Parental acceptability of HPV vaccination for boys and girls aged 9–13 years in China – A population-based study

Publication date: Available online 30 March 2018
Source:Vaccine
Author(s): Zixin Wang, Jingjing Wang, Yuan Fang, Danielle L. Gross, Martin C.S. Wong, Eliza L.Y. Wong, Joseph T.F. Lau
BackgroundThis study was to investigate parental acceptability of HPV vaccination for their sons and daughters aged 9–13 years under different cost scenarios, and factors associated with parental acceptability at market price.MethodsParticipants were: (1) Chinese speaking parents aged 18–60 years with a Hong Kong ID card; (2) had a son or a daughter aged 9–13 years at the date of the survey; (3) the child had the right to abode in Hong Kong. Random telephone numbers were selected from up-to-date telephone directories of Hong Kong. A total of 300 eligible parents (boys' parents: 162; girls' parents: 138, response rate: 68.9% & 69%) provided verbal informed consent and completed the anonymous telephone interview during March to October 2016. Using parental acceptability of HPV vaccination at market price as the dependent variable, univariate and multiple logistic regression models were fitted.ResultsThe prevalence of HPV vaccination was very low among boys and girls (0.6% vs. 2.2%, p = 0.242). Among those whose children had not taken up HPV vaccination, the prevalence of parental acceptability of HPV vaccination for the index son and daughter were: 14.9% and 27.4% (market price), and 51.6% and 63.0% (free vaccination). Adjusted for sociodemographic variables, attitudinal variables based on the Health Belief Model were associated with parental acceptability of HPV vaccination for their sons (perception that it was not worthy, perceived cue to action from mass media and perceived self-efficacy) and for their daughters (perceived susceptibility and perceived severity of HPV infection among females, perceived benefit of HPV vaccination and perceived self-efficacy).ConclusionCoverage of HPV vaccination among children aged 9–13 years was very low. Instead of waiting for the free universal vaccination to become available, promotion of self-paid HPV vaccination targeting parents is urgently needed. Different strategies should be applied to boys' and girls' parents.



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Knowledge, attitudes and practices related to the influenza virus and vaccine among older adults in Eastern China

Publication date: Available online 30 March 2018
Source:Vaccine
Author(s): Rachael Wendlandt, B.J. Cowling, Yuyun Chen, Fiona Havers, Pat Shifflett, Ying Song, Ran Zhang, Danielle Iuliano, Cuiling Xu, Hongie Yu, Jun Zhang, Hongjun Zhang, Fenyang Tang, Mark Thompson
BackgroundThis study aims to assess the association between socio-demographic and health characteristics of older adults in Eastern China and knowledge, attitudes, and practices (KAP) about the influenza virus and vaccine.MethodsA prospective cohort of 1506 older adults (aged ≥60 years) was enrolled from November to December 2015 in Jiangsu Province. We examined the association between demographics, health and functional status, and cognitive impairment at enrollment with awareness of influenza virus and vaccine and KAP items focused on five Health Belief Model domains. At a 12-month follow-up interview we assessed change in awareness and readiness to be vaccinated.ResultsOne in five older adults was aware of the influenza virus (21%) or vaccine (20%); even fewer reported having at least "a little" knowledge of the virus and vaccine (7% and 4%, respectively); less than 1% reported ever receiving an influenza vaccine. Retirement, higher education and income, and normal cognitive status were consistently associated with both awareness and knowledge of influenza virus. The odds of having at least "a little" knowledge of the vaccine was 2.9-fold (95% CI = 1.6–5.3) higher among older adults with at least some secondary schooling. Among the 108 with knowledge of the virus, 55% said they "worry about getting the flu this season." Among the 73 with knowledge of the vaccine, 92% believed the vaccine was at least somewhat effective and less than half (43%) thought that influenza vaccination was safe. At a 12-month follow-up interview, 33% (442/1333) increased from no knowledge to at least "a little".ConclusionsIf and when influenza vaccines become widely available to older adults in China, our results indicate that influenza vaccination campaigns with basic information on the virus and vaccine could be beneficial for all older adults, especially those with less education and/or more cognitive impairment.



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Long-term follow-up of HIV-1-infected adults who received the F4/AS01B HIV-1 vaccine candidate in two randomised controlled trials

Publication date: Available online 30 March 2018
Source:Vaccine
Author(s): Thomas Harrer, Warren Dinges, François Roman
This Phase I/II, open, long-term follow-up study was conducted in antiretroviral therapy (ART)-naïve (N = 212) and ART-treated (N = 19) human immunodeficiency virus 1 (HIV-1)-infected adults, who received an HIV-1 investigational vaccine (F4/AS01B) or placebo in two previous studies (NCT00814762 and NCT01218113). After a minimum of two years and a maximum of four years of follow-up post-vaccination per patient, no significant differences were observed between F4/AS01B and placebo groups in terms of viral load, CD4⁺ T-cell count and incidence of specific clinical events. Vaccine-induced polyfunctional CD4⁺ T-cells persisted up to study end and no relevant vaccine-related safety events were reported in F4/AS01B groups. This study has been registered at ClinicalTrials.gov (NCT01092611).



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Factors associated with routine immunization coverage of children under one year old in Lao People’s Democratic Republic

Publication date: Available online 30 March 2018
Source:Vaccine
Author(s): Bounfeng Phoummalaysith, Eiko Yamamoto, Anonh Xeuatvongsa, Viengsakhone Louangpradith, Bounxou Keohavong, Yu Mon Saw, Nobuyuki Hamajima
BackgroundRoutine vaccination is administered free of charge to all children under one year old in Lao People's Democratic Republic (Lao PDR) and the national goal is to achieve at least 95% coverage with all vaccines included in the national immunization program by 2025. In this study, factors related to the immunization system and characteristics of provinces and districts in Lao PDR were examined to evaluate the association with routine immunization coverage.MethodsCoverage rates for Bacillus Calmette-Guerin (BCG), Diphtheria-Tetanus-Pertussis-Hepatitis B (DTP-HepB), DTP-HepB-Hib (Haemophilus influenzae type B), polio (OPV), and measles (MCV1) vaccines from 2002 to 2014 collected through regular reporting system, were used to identify the immunization coverage trends in Lao PDR. Correlation analysis was performed using immunization coverage, characteristics of provinces or districts (population, population density, and proportion of poor villages and high-risk villages), and factors related to immunization service (including the proportions of the following: villages served by health facility levels, vaccine session types, and presence of well-functioning cold chain equipment). To determine factors associated with low coverage, provinces were categorized based on 80% of DTP-HepB-Hib3 coverage (<80% = low group; ≥80% = high group).ResultsCoverages of BCG, DTP-HepB3, OPV3 and MCV1 increased gradually from 2007 to 2014 (82.2–88.3% in 2014). However, BCG coverage showed the least improvement from 2002 to 2014. The coverage of each vaccine correlated with the coverage of the other vaccines and DTP-HepB-Hib dropout rate in provinces as well as districts. The provinces with low immunization coverage were correlated with higher proportions of poor villages.ConclusionsRoutine immunization coverage has been improving in the last 13 years, but the national goal is not yet reached in Lao PDR. The results of this study suggest that BCG coverage and poor villages should be targeted to improve nationwide coverage.



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Ultrasound Detection of Microcalcifications in Surgical Breast Specimens

Publication date: Available online 29 March 2018
Source:Ultrasound in Medicine & Biology
Author(s): Priscilla Machado, John R. Eisenbrey, Maria Stanczak, Barbara C. Cavanaugh, Lisa M. Zorn, Flemming Forsberg
The objective was to evaluate a commercial image processing technique (MicroPure, Canon Medical Systems, Tustin, CA, USA) for detection of microcalcifications in breast surgical specimens. Twenty women scheduled for surgical excision of an area with breast calcifications were enrolled, their surgical specimens underwent grayscale ultrasound (US) and MicroPure examination using an Aplio XG scanner (Canon). Four independent and blinded readers analyzed 54 US and 54 MicroPure digital clips to determine the number of calcifications and scored image quality and artifacts on a 10-point scale. All readers saw significantly more microcalcifications with MicroPure than with US, 14.0 ± 12.0 versus 3.0 ± 3.2 (p < 0.0001). Three readers preferred MicroPure image quality over that of US (p < 0.009) and vice versa for one reader (p = 0.003). Three readers saw fewer Cooper's ligament artifacts with MicroPure than with US (p < 0.0001); one reader saw no significance difference between them (p = 0.58). In conclusion MicroPure identified more breast microcalcifications than grayscale US in ex vivo surgical breast specimens.



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Pharmacological therapy selection of type 2 diabetes based on the SWARA and modified MULTIMOORA methods under a fuzzy environment

Publication date: Available online 30 March 2018
Source:Artificial Intelligence in Medicine
Author(s): M. Eghbali-Zarch, R. Tavakkoli-Moghaddam, F. Esfahanian, M.M. Sepehri, A. Azaron
Medication selection for Type 2 Diabetes (T2D) is a challenging medical decision-making problem involving multiple medications that can be prescribed to control the patient's blood glucose. The wide range of hyperglycemia lowering agents with varying effects and various side effects makes the decision quite difficult. This paper presents computer-aided medical decision support using a fuzzy Multi-Criteria Decision-Making (MCDM) model that hybridizes a Step-wise Weight Assessment Ratio Analysis (SWARA) method with a modification of Fuzzy Multi-Objective Optimization on the basis of a Ratio Analysis plus the full multiplicative form (FMULTIMOORA) method for pharmacological therapy selection of T2D. It makes the use of SWARA for obtaining the relative significance of every selected criterion by soliciting experts' opinions and FMULTIMOORA method for evaluation of each alternative according to all criteria based on a published clinical guideline. In this paper, an extended reference point approach is considered in the proposed hybrid MCDM model that resolves the classic reference point limitations and improves the FMULTIMOORA ranking procedure. Computational results indicate that Metformin is confirmed as the first-line medication and Sulfonylurea as the second-line add-on therapy. The Glucagon-like peptide-1 receptor agonist, Dipeptidyl peptidase-4 inhibitor, and Insulin are placed 3rd, 4th, and 5th, respectively. A sensitivity analysis is conducted to validate the model performance by comparing its result with studies in the literature, other fuzzy MCDM techniques and an interval MULTIMOORA method based on an observational dataset. The close correspondence between the final rankings of anti-diabetic agents resulted from the proposed hybrid model and other methodologies provide significant implications for endocrinologists to refer.



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What Can ‘Brown-ing’ Do For You?

Publication date: Available online 29 March 2018
Source:Trends in Endocrinology & Metabolism
Author(s): Amar M. Singh, Stephen Dalton
Human stem cell-based models of thermogenic adipocytes provide an opportunity for the establishment of new therapeutics, modeling of disease mechanisms, and understanding of development. Pluripotent stem cells, adipose-derived stem cells/preadipocytes, and programming-reprogramming-based approaches have been used to develop cell-based platforms for drug screening and transplantable therapeutics in the metabolic disease arena. Here we provide a detailed overview of these approaches, the latest advances in this field, and the opportunities and shortcomings they present. Moreover, we comment on how stem-cell-based platforms can be best utilized in the future for the treatment and understanding of metabolic diseases, including type 2 diabetes and associated medical issues such as obesity.



https://ift.tt/2uyYYUm

The Missed Notch to Bring Down Diabetes

Publication date: Available online 29 March 2018
Source:Trends in Endocrinology & Metabolism
Author(s): Peter Mirtschink, Triantafyllos Chavakis
Notch signaling contributes to maintenance of adult tissue homeostasis and is also involved in disease. A recent study demonstrates that inhibition of Dll4–Notch signaling by anti-Dll4 improves pancreatic islet function and insulin production by multiple complementary mechanisms. Thus, anti-Dll4 represents a therapeutic approach for compromised insulin production in diabetes.



https://ift.tt/2GWeVGs

New MRI Biomarkers in Head and Neck Cancers

Condition:   Head and Neck Cancer
Intervention:   Other: MRI examinations
Sponsor:   Memorial Sloan Kettering Cancer Center
Recruiting

https://ift.tt/2pNJmrd

Evaluation of salivary surface tension in a cohort of young healthy adults

OBJECTIVE: To determine salivary pH, flow rate (FR) and surface tension (γs) in a cohort of 30 healthy young adults. To acquire cohort biological independent variables (age, gender, weight, height, medications, smoking, pathologies, and allergies) and to correlate them with pH, FR and γs obtained values. Evaluate the possible variation of the γs values during the time after the withdrawal and the influence of the operational abilities of the experimenting operators. Evaluate the relationship between γs, pH and FR  and the dependence between pH and FR.

PATIENTS AND METHODS: Non-stimulated saliva samples were taken in four different time span, for three days, with a drooling method for 15 minutes. The saliva sample was analyzed, in terms of γs, by two different operators (OP1 and OP2), twice consecutive (γs-1 and γs-2) for a total of 360 measurements. The γs was calculated using the du Noüy method. The FR was evaluated by weighing technique and pH by pH indicator papers.

RESULTS: The measurements of γs performed by two different operators (OP1, OP2) showed respectively average values of 46.46 mN/m and 43.45 mN/m, while the mean FR was 0.29 ± 0.13 mL/min and the average pH was 7.1 ± 0.43. There were no significant correlations between γs and the biological variables analyzed.

CONCLUSIONS: We can consider as reference values, in a sample of young adults, γs 45.56 ± 6.51 mN/m.

L'articolo Evaluation of salivary surface tension in a cohort of young healthy adults sembra essere il primo su European Review.

https://ift.tt/2J4gaEt

An evaluation of a near real-time survey for improving patients’ experiences of the relational aspects of care: a mixed-methods evaluation.

This study found that near real-time feedback from patients produced a modest improvement in relational care and made recommendations for trusts wishing to implement this approach.

https://ift.tt/2E7RuqG

Variation in outcome of hospitalised patients with out-of-hospital cardiac arrest from acute coronary syndrome: a cohort study.

There is variability in survival after out-of-hospital cardiac arrest and early reperfusion in STEMI appears beneficial, but no additional benefit was seen from transfer to larger hospitals with specialist services.

https://ift.tt/2GZSxfG

Management of Antiplatelet Therapy Among Patients on Antiplatelet Therapy for Cerebrovascular or Peripheral Vascular Diseases Undergoing Elective Non-Cardiac Surgery [Internet].

The perioperative management of antiplatelet therapy (APT) for patients with coronary, cerebrovascular, or peripheral vascular stents remains unclear. After percutaneous coronary intervention, American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend delaying elective non-cardiac surgery, ideally 6 months following drug-eluting stent placement and 30 days after bare metal stent placement. For patients on dual antiplatelet therapy (DAPT), ACC/AHA guidelines recommend continuing at least aspirin (ASA) throughout the perioperative period and restarting the P2Y12 inhibitor as soon as possible following surgery. However, this latter recommendation is based on expert opinion and was the focus of a recent ESP report. The conclusion of this report was that studies evaluating APT therapy in patients with coronary stents had significant methodologic limitations and that APT therapy likely has a small impact on perioperative bleeding and major adverse cardiac event (MACE) outcomes, compared to other clinical factors such as operative urgency and timing since stent implantation.

https://ift.tt/2uyCenp

Access Management Improvement: A Systematic Review [Internet].

Timely access to care is one of the fundamental characteristics of a health system. Access to primary care is important since primary care both diagnoses and treats most common conditions and also acts as the gateway, in systems like VA, to other types of care.

https://ift.tt/2GXE2bT

Routine low-dose continuous or nocturnal oxygen for people with acute stroke: three-arm Stroke Oxygen Supplementation RCT.

Routine low-dose oxygen supplementation in stroke patients who were not hypoxic at baseline was safe but did not improve outcome after stroke.

https://ift.tt/2E6Yxji

Evidence Review: Social Determinants of Health for Veterans [Internet].

Social determinants of health are broad and often defined in the context of other factors that also impact health. For example, the Institute of Medicine's (IOM) report, Capturing Social and Behavioral Domains and Measures in Electronic Health Records, defined social determinants as "sociocultural, socio-economic, and socio-demographic status; biosocial interactions; and the various levels of social context…" This IOM report differentiated social from behavioral factors in that the latter indicate observable actions, underlying cognitions, and/or other related psychological constructs. Similarly, Tarlov's framework posited "social and societal characteristics" as one of 5 major categories of determinants of population health, with the others being genes and biology, health behaviors, medical care, and the "ecology of all living things." Although exact definitions vary somewhat, there is consensus that social determinants include many distinct concepts, and taken as a whole, they substantially influence health outcomes and contribute to health disparities.

https://ift.tt/2GWcvrr

Integrated Outpatient Palliative Care in Oncology [Internet].

More than 500,000 Americans, including 40,000 Veterans, are diagnosed with advanced cancer annually in the United States. Palliative care improves quality of life by managing patients' physical symptoms and psychosocial and spiritual distress, often provided concurrently with oncology care. Palliative care occurs across a continuum, beginning at the time of diagnosis of a serious illness and continuing until end of life. Integration of palliative care services with oncology care is now considered standard of care for patients with advanced cancer.

https://ift.tt/2uyTeKi

Violence and Mental Health: Opportunities for Prevention and Early Detection: Proceedings of a Workshop.

On February 26–27, 2014, the National Academies of Sciences, Engineering, and Medicine's Forum on Global Violence Prevention convened a workshop titled Mental Health and Violence: Opportunities for Prevention and Early Intervention. The workshop brought together advocates and experts in public health and mental health, anthropology, biomedical science, criminal justice, global health and development, and neuroscience to examine experience, evidence, and practice at the intersection of mental health and violence. Participants explored how violence impacts mental health and how mental health influences violence and discussed approaches to improve research and practice in both domains. This publication summarizes the presentations and discussions from the workshop.

https://ift.tt/2GWFueD

The TORC1-Regulated CPA Complex Rewires an RNA Processing Network to Drive Autophagy and Metabolic Reprogramming

Publication date: Available online 29 March 2018
Source:Cell Metabolism
Author(s): Hong-Wen Tang, Yanhui Hu, Chiao-Lin Chen, Baolong Xia, Jonathan Zirin, Min Yuan, John M. Asara, Leonard Rabinow, Norbert Perrimon
Nutrient deprivation induces autophagy through inhibiting TORC1 activity. We describe a novel mechanism in Drosophila by which TORC1 regulates RNA processing of Atg transcripts and alters ATG protein levels and activities via the cleavage and polyadenylation (CPA) complex. We show that TORC1 signaling inhibits CDK8 and DOA kinases, which directly phosphorylate CPSF6, a component of the CPA complex. These phosphorylation events regulate CPSF6 localization, RNA binding, and starvation-induced alternative RNA processing of transcripts involved in autophagy, nutrient, and energy metabolism, thereby controlling autophagosome formation and metabolism. Similarly, we find that mammalian CDK8 and CLK2, a DOA ortholog, phosphorylate CPSF6 to regulate autophagy and metabolic changes upon starvation, revealing an evolutionarily conserved mechanism linking TORC1 signaling with RNA processing, autophagy, and metabolism.

Graphical abstract

Teaser

Tang et al. investigate the mechanisms of how TORC1 regulates autophagy and cell metabolism. They demonstrate that CDK8 and DOA, two kinases downstream of TORC1 signaling, directly phosphorylate CPSF6 to regulate alternative mRNA polyadenylation and splicing and mediate TORC1-dependent physiological functions.


https://ift.tt/2GWL9l5

DNA methylation of genes regulating appetite and prediction of weight loss after bariatric surgery in obese individuals

Abstract

Purpose

Epigenetic traits are influenced by clinical variables; interaction between DNA methylation (DNAmeth) and bariatric surgery-induced weight loss has been scarcely explored. We investigated whether DNAmeth of genes encoding for molecules/hormones regulating appetite, food intake or obesity could predict successful weight outcome following Roux-en-Y gastric bypass (RYGB).

Methods

Forty-five obese individuals with no known comorbidities were stratified accordingly to weight decrease one-year after RYGB (excess weight loss, EWL ≥ 50%: good responders, GR; EWL < 50%: worse responders, WR). DNAmeth of leptin (LEP), ghrelin (GHRL), ghrelin receptor (GHSR) and insulin-growth factor-2 (IGF2) was assessed before intervention. Single nucleotide polymorphisms of genes affecting DNAmeth, DNMT3A and DNMT3B, were also determined.

Results

At baseline, type 2 diabetes was diagnosed by OGTT in 13 patients. Post-operatively, GR (n = 23) and WR (n = 22) achieved an EWL of 67.7 ± 9.6 vs 38.2 ± 9.0%, respectively. Baseline DNAmeth did not differ between GR and WR for any tested genes, even when the analysis was restricted to subjects with no diabetes. A relationship between GHRL and LEP methylation profiles emerged (r = 0.47, p = 0.001). Searching for correlation between DNAmeth of the studied genes with demographic characteristics and baseline biochemical parameters of the studied population, we observed a correlation between IGF2 methylation and folate (r = 0.44, p = 0.003). Rs11683424 for DNMT3A and rs2424913 for DNMT3B did not correlate with DNAmeth of the studied genes.

Conclusions

In severely obese subjects, the degree of DNAmeth of some genes affecting obesity and related conditions does not work as predictor of successful response to RYGB.

https://ift.tt/2pRUfY9