifying the 3D-network structure nor the strength of pastes. Limestone can be considered as a precursor; its addition reduced the alkali consumption, changed the chemical composition and the assemblage of the reaction products, while preserving their 3D-network structure.
•Compositional parameters were studied on Limestone-Metakaolin alkaline cements.•The main reaction products were amorphous 3D structured N-A-S-H and N-(C)-A-S-H.•Using 60% limestone increased Ca2+ uptake in N-(C)-A-S-H via ion exchange Na+↔Ca2+.•The 3D-network of N-(C)-A-S-H was preserved with the higher Ca2+ contents.•Reduced SiO2/Al2O3 formed zeolites and C-A-S-H and reduced the strength.
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