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A phased introduction of routine influenza vaccination of healthy children was recommended in the UK in 2012, with the aim of protecting both vaccinated children and the wider population through reducing transmission. In the first year of the programme in 2013–2014, 4- to 11-year-olds were targeted in pilot areas across England. This study assesses if this was associated with school absenteeism, an important societal burden of influenza. During the spring 2014 term when influenza predominantly circulated, the proportion of absence sessions due to illness was compared between vaccination pilot and non-pilot areas for primary schools (to measure overall impact) and secondary schools (to measure indirect impact). A linear multilevel regression model was applied, adjusting for clustering within schools and potential school-level confounders, including deprivation, past absenteeism, and ethnicity. Low levels of influenza activity were reported in the community in 2013–2014. Primary schools in pilot areas had a significantly adjusted decrease in illness absenteeism of 0·05% relative to non-pilot schools; equivalent to an average of 4 days per school. In secondary schools, there was no significant indirect impact of being located in a pilot area on illness absenteeism. These insights can be used in conjunction with routine healthcare surveillance data to evaluate the full benefits of such a programme.
To evaluate the safety and tolerability of subcutaneous (s.c.) cladribine therapy in patients with chronic progressive multiple sclerosis (CPMS), and to evaluate the effects on lymphocyte subsets.
Background:
Cladribine, a synthetic antineoplastic agent with immunosuppressive effects, may favourably affect the course of CPMS. However results of a previous reported clinical trial showed significant myelosuppression in some patients.
Design/Methods:
19 patients with severe (mean extended disability status score [EDSS] = 6.7) CPMS were treated on a compassionate basis with cladribine 0.07 mg/kg/ day s.c. for 5 days per cycle, repeated every 4 weeks for a total of 6 cycles. Patients underwent clinical evaluation, EDSS, and hematologic analysis before, during, and following therapy.
Results:
The treatment was very well tolerated with no clinically significant side effects observed. Between baseline and the end of cycle 6, mean decreases were noted in absolute lymphocyte count from 1697 to 463 (p = 0.000012), CD4 count from 865 to 187 (p = 0.0000008), CD8 from 418 to 165 (p = 0.005) and CD19 from 197 to 26 (p = 0.000002). Platelet, granulocyte and RBC counts were unaffected. Approximately one year after completion of therapy, some recovery of CD4 and CD8 counts had occurred although both counts remained suppressed compared to baseline (302 and 227 respectively); the CD19 count had recovered essentially to normal by one year. EDSS scores post-therapy revealed some deterioration in 8 patients and stable scores in the remaining 11. Global patient evaluations of the treatment were mixed.
Conclusions:
Cladribine therapy, at lower doses than previously reported, was remarkably well tolerated in CPMS, with no significant myelosuppression. Profound effects occurred in total lymphocyte count and CD4, CD8 and CD19 subsets.
We carried out a population-based study of dystrophin mutations in patients followed by members of the Canadian Paediatric Neuromuscular Group (CPNG) over a ten-year period.
Objectives:
We aimed to describe the changes in diagnostic testing for dystrophinopathy and to determine the frequency of dystrophin mutations from 2000 to 2009.
Methods:
De-identified data containing the clinical phenotypes, diagnostic methods, and mutational reports from dystrophinopathy patients followed by CPNG centres from January 2000 to December 2009 were analyzed using descriptive statistics.
Results:
773 patients had a confirmed diagnosis of dystrophinopathy based on genetic testing (97%), muscle biopsy (2%), or family history (1%). 573 (74%) had complete deletion/duplication analysis of all 79 exons or whole gene sequencing, resulting in 366 (64%) deletions, 64 (11%) duplications, and 143 (25%) point mutations. The percentage of patients who were diagnosed using currently accepted genetic testing methods varied across Canada, with a mean of 63% (SD 23). 246 (43%) mutations involved exons 45 to 53. The top ten deletions (n=147, 26%) were exons 45-47, 45-48, 45, 45-50, 45-55, 51, 45-49, 45-52, 49-50, and 46-47. 169 (29%) mutations involved exons 2 to 20. The most common duplications (n=29, 5.1%) were exons 2, 2-7, 2-17, 3-7, 8-11, 10, 10-11, and 12.
Conclusion:
This is the most comprehensive report of dystrophin mutations in Canada. Consensus guidelines regarding the diagnostic approach to dystrophinopathy will hopefully reduce the geographical variation in mutation detection rates in the coming decade.
Nitrous oxide (N2O) emissions associated with urine nitrogen (N) deposition during grazing are a major component of greenhouse gas emissions from domestic livestock. The present study investigated the relationship between urine N loading rate and the efficacy of a nitrification inhibitor, dicyandiamide (DCD), on cumulative N2O emissions from a grassland soil in Ireland over 80 and 360-day periods in 2009/10 and 2010/11. A diminishing curvilinear relationship between urine N rate and cumulative N2O emissions was observed in both years. Despite this increase in cumulative N2O emissions, the emission factor (EF3) for N2O decreased with increasing urine N rate from, on average, 0·24 to 0·10% (urine applied at 300 and 1000 kg N/ha, respectively), during an 80-day measurement period. This was probably the result of a factor other than N, such as carbon (C), limiting the production of N2O. The efficacy of DCD varied with urine N loading rate, and inter-annual variability in efficacy was also observed. Dicyandiamide was effective at reducing N2O production for 50–80 days after urine application, which accounted for the major period of elevated daily flux. However, DCD was ineffective at reducing N2O production after this period, which was likely a result of its removal from the soil via degradation and leaching.
For over three decades, the importance of taxon sampling curves for comparative biodiversity studies has been repeatedly stated. However, many entomologists (both within Canada and worldwide) continue to publish studies without standardizing their data to take sampling effort into account. We present a case study to illustrate the importance of such standardization, using the collection of spiders (Araneae) by pitfall traps as model data. Data were analyzed using rarefaction to represent one example of a taxon sampling curve, and by a variety of traditional diversity indices to describe alpha diversity. Raw species richness and single-index diversity measures (Shannon–Wiener, Simpson's, and Fisher's α) provided contradictory results. Rarefied species richness standardized to the number of individuals collected enabled more accurate comparisons of diversity and revealed when sampling was insufficient. Focusing on arthropods occurring in forested ecosystems, we also examined the use of taxon sampling curves in current literature by reviewing 133 published articles from 14 journals. Only 26% of the published articles in our review used a taxon sampling curve, and raw species richness and the Shannon–Wiener index of diversity were the most commonly used estimates. There is clearly a need to modify how alpha diversity is measured and compared for arthropod biodiversity studies. We recommend the abandonment of both raw species richness and single-index measures of diversity, and reiterate the need to use rarefaction or a related technique that allows for meaningful comparisons of species richness while taking into account sampling effort.
The numbers and types of bacteria in thirty-nine samples of dried whale meat of the 1946–7 and 1947–8 Antarctic whaling seasons have been investigated.
The total number of bacteria was low for this type of product and there were about equal numbers of clostridia and aerobic bacteria.
A detailed examination of the clostridia present showed that they were of types commonly found in material from mammalian sources.
No Clostridium pathogenic to the mouse was found, although some cultures on prolonged incubation killed mice by ammonia poisoning. Ammonia poisoning was produced by injection of cultures and never by oral administration.
Lethal irradiation (850 rads) of mice made resistant to Trichuris muris markedly depressed their ability to expel a challenge infection. Expulsion was restored within 7–10 days when MLNC from uninfected mice were transferred on the day of infection, but no significant restoration was evident after transfer of immune serum. Transfer of BM alone had no restorative effect within 10 days and no synergism was seen when both BM and MLNC were transferred. MLNC from uninfected donors did not restore challenge expulsion when transfer was delayed until day 7 and the mice were killed 3 days later, although MLNC from resistant donors were effective within this time. When irradiated mice were given BM and the challenge infection allowed to continue for 15 days expulsion was restored, as it was when challenge was delayed for 7 days after BM transfer in thymectomized mice. The results confirm that expulsion of T. muris involves both antibody-mediated and lymphoid cell-mediated phases and offer no evidence for the involvement of other cell types.
Mice infected with Trichuris muris during lactation were unable to expel the infection at the normal time, but expulsion occurred when lactation was terminated. Suppression of expulsion was uniform in mice suckling more than five young but variable with smaller litters. Mice exposed to a primary infection while lactating were shown to have serum antibodies capable of passively transferring immunity to recipient mice and showed near normal immunity to a secondary infection given after lactation had ceased.
Acquired immunity to T. muris was also suppressed by lactation, but the worms which became established in lactating resistant mice were fewer and smaller than those in non-lactating, non-resistant controls.
It is suggested that the suppressive effect of lactation in this hostparasite relationship is exerted on the second, lymphoid cell-mediated phase of worm expulsion.
The current incidence of missile injury to the temporal bone (MITB) is very low in the United Kingdom. However, the increasing frequency of firearm violence in Britain suggestsa greater risk of occurrence. This, along with the devastating potential sequelae of MITB (facial palsy, dead ear, intracranial damage, major vascular injury and cosmetic disfigurement), requires otolaryngologists to be conversant with all aspects of their management. The risk of major complications is much higher with MITB than with temporal bone injury following blunt trauma, and surgical management is, therefore, much more common. We present one such case, and review the literature outlining the pathogenesis, clinical features, and recommended management.
We present a novel microfabrication process for realizing a new type of flexible sensory “smart skin”. In this work, we focus on demonstration of a skin containing a two dimensional array of tactile sensors using polyimide and metal strain gauges. A novel polymer microfabrication approach coupled with surface release methods is demonstrated. The process yields flexible sensory skins in a low cost, efficient manner. Experimental characterization of the devices is also presented. The demonstrated sensors use metal-film strain gauges in a multiplexed two-dimensional array of tactile pixels (taxels) embedded in a polyimide thin film membrane to detect force distribution on the flexible skin. The arrays have been used to image force distributions and could be used with slip-detection friction measurement for robotic gripping application.
Studies suggest that symptoms of traumatic grief constitute a distinct syndrome worthy of diagnosis.
Aims
A consensus conference aimed to develop and test a criteria set for traumatic grief.
Method
The expert panel proposed consensus criteria for traumatic grief. Receiver operator characteristic (ROC) analyses tested the performance of the proposed criteria on 306 widowed respondents at seven months post-loss.
Results
ROC analyses indicated that three of four separation distress symptoms (e.g. yearning, searching, loneliness) had to be endorsed as at least ‘sometimes true’ and four of the final eight traumatic distress symptoms (e.g. numbness, disbelief, distrust, anger, sense of futility about the future) had to be endorsed as at least ‘mostly true’ to yield a sensitivity of 0.93 and a specificity of 0.93 for a diagnosis of traumatic grief.
Conclusions
Preliminary analyses suggest the consensus criteria for traumatic grief have satisfactory operating characteristics, and point to directions for further refinement of the criteria set.
The use of Stellar Speckle Interferometry has been extended to the near infrared using a single element detector. Preliminary measurements indicate that diffraction limited information is available in this wavelength region.
Yeast extract was fractionated on Sephadex G-25 into 7 fractions. The fraction most stimulatory to the growth of Streptococcus lactis C10 contained over 70% of the amino N present in yeast extract and consisted of a wide variety of free amino acids and a small amount of peptide material. Examination of possible replacement factors for this fraction revealed that the amino-acid material present was largely responsible for the stimulation of Str. lactis C10. Purine and pyrimidine bases and inorganic constituents also contributed to the stimulation. In addition, yeast extract contained a component which decomposed H2O2, a metabolite which accumulates in the growth medium under aerobic conditions and inhibits growth. The nature of the stimulation was studied by isolating slow and fast acid-producing colonies of Str. lactis C10. It appeared that yeast extract and other amino-acid supplements prevented an observed inhibition of the growth of the slow variants below pH 6·0, apparently by satisfying a nutritional deficiency caused by a drop in pH.
By twentieth-century American standards, or fourteenth-century Florentine standards, Filippo Villani, nephew of the more famous Giovanni Villani, was a successful man. As early as 1361 he held a chair of jurisprudence in the Studio at Florence, was appointed chancellor of the Commune of Perugia in 1377, which position he held for five or six years, and in the latter years of his life spent a very pleasant old age as public reader of Dante at Florence.
In addition to his public duties, he wrote in Latin and published in 1381-82 a work in two books on the history of Florence and the lives of her famous citizens, which gained the approval as well as the corrections and comments of the learned Coluccio Salutati, chancellor of the Commune of Florence. We may well imagine that Filippo, as a chronicler, following in the footsteps of his uncle Giovanni and his father Matteo, was infected by the brilliant revival of Latin letters set in motion by Petrarch and spurred on by Salutati.
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